1
|
Bennett JC, O'Hanlon J, Acker Z, Han PD, McDonald D, Wright T, Luiten KG, Regelbrugge L, McCaffrey KM, Pfau B, Wolf CR, Gottlieb GS, Hughes JP, Carone M, Starita LM, Chu HY, Weil AA. Evaluation of a novel university-based testing platform to increase access to SARS-CoV-2 testing during the COVID-19 pandemic in a cohort study. BMJ Open 2024; 14:e081837. [PMID: 38834321 DOI: 10.1136/bmjopen-2023-081837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVE We aimed to evaluate the feasibility and utility of an unsupervised testing mechanism, in which participants pick up a swab kit, self-test (unsupervised) and return the kit to an on-campus drop box, as compared with supervised self-testing at staffed locations. DESIGN University SARS-CoV-2 testing cohort. SETTING Husky Coronavirus Testing provided voluntary SARS-CoV-2 testing at a university in Seattle, USA. OUTCOME MEASURES We computed descriptive statistics to describe the characteristics of the study sample. Adjusted logistic regression implemented via generalised estimating equations was used to estimate the odds of a self-swab being conducted through unsupervised versus supervised testing mechanisms by participant characteristics, including year of study enrolment, pre-Omicron versus post-Omicron time period, age, sex, race, ethnicity, affiliation and symptom status. RESULTS From September 2021 to July 2022, we received 92 499 supervised and 26 800 unsupervised self-swabs. Among swabs received by the laboratory, the overall error rate for supervised versus unsupervised swabs was 0.3% vs 4%, although this declined to 2% for unsupervised swabs by the spring of the academic year. Results were returned for 92 407 supervised (5% positive) and 25 836 unsupervised (4%) swabs from 26 359 participants. The majority were students (79%), 61% were female and most identified as white (49%) or Asian (34%). The use of unsupervised testing increased during the Omicron wave when testing demand was high and stayed constant in spring 2022 even when testing demand fell. We estimated the odds of using unsupervised versus supervised testing to be significantly greater among those <25 years of age (p<0.001), for Hispanic versus non-Hispanic individuals (OR 1.2, 95% CI 1.0 to 1.3, p=0.01) and lower among individuals symptomatic versus asymptomatic or presymptomatic (0.9, 95% CI 0.8 to 0.9, p<0.001). CONCLUSIONS Unsupervised swab collection permitted increased testing when demand was high, allowed for access to a broader proportion of the university community and was not associated with a substantial increase in testing errors.
Collapse
Affiliation(s)
| | - Jessica O'Hanlon
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | | | - Peter D Han
- Brotman Baty Institute, Seattle, Washington, USA
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Devon McDonald
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Tessa Wright
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Kyle G Luiten
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | | | | | - Brian Pfau
- Brotman Baty Institute, Seattle, Washington, USA
| | - Caitlin R Wolf
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Geoffrey S Gottlieb
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Environmental Health & Safety Department, University of Washington, Seattle, WA, USA
| | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Marco Carone
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Lea M Starita
- Brotman Baty Institute, Seattle, Washington, USA
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Helen Y Chu
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Ana A Weil
- Department of Medicine, University of Washington, Seattle, Washington, USA
| |
Collapse
|
2
|
Leal WE, Piquero AR, Dees W, Piquero NL. Down, set, spread: The association between college football and COVID-19. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1255-1262. [PMID: 35549820 DOI: 10.1080/07448481.2022.2074278] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 04/25/2022] [Accepted: 05/01/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Before the Fall 2020 semester, college presidents and the NCAA made decisions about playing college football. The current study aims to examine the association between college football games and COVID-19 infections at universities. PARTICIPANTS More than 1,800 college campuses nationwide from The New York Times database on COVID-19 cases on college campuses. METHODS Random effects negative binomial regression is used to analyze the association between college football games, membership to college football organizations, and COVID-19 cases at the universities studied. RESULTS The number of football games played was significantly associated with higher COVID-19 cases at the universities studied. Membership to certain college football organizations was also significantly associated with higher COVID-19 cases, particularly FBS and Power Five conferences. CONCLUSIONS These findings provide a baseline for subsequent analyses across other sports and advocates for continued assessment of protocols that ensure the safety and well-being of student-athletes, fans, and university communities.
Collapse
Affiliation(s)
- Wanda E Leal
- Department of Criminal Justice and Criminology, Sam Houston State University, Huntsville, Texas, USA
| | - Alex R Piquero
- Department of Sociology and Criminology, University of Miami, Coral Gables, Florida, USA
- School of Social Science, Criminology, Monash University, Melbourne, Australia
| | - Windy Dees
- Department of Kinesiology & Sport Sciences, University of Miami, Coral Gables, Florida, USA
| | - Nicole Leeper Piquero
- Department of Sociology and Criminology, University of Miami, Coral Gables, Florida, USA
| |
Collapse
|
3
|
Lederer AM, Hoban MT, Kukich C. An Investigation of COVID-19 Outcomes and College Student Demographics: Results from a National Sample. Am J Health Promot 2024; 38:528-533. [PMID: 38084068 DOI: 10.1177/08901171231216532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
PURPOSE To assess the effects of COVID-19 on college students and any differential outcomes across collegiate sub-populations towards the beginning of the pandemic. DESIGN Cross-sectional survey. SETTING Fall 2020 American College Health Association-National College Health Assessment. SUBJECTS N = 13 373 undergraduate/graduate/professional students; 22 colleges/universities. MEASURES Six COVID-19 outcomes; 10 demographics. ANALYSIS Campus-specific weights for student enrollment/sex distribution. Cross-tabulations/Pearson χ2 test; Cramer's V/effect size; Bonferroni multiple testing correction (P < .0009). RESULTS 5.6% of students had been diagnosed with COVID-19. Compared to counterparts within each demographic category, rates were significantly higher among many BIPOC student groups (e.g., Native Hawaiian/Other Pacific Islander: 15.0%); cisgender women (5.9%) and men (5.6%); heterosexuals (6.1%); undergraduates (6.3%); and sorority/fraternity members (13.7%). Due to COVID-19, 8.8% of students had lost a loved one; 14.6% had a loved one with long term effects from COVID; 38.6% had increased stress; 61.4% had more financial concerns; and 52.7% had more difficulty accessing mental healthcare. Students identifying as BIPOC; cisgender women and transgender/gender non-conforming (TGNC); queer-spectrum; undergraduate; first-generation; having a disability; and taking courses online were significantly more affected by most of these outcomes (all comparisons P < .0009). CONCLUSIONS Students were widely impacted by COVID-19 with substantive differences across sub-populations. Future research should examine trends over time and explore ways to reduce health disparities.
Collapse
Affiliation(s)
- Alyssa M Lederer
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Mary T Hoban
- American College Health Association, Silver Spring, MD, USA
| | | |
Collapse
|
4
|
Uthappa DM, McClain MT, Nicholson BP, Park LP, Zhbannikov I, Suchindran S, Jimenez M, Constantine FJ, Nichols M, Jones DC, Hudson LL, Jaggers LB, Veldman T, Burke TW, Tsalik EL, Ginsburg GS, Woods CW. Implementation of a Prospective Index-Cluster Sampling Strategy for the Detection of Presymptomatic Viral Respiratory Infection in Undergraduate Students. Open Forum Infect Dis 2024; 11:ofae081. [PMID: 38440301 PMCID: PMC10911223 DOI: 10.1093/ofid/ofae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 02/12/2024] [Indexed: 03/06/2024] Open
Abstract
Background Index-cluster studies may help characterize the spread of communicable infections in the presymptomatic state. We describe a prospective index-cluster sampling strategy (ICSS) to detect presymptomatic respiratory viral illness and its implementation in a college population. Methods We enrolled an annual cohort of first-year undergraduates who completed daily electronic symptom diaries to identify index cases (ICs) with respiratory illness. Investigators then selected 5-10 potentially exposed, asymptomatic close contacts (CCs) who were geographically co-located to follow for infections. Symptoms and nasopharyngeal samples were collected for 5 days. Logistic regression model-based predictions for proportions of self-reported illness were compared graphically for the whole cohort sampling group and the CC group. Results We enrolled 1379 participants between 2009 and 2015, including 288 ICs and 882 CCs. The median number of CCs per IC was 6 (interquartile range, 3-8). Among the 882 CCs, 111 (13%) developed acute respiratory illnesses. Viral etiology testing in 246 ICs (85%) and 719 CCs (82%) identified a pathogen in 57% of ICs and 15% of CCs. Among those with detectable virus, rhinovirus was the most common (IC: 18%; CC: 6%) followed by coxsackievirus/echovirus (IC: 11%; CC: 4%). Among 106 CCs with a detected virus, only 18% had the same virus as their associated IC. Graphically, CCs did not have a higher frequency of self-reported illness relative to the whole cohort sampling group. Conclusions Establishing clusters by geographic proximity did not enrich for cases of viral transmission, suggesting that ICSS may be a less effective strategy to detect spread of respiratory infection.
Collapse
Affiliation(s)
- Diya M Uthappa
- Doctor of Medicine Program, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Micah T McClain
- Center for Infectious Disease Diagnostics and Innovation, Duke University Medical Center, Durham, North Carolina, USA
- Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
| | | | - Lawrence P Park
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Center for Infectious Disease Diagnostics and Innovation, Duke University Medical Center, Durham, North Carolina, USA
- Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
| | - Ilya Zhbannikov
- Bioinformatics and Clinical Analytics Team, Clinical Research Unit, Duke University Department of Medicine, Durham, North Carolina, USA
| | - Sunil Suchindran
- Center for Infectious Disease Diagnostics and Innovation, Duke University Medical Center, Durham, North Carolina, USA
| | - Monica Jimenez
- Institute for Medical Research, Durham, North Carolina, USA
| | - Florica J Constantine
- Center for Infectious Disease Diagnostics and Innovation, Duke University Medical Center, Durham, North Carolina, USA
| | - Marshall Nichols
- Duke Institute for Health Innovation, Durham, North Carolina, USA
| | - Daphne C Jones
- Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
| | - Lori L Hudson
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - L Brett Jaggers
- Center for Infectious Disease Diagnostics and Innovation, Duke University Medical Center, Durham, North Carolina, USA
| | - Timothy Veldman
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Thomas W Burke
- Center for Infectious Disease Diagnostics and Innovation, Duke University Medical Center, Durham, North Carolina, USA
| | - Ephraim L Tsalik
- Center for Infectious Disease Diagnostics and Innovation, Duke University Medical Center, Durham, North Carolina, USA
- Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
| | - Geoffrey S Ginsburg
- Center for Infectious Disease Diagnostics and Innovation, Duke University Medical Center, Durham, North Carolina, USA
| | - Christopher W Woods
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Center for Infectious Disease Diagnostics and Innovation, Duke University Medical Center, Durham, North Carolina, USA
- Durham Veterans Affairs Health Care System, Durham, North Carolina, USA
| |
Collapse
|
5
|
Bennett JC, Luiten KG, O'Hanlon J, Han PD, McDonald D, Wright T, Wolf CR, Lo NK, Acker Z, Regelbrugge L, McCaffrey KM, Pfau B, Stone J, Schwabe-Fry K, Lockwood CM, Guthrie BL, Gottlieb GS, Englund JA, Uyeki TM, Carone M, Starita LM, Weil AA, Chu HY. Utilizing a university testing program to estimate relative effectiveness of monovalent COVID-19 mRNA booster vaccine versus two-dose primary series against symptomatic SARS-CoV-2 infection. Vaccine 2024; 42:1332-1341. [PMID: 38307746 DOI: 10.1016/j.vaccine.2024.01.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/04/2024]
Abstract
Vaccine effectiveness (VE) studies utilizing the test-negative design are typically conducted in clinical settings, rather than community populations, leading to bias in VE estimates against mild disease and limited information on VE in healthy young adults. In a community-based university population, we utilized data from a large SARS-CoV-2 testing program to estimate relative VE of COVID-19 mRNA vaccine primary series and monovalent booster dose versus primary series only against symptomatic SARS-CoV-2 infection from September 2021 to July 2022. We used the test-negative design and logistic regression implemented via generalized estimating equations adjusted for age, calendar time, prior SARS-CoV-2 infection, and testing frequency (proxy for test-seeking behavior) to estimate relative VE. Analyses included 2,218 test-positive cases (59 % received monovalent booster dose) and 9,615 test-negative controls (62 %) from 9,066 individuals, with median age of 21 years, mostly students (71 %), White (56 %) or Asian (28 %), and with few comorbidities (3 %). More cases (23 %) than controls (6 %) had COVID-19-like illness. Estimated adjusted relative VE of primary series and monovalent booster dose versus primary series only against symptomatic SARS-CoV-2 infection was 40 % (95 % CI: 33-47 %) during the overall analysis period and 46 % (39-52 %) during the period of Omicron circulation. Relative VE was greater for those without versus those with prior SARS-CoV-2 infection (41 %, 34-48 % versus 33 %, 9 %-52 %, P < 0.001). Relative VE was also greater in the six months after receiving a booster dose (41 %, 33-47 %) compared to more than six months (27 %, 8-42 %), but this difference was not statistically significant (P = 0.06). In this relatively young and healthy adult population, an mRNA monovalent booster dose provided increased protection against symptomatic SARS-CoV-2 infection, overall and with the Omicron variant. University testing programs may be utilized for estimating VE in healthy young adults, a population that is not well-represented by routine VE studies.
Collapse
Affiliation(s)
- Julia C Bennett
- Department of Medicine, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA.
| | - Kyle G Luiten
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Jessica O'Hanlon
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Peter D Han
- Brotman Baty Institute, Seattle, WA, USA; Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Devon McDonald
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Tessa Wright
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Caitlin R Wolf
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Natalie K Lo
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Zack Acker
- Brotman Baty Institute, Seattle, WA, USA
| | | | | | - Brian Pfau
- Brotman Baty Institute, Seattle, WA, USA
| | - Jeremey Stone
- Brotman Baty Institute, Seattle, WA, USA; Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | | | - Christina M Lockwood
- Brotman Baty Institute, Seattle, WA, USA; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Brandon L Guthrie
- Department of Epidemiology, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA
| | - Geoffrey S Gottlieb
- Department of Medicine, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Center for Emerging and Re-Emerging Infectious Diseases, University of Washington, Seattle, WA, USA; Environmental Health & Safety Department, University of Washington, Seattle, WA, USA
| | - Janet A Englund
- Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marco Carone
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Lea M Starita
- Brotman Baty Institute, Seattle, WA, USA; Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Ana A Weil
- Department of Medicine, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Center for Emerging and Re-Emerging Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Helen Y Chu
- Department of Medicine, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA; Center for Emerging and Re-Emerging Infectious Diseases, University of Washington, Seattle, WA, USA
| |
Collapse
|
6
|
Osberg TM, Doxbeck CR. Partying during a pandemic: role of descriptive partying norms, residence, college alcohol beliefs, and political ideology in COVID-19 party behavior. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2938-2948. [PMID: 34855573 DOI: 10.1080/07448481.2021.2008400] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 10/18/2021] [Accepted: 11/12/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Non-adherence to COVID-19 guidelines is a major public health issue. This study explored factors that explain college student party behavior (PB; defined as attending a college party wherein COVID-19 guidelines, including masks and social distancing were ignored) during the pandemic. METHOD Freshmen students at a northeastern university (N = 207; 72% women) responded to an online Fall 2020 semester survey. RESULTS The percentage of students who participated in on-campus partying during past month was 11.6%, with 20.3% participating in off-campus partying. Living on campus and higher perceived norms for partying were associated with higher levels of on-campus PB, whereas higher perceived norms for partying, stronger college alcohol beliefs, and a more conservative political ideology accounted for significant variance in off-campus PB. CONCLUSIONS Efforts to reduce party behavior should target misperception of party behavior norms as well as college alcohol beliefs, and take into account students' residence and political ideology.
Collapse
Affiliation(s)
| | - Courtney R Doxbeck
- Department of Counseling, School, and Educational Psychology, University at Buffalo, Buffalo, New York, USA
| |
Collapse
|
7
|
Nazione S, Heller LR, Vredeveld A, Dexter CA, McElveen M. Longitudinal associations with positivity, quarantining and pass/fail policy use on student GPAs during the first three semesters of the pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37988632 DOI: 10.1080/07448481.2023.2280841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/27/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE This research sought to understand the effects of testing positive, quarantining, and pass/fail policy use on college student GPAs across three semesters from Spring 2020 to Spring 2021. PARTICIPANTS 644 students were followed across three semesters. METHODS Anonymized secondary data sets regarding student health behaviors, perceived stress, and satisfaction were combined with registrar data concerning demographic factors, COVID-19 infection, the need to quarantine, and converting grades to pass/fail (P/F). RESULTS The use of P/F was associated with inflated GPAs when offered during Spring and Fall 2020. Students opting to use P/F were more likely to be low-income and achieve a lower GPA in Spring 2021 when the P/F option was no longer offered. Testing positive and quarantining did not have a significant association with student GPA. CONCLUSIONS The research challenges the value of providing students the ability to convert grades to P/F during the pandemic.
Collapse
Affiliation(s)
- Samantha Nazione
- Department of Management & Marketing, Berry College, Mt Berry, Georgia, USA
| | - Lauren R Heller
- Department of Economics, Berry College, Mt Berry, Georgia, USA
| | - Anna Vredeveld
- Department of Management & Marketing, Berry College, Mt Berry, Georgia, USA
| | - Casey A Dexter
- Department of Psychology, Berry College, Mt Berry, Georgia, USA
| | | |
Collapse
|
8
|
Waghmare PH, Siracuse MV, Ohri LK, Bramble JD. A survey of university students on attitudes, behaviors, and intentions toward influenza vaccination. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2244-2257. [PMID: 34449293 DOI: 10.1080/07448481.2021.1965611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 06/11/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
Objective To determine attitudes, behaviors, and intentions of university students regarding influenza vaccination.ParticipantsUndergraduate, graduate, and professional students enrolled at a private, midwestern university.Methods A 24-item electronic survey was designed and distributed after literature review and inputs from experts on immunizations. Bivariate tests were performed to observe differences between various subgroups of respondents (age, gender, race/ethnicity, housing, and academic program). Multivariate logistic regression was performed to find associations with their vaccination preferences.Results Of 3,267 complete responses (36.3% of total students), 75% reported obtaining influenza vaccination in 2016-2017. Vaccination rates were highest for Asian (81.0%) and lowest for Black students (59.6%). Health professional student vaccination rates of 89.3% were achieved with a vaccination mandate in place. Lowest immunization rates were identified for law (47.1%) and business (52.7%) students. Positive promotional factors were identified.Conclusions Access to free, on-campus vaccinations, mandates and promotional efforts are associated with high influenza vaccination rates.
Collapse
Affiliation(s)
- Prajakta H Waghmare
- Department of Pharmacy Practice, Purdue University College of Pharmacy, West Lafayette, Indiana, USA
| | - Mark V Siracuse
- Department of Pharmacy Sciences, School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska, USA
| | - Linda K Ohri
- Department of Pharmacy Practice, School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska, USA
| | - James D Bramble
- Department of Pharmacy Sciences, School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska, USA
| |
Collapse
|
9
|
Hayden ME, Burns L, Farquhar S, Tanabe KO, Bernheim RG, Holstege CP. Using an Exposure Call Center to Help Mitigate Outbreaks, Such as COVID-19, on a University Campus. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:725-728. [PMID: 37097205 DOI: 10.1097/phh.0000000000001750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Rapid identification and management of close contacts is an important component of an effective university mitigation strategy for highly contagious infectious diseases such as measles and coronavirus disease-2019 (COVID-19). Institutions of higher education must plan for an associated large influx of calls that can overwhelm standard student health and local public health operations. In fall 2020, a large state public university's Department of Student Health and Wellness created a dedicated exposure call center (ECC), in close collaboration with the local public health department, to quickly assess students who learned of a COVID-19 exposure outside of the formal contact tracing process. The ECC operated 7 days a week and fielded 3361 calls: 3187 from students and 174 from staff, faculty, and parents. The ECC provided rapid assessment and guidance for students with COVID-19 exposure, allowing for prompt quarantine and medical assessment when warranted. Call centers can increase the bandwidth of university health centers and also reduce the burden on health care providers and other public health resources during periods of crisis or high demand.
Collapse
Affiliation(s)
- Meredith E Hayden
- Departments of Student Health and Wellness (Drs Hayden and Holstege and Mss Burns, Farquhar, and Tanabe), Public Health Sciences (Ms Bernheim), and Emergency Medicine and Pediatrics (Dr Holstege), University of Virginia, Charlottesville, Virginia
| | | | | | | | | | | |
Collapse
|
10
|
Zohoori N, Barsotti T, Porter A, Brown C, Amick BC, Cima M, Gandy J, Markham M. COVID-19 Vaccine Uptake Among Students in Public Institutions of Higher Education in Arkansas in 2021. Public Health Rep 2023:333549231192464. [PMID: 37610163 DOI: 10.1177/00333549231192464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
OBJECTIVE Disparities in COVID-19 vaccine coverage among college students are not well studied. We analyzed the extent of COVID-19 vaccination among all students at public institutions of higher education in Arkansas in spring and fall 2021 and examined factors associated with vaccination rates. METHODS We matched student enrollment data for the spring and fall 2021 semesters separately with immunization registry data to determine the COVID-19 vaccination status of students in each semester. We used multivariable logistic regression to determine variables associated with being fully vaccinated. RESULTS Overall, by the end of the fall 2021 semester, 49.1% of students were fully vaccinated, compared with 52.3% of students at the end of the spring 2021 semester. However, we observed important differences between student groups. Students who were in rural areas (vs urban areas), freshman (vs all other class years), at a 2-year college (vs 4-year college), non-Hispanic Black (vs Hispanic or non-Hispanic White), or in a nonhealth major (vs health major) were less likely to be fully vaccinated. CONCLUSION Given the disparities in COVID-19 vaccine coverage among college students, continued efforts are needed in this young, but important, population segment to address students' confidence in vaccines and to make vaccines more available and accessible on and near campuses. Novel approaches for tailored messaging and interventions to facilitate vaccine uptake may be needed for groups such as non-Hispanic Black students and students in rural areas who are less likely, compared with their counterparts, to accept COVID-19 vaccines.
Collapse
Affiliation(s)
- Namvar Zohoori
- Faye W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Arkansas Department of Health, Little Rock, AR, USA
| | | | - Austin Porter
- Faye W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Arkansas Department of Health, Little Rock, AR, USA
| | - Clare Brown
- Faye W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Benjamin C Amick
- Faye W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Winthrop J. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Mike Cima
- Arkansas Department of Health, Little Rock, AR, USA
| | - Jay Gandy
- Faye W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Northwest Regional Campus, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Maria Markham
- Division of Higher Education, Arkansas Department of Education, Little Rock, AR, USA
| |
Collapse
|
11
|
Allen JL, Amick BC, Williams ML, Kennedy JL, Boehme KW, Forrest JC, Primack B, Sides EA, Nembhard WN, Gardner SF, Snowden JN, James LP, Olgaard E, Gandy J. A longitudinal study of SARS-CoV-2 antibody seroprevalence and mitigation behaviors among college students at an Arkansas University. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 37289962 DOI: 10.1080/07448481.2023.2217456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 03/29/2023] [Accepted: 05/19/2023] [Indexed: 06/10/2023]
Abstract
Objective: Assess university students' SARS-CoV-2 antibody seroprevalence and mitigation behaviors over time. Participants: Randomly selected college students (N = 344) in a predominantly rural Southern state. Methods: Participants provided blood samples and completed self-administered questionnaires at three timepoints over the academic year. Adjusted odds ratios and 95% confidence intervals were estimated from logistic regression analyses. Results: SARS-CoV-2 antibody seroprevalence was 18.2% in September 2020, 13.1% in December, and 45.5% in March 2021 (21% for those with no vaccination history). SARS-CoV-2 antibody seroprevalence was associated with large social gatherings, staying local during the summer break, symptoms of fatigue or rhinitis, Greek affiliation, attending Greek events, employment, and using social media as the primary COVID-19 information source. In March 2021, seroprevalence was associated with receiving at least one dose of a COVID-19 vaccination. Conclusion: SARS-CoV-2 seroprevalence was higher in this population of college students than previous studies. Results can assist leaders in making informed decisions as new variants threaten college campuses.
Collapse
Affiliation(s)
- Jaimi L Allen
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Benjamin C Amick
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mark L Williams
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Joshua L Kennedy
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Arkansas Children's Research Institute, Little Rock, Arkansas, USA
| | - Karl W Boehme
- Department of Microbiology & Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Centre for Microbial Pathogenesis and Host Inflammatory Responses, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - J Craig Forrest
- Department of Microbiology & Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Brian Primack
- Department of Public Health and Medicine, University of Arkansas, Fayetteville, Arkansas, USA
| | - Erica Ashley Sides
- Translational Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Wendy N Nembhard
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Stephanie F Gardner
- College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jessica N Snowden
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Arkansas Children's Research Institute, Little Rock, Arkansas, USA
| | - Laura P James
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Translational Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ericka Olgaard
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jay Gandy
- Department of Environmental Health, University of Arkansas for Medical Sciences, Fayetteville, Arkansas, USA
| |
Collapse
|
12
|
Dillard JP, Tian X, Cruz SM, Smith RA, Shen L. Persuasive Messages, Social Norms, and Reactance: A Study of Masking Behavior during a COVID-19 Campus Health Campaign. HEALTH COMMUNICATION 2023; 38:1338-1348. [PMID: 34879752 DOI: 10.1080/10410236.2021.2007579] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Efforts by universities to reduce the spread of COVID-19 include health campaigns intended to encourage students to wear masks. While well-intended, these efforts may produce counter-persuasion (e.g., decrease masking) if they are seen as threatening individuals' freedom to choose. In a rolling cross-sectional study of one university campaign (n = 681), we found that the presence of the campaign did instigate a form of resistance known as reactance and that reactance was negatively associated with masking behavior. Masking was also diminished by the frequency with which respondents observed others not wearing a mask (anti-masking descriptive norm) and the frequency with which respondents observed others expressing disdain for masking (anti-masking injunctive norm). Most of these findings were magnified among students who identified as politically conservative. There was no evidence that the frequency of seeing others speak in favor of masks (pro-masking injunctive norm) produced an increase in masking. The results provide valuable theoretical insights into the causes of reactance and empirical evidence of the risks associated with student-oriented COVID safety campaigns.
Collapse
Affiliation(s)
- James Price Dillard
- Department of Communication Arts and Sciences, The Pennsylvania State University
| | - Xi Tian
- Department of Communication Arts and Sciences, The Pennsylvania State University
| | - Shannon M Cruz
- Department of Communication Arts and Sciences, The Pennsylvania State University
| | - Rachel A Smith
- Department of Communication Arts and Sciences, The Pennsylvania State University
| | - Lijiang Shen
- Department of Communication Arts and Sciences, The Pennsylvania State University
| |
Collapse
|
13
|
Andrews KR, New DD, Gour DS, Francetich K, Minnich SA, Robison BD, Hovde CJ. Genomic surveillance identifies potential risk factors for SARS-CoV-2 transmission at a mid-sized university in a small rural town. Sci Rep 2023; 13:7902. [PMID: 37193760 PMCID: PMC10185956 DOI: 10.1038/s41598-023-34625-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/04/2023] [Indexed: 05/18/2023] Open
Abstract
Understanding transmission dynamics of SARS-CoV-2 in institutions of higher education (IHEs) is important because these settings have potential for rapid viral spread. Here, we used genomic surveillance to retrospectively investigate transmission dynamics throughout the 2020-2021 academic year for the University of Idaho ("University"), a mid-sized IHE in a small rural town. We generated genome assemblies for 1168 SARS-CoV-2 samples collected during the academic year, representing 46.8% of positive samples collected from the University population and 49.8% of positive samples collected from the surrounding community ("Community") at the local hospital during this time. Transmission dynamics differed for the University when compared to the Community, with more infection waves that lasted shorter lengths of time, potentially resulting from high-transmission congregate settings along with mitigation efforts implemented by the University to combat outbreaks. We found evidence for low transmission rates between the University and Community, with approximately 8% of transmissions into the Community originating from the University, and approximately 6% of transmissions into the University originating from the Community. Potential transmission risk factors identified for the University included congregate settings such as sorority and fraternity events and residences, holiday travel, and high caseloads in the surrounding community. Knowledge of these risk factors can help the University and other IHEs develop effective mitigation measures for SARS-CoV-2 and similar pathogens.
Collapse
Affiliation(s)
- Kimberly R Andrews
- Institute for Interdisciplinary Data Sciences, University of Idaho, Moscow, ID, 83844, USA.
| | - Daniel D New
- Institute for Interdisciplinary Data Sciences, University of Idaho, Moscow, ID, 83844, USA
| | - Digpal S Gour
- Institute for Interdisciplinary Data Sciences, University of Idaho, Moscow, ID, 83844, USA
| | | | - Scott A Minnich
- Department of Animal, Veterinary and Food Science, University of Idaho, Moscow, ID, 83844, USA
| | - Barrie D Robison
- Institute for Interdisciplinary Data Sciences, University of Idaho, Moscow, ID, 83844, USA
| | - Carolyn J Hovde
- Department of Animal, Veterinary and Food Science, University of Idaho, Moscow, ID, 83844, USA
| |
Collapse
|
14
|
Hunter LA, Wyman S, Packel LJ, Facente SN, Li Y, Harte A, Nicolette G, Di Germanio C, Busch MP, Reingold AL, Petersen ML. Monitoring SARS-CoV-2 incidence and seroconversion among university students and employees: a longitudinal cohort study in California, June-August 2020. BMJ Open 2023; 13:e063999. [PMID: 37024253 PMCID: PMC10083519 DOI: 10.1136/bmjopen-2022-063999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
OBJECTIVES To identify incident SARS-CoV-2 infections and inform effective mitigation strategies in university settings, we piloted an integrated symptom and exposure monitoring and testing system among a cohort of university students and employees. DESIGN Prospective cohort study. SETTING A public university in California from June to August 2020. PARTICIPANTS 2180 university students and 738 university employees. PRIMARY OUTCOME MEASURES At baseline and endline, we tested participants for active SARS-CoV-2 infection via quantitative PCR (qPCR) test and collected blood samples for antibody testing. Participants received notifications to complete additional qPCR tests throughout the study if they reported symptoms or exposures in daily surveys or were selected for surveillance testing. Viral whole genome sequencing was performed on positive qPCR samples, and phylogenetic trees were constructed with these genomes and external genomes. RESULTS Over the study period, 57 students (2.6%) and 3 employees (0.4%) were diagnosed with SARS-CoV-2 infection via qPCR test. Phylogenetic analyses revealed that a super-spreader event among undergraduates in congregate housing accounted for at least 48% of cases among study participants but did not spread beyond campus. Test positivity was higher among participants who self-reported symptoms (incidence rate ratio (IRR) 12.7; 95% CI 7.4 to 21.8) or had household exposures (IRR 10.3; 95% CI 4.8 to 22.0) that triggered notifications to test. Most (91%) participants with newly identified antibodies at endline had been diagnosed with incident infection via qPCR test during the study. CONCLUSIONS Our findings suggest that integrated monitoring systems can successfully identify and link at-risk students to SARS-CoV-2 testing. As the study took place before the evolution of highly transmissible variants and widespread availability of vaccines and rapid antigen tests, further research is necessary to adapt and evaluate similar systems in the present context.
Collapse
Affiliation(s)
- Lauren A Hunter
- School of Public Health, University of California, Berkeley, California, USA
| | - Stacia Wyman
- Innovative Genomics Institute, University of California, Berkeley, California, USA
| | - Laura J Packel
- School of Public Health, University of California, Berkeley, California, USA
| | - Shelley N Facente
- School of Public Health, University of California, Berkeley, California, USA
- Facente Consulting, Richmond, California, USA
| | - Yi Li
- School of Public Health, University of California, Berkeley, California, USA
| | - Anna Harte
- University Health Services, University of California, Berkeley, California, USA
| | - Guy Nicolette
- University Health Services, University of California, Berkeley, California, USA
| | | | - Michael P Busch
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California, San Francisco, California, USA
| | - Arthur L Reingold
- School of Public Health, University of California, Berkeley, California, USA
| | - Maya L Petersen
- School of Public Health, University of California, Berkeley, California, USA
| |
Collapse
|
15
|
Turner MM, Jang Y, Wade R, Heo RJ, Ye Q, Hembroff LA, Lim JI. The effects of moral norms and anticipated guilt on COVID19 prevention behaviors. CURRENT PSYCHOLOGY 2023:1-13. [PMID: 37359698 PMCID: PMC10036969 DOI: 10.1007/s12144-023-04477-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/26/2023]
Abstract
Studies have shown that older adolescents have a low perceived personal risk of COVID-19, and yet their ability and willingness to engage in COVID-19 prevention behaviors is imperative for community health. Thus, health communication scholars need to consider alternative psycho-social predictors of prevention behaviors that will assist in protecting others in a pandemic. Based on Schwartz's Norms Activation Model (NAM; Schwartz, 1977), we examined the relationship between moral norms and COVID-19 prevention behaviors (mask wearing and physical distancing). We predicted that anticipated guilt would mediate the relationship between moral norms and intention to engage in prevention behaviors, and that collective orientation would strengthen the association between moral norms and anticipated guilt. We tested predictions with data from a cross-sectional survey with a probability-based sample of college students at a large land grant university. These data indicated that moral norms were associated with behavioral intention, and this relationship was mediated by anticipated guilt. Collective orientation was found to moderate the relationship between moral norms and anticipated guilt in the context of physical distancing but not mask wearing. These findings suggest that making moral norms salient when designing an intervention is an effective strategy for older adolescents. Supplementary information The online version contains supplementary material available at 10.1007/s12144-023-04477-5.
Collapse
Affiliation(s)
- Monique Mitchell Turner
- Present Address: Department of Communication, Michigan State University, 404 Wilson Road, Room 444, MI 48824 East Lansing, USA
- National Social Norms Center, Michigan State University, MI East Lansing, USA
| | - Youjin Jang
- Present Address: Department of Communication, Michigan State University, 404 Wilson Road, Room 444, MI 48824 East Lansing, USA
- National Social Norms Center, Michigan State University, MI East Lansing, USA
| | - Rachel Wade
- Present Address: School of Communication, The Ohio State University, OH Columbus, USA
| | - Ruth Jinhee Heo
- Present Address: Department of Communication, Michigan State University, 404 Wilson Road, Room 444, MI 48824 East Lansing, USA
- National Social Norms Center, Michigan State University, MI East Lansing, USA
| | - Qijia Ye
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Larry A. Hembroff
- National Social Norms Center, Michigan State University, MI East Lansing, USA
| | - Jong In Lim
- Present Address: Department of Communication, Michigan State University, 404 Wilson Road, Room 444, MI 48824 East Lansing, USA
| |
Collapse
|
16
|
Zhou Y, Li R, Shen L. Targeting COVID-19 vaccine-hesitancy in college students: An audience-centered approach. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 36853986 DOI: 10.1080/07448481.2023.2180988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/27/2022] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Objective: The study tested potential factors that differentiated the COVID-19 vaccine-hesitant and -inclined college students and, based on these factors, identified subgroups of the vaccine-hesitant students. Participants: Participants were 1,183 U.S. college students attending four-year universities or community colleges recruited through Qualtrics between January 25 and March 3, 2021. Methods: Participants completed an online survey assessing their COVID-19 vaccination intention, perceived risks of COVID-19 and the COVID-19 vaccines, efficacy beliefs regarding COVID-19 and the COVID-19 vaccines, and emotions toward taking the COVID-19 vaccines. Results: Vaccine-hesitant and -inclined college students varied in their emotions, risk perceptions, and efficacy beliefs regarding the virus and the vaccines. Using these factors as indicators, vaccine-hesitant college students were classified into five latent subgroups with distinct characteristics. Conclusions: In identifying subgroups of the vaccine-hesitant college students, the study has important insights to offer regarding the design of vaccine-promotion messaging strategies targeting the college student population.
Collapse
Affiliation(s)
- Yanmengqian Zhou
- Department of Communication Studies, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Ruobing Li
- School of Communication & Journalism, Stony Brook University, Stony Brook, New York, USA
| | - Lijiang Shen
- Department of Communication Arts & Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
| |
Collapse
|
17
|
Moreland S, Zviedrite N, Ahmed F, Uzicanin A. COVID-19 prevention at institutions of higher education, United States, 2020-2021: implementation of nonpharmaceutical interventions. BMC Public Health 2023; 23:164. [PMID: 36694136 PMCID: PMC9872740 DOI: 10.1186/s12889-023-15079-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND In early 2020, following the start of the coronavirus disease 2019 (COVID-19) pandemic, institutions of higher education (IHEs) across the United States rapidly pivoted to online learning to reduce the risk of on-campus virus transmission. We explored IHEs' use of this and other nonpharmaceutical interventions (NPIs) during the subsequent pandemic-affected academic year 2020-2021. METHODS From December 2020 to June 2021, we collected publicly available data from official webpages of 847 IHEs, including all public (n = 547) and a stratified random sample of private four-year institutions (n = 300). Abstracted data included NPIs deployed during the academic year such as changes to the calendar, learning environment, housing, common areas, and dining; COVID-19 testing; and facemask protocols. We performed weighted analysis to assess congruence with the October 29, 2020, US Centers for Disease Control and Prevention (CDC) guidance for IHEs. For IHEs offering ≥50% of courses in person, we used weighted multivariable linear regression to explore the association between IHE characteristics and the summated number of implemented NPIs. RESULTS Overall, 20% of IHEs implemented all CDC-recommended NPIs. The most frequently utilized NPI was learning environment changes (91%), practiced as one or more of the following modalities: distance or hybrid learning opportunities (98%), 6-ft spacing (60%), and reduced class sizes (51%). Additionally, 88% of IHEs specified facemask protocols, 78% physically changed common areas, and 67% offered COVID-19 testing. Among the 33% of IHEs offering ≥50% of courses in person, having < 1000 students was associated with having implemented fewer NPIs than IHEs with ≥1000 students. CONCLUSIONS Only 1 in 5 IHEs implemented all CDC recommendations, while a majority implemented a subset, most commonly changes to the classroom, facemask protocols, and COVID-19 testing. IHE enrollment size and location were associated with degree of NPI implementation. Additional research is needed to assess adherence to NPI implementation in IHE settings.
Collapse
Affiliation(s)
- Sarah Moreland
- grid.416738.f0000 0001 2163 0069Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30329 USA ,grid.410547.30000 0001 1013 9784Oak Ridge Institute for Science and Education, 1299 Bethel Valley Rd, Oak Ridge, TN 37830 USA
| | - Nicole Zviedrite
- Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA.
| | - Faruque Ahmed
- grid.416738.f0000 0001 2163 0069Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30329 USA
| | - Amra Uzicanin
- grid.416738.f0000 0001 2163 0069Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30329 USA
| |
Collapse
|
18
|
Heck CJ, Theodore DA, Sovic B, Austin E, Yang C, Rotbert J, Greissman S, Zucker J, Autry A, Catallozzi M, Sobieszczyk ME, Castor D. Correlates of psychological distress among undergraduate women engaged in remote learning through a New York City college during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 36649543 PMCID: PMC10350472 DOI: 10.1080/07448481.2022.2156797] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/14/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The study's objective is to explore psychological distress (PD) among remote learners during COVID-19. PARTICIPANTS Female undergraduates matriculated at an NYC college in Winter 2020. METHODS Using the Kessler-6 scale, we defined PD as no/low (LPD), mild/moderate (MPD), and severe (SPD) and assessed if residing in/near NYC modified associations. RESULTS PD was common (MPD: 34.1%, SPD: 38.9%). Students identifying as Other/Multiracial had lower MPD odds (aOR = 0.39 [0.17-0.88]). SPD was associated with identifying as White (aOR = 2.02 [1.02-3.99]), unbalanced meals (aOR = 2.59 [1.06-6.30]), violence experience (aOR = 1.77 [1.06-2.94]), no social support (aOR = 3.24 [1.37-7.64]), and loneliness (aOR = 2.52 [1.29-4.95]). Among students in/near NYC, moderate/high drug use (aOR = 2.76 [1.15-6.61]), no social support (aOR = 3.62 [1.10-1.19]), and loneliness (aOR = 2.92 [1.11-7.63]) were SPD correlates. CONCLUSIONS PD was high and associated with food insecurity, violence experience, no social support, and loneliness. Living in/near NYC modified drug use, loneliness, and social support associations. Mental health initiatives should address modifiable risk factors to ameliorate pandemic-associated PD.
Collapse
Affiliation(s)
- Craig J. Heck
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
| | - Deborah A. Theodore
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Brit Sovic
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Eloise Austin
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | | | | | - Samantha Greissman
- Department of Medicine, NewYork-Presbyterian/Columbia University Medical Center, New York, NY
| | - Jason Zucker
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | | | - Marina Catallozzi
- Barnard College, New York, NY
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
- Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, New York, NY
| | - Magdalena E. Sobieszczyk
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Delivette Castor
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| |
Collapse
|
19
|
Couture MC, L'Engle KL, Swathi PA, Regan AK. COVID-19 vaccine coverage among college students following vaccine mandates. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-5. [PMID: 36624974 DOI: 10.1080/07448481.2022.2155460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 08/23/2022] [Accepted: 09/19/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Colleges are potential hotspots for transmission of SARS-CoV-2 due to lower immunization rates and possible close contacts among young adults. Some universities have implemented policies mandating COVID-19 vaccination; however, their effects remain uncertain. We estimated COVID-19 vaccination rates with and without university-mandated vaccination policies. PARTICIPANTS A university-wide survey was conducted among 2,011 students. METHODS Students completed an online questionnaire on sociodemographics, COVID-19 vaccine status, and vaccine intention. RESULTS Without university vaccine mandates, 76% of students would receive a COVID-19 vaccination, and with vaccine mandates, more than 82% of students would receive vaccination. Despite this improvement, we observed fewer changes in vaccine coverage for certain subgroups of students, indicating these policies could exacerbate ongoing disparities in COVID-19 vaccination rates. CONCLUSIONS COVID-19 vaccine mandates on campuses are likely to increase vaccination rates modestly. However, interventions will likely be required to supplement vaccine mandates.
Collapse
Affiliation(s)
- Marie-Claude Couture
- Health Professions Department, School of Nursing and Health Professions, University of San Francisco, San Francisco, California, USA
| | - Kelly L L'Engle
- Health Professions Department, School of Nursing and Health Professions, University of San Francisco, San Francisco, California, USA
| | - Pallavi Aytha Swathi
- College of Arts and Sciences, University of San Francisco, San Francisco, California, USA
| | - Annette K Regan
- Health Professions Department, School of Nursing and Health Professions, University of San Francisco, San Francisco, California, USA
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, USA
| |
Collapse
|
20
|
Rosenberg M, Carroll AE, Menachemi N, Inman H, Agard A, Hiller KM, Dbeibo L. In-person classroom instruction and risk of SARS-CoV-2 infection among undergraduates at Indiana University, Fall 2020. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-6. [PMID: 36595635 DOI: 10.1080/07448481.2022.2155459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 07/21/2022] [Accepted: 09/19/2022] [Indexed: 06/17/2023]
Abstract
Objective: To examine how in-person classroom instruction was related to risk of SARS-CoV-2 infection in undergraduate students. Participants: Indiana University undergraduate students (n = 69,606) enrolled in Fall 2020, when courses with in-person and remote instruction options were available. Methods: Students participated weekly in mandatory SARS-CoV-2 RT-PCR asymptomatic testing by random selection, supplemented with symptomatic testing as needed. We used log-binomial regression models to estimate the association between number of in-person credit hours and the risk of SARS-CoV-2 infection over the course of the semester. Results: Overall 5,786 SARS-CoV-2 cases were observed. Increased in-person credit hour exposures were not associated with increased risk of SARS-CoV-2 overall [aRR (95% CI): 0.98 (0.97,0.99)], nor within specific subgroups (Greek affiliation and class). Conclusions: In-person instruction did not appear to increase SARS-CoV-2 transmission in a university setting with rigorous protective measures in place, prior to mass vaccine rollout and prior to delta variant emergence.
Collapse
Affiliation(s)
- Molly Rosenberg
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| | - Aaron E Carroll
- Pediatric and Adolescent Comparative Effectiveness Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Nir Menachemi
- Department of Health Policy and Management, Indiana University Fairbanks School of Public Health at IUPUI, Indianapolis, Indiana, USA
| | - Hannah Inman
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Amanda Agard
- Department of Emergency Medicine, Indiana University School of Medicine Bloomington, Bloomington, Indiana, USA
| | - Katherine M Hiller
- Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Lana Dbeibo
- Department of Emergency Medicine, Indiana University School of Medicine Bloomington, Bloomington, Indiana, USA
| |
Collapse
|
21
|
Rifat SAA, Liu W. One year into the pandemic: the impacts of social vulnerability on COVID-19 outcomes and urban-rural differences in the conterminous United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2601-2619. [PMID: 34554860 DOI: 10.1080/09603123.2021.1979196] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/07/2021] [Indexed: 06/13/2023]
Abstract
This paper first explores spatial distributions and patterns of COVID-19 case rates (cases/100,000 people) and mortality rates (deaths/100,000 people) and their disparities between urban and rural counties in the contiguous US. A county-level social vulnerability index was created using principal component analysis. Social vulnerability components were regressed against both county case and mortality rates. Results suggest that hotspots of case and mortality rates are clustered in Midwest and Upper-Midwest US. We found substantial disparities in case and mortality rates between urban and rural counties. County social vulnerability was positively correlated with both case and mortality rates suggesting counties with higher social vulnerability had higher case and mortality rates. Relationships between social vulnerability components and case and mortality rates vary across the conterminous US. Additionally, counties with increased racial and ethnic minorities, higher percentages of minors, and lower median household income are associated with higher COVID-19 case and mortality rates.
Collapse
Affiliation(s)
- Shaikh Abdullah Al Rifat
- Department of Geosciences, Florida Atlantic University, Boca Raton, FL, USA
- The Polis Center, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Weibo Liu
- Department of Geosciences, Florida Atlantic University, Boca Raton, FL, USA
| |
Collapse
|
22
|
Tinker SC, Prince-Guerra JL, Vermandere K, Gettings J, Drenzik C, Voccio G, Parrott T, Drobeniuc J, Hayden T, Briggs S, Heida D, Thornburg N, Barrios LC, Neatherlin JC, Madni S, Rasberry CN, Swanson KD, Tamin A, Harcourt JL, Lester S, Atherton L, Honein MA. Evaluation of self-administered antigen testing in a college setting. Virol J 2022; 19:202. [PMID: 36457114 PMCID: PMC9713151 DOI: 10.1186/s12985-022-01927-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The objective of our investigation was to better understand barriers to implementation of self-administered antigen screening testing for SARS-CoV-2 at institutions of higher education (IHE). METHODS Using the Quidel QuickVue At-Home COVID-19 Test, 1347 IHE students and staff were asked to test twice weekly for seven weeks. We assessed seroconversion using baseline and endline serum specimens. Online surveys assessed acceptability. RESULTS Participants reported 9971 self-administered antigen test results. Among participants who were not antibody positive at baseline, the median number of tests reported was eight. Among 324 participants seronegative at baseline, with endline antibody results and ≥ 1 self-administered antigen test results, there were five COVID-19 infections; only one was detected by self-administered antigen test (sensitivity = 20%). Acceptability of self-administered antigen tests was high. CONCLUSIONS Twice-weekly serial self-administered antigen testing in a low prevalence period had low utility in this investigation. Issues of testing fatigue will be important to address in future testing strategies.
Collapse
Affiliation(s)
- Sarah C. Tinker
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - Jessica L. Prince-Guerra
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA ,grid.416738.f0000 0001 2163 0069Laboratory Leadership Service, CDC, Atlanta, GA USA
| | - Kelly Vermandere
- grid.420388.50000 0004 4692 4364Georgia Department of Public Health, Atlanta, GA USA
| | - Jenna Gettings
- grid.420388.50000 0004 4692 4364Georgia Department of Public Health, Atlanta, GA USA ,grid.416738.f0000 0001 2163 0069Epidemic Intelligence Service, CDC, Atlanta, GA USA
| | - Cherie Drenzik
- grid.420388.50000 0004 4692 4364Georgia Department of Public Health, Atlanta, GA USA
| | - Gary Voccio
- grid.420388.50000 0004 4692 4364Georgia Department of Public Health, Atlanta, GA USA
| | | | - Jan Drobeniuc
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - Tonya Hayden
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - Stephen Briggs
- grid.423400.10000 0000 9002 0195Berry College, Rome, GA USA
| | - Debbie Heida
- grid.423400.10000 0000 9002 0195Berry College, Rome, GA USA
| | - Natalie Thornburg
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - Lisa C. Barrios
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - John C. Neatherlin
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - Sabrina Madni
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - Catherine N. Rasberry
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - Kenneth D. Swanson
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - Azaibi Tamin
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - Jennifer L. Harcourt
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - Sandra Lester
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - Lydia Atherton
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| | - Margaret A. Honein
- grid.416738.f0000 0001 2163 0069COVID-19 Response Team, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333 USA
| |
Collapse
|
23
|
Diepstra K, Bullington BW, Premkumar L, Shook-Sa BE, Jones C, Pettifor A. SARS-CoV-2 Seroprevalence: Demographic and Behavioral Factors Associated With Seropositivity Among College Students in a University Setting. J Adolesc Health 2022; 71:559-569. [PMID: 35985917 PMCID: PMC9377272 DOI: 10.1016/j.jadohealth.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/15/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Examine SARS-CoV-2 seroprevalence and the association of seropositivity with demographic, geographic, and behavioral variables among University of North Carolina Chapel Hill (UNC-CH) undergraduate students enrolled in the fall 2020 semester. METHODS All UNC-CH undergraduate students were invited to participate in the Heelcheck study; participants were weighted to the UNC-CH undergraduate population using raking methods. We estimate SARS-CoV-2 seroprevalence at study entrance (11/12/2020-12/10/2020) and bivariable associations using log-binomial regression. RESULTS SARS-CoV-2 seroprevalence was 7.3% (95% confidence interval (CI): 5.4%-9.2%) at baseline. Compared to students who were living off-campus in the Chapel Hill/Carrboro area (CH) for the Fall 2020 semester (8.6% seroprevalence), students who never returned to CH had lower seroprevalence (1.9%, prevalence ratio (PR), 95% CI: 0.22, 0.06-0.81), whereas, students who started the semester on-campus and moved to off-campus CH housing had 18.9% seroprevalence (PR, 95% CI: 2.21, 1.04-4.72) and students who spent the semester living in a Sorority/Fraternity house had 46.8% seroprevalence (PR, 95% CI: 5.47, 2.62-11.46). Those who predicted they would join an indoor party unmasked had 3.8 times the seroprevalence of those who indicated they would not attend (PR, 95% CI: 3.80, 1.58-9.16). Compared to students who disagreed with the statement "…I am not going to let COVID-19 stop me from having fun…", those who agreed had higher seroprevalence (14.0% vs. 5.7%; (PR, 95% CI: 2.45, 1.13-5.32)). DISCUSSION Increased seroprevalence was associated with congregate living and participation (actual or endorsed) in social activities. During pandemics, universities must create safe socializing opportunities while minimizing transmission.
Collapse
Affiliation(s)
- Karen Diepstra
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Brooke W. Bullington
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lakshmanane Premkumar
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Bonnie E. Shook-Sa
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Corbin Jones
- Department of Biology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Audrey Pettifor
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
24
|
Bhatia R, Sledge I, Baral S. Missing science: A scoping study of COVID-19 epidemiological data in the United States. PLoS One 2022; 17:e0248793. [PMID: 36223335 PMCID: PMC9555641 DOI: 10.1371/journal.pone.0248793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/12/2022] [Indexed: 11/06/2022] Open
Abstract
Systematic approaches to epidemiologic data collection are critical for informing pandemic responses, providing information for the targeting and timing of mitigations, for judging the efficacy and efficiency of alternative response strategies, and for conducting real-world impact assessments. Here, we report on a scoping study to assess the completeness of epidemiological data available for COVID-19 pandemic management in the United States, enumerating authoritative US government estimates of parameters of infectious transmission, infection severity, and disease burden and characterizing the extent and scope of US public health affiliated epidemiological investigations published through November 2021. While we found authoritative estimates for most expected transmission and disease severity parameters, some were lacking, and others had significant uncertainties. Moreover, most transmission parameters were not validated domestically or re-assessed over the course of the pandemic. Publicly available disease surveillance measures did grow appreciably in scope and resolution over time; however, their resolution with regards to specific populations and exposure settings remained limited. We identified 283 published epidemiological reports authored by investigators affiliated with U.S. governmental public health entities. Most reported on descriptive studies. Published analytic studies did not appear to fully respond to knowledge gaps or to provide systematic evidence to support, evaluate or tailor community mitigation strategies. The existence of epidemiological data gaps 18 months after the declaration of the COVID-19 pandemic underscores the need for more timely standardization of data collection practices and for anticipatory research priorities and protocols for emerging infectious disease epidemics.
Collapse
Affiliation(s)
- Rajiv Bhatia
- Primary Care and Population Health, Stanford University, Stanford, CA, United States of America
- * E-mail:
| | | | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
| |
Collapse
|
25
|
Cramer EY, Snyder T, Ravenhurst J, Lover AA. Optimizing the implementation of a participant-collected, mail-based SARS-CoV-2 serological survey in university-affiliated populations: lessons learned and practical guidance. BMC Public Health 2022; 22:1907. [PMID: 36224583 PMCID: PMC9556138 DOI: 10.1186/s12889-022-14234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/25/2022] [Indexed: 11/25/2022] Open
Abstract
The rapid spread of SARS-CoV-2 is largely driven by pre-symptomatic or mildly symptomatic individuals transmitting the virus. Serological tests to identify antibodies against SARS-CoV-2 are important tools to characterize subclinical infection exposure. During the summer of 2020, a mail-based serological survey with self-collected dried blood spot (DBS) samples was implemented among university affiliates and their household members in Massachusetts, USA. Described are challenges faced and novel procedures used during the implementation of this study to assess the prevalence of SARS-CoV-2 antibodies amid the pandemic. Important challenges included user-friendly remote and contact-minimized participant recruitment, limited availability of some commodities and laboratory capacity, a potentially biased sample population, and policy changes impacting the distribution of clinical results to study participants. Methods and lessons learned to surmount these challenges are presented to inform design and implementation of similar sero-studies. This study design highlights the feasibility and acceptability of self-collected bio-samples and has broad applicability for other serological surveys for a range of pathogens. Key lessons relate to DBS sampling, supply requirements, the logistics of packing and shipping packages, data linkages to enrolled household members, and the utility of having an on-call nurse available for participant concerns during sample collection. Future research might consider additional recruitment techniques such as conducting studies during academic semesters when recruiting in a university setting, partnerships with supply and shipping specialists, and using a stratified sampling approach to minimize potential biases in recruitment.
Collapse
Affiliation(s)
- Estee Y Cramer
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, USA
| | - Teah Snyder
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, USA
| | - Johanna Ravenhurst
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, USA
| | - Andrew A Lover
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, USA.
| |
Collapse
|
26
|
Zullig KJ, Gardner M. A Profile of Students Who Reported Mask Mandates Violate Civil Liberties during COVID-19. Am J Health Behav 2022; 46:456-466. [PMID: 36109855 DOI: 10.5993/ajhb.46.4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: In this paper, we explore differences in demographics, mask wearing attitudes and behaviors, and vaccination perceptions among students who reported that mask mandates violate their civil liberties compared to those who did not. Methods: Participants completed an online survey in April 2021 (N=619). Results: Students who reported that mask mandates violate their civil liberties were more likely to identify as male, report good health, attend in-person classes, and less likely to report being vaccinated (p<.05). These students were also more likely to endorse not wearing masks because masks make it difficult to breathe, provide a false sense of security, and because they value their independence; in addition, they were more likely to endorse not being vaccinated because they are at low perceived risk for infection, because of the unknown side effects of vaccines, and because vaccines were rushed into production (p<.05). Whereas students who reported that mask mandates violate their civil liberties were about 5.2 times more likely (p<.0001) to report being unvaccinated, vaccine status was only modestly positively correlated (r=.36, p<.0001). Conclusions: Although students who reported mask mandates violate their civil liberties were also more likely to be unvaccinated, these individuals are not necessarily the same, suggesting different public health messaging may be required to increase both mask use and vaccine uptake.
Collapse
Affiliation(s)
- Keith J Zullig
- Keith J. Zullig, Professor, Department of Social & Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, United States;,
| | - Madelin Gardner
- Madelin Gardner, Department of Epidemiology & Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, United States
| |
Collapse
|
27
|
Landry M, Vyas A, Nagaraj N, Sardon GA, Bornstein S, Latif H, Kucherlapaty P, McDonnell K, Castel A, Goldman L. Characteristics of student SARS-CoV-2 cases on an urban university campus: An Observational Study. Interact J Med Res 2022; 11:e39230. [PMID: 36037255 PMCID: PMC9472507 DOI: 10.2196/39230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Academic institutions are central hubs for young adults, laden with academic and social interactions, and communal living arrangements, heightening the risk of transmission of many communicable diseases, including COVID-19. Shortly after the start of the Fall 2020 academic year, institutions of higher learning were identified as hotspots for rises in COVID-19 incidence among young adults. OBJECTIVE This analysis aims to identify the characteristics of student SARS-CoV-2 cases, identify the extent to which the student population adhered to preventative strategies, and examine behaviors that would put them at higher risk of contracting or spreading COVID-19. METHODS This observational study comprises 1,175 university students at The George Washington University (GWU) in Washington, DC, with a confirmed COVID-19 diagnosis between August 3, 2020, and November 30, 2021. Case investigation and contact tracing tools were developed by the Campus COVID-19 Support Team and captured in REDCap. Trained case investigators were notified of a case and attempted to contact all cases within 24 hours of the case receiving their lab result. Associations between case characteristics and number of contacts were examined using Wilcoxon Rank Sum tests. Knowledge of exposure, behaviors since exposure, and student residence status, and fraternity and sorority life affiliation were examined using Chi-Square tests. RESULTS Positive student cases reported a median of three close contacts and 84.6% reported at least one symptom with a median of four COVID-19 symptoms. Congestion (53.4%), cough (45.1%), and headache (41.2%) were the most frequently reported symptoms. Thirty-six percent reported that they did not know how they were exposed to the virus. Among those aware of contact with a COVID-19 confirmed case, 55.1% reported the contact was a close friend or family member and 25.3% reported that it was someone with whom they lived. Athletes (vs. non-athletes), on-campus (vs. off-campus), and undergraduate (vs. graduate) students all reported a significantly higher number of contacts (P<.01). Students living on campus were more likely to report attending campus events in the two days prior to symptom onset or positive test result (P=.004). Students with fraternity/sorority affiliation were more likely to report attending campus events in the two days prior to symptom onset or positive test result (P<.001). CONCLUSIONS COVID-19 cases have not yet stabilized to a predictable state, but this study provides case characteristics and insights for how academic institutions might prepare to mitigate outbreaks on their campuses as the world plans for the transition from pandemic to endemic COVID-19. CLINICALTRIAL
Collapse
Affiliation(s)
- Megan Landry
- Office of the Dean, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 7th Floor, Washington, US
| | - Amita Vyas
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 3rd Floor, Washington, US
| | - Nitasha Nagaraj
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 3rd Floor, Washington, US
| | - Gary A Sardon
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, US
| | - Sydney Bornstein
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, US
| | - Hannah Latif
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 3rd Floor, Washington, US
| | - Padmini Kucherlapaty
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 3rd Floor, Washington, US
| | - Karen McDonnell
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 3rd Floor, Washington, US
| | - Amanda Castel
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, US
| | - Lynn Goldman
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, US.,Office of the Dean, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, 7th Floor, Washington, US
| |
Collapse
|
28
|
Rosenblum HG, Segaloff HE, Cole D, Lee CC, Currie DW, Abedi GR, Remington PL, Kelly GP, Pitts C, Langolf K, Kahrs J, Leibold K, Westergaard RP, Hsu CH, Kirking HL, Tate JE. Behaviors and attitudes of college students during an academic semester at two Wisconsin universities during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-8. [PMID: 35776927 DOI: 10.1080/07448481.2022.2080504] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 05/04/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Characterize college student COVID-19 behaviors and attitudes during the early pandemic. Participants: Students on two university campuses in Wisconsin. METHODS Surveys administered in September and November 2020. RESULTS Few students (3-19%) participated in most in-person activities during the semester, with eating at restaurants as the exception (72-80%) and attending work (35%) and parties (33%) also reported more frequently. The majority wore masks in public (94-99%), but comparatively fewer (42%) did so at parties. Mask-wearing at parties decreased from September to November (p < 0.05). Students attending parties, or consuming more alcohol, were less concerned and more likely to take COVID-19-associated risks. CONCLUSIONS Students were motivated to adhere to COVID-19 prevention measures but gathered socially. Though there was frequent public masking, mask-wearing at parties declined in November and may represent pandemic fatigue. High-yield strategies for decreasing viral spread may include changing masking social norms and engaging with students about creative risk-reduction strategies.
Collapse
Affiliation(s)
- Hannah G Rosenblum
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA
| | - Hannah E Segaloff
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA
- Wisconsin Department of Health Services, Madison, Wisconsin, USA
| | - Devlin Cole
- Wisconsin Department of Health Services, Madison, Wisconsin, USA
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Christine C Lee
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Laboratory Leadership Service, CDC, Atlanta, Georgia, USA
| | - Dustin W Currie
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA
| | - Glen R Abedi
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Patrick L Remington
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - G Patrick Kelly
- University Health Services, University of Wisconsin-Madison, Madison, Wisconsin
| | - Collin Pitts
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- University Health Services, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Juliana Kahrs
- University of Wisconsin Oshkosh, Oshkosh, Wisconsin, USA
| | - Kurt Leibold
- University of Wisconsin Oshkosh, Oshkosh, Wisconsin, USA
| | - Ryan P Westergaard
- Wisconsin Department of Health Services, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Christopher H Hsu
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Hannah L Kirking
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jacqueline E Tate
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
29
|
Meredith GR, Osman M, Cazer CL, Cummings KJ, Hecht J, Madsen CG, Santacrose LB, Dubovi AS, Clarkberg M, Johnson T, Fitzpatrick MD, Parrilla L, Li Y, Francis L, Weisfuse IB, Travis AJ, Jones AC, Warnick LD, Koretzky GA. Integrated Surveillance System for Controlling COVID-19 on a University Campus, 2020‒2021. Am J Public Health 2022; 112:980-984. [PMID: 35728024 PMCID: PMC9222446 DOI: 10.2105/ajph.2022.306838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 11/04/2022]
Abstract
To minimize the impacts of COVID-19 and to keep campus open, Cornell University's Ithaca, NY, campus implemented a comprehensive process to monitor COVID-19 spread, support prevention practices, and assess early warning indicators linked to knowledge, behaviors, and attitudes of campus community members. The integrated surveillance approach informed leadership and allowed for prompt adjustments to university policies and practices through evidence-based decisions. This approach enhanced healthy behaviors and promoted the well-being and safety of all community members. (Am J Public Health. 2022;112(7):980-984. https://doi.org/10.2105/AJPH.2022.306838).
Collapse
Affiliation(s)
- Genevive R Meredith
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Marwan Osman
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Casey L Cazer
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Kevin J Cummings
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Jason Hecht
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Cecelia G Madsen
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Laura B Santacrose
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Abigail S Dubovi
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Marin Clarkberg
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Tyler Johnson
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Maria D Fitzpatrick
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Lara Parrilla
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Yihong Li
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Lorraine Francis
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Isaac B Weisfuse
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Alexander J Travis
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Anne C Jones
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Lorin D Warnick
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| | - Gary A Koretzky
- Genevive R. Meredith, Kevin J. Cummings, Cecelia G. Madsen, Lara Parrilla, Yihong Li, Lorraine Francis, Isaac B. Weisfuse, and Alexander J. Travis are with the Master of Public Health Program, Cornell University, Ithaca, NY. Marwan Osman, Casey L. Cazer, and Lorin D. Warnick are with the Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University. Jason Hecht and Marin Clarkberg are with the Office of Institutional Research and Planning, Cornell University. Laura B. Santacrose and Abigail S. Dubovi are with the Skorton Center for Health Initiatives, Cornell University. Tyler Johnson is with Student and Campus Life, Cornell University. Maria D. Fitzpatrick is with the Department of Policy Analysis and Management, College of Human Ecology, Cornell University. Anne C. Jones is with Cornell Health, Cornell University. Gary A. Koretzky is with the Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University
| |
Collapse
|
30
|
Chen X, Ariati J, McMaughan DJ, Han H, Hubach RD, Miller BM. COVID-19 information-seeking behaviors and preventive behaviors among college students in Oklahoma. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-9. [PMID: 35737973 DOI: 10.1080/07448481.2022.2090842] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/11/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
Objective: To explore experiences, beliefs, and information-seeking behavior around COVID-19 among college students in Oklahoma. Participants: Fifteen college students participated during the pandemic period from April to July 2020. Methods: An exploratory, qualitative research approach method was used to discover students' experiences, beliefs, and information-seeking behaviors around COVID-19. Exploration of beliefs was guided by the Health Belief Model. Results: Students engaged in COVID-19 information-seeking behaviors predominantly through Internet sites, broadcast news, health professionals, and governmental sources. Students experienced emotional burden as a result of COVID-19 misinformation in these sources. While most students perceived a low chance of acquiring the virus due to their lack of underlying medical conditions, they were still concerned about the consequences of becoming infected. Students noted the difficulty of physical distancing while on campus. Conclusions: Colleges/universities should maximize the dissemination of timely, valid health information for the safety of their students and the broader community.
Collapse
Affiliation(s)
- Xuewei Chen
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Jati Ariati
- School of Educational Foundations, Leadership and Aviation, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Darcy Jones McMaughan
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Ho Han
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Randolph D Hubach
- Department of Public Health, Purdue University, West Lafayette, Indiana, USA
| | - Bridget M Miller
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
31
|
Morra CN, Adkins-Jablonsky SJ, Barnes ME, Pirlo OJ, Almehmi SE, Convers BJ, Dang DL, Howell ML, Fleming R, Raut SA. Expert-Led Module Improves Non-STEM Undergraduate Perception of and Willingness to Receive COVID-19 Vaccines. Front Public Health 2022; 10:816692. [PMID: 35664101 PMCID: PMC9157538 DOI: 10.3389/fpubh.2022.816692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 04/12/2022] [Indexed: 12/23/2022] Open
Abstract
As evidence mounted that existing prevention methods would be insufficient to end the COVID-19 pandemic, it became clear that vaccines would be critical to achieve and maintain reduced rates of infection. However, vaccine-hesitant sentiments have become widespread, particularly in populations with lower scientific literacy. The non-STEM major (called non-major) college students represent one such population who rely on one or more science classes to develop their scientific literacy and thus, become candidates of interest for the success of the COVID-19 vaccine campaign. As these students have fewer opportunities to learn how to identify reputable scientific sources or judge the validity of novel scientific findings, it is particularly important that these skills are included in the science courses offered to non-majors. Two concurrent non-major biology courses (N = 98) at the University of Alabama at Birmingham in Spring 2021 completed Likert questionnaires with open-ended questions prior to and after an expert-led Vaccine Awareness educational intervention addressing vaccine-related concerns. In the module, experts gave presentations about COVID-19 related to microbiology, epidemiological factors, and professional experiences relating to COVID-19. Ten students agreed to participate in post-semester one-on-one interviews. Student interviews revealed that students perceived guest lecturers as providing more information and assurance. Questionnaire data showed an increase in student willingness to accept a COVID-19 vaccine as well as increased student perception of the COVID-19 vaccines as both safe and effective (Wilcoxon Rank Sum Test, p < 0.05). However, the questionnaire data revealed 10 of 98 students remained vaccine-resistant, and these students expressed insufficient research and side effects as leading vaccination concerns. Overall, we show expert-led modules can be effective in increasing non-majors willingness to accept COVID-19 vaccines. Future research should explore the experiences of non-majors and guest lectures, particularly as they relate to vaccination and vaccine concerns.
Collapse
Affiliation(s)
- Christina N Morra
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Sarah J Adkins-Jablonsky
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States.,Alabama College of Osteopathic Medicine, Dothan, AL, United States
| | - M Elizabeth Barnes
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN, United States
| | - Obadiah J Pirlo
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Sloan E Almehmi
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Bianca J Convers
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Derek L Dang
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Michael L Howell
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ryleigh Fleming
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Samiksha A Raut
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| |
Collapse
|
32
|
Klein B, Generous N, Chinazzi M, Bhadricha Z, Gunashekar R, Kori P, Li B, McCabe S, Green J, Lazer D, Marsicano CR, Scarpino SV, Vespignani A. Higher education responses to COVID-19 in the United States: Evidence for the impacts of university policy. PLOS DIGITAL HEALTH 2022; 1:e0000065. [PMID: 36812533 PMCID: PMC9931316 DOI: 10.1371/journal.pdig.0000065] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 05/18/2022] [Indexed: 11/19/2022]
Abstract
With a dataset of testing and case counts from over 1,400 institutions of higher education (IHEs) in the United States, we analyze the number of infections and deaths from SARS-CoV-2 in the counties surrounding these IHEs during the Fall 2020 semester (August to December, 2020). We find that counties with IHEs that remained primarily online experienced fewer cases and deaths during the Fall 2020 semester; whereas before and after the semester, these two groups had almost identical COVID-19 incidence. Additionally, we see fewer cases and deaths in counties with IHEs that reported conducting any on-campus testing compared to those that reported none. To perform these two comparisons, we used a matching procedure designed to create well-balanced groups of counties that are aligned as much as possible along age, race, income, population, and urban/rural categories-demographic variables that have been shown to be correlated with COVID-19 outcomes. We conclude with a case study of IHEs in Massachusetts-a state with especially high detail in our dataset-which further highlights the importance of IHE-affiliated testing for the broader community. The results in this work suggest that campus testing can itself be thought of as a mitigation policy and that allocating additional resources to IHEs to support efforts to regularly test students and staff would be beneficial to mitigating the spread of COVID-19 in a pre-vaccine environment.
Collapse
Affiliation(s)
- Brennan Klein
- Network Science Institute, Northeastern University, Boston, United States of America
- Laboratory for the Modeling of Biological and Socio-Technical Systems, Northeastern University, Boston, Massachusetts, United States of America
| | - Nicholas Generous
- Network Science Institute, Northeastern University, Boston, United States of America
- Laboratory for the Modeling of Biological and Socio-Technical Systems, Northeastern University, Boston, Massachusetts, United States of America
- Biosecurity and Public Health Group, Los Alamos National Laboratory, Los Alamos, New Mexico, United States of America
| | - Matteo Chinazzi
- Network Science Institute, Northeastern University, Boston, United States of America
- Laboratory for the Modeling of Biological and Socio-Technical Systems, Northeastern University, Boston, Massachusetts, United States of America
| | - Zarana Bhadricha
- Network Science Institute, Northeastern University, Boston, United States of America
- College of Engineering, Northeastern University, Boston, Massachusetts, United States of America
| | - Rishab Gunashekar
- Network Science Institute, Northeastern University, Boston, United States of America
- College of Engineering, Northeastern University, Boston, Massachusetts, United States of America
| | - Preeti Kori
- Network Science Institute, Northeastern University, Boston, United States of America
- College of Engineering, Northeastern University, Boston, Massachusetts, United States of America
| | - Bodian Li
- Network Science Institute, Northeastern University, Boston, United States of America
- College of Professional Studies, Northeastern University, Boston, Massachusetts, United States of America
| | - Stefan McCabe
- Network Science Institute, Northeastern University, Boston, United States of America
| | - Jon Green
- Network Science Institute, Northeastern University, Boston, United States of America
- Shorenstein Center on Media, Politics and Public Policy, Harvard University, Massachusetts, Boston, United States of America
| | - David Lazer
- Network Science Institute, Northeastern University, Boston, United States of America
| | - Christopher R. Marsicano
- Educational Studies Department, Davidson College, Davidson, North Carolina, United States of America
- College Crisis Initiative, Davidson College, Davidson, North Carolina, United States of America
| | - Samuel V. Scarpino
- Network Science Institute, Northeastern University, Boston, United States of America
- Vermont Complex Systems Center, University of Vermont, Burlington, Vermont, United States of America
- Santa Fe Institute, Santa Fe, United States of America
| | - Alessandro Vespignani
- Network Science Institute, Northeastern University, Boston, United States of America
- Laboratory for the Modeling of Biological and Socio-Technical Systems, Northeastern University, Boston, Massachusetts, United States of America
| |
Collapse
|
33
|
Arnold CRK, Srinivasan S, Rodriguez S, Rydzak N, Herzog CM, Gontu A, Bharti N, Small M, Rogers CJ, Schade MM, Kuchipudi SV, Kapur V, Read AF, Ferrari MJ. A longitudinal study of the impact of university student return to campus on the SARS-CoV-2 seroprevalence among the community members. Sci Rep 2022; 12:8586. [PMID: 35597780 PMCID: PMC9124192 DOI: 10.1038/s41598-022-12499-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 05/04/2022] [Indexed: 12/02/2022] Open
Abstract
Returning university students represent large-scale, transient demographic shifts and a potential source of transmission to adjacent communities during the COVID-19 pandemic. In this prospective longitudinal cohort study, we tested for IgG antibodies against SARS-CoV-2 in a non-random cohort of residents living in Centre County prior to the Fall 2020 term at the Pennsylvania State University and following the conclusion of the Fall 2020 term. We also report the seroprevalence in a non-random cohort of students collected at the end of the Fall 2020 term. Of 1313 community participants, 42 (3.2%) were positive for SARS-CoV-2 IgG antibodies at their first visit between 07 August and 02 October 2020. Of 684 student participants who returned to campus for fall instruction, 208 (30.4%) were positive for SARS-CoV-2 antibodies between 26 October and 21 December. 96 (7.3%) community participants returned a positive IgG antibody result by 19 February. Only contact with known SARS-CoV-2-positive individuals and attendance at small gatherings (20-50 individuals) were significant predictors of detecting IgG antibodies among returning students (aOR, 95% CI 3.1, 2.07-4.64; 1.52, 1.03-2.24; respectively). Despite high seroprevalence observed within the student population, seroprevalence in a longitudinal cohort of community residents was low and stable from before student arrival for the Fall 2020 term to after student departure. The study implies that heterogeneity in SARS-CoV-2 transmission can occur in geographically coincident populations.
Collapse
Affiliation(s)
- Callum R K Arnold
- Department of Biology, Pennsylvania State University, University Park, PA, 16802, USA.
- Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA, 16802, USA.
| | - Sreenidhi Srinivasan
- Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA, 16802, USA
- Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA, 16802, USA
| | - Sophie Rodriguez
- Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA, 16802, USA
| | - Natalie Rydzak
- Department of Veterinary and Biomedical Sciences, Pennsylvania State University, University Park, PA, 16802, USA
| | - Catherine M Herzog
- Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA, 16802, USA
- Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA, 16802, USA
| | - Abhinay Gontu
- Department of Veterinary and Biomedical Sciences, Pennsylvania State University, University Park, PA, 16802, USA
| | - Nita Bharti
- Department of Biology, Pennsylvania State University, University Park, PA, 16802, USA
- Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA, 16802, USA
| | - Meg Small
- College of Health and Human Development, Pennsylvania State University, University Park, PA, 16802, USA
- Social Science Research Institute, Pennsylvania State University, University Park, PA, 16802, USA
| | - Connie J Rogers
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, 16802, USA
| | - Margeaux M Schade
- College of Health and Human Development, Pennsylvania State University, University Park, PA, 16802, USA
| | - Suresh V Kuchipudi
- Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA, 16802, USA
- Department of Veterinary and Biomedical Sciences, Pennsylvania State University, University Park, PA, 16802, USA
| | - Vivek Kapur
- Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA, 16802, USA
- Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA, 16802, USA
- Department of Animal Science, Pennsylvania State University, University Park, PA, 16802, USA
| | - Andrew F Read
- Department of Biology, Pennsylvania State University, University Park, PA, 16802, USA
- Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA, 16802, USA
- Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA, 16802, USA
| | - Matthew J Ferrari
- Department of Biology, Pennsylvania State University, University Park, PA, 16802, USA.
- Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA, 16802, USA.
| |
Collapse
|
34
|
Bauler S, Hege A, Davis T, Schluth E, Pruitt C, Moreno V, Verhaeghe M, Bouldin ED. Behavioral determinants for COVID-19 vaccine acceptance among students, faculty, and staff at a rural public university. Health Psychol Behav Med 2022; 10:467-479. [PMID: 35600086 PMCID: PMC9116233 DOI: 10.1080/21642850.2022.2074007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Vaccine hesitancy for COVID-19 is a major obstacle to achieving high vaccine coverage. Low vaccine confidence among college students is one factor fueling the COVID-19 pandemic in the U.S. Objective The purpose of this study was to evaluate COVID-19 vaccine hesitancy and barriers to vaccine uptake among students, faculty, and staff at a rural public university. Method We used the Barrier Analysis (BA) mixed-methods approach, which explores determinants of the desired behavior using the Health Belief Model and Theory of Reasoned Action. We developed a BA questionnaire and distributed it through Qualtrics to 4,600 randomly selected students (n = 4,000), faculty (n = 300), and staff (n = 300) from March 11 to April 1, 2021. We defined Acceptors as those who were willing to be vaccinated and Non-acceptors as those who were not. Results Our analysis found that among Non-acceptors, perceived social norms, perceived negative consequences, and trust had the highest association with COVID-19 vaccine hesitancy among students, faculty, and staff. Conclusion These findings illustrate the need to develop effective behavior change strategies for COVID-19 vaccines uptake that identify sources of trusted information among vaccine-hesitant college students, faculty, and staff, while leveraging enablers to increase COVID-19 vaccination coverage on university campuses.
Collapse
Affiliation(s)
- Sarah Bauler
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
- World Vision International, Geneva, Switzerland
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Adam Hege
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
| | - Tom Davis
- World Vision International, Geneva, Switzerland
| | - Emilee Schluth
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
| | - Caroline Pruitt
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
| | - Victoria Moreno
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
| | - Monica Verhaeghe
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
| | - Erin D. Bouldin
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA
| |
Collapse
|
35
|
Hakre S, Lakhal-Naouar I, King DB, Burns JL, Jackson KN, Krauss SW, Chandrasekaran P, McCauley MD, Ober Shepherd BL, McHenry S, Bianchi EJ, Ouellette J, Darden JM, Sanborn AD, Daye SP, Kwon PO, Stubbs J, Brigantti CL, Hall TL, Beagle MH, Pieri JA, Frambes TR, O’Connell RJ, Modjarrad K, Murray CK, Jagodzinski LL, Scott PT, Peel SA. Virological and Serological Assessment of US Army Trainees Isolated for Coronavirus Disease 2019. J Infect Dis 2022; 226:1743-1752. [PMID: 35543272 PMCID: PMC9129211 DOI: 10.1093/infdis/jiac198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/09/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Laboratory screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a key mitigation measure to avoid the spread of infection among recruits starting basic combat training in a congregate setting. Because viral nucleic acid can be detected persistently after recovery, we evaluated other laboratory markers to distinguish recruits who could proceed with training from those who were infected. METHODS Recruits isolated for coronavirus disease 2019 (COVID-19) were serially tested for SARS-CoV-2 subgenomic ribonucleic acid (sgRNA), and viral load (VL) by reverse-transcriptase polymerase chain reaction (RT-PCR), and for anti- SARS-CoV-2. Cluster and quadratic discriminant analyses of results were performed. RESULTS Among 229 recruits isolated for COVID-19, those with a RT-PCR cycle threshold >30.49 (sensitivity 95%, specificity 96%) or having sgRNA log10 RNA copies/mL <3.09 (sensitivity and specificity 96%) at entry into isolation were likely SARS-CoV-2 uninfected. Viral load >4.58 log10 RNA copies/mL or anti-SARS-CoV-2 signal-to-cutoff ratio <1.38 (VL: sensitivity and specificity 93%; anti-SARS-CoV-2: sensitivity 83%, specificity 79%) had comparatively lower sensitivity and specificity when used alone for discrimination of infected from uninfected. CONCLUSIONS Orthogonal laboratory assays used in combination with RT-PCR may have utility in determining SARS-CoV-2 infection status for decisions regarding isolation.
Collapse
Affiliation(s)
- Shilpa Hakre
- Correspondence: Shilpa Hakre, DrPH MPH, Emerging Infectious Diseases Branch, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., 6720-A Rockledge Drive, Suite 400, Bethesda, MD 20817 ()
| | - Ines Lakhal-Naouar
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA,Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - David B King
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Jennifer L Burns
- Walter Reed Army Institute of Research, Pilot Bioproduction Facility, Silver Spring, Maryland, USA
| | - Kenya N Jackson
- Walter Reed Army Institute of Research, Experimental Therapeutics, Silver Spring, Maryland, USA
| | - Stephen W Krauss
- Walter Reed Army Institute of Research, Center for Military Psychiatry and Neuroscience, Silver Spring, Maryland, USA
| | - Prabha Chandrasekaran
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA,Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - Melanie D McCauley
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Brittany L Ober Shepherd
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Samantha McHenry
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Elizabeth J Bianchi
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA
| | - Jason Ouellette
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA,Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - Janice M Darden
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MarylandUSA,Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - Aaron D Sanborn
- Walter Reed Army Institute of Research, Clinical Trials Center, Silver Spring, Maryland, USA
| | - Sharon P Daye
- Walter Reed Army Institute of Research, One Health Branch, Silver Spring, Maryland, USA
| | - Paul O Kwon
- Program Executive Office for Simulation, Training and Instrumentation, Orlando, Florida, USA
| | | | - Crystal L Brigantti
- DiLorenzo Pentagon Health Clinic, Optometry, Washington, District of Columbia, USA
| | - Tara L Hall
- Moncrief Army Health Clinic, Fort Jackson, South Carolina, USA
| | | | - Jason A Pieri
- United States Army Training Center, Fort Jackson, South Carolina, USA
| | - Timothy R Frambes
- United States Army Training Center, Fort Jackson, South Carolina, USA
| | | | - Kayvon Modjarrad
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA
| | | | - Linda L Jagodzinski
- Walter Reed Army Institute of Research, Diagnostics and Countermeasures Branch, Silver Spring, Maryland, USA
| | - Paul T Scott
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Branch, Silver Spring, Maryland, USA
| | | |
Collapse
|
36
|
Swift CL, Isanovic M, Correa Velez KE, Sellers SC, Norman RS. Wastewater surveillance of SARS-CoV-2 mutational profiles at a university and its surrounding community reveals a 20G outbreak on campus. PLoS One 2022; 17:e0266407. [PMID: 35421164 PMCID: PMC9009614 DOI: 10.1371/journal.pone.0266407] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/20/2022] [Indexed: 12/16/2022] Open
Abstract
Wastewater surveillance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been leveraged during the Coronavirus Disease 2019 (COVID-19) pandemic as a public health tool at the community and building level. In this study, we compare the sequence diversity of SARS-CoV-2 amplified from wastewater influent to the Columbia, South Carolina, metropolitan wastewater treatment plant (WWTP) and the University of South Carolina campus during September 2020, which represents the peak of COVID-19 cases at the university during 2020. A total of 92 unique mutations were detected across all WWTP influent and campus samples, with the highest frequency mutations corresponding to the SARS-CoV-2 20C and 20G clades. Signature mutations for the 20G clade dominated SARS-CoV-2 sequences amplified from localized wastewater samples collected at the University of South Carolina, suggesting that the peak in COVID-19 cases during early September 2020 was caused by an outbreak of the 20G lineage. Thirteen mutations were shared between the university building-level wastewater samples and the WWTP influent collected in September 2020, 62% of which were nonsynonymous substitutions. Co-occurrence of mutations was used as a similarity metric to compare wastewater samples. Three pairs of mutations co-occurred in university wastewater and WWTP influent during September 2020. Thirty percent of the detected mutations, including 12 pairs of concurrent mutations, were only detected in university samples. This report affirms the close relationship between the prevalent SARS-CoV-2 genotypes of the student population at a university campus and those of the surrounding community. However, this study also suggests that wastewater surveillance at the building-level at a university offers important insight by capturing sequence diversity that was not apparent in the WWTP influent, thus offering a balance between the community-level wastewater and clinical sequencing.
Collapse
Affiliation(s)
- Candice L. Swift
- Department of Environmental Health Sciences, University of South Carolina, Columbia, SC, United States of America
| | - Mirza Isanovic
- Department of Environmental Health Sciences, University of South Carolina, Columbia, SC, United States of America
| | - Karlen E. Correa Velez
- Department of Environmental Health Sciences, University of South Carolina, Columbia, SC, United States of America
| | - Sarah C. Sellers
- Department of Environmental Health Sciences, University of South Carolina, Columbia, SC, United States of America
| | - R. Sean Norman
- Department of Environmental Health Sciences, University of South Carolina, Columbia, SC, United States of America
- * E-mail:
| |
Collapse
|
37
|
Harris JE. Geospatial Analysis of a COVID-19 Outbreak at the University of Wisconsin - Madison: Potential Role of a Cluster of Local Bars. Epidemiol Infect 2022; 150:1-31. [PMID: 35380104 PMCID: PMC9043656 DOI: 10.1017/s0950268822000498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 02/10/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
We combined smartphone mobility data with census track-based reports of positive case counts to study a coronavirus disease 2019 (COVID-19) outbreak at the University of Wisconsin–Madison campus, where nearly 3000 students had become infected by the end of September 2020. We identified a cluster of twenty bars located at the epicentre of the outbreak, in close proximity to campus residence halls. Smartphones originating from the two hardest-hit residence halls (Sellery-Witte), where about one in five students were infected, were 2.95 times more likely to visit the 20-bar cluster than smartphones originating in two more distant, less affected residence halls (Ogg-Smith). By contrast, smartphones from Sellery-Witte were only 1.55 times more likely than those from Ogg-Smith to visit a group of 68 restaurants in the same area [rate ratio 1.91, 95% confidence interval (CI) 1.29–2.85, P < 0.001]. We also determined the per-capita rates of visitation to the 20-bar cluster and to the 68-restaurant comparison group by smartphones originating in each of 21 census tracts in the university area. In a multivariate instrumental variables regression, the visitation rate to the bar cluster was a significant determinant of the per-capita incidence of positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests in each census tract (elasticity 0.88, 95% CI 0.08–1.68, P = 0.032), while the restaurant visitation rate showed no such relationship. The potential super-spreader effects of clusters or networks of places, rather than individual sites, require further attention.
Collapse
Affiliation(s)
- Jeffrey E Harris
- Professor of Economics, Emeritus, Massachusetts Institute of Technology, Cambridge MA 02139; Physician, Eisner Health, Los AngelesCA90015.
| |
Collapse
|
38
|
Xiao A, Wu F, Bushman M, Zhang J, Imakaev M, Chai PR, Duvallet C, Endo N, Erickson TB, Armas F, Arnold B, Chen H, Chandra F, Ghaeli N, Gu X, Hanage WP, Lee WL, Matus M, McElroy KA, Moniz K, Rhode SF, Thompson J, Alm EJ. Metrics to relate COVID-19 wastewater data to clinical testing dynamics. WATER RESEARCH 2022; 212:118070. [PMID: 35101695 PMCID: PMC8758950 DOI: 10.1016/j.watres.2022.118070] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 11/29/2021] [Accepted: 01/11/2022] [Indexed: 05/02/2023]
Abstract
Wastewater surveillance has emerged as a useful tool in the public health response to the COVID-19 pandemic. While wastewater surveillance has been applied at various scales to monitor population-level COVID-19 dynamics, there is a need for quantitative metrics to interpret wastewater data in the context of public health trends. 24-hour composite wastewater samples were collected from March 2020 through May 2021 from a Massachusetts wastewater treatment plant and SARS-CoV-2 RNA concentrations were measured using RT-qPCR. The relationship between wastewater copy numbers of SARS-CoV-2 gene fragments and COVID-19 clinical cases and deaths varies over time. We demonstrate the utility of three new metrics to monitor changes in COVID-19 epidemiology: (1) the ratio between wastewater copy numbers of SARS-CoV-2 gene fragments and clinical cases (WC ratio), (2) the time lag between wastewater and clinical reporting, and (3) a transfer function between the wastewater and clinical case curves. The WC ratio increases after key events, providing insight into the balance between disease spread and public health response. Time lag and transfer function analysis showed that wastewater data preceded clinically reported cases in the first wave of the pandemic but did not serve as a leading indicator in the second wave, likely due to increased testing capacity, which allows for more timely case detection and reporting. These three metrics could help further integrate wastewater surveillance into the public health response to the COVID-19 pandemic and future pandemics.
Collapse
Affiliation(s)
- Amy Xiao
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA
| | - Fuqing Wu
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA
| | - Mary Bushman
- Harvard T.H. Chan School of Public Health, Harvard University USA
| | - Jianbo Zhang
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA
| | | | - Peter R Chai
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School USA; The Fenway Institute, Fenway Health, Boston, MA USA; The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology USA; Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute USA
| | | | | | - Timothy B Erickson
- Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School USA; Harvard Humanitarian Initiative, Harvard University USA
| | - Federica Armas
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Brian Arnold
- Department of Computer Science, Princeton University USA; Center for Statistics and Machine Learning, Princeton University USA
| | - Hongjie Chen
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - Franciscus Chandra
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | | | - Xiaoqiong Gu
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | - William P Hanage
- Harvard T.H. Chan School of Public Health, Harvard University USA
| | - Wei Lin Lee
- Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore
| | | | | | - Katya Moniz
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA
| | | | - Janelle Thompson
- Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore; Asian School of the Environment, Nanyang Technological University, Singapore
| | - Eric J Alm
- Department of Biological Engineering, Massachusetts Institute of Technology USA; Center for Microbiome Informatics and Therapeutics, Massachusetts Institute of Technology USA; Singapore-MIT Alliance for Research and Technology, Antimicrobial Resistance Interdisciplinary Research Group, Singapore; Campus for Research Excellence and Technological Enterprise (CREATE), Singapore; Broad Institute of MIT and Harvard, Cambridge, MA USA.
| |
Collapse
|
39
|
Bharti N, Lambert B, Exten C, Faust C, Ferrari M, Robinson A. Large university with high COVID-19 incidence is not associated with excess cases in non-student population. Sci Rep 2022; 12:3313. [PMID: 35228585 PMCID: PMC8885693 DOI: 10.1038/s41598-022-07155-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 02/09/2022] [Indexed: 11/09/2022] Open
Abstract
Large US colleges and universities that re-opened campuses in the fall of 2020 and the spring of 2021 experienced high per capita rates of COVID-19. Returns to campus were controversial because they posed a potential risk to surrounding communities. A large university in Pennsylvania that returned to in-person instruction for Fall 2020 and Spring 2021 semesters reported high incidence of COVID-19 among students. However, the co-located non-student resident population in the county experienced fewer COVID-19 cases per capita than reported in neighboring counties. Activity patterns from mobile devices indicate that the non-student resident population near the university restricted their movements during the pandemic more than residents of neighboring counties. Respiratory virus prevention and management in student and non-student populations requires different, specifically targeted strategies.
Collapse
|
40
|
Natalia YA, Faes C, Neyens T, Molenberghs G. The COVID-19 wave in Belgium during the Fall of 2020 and its association with higher education. PLoS One 2022; 17:e0264516. [PMID: 35213651 PMCID: PMC8880857 DOI: 10.1371/journal.pone.0264516] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 02/13/2022] [Indexed: 11/30/2022] Open
Abstract
Soon after SARS-CoV-2 emerged in late 2019, Belgium was confronted with a first COVID-19 wave in March-April 2020. SARS-CoV-2 circulation declined in the summer months (late May to early July 2020). Following a successfully trumped late July-August peak, COVID-19 incidence fell slightly, to then enter two successive phases of rapid incline: in the first half of September, and then again in October 2020. The first of these coincided with the peak period of returning summer travelers; the second one coincided with the start of higher education’s academic year. The largest observed COVID-19 incidence occurred in the period 16–31 October, particularly in the Walloon Region, the southern, French-speaking part of Belgium. We examine the potential association of the higher education population with spatio-temporal spread of COVID-19, using Bayesian spatial Poisson models for confirmed test cases, accounting for socio-demographic heterogeneity in the population. We find a significant association between the number of COVID-19 cases in the age groups 18–29 years and 30–39 years and the size of the higher education student population at the municipality level. These results can be useful towards COVID-19 mitigation strategies, particularly in areas where virus transmission from higher education students into the broader community could exacerbate morbidity and mortality of COVID-19 among populations with prevalent underlying conditions associated with more severe outcomes following infection.
Collapse
Affiliation(s)
| | - Christel Faes
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Thomas Neyens
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
- L-BioStat, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Geert Molenberghs
- I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
- L-BioStat, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium
| |
Collapse
|
41
|
Garcia M. This Is America: Systemic Racism and Health Inequities Amidst the COVID-19 Pandemic. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:105-121. [PMID: 34592909 DOI: 10.1080/19371918.2021.1981509] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The Coronavirus 2019 (COVID-19) continues to devastate the world and the United States remains number one of reported COVID-19 cases and deaths. Research demonstrates that Blacks and Hispanics in the United States are disproportionately impacted by COVID-19, especially among highly marginalized people at the intersection of immigration and incarceration. Social distancing is a privilege and contact tracing is a deterrent for historically oppressed populations. Public health professionals have attempted a multicausal approach to prevent the spread of infectious diseases, but they have been unsuccessful in addressing the biological-social impact of highly vulnerable populations. An emphasis is placed on syndemics and social determinants of health to address health inequities associated with COVID-19 due to systemic racism. Implications for social work will reinforce the profession's obligation to address public emergencies through social and political action. Recommendations will be made for social workers to support local, state, and federal level responses of COVID-19.
Collapse
Affiliation(s)
- Moctezuma Garcia
- School of Social Work, San Jose State University, San Jose, California, USA
| |
Collapse
|
42
|
Lehnig CL, Oren E, Vaidya NK. Effectiveness of alternative semester break schedules on reducing COVID-19 incidence on college campuses. Sci Rep 2022; 12:2116. [PMID: 35136172 PMCID: PMC8825861 DOI: 10.1038/s41598-022-06260-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 01/20/2022] [Indexed: 12/11/2022] Open
Abstract
Despite COVID-19 vaccination programs, the threat of new SARS-CoV-2 strains and continuing pockets of transmission persists. While many U.S. universities replaced their traditional nine-day spring 2021 break with multiple breaks of shorter duration, the effects these schedules have on reducing COVID-19 incidence remains unclear. The main objective of this study is to quantify the impact of alternative break schedules on cumulative COVID-19 incidence on university campuses. Using student mobility data and Monte Carlo simulations of returning infectious student size, we developed a compartmental susceptible-exposed-infectious-asymptomatic-recovered (SEIAR) model to simulate transmission dynamics among university students. As a case study, four alternative spring break schedules were derived from a sample of universities and evaluated. Across alternative multi-break schedules, the median percent reduction of total semester COVID-19 incidence, relative to a traditional nine-day break, ranged from 2 to 4% (for 2% travel destination prevalence) and 8-16% (for 10% travel destination prevalence). The maximum percent reduction from an alternate break schedule was estimated to be 37.6%. Simulation results show that adjusting academic calendars to limit student travel can reduce disease burden. Insights gleaned from our simulations could inform policies regarding appropriate planning of schedules for upcoming semesters upon returning to in-person teaching modalities.
Collapse
Affiliation(s)
- Chris L Lehnig
- Computational Science Research Center, San Diego State University, San Diego, USA
| | - Eyal Oren
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, USA
| | - Naveen K Vaidya
- Computational Science Research Center, San Diego State University, San Diego, USA.
- Department of Mathematics and Statistics, San Diego State University, San Diego, USA.
- Viral Information Institute, San Diego State University, San Diego, USA.
| |
Collapse
|
43
|
Schultz EA, Kussman A, Jerome A, Abrams GD, Hwang CE. Comparison of SARS-CoV-2 Test Positivity in NCAA Division I Student Athletes vs Nonathletes at 12 Institutions. JAMA Netw Open 2022; 5:e2147805. [PMID: 35138397 PMCID: PMC8829663 DOI: 10.1001/jamanetworkopen.2021.47805] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
IMPORTANCE The COVID-19 pandemic initially led to the abrupt shutdown of collegiate athletics until guidelines were established for a safe return to play for student athletes. Currently, no literature exists that examines the difference in SARS-CoV-2 test positivity between student athletes and nonathletes at universities across the country. OBJECTIVE To identify the difference in risk of COVID-19 infection between student athlete and nonathlete student populations and evaluate the hypothesis that student athletes may display increased SARS-CoV-2 test positivity associated with increased travel, competition, and testing compared with nonathletes at their respective universities. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional analysis, a search of publicly available official university COVID-19 dashboards and press releases was performed for all 65 Power 5 National Collegiate Athletic Association (NCAA) Division I institutions during the 2020 to 2021 academic year. Data were analyzed at the conclusion of the academic year. Schools that released at least 4 months of testing data, including the fall 2020 football season, for student athletes and nonathlete students were included in the analysis. Power 5 NCAA Division I student athletes and their nonathlete student counterparts were included in the analysis. EXPOSURE Designation as a varsity student athlete. MAIN OUTCOMES AND MEASURES The main outcome was SARS-CoV-2 test positivity for student athletes and nonathlete students at the included institutions for the 2020 to 2021 academic year, measured as a relative risk for student athletes. RESULTS Among 12 schools with sufficient data available included in the final analysis, 555 372 student athlete tests and 3 482 845 nonathlete student tests were performed. There were 9 schools with decreased test positivity in student athletes compared with nonathlete students (University of Arkansas: 0.01% vs 3.52%; University of Minnesota: 0.63% vs 5.96%; Penn State University: 0.74% vs 6.58%; Clemson University: 0.40% vs 1.88%; University of Louisville: 0.75% vs 3.05%; Purdue University: 0.79% vs 2.97%; University of Michigan: 0.40% vs 1.12%; University of Illinois: 0.17% vs 0.40%; University of Virginia: 0.64% vs 1.04%) (P < .001 for each). The median (range) test positivity in these 9 schools was 0.46% (0.01%-0.79%) for student athletes and 1.04% (0.40%-6.58%) for nonathlete students. In 1 school, test positivity was increased in the student athlete group (Stanford University: 0.20% vs 0.05%; P < .001). Overall, there were 2425 positive tests (0.44%) among student athletes and 30 567 positive tests (0.88%) among nonathlete students, for a relative risk of 0.50 (95% CI, 0.48-0.52; P < .001). There was no statistically significant difference in student athlete test positivity between included schools; however, test positivity among nonathlete students varied considerably between institutions, ranging from 133 of 271 862 tests (0.05%) at Stanford University to 2129 of 32 336 tests (6.58%) at Penn State University. CONCLUSIONS AND RELEVANCE This study found that in the setting of SARS-CoV-2 transmission mitigation protocols implemented by the NCAA, participation in intercollegiate athletics was not associated with increased SARS-CoV-2 test positivity. This finding suggests that collegiate athletics may be held without an associated increased risk of infection among student athletes.
Collapse
Affiliation(s)
- Emily A. Schultz
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Andrea Kussman
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Alyssa Jerome
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Geoffrey D. Abrams
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Calvin E. Hwang
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| |
Collapse
|
44
|
Johnson D, Cahill M, Choate S, Roelfs D, Walsh SE. The Influence of Public Health Faculty on College and University Plans During the COVID-19 Pandemic. Front Public Health 2022; 9:745232. [PMID: 35096729 PMCID: PMC8795676 DOI: 10.3389/fpubh.2021.745232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to explore whether the institutional presence of public health expertise within colleges and universities was associated with operational plans for the fall semester of 2020. Using cross-sectional data collected by the College Crisis Initiative of Davidson College, six levels of instructional modalities (ranked from least to most restrictive) were compared between Council on Education of Public Health (CEPH)-accredited and non-CEPH-accredited 4-year institutions. Institutions with CEPH-accredited schools and programs were more likely to select some restrictive teaching modalities: 63.8% more likely to use hybrid/hyflex or more restrictive and 66.9% more likely to be primarily online (with some in person) or more restrictive. However, having CEPH-accredited programs did not push institutions to the most restrictive modalities. COVID-19 cases in county, enrollment, and political affiliation of the state governor were also found to be associated with instructional modality selection. While any ecological study has certain limitations, this study suggests that college and university fall plans may have been influenced by the presence of CEPH-accredited schools and programs of public health, and/or the input of their faculty. The influence of relevant faculty expertise on institutional decision-making can help inform college and university responses to future crises.
Collapse
Affiliation(s)
- David Johnson
- Department of Health Management and Systems Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, United States
- *Correspondence: David Johnson
| | - Meredith Cahill
- Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, United States
| | - Sara Choate
- Department of Health Management and Systems Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, United States
| | - David Roelfs
- Department of Sociology, College of Arts and Sciences, University of Louisville, Louisville, KY, United States
| | - Sarah E. Walsh
- School of Health Sciences, Eastern Michigan University, Ypsilanti, MI, United States
| |
Collapse
|
45
|
Chang CN, Chien HY, Malagon-Palacios L. College reopening and community spread of COVID-19 in the United States. Public Health 2022; 204:70-75. [PMID: 35176623 PMCID: PMC8747949 DOI: 10.1016/j.puhe.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/19/2021] [Accepted: 01/04/2022] [Indexed: 10/29/2022]
Abstract
OBJECTIVE After months of lockdown due to the COVID-19 outbreak, the US postsecondary institutions implemented different instruction approaches to bring their students back for the Fall 2020 semester. Given public health concerns with reopening campuses, the study evaluated the impact of Fall 2020 college reopenings on COVID-19 transmission within the 632 US university counties. STUDY DESIGN This was a retrospective and observational study. METHODS Bayesian Structural Time Series (BSTS) models were conducted to investigate the county-level COVID-19 case increases during the first 21 days of Fall 2020. The case increase for each county was estimated by comparing the observed time series (actual daily cases after school reopening) to the BSTS counterfactual time series (predictive daily cases if not reopening during the same time frame). We then used multilevel models to examine the associations between opening approaches (in-person, online, and hybrid) and county-level COVID-19 case increases within 21 and 42 days after classes began. The multigroup comparison between mask and non-mask-required states for these associations were also performed, given that the statewide guidelines might moderate the effects of college opening approaches. RESULTS More than 80% of our university county sample did not experience a significant case increase in Fall 2020. There were no significant relationships between opening approaches and community transmission in both mask-required and non-mask-required states. Only small metropolitan counties and counties with a non-community college or a higher percentage of student population showed significantly positive associations with the case number increase within the first 21-day period of Fall 2020. For the longer 42-day period, the counties with a higher percentage of the student population showed a significant case increase. CONCLUSION The overall findings underscored the outcomes of US higher education reopening efforts when the vaccines were still under development in Fall 2020. For individual county results, we invite the college- and county-level decision-makers to interpret their results using our web application.
Collapse
Affiliation(s)
- C-N Chang
- Life Span Institute, University of Kansas, USA.
| | - H-Y Chien
- Department of Educational Psychology, Texas A&M University, USA
| | | |
Collapse
|
46
|
Greenhalgh T, Katzourakis A, Wyatt TD, Griffin S. Rapid evidence review to inform safe return to campus in the context of coronavirus disease 2019 (COVID-19). Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.17270.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted predominantly through the air in crowded and unventilated indoor spaces, especially among unvaccinated people. Universities and colleges are potential settings for its spread. Methods: An interdisciplinary team from public health, virology, and biology used narrative methods to summarise and synthesise evidence on key control measures, taking account of mode of transmission. Results: Evidence from a wide range of primary studies supports six measures. Vaccinate (aim for > 90% coverage and make it easy to get a jab). Require masks indoors, especially in crowded settings. If everyone wears well-fitting cloth masks, source control will be high, but for maximum self-protection, respirator masks should be worn. Masks should not be removed for speaking or singing. Space people out by physical distancing (but there is no “safe” distance because transmission risk varies with factors such as ventilation, activity levels and crowding), reducing class size (including offering blended learning), and cohorting (students remain in small groups with no cross-mixing). Clean indoor air using engineering controls—ventilation (while monitoring CO2 levels), inbuilt filtration systems, or portable air cleaners fitted with high efficiency particulate air [HEPA] filters). Test asymptomatic staff and students using lateral flow tests, with tracing and isolating infectious cases when incidence of coronavirus disease 2019 (COVID-19) is high. Support clinically vulnerable people to work remotely. There is no direct evidence to support hand sanitising, fomite controls or temperature-taking. There was no evidence that freestanding plastic screens, face visors and electronic air-cleaning systems are effective. Conclusions: The above evidence-based measures should be combined into a multi-faceted strategy to maximise both student safety and the continuation of in-person and online education provision. Those seeking to provide a safe working and learning environment should collect data (e.g. CO2 levels, room occupancy) to inform their efforts.
Collapse
|
47
|
Shah M, Ferra G, Fitzgerald S, Barreira PJ, Sabeti PC, Colubri A. Containing the spread of mumps on college campuses. ROYAL SOCIETY OPEN SCIENCE 2022; 9:210948. [PMID: 35116142 PMCID: PMC8790351 DOI: 10.1098/rsos.210948] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 01/04/2022] [Indexed: 06/14/2023]
Abstract
College campuses are vulnerable to infectious disease outbreaks, and there is an urgent need to develop better strategies to mitigate their size and duration, particularly as educational institutions around the world adapt to in-person instruction during the COVID-19 pandemic. Towards addressing this need, we applied a stochastic compartmental model to quantify the impact of university-level responses to contain a mumps outbreak at Harvard University in 2016. We used our model to determine which containment interventions were most effective and study alternative scenarios without and with earlier interventions. This model allows for stochastic variation in small populations, missing or unobserved case data and changes in disease transmission rates post-intervention. The results suggest that control measures implemented by the University's Health Services, including rapid isolation of suspected cases, were very effective at containing the outbreak. Without those measures, the outbreak could have been four times larger. More generally, we conclude that universities should apply (i) diagnostic protocols that address false negatives from molecular tests and (ii) strict quarantine policies to contain the spread of easily transmissible infectious diseases such as mumps among their students. This modelling approach could be applied to data from other outbreaks in college campuses and similar small population settings.
Collapse
Affiliation(s)
| | | | | | | | - Pardis C. Sabeti
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
- Harvard School of Public Health, Boston, MA, USA
| | - Andrés Colubri
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
- Program in Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA, USA
| |
Collapse
|
48
|
Schultes O, Clarke V, Paltiel AD, Cartter M, Sosa L, Crawford FW. COVID-19 Testing and Case Rates and Social Contact Among Residential College Students in Connecticut During the 2020-2021 Academic Year. JAMA Netw Open 2021; 4:e2140602. [PMID: 34940864 PMCID: PMC8703252 DOI: 10.1001/jamanetworkopen.2021.40602] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/30/2021] [Indexed: 01/24/2023] Open
Abstract
Importance During the 2020-2021 academic year, many institutions of higher education reopened to residential students while pursuing strategies to mitigate the risk of SARS-CoV-2 transmission on campus. Reopening guidance emphasized polymerase chain reaction or antigen testing for residential students and social distancing measures to reduce the frequency of close interpersonal contact, and Connecticut colleges and universities used a variety of approaches to reopen campuses to residential students. Objective To characterize institutional reopening strategies and COVID-19 outcomes in 18 residential college and university campuses across Connecticut. Design, Setting, and Participants This retrospective cohort study used data on COVID-19 testing and cases and social contact from 18 college and university campuses in Connecticut that had residential students during the 2020-2021 academic year. Exposures Tests for COVID-19 performed per week per residential student. Main Outcomes and Measures Cases per week per residential student and mean (95% CI) social contact per week per residential student. Results Between 235 and 4603 residential students attended the fall semester across each of 18 institutions of higher education in Connecticut, with fewer residential students at most institutions during the spring semester. In census block groups containing residence halls, the fall student move-in resulted in a 475% (95% CI, 373%-606%) increase in mean contact, and the spring move-in resulted in a 561% (95% CI, 441%-713%) increase in mean contact compared with the 7 weeks prior to move-in. The association between test frequency and case rate per residential student was complex; institutions that tested students infrequently detected few cases but failed to blunt transmission, whereas institutions that tested students more frequently detected more cases and prevented further spread. In fall 2020, each additional test per student per week was associated with a decrease of 0.0014 cases per student per week (95% CI, -0.0028 to -0.00001). Conclusions and Relevance The findings of this cohort study suggest that, in the era of available vaccinations and highly transmissible SARS-CoV-2 variants, colleges and universities should continue to test residential students and use mitigation strategies to control on-campus COVID-19 cases.
Collapse
Affiliation(s)
| | | | | | | | - Lynn Sosa
- Connecticut Department of Public Health, Hartford
| | | |
Collapse
|
49
|
Affiliation(s)
- A David Paltiel
- Public Health Modeling Unit, Yale School of Public Health, New Haven, Connecticut
| |
Collapse
|
50
|
Pollock BH, Kilpatrick AM, Eisenman DP, Elton KL, Rutherford GW, Boden-Albala BM, Souleles DM, Polito LE, Martin NK, Byington CL. Safe reopening of college campuses during COVID-19: The University of California experience in Fall 2020. PLoS One 2021; 16:e0258738. [PMID: 34735480 PMCID: PMC8568179 DOI: 10.1371/journal.pone.0258738] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 10/05/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Epidemics of COVID-19 in student populations at universities were a key concern for the 2020-2021 school year. The University of California (UC) System developed a set of recommendations to reduce campus infection rates. SARS-CoV-2 test results are summarized for the ten UC campuses during the Fall 2020 term. METHODS UC mitigation efforts included protocols for the arrival of students living on-campus students, non-pharmaceutical interventions, daily symptom monitoring, symptomatic testing, asymptomatic surveillance testing, isolation and quarantine protocols, student ambassador programs for health education, campus health and safety pledges, and lowered density of on-campus student housing. We used data from UC campuses, the UC Health-California Department of Public Health Data Modeling Consortium, and the U.S. Census to estimate the proportion of each campus' student populations that tested positive for SARS-CoV-2 and compared it to the fraction individuals aged 20-29 years who tested positive in their respective counties. RESULTS SARS-CoV-2 cases in campus populations were generally low in September and October 2020, but increased in November and especially December, and were highest in early to mid-January 2021, mirroring case trajectories in their respective counties. Many students were infected during the Thanksgiving and winter holiday recesses and were detected as cases upon returning to campus. The proportion of students who tested positive for SARS-CoV-2 during Fall 2020 ranged from 1.2% to 5.2% for students living on campus and was similar to students living off campus. For most UC campuses the proportion of students testing positive was lower than that for the 20-29-year-old population in which campuses were located. CONCLUSIONS The layered mitigation approach used on UC campuses, informed by public health science and augmented perhaps by a more compliant population, likely minimized campus transmission and outbreaks and limited transmission to surrounding communities. University policies that include these mitigation efforts in Fall 2020 along with SARS-CoV-2 vaccination, may alleviate some local concerns about college students returning to communities and facilitate resumption of normal campus operations and in-person instruction.
Collapse
Affiliation(s)
- Brad H. Pollock
- Department of Public Health Sciences, University of California Davis, Davis, California, United States of America
| | - A. Marm Kilpatrick
- Department of Ecology and Evolutionary Biology, University of California Santa Cruz, Santa Cruz, California, United States of America
| | - David P. Eisenman
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, Fielding School of Public Health, University of California, Los Angeles, California, United States of America
- Center for Public Health and Disasters, Fielding School of Public Health, University of California, Los Angeles, California, United States of America
| | - Kristie L. Elton
- University of California Office of the President, Oakland, California, United States of America
| | - George W. Rutherford
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America
| | - Bernadette M. Boden-Albala
- Department of Health Society and Behavior, Program in Public Health, Department of Neurology, School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, California, United States of America
| | - David M. Souleles
- Department of Health Society and Behavior, Program in Public Health, Department of Neurology, School of Medicine, Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, California, United States of America
| | - Laura E. Polito
- Student Health, University of California Santa Barbara, Santa Barbara, California, United States of America
| | - Natasha K. Martin
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, California, United States of America
| | - Carrie L. Byington
- University of California Office of the President, Oakland, California, United States of America
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of California San Francisco, San Francisco, California, United States of America
| |
Collapse
|