Modeling COVID-19 and Its Impacts on U.S. Immigration and Customs Enforcement (ICE) Detention Facilities, 2020

Preparing correctional settings for the next pandemic: a modeling study of COVID-19 outbreaks in two high-income countries

Introduction

Correctional facilities are high-priority settings for coordinated public health responses to the COVID-19 pandemic. These facilities are at high risk of disease transmission due to close contacts between people in prison and with the wider community. People in prison are also vulnerable to severe disease given their high burden of co-morbidities.

Methods

We developed a mathematical model to evaluate the effect of various public health interventions, including vaccination, on the mitigation of COVID-19 outbreaks, applying it to prisons in Australia and Canada.

Results

We found that, in the absence of any intervention, an outbreak would occur and infect almost 100% of people in prison within 20 days of the index case. However, the rapid rollout of vaccines with other non-pharmaceutical interventions would almost eliminate the risk of an outbreak.

Discussion

Our study highlights that high vaccination coverage is required for variants with high transmission probability to completely mitigate the outbreak risk in prisons.

The impact of immigration detention on the health of asylum seekers during the COVID-19 pandemic

COVID-19 disproportionately affects racial and ethnic minority groups as well as people in jails and immigration detention centers in the United States. Between April and August of 2020, the mean monthly COVID-19 case ratio for ICE detainees was 13.4 times that of the general U.S. population. This study aims to understand the experiences of detained asylum seekers during the pandemic and to provide insight into COVID-19's impact on this population's health. This qualitative study employed first-person, in-depth narratives obtained from 12 asylum seekers, all of whom were detained in immigration detention centers or prisons during the initial surge of the COVID-19 pandemic and were subsequently released. Detained asylum seekers reported inadequate medical care, obstacles to receiving care, an inability to social distance, poor hygiene, restricted movement, and a lack of infection control-- all which increased their risk of contracting and spreading COVID-19 and exacerbated health inequalities brought to the forefront by the pandemic. Advocating for improved disease prevention and screening, prompt access to health care and treatment, cohorting of infectious cases, and community alternatives to detention to decrease the detained immigrant population sizes are crucial to halt communicability of the virus and its subsequent morbidity and mortality in this vulnerable population.

Ações governamentais para controle e prevenção da COVID-19 em prisões: uma revisão de escopo

Resumo Trata-se de uma revisão de escopo da literatura sobre as ações adotadas pelos países, durante o ano de 2020, para o cuidado das pessoas que vivenciam o ambiente prisional durante a pandemia de COVID-19. Selecionamos 54 publicações para extração de dados, encontrando dados de 45 países, que foram organizados em categorias. A maior parte das publicações abordava as estratégias adotadas pelos países de economia avançada. Todas as publicações citavam alguma estratégia destinada a reduzir a transmissão viral - as principais foram a restrição/suspensão da visitação de familiares e o desencarceramento - e intervenções relativas à melhoria da infraestrutura nas prisões, sendo mais citada a disponibilização de telefone e/ou outro dispositivo para chamadas ou videochamadas. As políticas destinadas à mitigação das consequências da epidemia e das intervenções foram encontradas em publicações referentes a 33 países, sendo mais abordada a manutenção do contato familiar e a revisão da política de segurança pública. Em relação às políticas de governança, foram relatadas ações de 11 países, sendo a mais citada o fortalecimento da autoridade nacional. Este estudo aponta para a necessidade de pesquisas a respeito do sucesso de cada estratégia e das diferenças entre os países.

Government actions for COVID-19 control and prevention in prisons: a scoping review

Abstract This is a scoping review of the literature on actions taken by countries during 2020 regarding the care for people living in the prison environment during the COVID-19 pandemic. We selected 54 publications for data mining and found data from 45 countries, which were organized into categories. Most of the literature addressed strategies adopted by countries with advanced economies. All of them mentioned some strategies to reduce viral transmission - the major ones were restricted/suspended family visits and desincarceration - and interventions to improve infrastructures in prisons, the provision of a telephone or other devices for calls or video calls being the most mentioned. Policies to mitigate the effects of the epidemic and interventions were found in publications referencing 33 countries, with the main focus on keeping family contact and reviewing the public safety policy. Concerning governance policies, measures from 11 countries were reported, and the most cited was national authority reinforcement. This study highlights the need for research on the success of each strategy and the differences among those countries.

Association between immigration enforcement encounters and COVID-19 testing and delays in care: a cross-sectional study of undocumented young adult immigrants in california

BACKGROUND

Undocumented immigrants are expected to face increased risks related to COVID-19 due to marginalizing restrictive immigration policies. However, few studies have assessed the prevalence of direct encounters with the immigration enforcement system among the undocumented and its impacts on their COVID-related health behaviors and outcomes. In this study, we quantify undocumented immigrants' lifetime exposure to various immigration enforcement tactics and their association with delays in COVID-19 testing and healthcare behaviors.

METHODS

This cross-sectional study included a non-random sample of 326 Asian and Latinx undocumented immigrants in California from September 2020 to February 2021. The primary exposure was immigration enforcement encounter scores ranging from 0-9, assessed through self-reports of direct experiences with the immigration system, immigration officials, and law enforcement. The main outcomes were positive test for COVID-19, had or suspected having COVID-19, and delayed or avoided testing and/or treatment for COVID-19 due to immigration status. We used multivariable logistic regression models to examine the association between the primary exposure and outcomes of interest.

RESULTS

Among 326 participants, 7% had received a positive COVID-19 test result, while 43% reported having or suspected having COVID-19. Almost 13% delayed or avoided COVID-19 testing and/or treatment because of their immigration status. Overall, an increase in immigration enforcement encounters was associated with higher odds of suspecting having had COVID-19 (aOR = 1.13; 95% CI: 1.01,1.26). Reporting an additional enforcement encounter was associated with higher odds of delaying or avoiding testing and/or treatment because of immigration status (aOR = 1.53, 95% CI: 1.26,1.86). Compared to their Latino counterparts, Asian respondents were more likely to report higher odds of delaying or avoiding testing and/or treatment (aOR = 3.13, 95% CI: 1.17,8.42). There were no significant associations between the enforcement score and testing positive for COVID-19. Additionally, while Latinxs were more likely to report immigration enforcement encounters than Asians, there were no differences in the effects of race on COVID-19 testing and healthcare behaviors in models with race as an interaction term (p < 0.05).

CONCLUSIONS

Immigration enforcement encounters compound barriers to COVID-19 testing and treatment for undocumented immigrants.

COVID-19 testing, infection, and vaccination among deported Mexican migrants: Results from a survey on the Mexico-U.S. border

Background

Migrants detained and held in immigration and other detention settings in the U.S. have faced increased risk of COVID-19 infection, but data on this population is scarce. This study sought to estimate rates of COVID-19 testing, infection, care seeking, and vaccination among Mexican migrants detained by U.S. immigration authorities and forcibly returned to Mexico.

Methods

We conducted a cross-sectional probability survey of Mexican migrants deported from the U.S. to three Mexican border cities: Tijuana, Ciudad Juárez, and Matamoros (N = 306). Deported migrants were recruited at Mexican migration facilities after being processed and cleared for departure. A two-stage sampling strategy was used. Within each city, a selection of days and shifts were selected during the operating hours of these deportation facilities. The probability of selection was proportional to the volume of migrants deported on each day of the month and during each time period. During the selected survey shifts, migrants were consecutively approached, screened for eligibility, and invited to participate in the survey. Survey measures included self-reported history of COVID-19 testing, infection, care seeking, vaccination, intentions to vaccinate, and other prevention and risk factors. Weighted data were used to estimate population-level prevalence rates. Bivariate tests and adjusted logistic regression models were estimated to identify associations between these COVID-19 outcomes and demographic, migration, and contextual factors.

Results

About 84.1% of migrants were tested for COVID-19, close to a third were estimated to have been infected, and, among them, 63% had sought care for COVID-19. An estimated 70.1% had been vaccinated against COVID-19 and, among those not yet vaccinated, 32.5% intended to get vaccinated. Close to half (44.3%) of respondents had experienced crowdedness while in detention in the U.S. Socio-demographic (e.g. age, education, English fluency) and migration-related (e.g. type of detention facility and time in detention) variables were significantly associated with COVID-19 testing, infection, care seeking, and vaccination history. Age, English fluency, and length of detention were positively associated with testing and vaccination history, whereas detention in an immigration center and length of time living in the U.S. were negatively related to testing, infection, and vaccination history. Survey city and survey quarter also showed adjusted associations with testing, infection, and vaccination history, reflecting potential variations in access to services across geographic regions and over time as the pandemic unfolded.

Conclusion

These findings are evidence of increased risk of COVID-19 infection, insufficient access to testing and treatment, and missed opportunities for vaccination among Mexican migrants detained in and deported from the U.S. Deportee receiving stations can be leveraged to reduce disparities in testing and vaccination for deported migrants. In addition, decarceration of migrants and other measures informed by public health principles must be implemented to reduce COVID-19 risk and increase access to prevention, diagnostic, and treatment services among this underserved population.

Proportionate mortality and national rate of death from COVID-19 among US law enforcement officers: 2020

Purpose –

The goal of the present study is to determine the proportionate mortality and national rate of duty-related deaths from COVID-19 among US law enforcement officers during the year 2020.

Design/methodology/approach –

Data for the current study were obtained from the National Law Enforcement Officer Memorial Fund (NLEOMF) database for the year 2020. The database contains deaths designated as caused by incidents that occurred while in the line of duty. The chi-square test and two-sample t-test were used to compare characteristics of officers who died of COVID-19 versus other causes of death. Both the proportionate mortality and rates of death were calculated. To compute the rate of death, the authors obtained data on the total number of law enforcement officers employed in the United States (and therefore at risk) for the year 2020 from Bureau of Labor Statistics.

Findings –

COVID-19 deaths (n = 182) accounted for 62% of all duty-related law enforcement officer deaths during 2020. The national rate of death due to COVID-19 (12.8/100,000 per year) for law enforcement officers was higher compared to all other causes of death combined (8.0/100,000 per year).

Research limitations/implications –

A limitation of the study is the uncertainty of a definitive assessment that the viral infection was acquired through work (versus at home or other non-work-related community settings). Although highly unlikely, deaths designated as duty related entail financial benefits for the survivors and may be a potential source of bias. Given the complexity of personal exposures, the percentage of COVID-19 deaths attributed to duty may represent an over or under estimation of the actual value. Therefore, the data should be interpreted cautiously.

Practical implications –

These findings provide police organizations with information needed to understand the risk of death among officers during the COVID-19 pandemic and to make informed decisions about future preparedness strategies.

Originality/value –

There are presently no published scientific studies that examine both the proportionate mortality and national rate of death from COVID-19 among law enforcement officers for the year 2020.

The impact of COVID-19 vaccination in prisons in England and Wales: a metapopulation model

BACKGROUND

High incidence of cases and deaths due to coronavirus disease 2019 (COVID-19) have been reported in prisons worldwide. This study aimed to evaluate the impact of different COVID-19 vaccination strategies in epidemiologically semi-enclosed settings such as prisons, where staff interact regularly with those incarcerated and the wider community.

METHODS

We used a metapopulation transmission-dynamic model of a local prison in England and Wales. Two-dose vaccination strategies included no vaccination, vaccination of all individuals who are incarcerated and/or staff, and an age-based approach. Outcomes were quantified in terms of COVID-19-related symptomatic cases, losses in quality-adjusted life-years (QALYs), and deaths.

RESULTS

Compared to no vaccination, vaccinating all people living and working in prison reduced cases, QALY loss and deaths over a one-year period by 41%, 32% and 36% respectively. However, if vaccine introduction was delayed until the start of an outbreak, the impact was negligible. Vaccinating individuals who are incarcerated and staff over 50 years old averted one death for every 104 vaccination courses administered. All-staff-only strategies reduced cases by up to 5%. Increasing coverage from 30 to 90% among those who are incarcerated reduced cases by around 30 percentage points.

CONCLUSIONS

The impact of vaccination in prison settings was highly dependent on early and rapid vaccine delivery. If administered to both those living and working in prison prior to an outbreak occurring, vaccines could substantially reduce COVID-19-related morbidity and mortality in prison settings.

"There are solutions and I think we're still working in the problem": The limitations of decriminalization under the good Samaritan drug overdose act and lessons from an evaluation in British Columbia, Canada

BACKGROUND

Drug prohibition has been associated with increased risk of overdose. However, drug prohibition remains the dominant drug policy, including in Canada with the Controlled Drugs and Substances Act. In 2017, the Good Samaritan Drug Overdose Act (GSDOA) was enacted, to encourage people to contact emergency medical services by providing bystanders at the scene of an overdose with legal protection for simple possession and conditions related to simple possession.

METHODS

We conducted an evaluation of the GSDOA in British Columbia, Canada that included one-on-one interviews with people who use illicit drugs (PWUD), to determine peoples' experiences and perceptions surrounding this form of decriminalization. We present findings from a thematic analysis of 37 interviews.

RESULTS

We identified limitations of the GSDOA at overdose events; key themes and concerns causing PWUD to hesitate to or avoid contacting emergency medical services included drug confiscation, the thin line between simple possession and drug trafficking, and enforcement of other charges and court ordered conditions that are not legally protected by the GSDOA. Moreover, participants discussed the GSDOA as inequitable; benefiting some while excluding PWUD with intersecting marginalized identities.

CONCLUSION

Our findings are pertinent in light of many jurisdictions across the world considering dejure decriminalization, including BC and Vancouver. The GSDOA and associated limitations that emerged in our evaluation can serve to guide jurisdictions implementing or amending dejure decriminalization policies.

Carceral ethnography in a time of pandemic: Examining migrant detention and deportation during COVID-19

Each year the United States government detains and deports hundreds of thousands of people who prior to their removal are held in confinement for an average of 55 days. The short and long-term effects of the coronavirus pandemic on migrant detention and deportation continue to be evaluated in real time, including how we can best study it. This paper provides a timely analysis on the relationship between immigration enforcement and confinement, public health emergencies, and ethnographic methods. It makes two contributions. The first is methodological and focuses on the challenges and opportunities of ethnographic methods in carceral settings when pandemic-related protocols have raised additional challenges to conventional in-person prison ethnography. The second contribution is empirical and documents how we adapted ethnographic methods to an interdisciplinary research design and to the exigencies of the pandemic to study the spread of the coronavirus in four immigrant detention facilities in New Jersey, USA.

Applications of GIS and geospatial analyses in COVID-19 research: A systematic review

Background: Geographic information science (GIS) has established itself as a distinct domain and incredibly useful whenever the research is related to geography, space, and other spatio-temporal dimensions. However, the scientific landscape on the integration of GIS in COVID-related studies is largely unknown. In this systematic review, we assessed the current evidence on the implementation of GIS and other geospatial tools in the COVID-19 pandemic.

Methods: We systematically retrieved and reviewed 79 research articles that either directly used GIS or other geospatial tools as part of their analysis. We grouped the identified papers under six broader thematic groups based on the objectives and research questions of the study- environmental, socio-economic, and cultural, public health, spatial transmission, computer-aided modeling, and data mining.

Results: The interdisciplinary nature of how geographic and spatial analysis was used in COVID-19 research was notable among the reviewed papers. Geospatial techniques, especially WebGIS, have even been widely used to visualize the data on a map and were critical to informing the public regarding the spread of the virus, especially during the early days of the pandemic. This review not only provided an overarching view on how GIS has been used in COVID-19 research so far but also concluded that geospatial analysis and technologies could be used in future public health emergencies along with statistical and other socio-economic modeling techniques. Our review also highlighted how scientific communities and policymakers could leverage GIS to extract useful information to make an informed decision in the future.

Conclusions:  Despite the limited applications of GIS in identifying the nature and spatio-temporal pattern of this raging pandemic, there are opportunities to utilize these techniques in handling the pandemic. The use of spatial analysis and GIS could significantly improve how we understand the pandemic as well as address the underserviced demographic groups and communities.

Quantifying transmissibility of SARS-CoV-2 and impact of intervention within long-term healthcare facilities

Estimates of the basic reproduction number (R ₀) for COVID-19 are particularly variable in the context of transmission within locations such as long-term healthcare (LTHC) facilities. We sought to characterize the heterogeneity of R ₀ across known outbreaks within these facilities. We used a unique comprehensive dataset of all outbreaks that occurred within LTHC facilities in British Columbia, Canada as of 21 September 2020. We estimated R ₀ in 18 LTHC outbreaks with a novel Bayesian hierarchical dynamic model of susceptible, exposed, infected and recovered individuals, incorporating heterogeneity of R ₀ between facilities. We further compared these estimates to those obtained with standard methods that use the exponential growth rate and maximum likelihood. The total size of outbreaks varied dramatically, with range of attack rates 2%-86%. The Bayesian analysis provided an overall estimate of R ₀ = 2.51 (90% credible interval 0.47-9.0), with individual facility estimates ranging between 0.56 and 9.17. Uncertainty in these estimates was more constrained than standard methods, particularly for smaller outbreaks informed by the population-level model. We further estimated that intervention led to 61% (52%-69%) of all potential cases being averted within the LTHC facilities, or 75% (68%-79%) when using a model with multi-level intervention effect. Understanding of transmission risks and impact of intervention are essential in planning during the ongoing global pandemic, particularly in high-risk environments such as LTHC facilities.

Effect of non-pharmacological interventions on the COVID-19 epidemic in Saudi Arabia

We quantified the potential impact of different social distancing and self-isolation scenarios on the coronavirus disease 2019 (COVID-19) pandemic trajectory in Saudi Arabia and compared the modelling results to the confirmed epidemic trajectory. Using the susceptible, exposed, infected, quarantined and self-isolated, requiring hospitalisation, recovered/immune individuals, fatalities model, we assessed the impact of a non-pharmacological interventions' subset. An unmitigated scenario (baseline), mitigation scenarios (25% reduction in social contact/twofold increase in self-isolation) and enhanced mitigation scenarios (50% reduction in social contact/twofold increase in self-isolation) were assessed and compared to the actual epidemic trajectory. For the unmitigated scenario, mitigation scenarios, enhanced mitigation scenarios and actual observed epidemic, the peak daily incidence rates (per 10 000 population) were 77.00, 16.00, 9.00 and 1.14 on days 71, 54, 35 and 136, respectively. The peak fatality rates were 35.00, 13.00, 5.00 and 0.016 on days 150, 125, 60 and 155, respectively. The R0 was 1.15, 1.14, 1.22 and 2.50, respectively. Aggressive implementation of social distancing and self-isolation contributed to the downward trend of the disease. We recommend using extensive models that comprehensively consider the natural history of COVID-19, social and behavioural patterns, age-specific data, actual network topology and population to elucidate the epidemic's magnitude and trajectory.

The House Is on Fire but We Kept the Burglars Out: Racial Apathy and White Ignorance in Pandemic-Era Immigration Detention

Past research shows that crises reveal the sensitive spots of established ideologies and practices, thereby providing opportunities for social change. We investigated immigration control amid the pandemic crisis, focusing on potential openings for both challengers and proponents of immigration detention. We asked: How have these groups responded to the pandemic crisis? Have they called for transformative change? We analyzed an original data set of primary content derived from immigrant advocates and stakeholders of the immigration detention industry. We found as the pandemic ravaged the world, it did not appear to result in significant cracks in the industry, as evidenced by the consistency of narratives dating back to pre-pandemic times. The American Civil Liberties Union’s (ACLU) criticisms of inhumane conditions in immigration detention resembled those from its pre-pandemic advocacy. Private prison companies, including CoreCivic and GEO Group, emphasized their roles as ordinary businesses rather than detention managers during the pandemic, just as they had before the crisis. U.S. Immigration and Customs Enforcement (ICE), however, manufactured an alternative storyline, emphasizing “COVID fraud” as the real threat to the “Homeland.” Although it did not call for radical change, it radically shifted its rhetoric in response to the pandemic. We discuss how these organizations’ indifference towards structural racism contributes to racial apathy and how the obliviousness and irresponsibility of industry stakeholders resembles white ignorance.

United States immigration detention amplifies disease interaction risk: A model for a transnational ICE-TB-DM2 syndemic

Detention and removal of unauthorised immigrants by United States (U.S.) Immigration and Customs Enforcement (ICE) has steadily increased despite declining rates of unauthorised migration. ICE detainees are held in overcrowded detention centres, often without due process and deprived of adequate food, sanitation, and medical care. Conditions of ICE detention contribute to malnutrition and increase the likelihood of infectious disease exposure, including tuberculosis (TB). TB infection interacts with Type 2 Diabetes (DM2), disproportionately affecting individuals who are routinely targeted by federal immigration practices. When two diseases interact and exacerbate one another within a larger structural context, thereby amplifying multiple disease interactions, this is called a syndemic. In this paper, we examine malnutrition in ICE detention as a pathway of bidirectional risks for and interactions between TB and DM2 among ICE detainees. Drawing from literature on detention conditions, TB, and DM2 rates along the U.S.-Mexico border, we propose an ICE-TB-DM2 syndemic model. We present a map displaying our proposed syndemic model to demonstrate the spatial application of syndemic theory in the context of ICE detention, strengthening the growing scholarship on syndemics of incarceration and removal.

Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: A systematic review

BACKGROUND

Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors.

METHODS

We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis.

RESULTS

3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement.

CONCLUSIONS

Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.

Preventing the Spread of COVID-19 in Immigration Detention Centers Requires the Release of Detainees

Immigration detention centers are densely populated facilities in which restrictive conditions limit detainees' abilities to engage in social distancing or hygiene practices designed to prevent the spread of COVID-19. With tens of thousands of adults and children in more than 200 immigration detention centers across the United States, immigration detention centers are likely to experience COVID-19 outbreaks and add substantially to the population of those infected.Despite compelling evidence indicating a heightened risk of infection among detainees, state and federal governments have done little to protect the health of detained im-migrants. An evidence-based public health framework must guide the COVID-19 response in immigration detention centers.We draw on the hierarchy of controls framework to demonstrate how immigration detention centers are failing to implement even the least effective control strategies. Drawing on this framework and recent legal and medical advocacy efforts, we argue that safely releasing detainees from immigration detention centers into their communities is the most effective way to prevent COVID-19 outbreaks in immigration detention settings. Failure to do so will result in infection and death among those detained and deepen existing health and social inequities.

Development and dissemination of infectious disease dynamic transmission models during the COVID-19 pandemic: what can we learn from other pathogens and how can we move forward?

The current COVID-19 pandemic has resulted in the unprecedented development and integration of infectious disease dynamic transmission models into policy making and public health practice. Models offer a systematic way to investigate transmission dynamics and produce short-term and long-term predictions that explicitly integrate assumptions about biological, behavioural, and epidemiological processes that affect disease transmission, burden, and surveillance. Models have been valuable tools during the COVID-19 pandemic and other infectious disease outbreaks, able to generate possible trajectories of disease burden, evaluate the effectiveness of intervention strategies, and estimate key transmission variables. Particularly given the rapid pace of model development, evaluation, and integration with decision making in emergency situations, it is necessary to understand the benefits and pitfalls of transmission models. We review and highlight key aspects of the history of infectious disease dynamic models, the role of rigorous testing and evaluation, the integration with data, and the successful application of models to guide public health. Rather than being an expansive history of infectious disease models, this Review focuses on how the integration of modelling can continue to be advanced through policy and practice in appropriate and conscientious ways to support the current pandemic response.

Applications of GIS and geospatial analyses in COVID-19 research: A systematic review

Background: Geographic information science (GIS) has established itself as a distinct domain and incredibly useful whenever the research is related to geography, space, and other spatio-temporal dimensions. However, the scientific landscape on the integration of GIS in COVID-related studies is largely unknown. In this systematic review, we assessed the current evidence on the implementation of GIS and other geospatial tools in the COVID-19 pandemic. Methods: We systematically retrieved and reviewed 79 research articles that either directly used GIS or other geospatial tools as part of their analysis. We grouped the identified papers under six broader thematic groups based on the objectives and research questions of the study- environmental, socio-economic, and cultural, public health, spatial transmission, computer-aided modeling, and data mining. Results: The interdisciplinary nature of how geographic and spatial analysis was used in COVID-19 research was notable among the reviewed papers. Geospatial techniques, especially WebGIS, have even been widely used to visualize the data on a map and were critical to informing the public regarding the spread of the virus, especially during the early days of the pandemic. This review not only provided an overarching view on how GIS has been used in COVID-19 research so far but also concluded that geospatial analysis and technologies could be used in future public health emergencies along with statistical and other socio-economic modeling techniques. Our review also highlighted how scientific communities and policymakers could leverage GIS to extract useful information to make an informed decision in the future. Conclusions:  Despite the limited applications of GIS in identifying the nature and spatio-temporal pattern of this raging pandemic, there are opportunities to utilize these techniques in handling the pandemic. The use of spatial analysis and GIS could significantly improve how we understand the pandemic as well as address the underserviced demographic groups and communities.

SARS-CoV-2 transmission: a sociological review

The current pandemic is defined by the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that can lead to coronavirus disease 2019 (COVID-19). How is SARS-CoV-2 transmitted? In this review, we use a global lens to examine the sociological contexts that are potentially and systematically involved in high rates of SARS-CoV-2 transmission, including lack of personal protective equipment, population density and confinement. Altogether, this review provides an in-depth conspectus of the current literature regarding how SARS-CoV-2 disproportionately impacts many minority communities. By contextualising and disambiguating transmission risks that are particularly prominent for disadvantaged populations, this review can assist public health efforts throughout and beyond the COVID-19 pandemic.

Response to coronavirus 2019 in Veterans Health Administration facilities participating in an implementation initiative to enhance access to medication for opioid use disorder

The actions needed to mitigate the spread of the coronavirus 2019 (COVID-19) have forged rapid paradigm shifts across healthcare delivery. In a time of crisis, continued access to and delivery of medication for opioid use disorder (M-OUD) is essential to save lives. However, prior to COVID-19, large variability in M-OUD adoption existed across the Veteran Health Administration (VHA) and it is unknown whether the COVID-19 pandemic exacerbated this divide. For the past two years, our team worked with eight VHA facilities to enhance adoption of M-OUD through a multi-component implementation intervention. This commentary explores these providers' responses to COVID-19 and the subsequent impact on their progress toward increasing adoption of M-OUD. Briefly, the loosening of regulatory restrictions fostered accelerated adoption of M-OUD, rapid support for telehealth offered a mechanism to increase M-OUD access, and reevaluation of current practices surrounding M-OUD strengthened adoption. Overall, during the COVID-19 crisis, facilities and providers responded positively to the call for increased access to M-OUD and appropriate care of patients with OUD. The VHA providers' responses and continued progress in enhancing M-OUD amidst a crisis may, in part, be attributable to their participation in an implementation effort prior to COVID-19 that established resources, expert support, and a community of practice. We anticipate the themes presented are generalizable to other healthcare systems grappling to deliver care to patients with OUD during a crisis. We propose areas of future research and quality improvement to continue to provide access and high quality, life-saving care to patients with OUD.

COVID-19 indoor exposure levels: An analysis of foot traffic scenarios within an academic building

Minimizing all aspects of COVID-19 exposure is a high priority as universities prepare to reopen. One of those aspects includes developing protocols for interior spaces such as academic buildings. This paper applies mathematical modeling to investigate different virus exposure levels due to traffic patterns within academic buildings. The assumption used are: 1) Risk of infection is a product of exposure rate and time and 2) the exposure rate decreases with distance. One-way vs. two-way pedestrian traffic scenarios within hallways were modeled and analyzed for various configurations. The underlying assumption that a small exposure to a large number of people is similar to a large exposure to a few people is the driver to minimize exposures levels in all aspects. The analysis indicates that minimizing the time spent in passing between classes is the driving factor in minimizing risk, and one-way traffic may increase the time required to pass between classes. While the case presented is limited, the modeled approaches are intended to provoke future research that can be extended and applied to larger populations to help provide decision makers with more rigorous tools to shape future policies regarding traffic flow within buildings.

No "back to normal" after COVID-19 for our failed drug policies

Before COVID-19 pandemic, advocates had long urged drug policy reforms based on health, security, civil rights, racial justice, fiscal stewardship, and other considerations. In the United States, such calls went largely unanswered. In response to COVID-19, public health and occupational safety concerns have rapidly transformed some drug policies, along with their enforcement. Almost contemporaneously, nationwide protests against violence and racism by militarized police have highlighted the enduring legacy of the Drug War in fueling carceral systems. Disruption from these historical events provides a once-in-a-century opportunity to reconsider the legal architecture of drug policy and policing–both in the U.S. and elsewhere. Rather than returning to a fundamentally broken and inequitable status quo, we urge envisioning a new drug policy in service to life, liberty, and the pursuit of happiness.