COVID-19 Literature Situation Report Sept. 1, 2020

• In a community outbreak involving two buses with indoor air recirculation on a 100-minute roundtrip to attend a worship event in Zhejiang province, passengers in the bus that had the index case had a 34% higher risk of getting COVID-19 compared to the other bus. Dividing seats on the exposed bus into high- and low-risk zones based on proximity from the index case, individuals in high-risk zones had moderately (but nonsignificantly) higher risk for COVID-19 compared with individuals in low-risk zones.

Shen et al. (Sept 1, 2020). Community Outbreak Investigation of SARS-CoV-2 Transmission Among Bus Riders in Eastern China. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2020.5225

• Inadequate ventilation may promote aerosol transmission, as suggested by an outbreak in one of the wards of a Dutch nursing home that was recently renovated with a ventilation system that only circulates outside air when the indoor CO2 concentration is below a certain concentration. Over 6 days, this ward reported 17 (81%) residents and 17 (50%) mask-equipped healthcare workers were positive for COVID-19, while all 106 healthcare workers and 95 residents of the other 6 wards that were ventilated with outside air tested negative (compared to a national weekly prevalence of 0.8%).

de Man et al. (Aug 28, 2020). Outbreak of COVID-19 in a Nursing Home Associated with Aerosol Transmission as a Result of Inadequate Ventilation. Clinical Infectious Diseases. https://doi.org/10.1093/cid/ciaa1270

• Results from an analysis of electronic health record data from a multi-state network of community health centers found that 2% of patients underwent SARS-CoV-2 testing, of whom 28% were positive. There was a higher SARS-CoV-2 testing rate among new patients compared to established patients. Additionally, speaking Spanish, being Hispanic, being uninsured, and speaking a language other than English or Spanish were associated with higher rates of positive test results, suggesting the need for targeted, language-concordant test strategies.

Heintzman et al. (Aug 31, 2020). SARS-CoV-2 Testing and Changes in Primary Care Services in a Multistate Network of Community Health Centers During the COVID-19 Pandemic. JAMA. https://doi.org/10.1001/jama.2020.15891

• Enforced home confinement due to the COVID-19 pandemic has been linked to psychosocial strain on people worldwide, with participants of a 7-language online survey (n=1,047) reporting that home confinement has triggered large decreases in social activity through family (-58%), friend/neighbors (-44%), or entertainment (-47%), as well as a 31% decrease in life satisfaction. Conversely, participants report being 25% more socially connected through digital technologies.

Ammar et al. (Aug 27, 2020). COVID-19 Home Confinement Negatively Impacts Social Participation and Life Satisfaction: A Worldwide Multicenter Study. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph17176237

• [Pre-print, not peer reviewed] A modeling study indicates that phased reopening of college campuses (one-third of student population returning to campus each month) coupled with pre-arrival SARS-CoV-2 testing would reduce peak of daily infections compared to pre-arrival testing without phased reopening or no intervention at all. Phased reopening with pre-arrival testing could reduce the peak of daily infections by up to 18% under highly effective mitigation strategies (R_t = 1.25) and by up to 64% at higher R_t

Rennert et al. (Aug 31, 2020). The Urgent Need for Phased University Reopenings to Mitigate the Spread of COVID-19 and Conserve Institutional Resources A Modeling Study. Pre-print downloaded Sep 1 from https://doi.org/10.1101/2020.08.25.20182030

• [Pre-print, not peer reviewed] A survey of Michigan Medicine biorepository participants (n=8,407, 133 COVID-19 cases) found that risk factors for COVID-19 included African American race (6% of African American participants reported COVID-19 vs 2% for  White participants), younger age (51 years among participants reporting COVID-19 vs 59 among participants not reporting COVID-19), and being an essential employee (45% vs 19%). African American participants were more likely than White participants to report being an essential worker. Self-reported precautions taken to avoid COVID-19 did not differ significantly by race.

Wu et al. (Aug 31, 2020). Exposure and Risk Factors for COVID-19 and the Impact of Staying Home on Michigan Residents. Pre-print downloaded Sep 1 from https://doi.org/10.1101/2020.08.25.20181800

• While electronic health record data from a New York university healthcare system (n=140,184) showed that the proportion of Black patients using telemedicine for urgent care increased from 2019 to 2020, Black patients were less likely than white patients to accessing care through telemedicine. The increase in utilization of telemedicine among Black patients was predominantly among women age 20-45 years.

Chunara et al. (Aug 31, 2020). Telemedicine and Healthcare Disparities: A Cohort Study in a Large Healthcare System in New York City during COVID-19. Journal of the American Medical Informatics Association. https://doi.org/10.1093/jamia/ocaa217

• During the initial phase of the COVID-19 pandemic in Texas (April to May 2020), 47% of families (n=200) receiving routine pediatric care at federally qualified health centers screened positive for food insecurity, with 94% indicating this had begun or worsened during the pandemic. Both Hispanic ethnicity (< 0.001) and WIC participation (p = 0.03) were associated with greater levels of food insecurity.

Abrams et al. (June 22, 2020). High Level of Food Insecurity among Families with Children Seeking Routine Care at Federally Qualified Health Centers during the Coronavirus Disease 2019 Pandemic. The Journal of Pediatrics: X. https://doi.org/10.1016/j.ympdx.2020.100044