{"id":7648,"date":"2021-03-25T11:09:10","date_gmt":"2021-03-25T18:09:10","guid":{"rendered":"https:\/\/depts.washington.edu\/pandemicalliance\/?p=7648"},"modified":"2021-03-26T11:32:33","modified_gmt":"2021-03-26T18:32:33","slug":"covid-19-literature-situation-report-march-25-2021","status":"publish","type":"post","link":"https:\/\/depts.washington.edu\/pandemicalliance\/2021\/03\/25\/covid-19-literature-situation-report-march-25-2021\/","title":{"rendered":"COVID-19 Literature Situation Report March 25, 2021"},"content":{"rendered":"<p>The scientific literature on COVID-19 is rapidly evolving and these articles were selected for review based on their relevance to Washington State decision making around COVID-19 response efforts. Included in these Lit Reps are some manuscripts that have been made available online as pre-prints but have not yet undergone peer review. Please be aware of this when reviewing articles included in the Lit Reps.<\/p>\n<p><em>Today&#8217;s summary is based on a review of 909 articles (793 published, 116 in preprint)<\/em><\/p>\n<p><a href=\"https:\/\/depts.washington.edu\/pandemicalliance\/wordpress\/wp-content\/uploads\/2021\/03\/LitRep_20210325.pdf\">View the PDF version here.<\/a><\/p>\n<h2>Key Takeaways<\/h2>\n<ul>\n<li><b>Only 1% of over 14,000 nursing home residents in the UK who have received the first dose of either the Pfizer-BioNTech or Oxford-AstraZeneca vaccines reported a positive SARS-CoV-2 PCR test in an observational study from December 2020 to March 2021. 90% of infections occurred within 28 days of the first dose. <\/b><a href=\"https:\/\/doi.org\/10.1101\/2021.03.19.21253940\"><span style=\"font-weight: 400\">More<\/span><\/a><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400\"><b>Weekly incidence of COVID-19 among healthcare workers in a two-campus medical center in Jerusalem steadily declined after commencement of two-dose vaccinations with the Pfizer-BioNTech vaccine in December 2020. Decline in incidence occurred despite a surge of the B.1.1.7 variant (up to 80% of cases) within the community.<\/b> <a href=\"https:\/\/doi.org\/10.1056\/NEJMc2101951\"><span style=\"font-weight: 400\">More<\/span><\/a><\/li>\n<\/ul>\n<div id=\"uw-accordion-shortcode\">\n<h3>Article Summaries<\/h3>\n<div class=\"js-accordion\" data-accordion-prefix-classes=\"uw-accordion-shortcode\">\n<div class=\"js-accordion__panel\" >\n<h2 class=\"js-accordion__header\"><span style=\"font-weight: 400\">Non-Pharmaceutical Interventions<\/span><\/h2>\n<div class=\"su-posts su-posts-default-loop\">\n<div id=\"su-post-7652\" class=\"su-post\">\n<h5 class=\"su-post-title\">Risk for Fomite-Mediated Transmission of SARS-CoV-2 in Child Daycares, Schools, Nursing Homes, and Offices<\/h5>\n<p>\t\t\t\t<!-- \n\n\n\n\n\n\n\n\n\n\n\n<div class=\"su-post-meta\">\n\t\t\t\t\t: \t\t\t\t<\/div>\n\n\n\n\n\n\n\n\n\n\n\n --><\/p>\n<div class=\"su-post-excerpt\">\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">A transmission model suggests that hourly cleaning and disinfection alone could interrupt fomite transmission of SARS-CoV-2 in some office settings, but would not be sufficient for child daycares and schools and should be combined with measures to reduce viral shedding such as mask wearing. Model estimates show that sustained transmission may be possible based on frequency of fomite touching and fraction of surfaces susceptible to contamination, with R<\/span><span style=\"font-weight: 400\">0<\/span><span style=\"font-weight: 400\"> being as high as 25 in high-risk settings such as child daycares. Handwashing interventions had minimal impact on model results.<\/span><\/li>\n<\/ul>\n<p><i><span style=\"font-weight: 400\">Kraay et al.\u00a0(Apr 2021). Risk for Fomite-Mediated Transmission of SARS-CoV-2 in Child Daycares, Schools, Nursing Homes, and Offices. Emerging Infectious Diseases. <\/span><\/i><a href=\"https:\/\/doi.org\/10.3201\/eid2704.203631\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.3201\/eid2704.203631<\/span><\/a><\/p>\n<\/p>\n<\/div>\n<p>\t\t\t\t\t\t\t\t\t<!-- <a href=\"\" class=\"su-post-comments-link\"><\/a> --><\/p>\n<\/div>\n<div id=\"su-post-7650\" class=\"su-post\">\n<h5 class=\"su-post-title\">In-Person Schooling and COVID-19 Transmission in Canada\u2019s Three Largest Cities<\/h5>\n<p>\t\t\t\t<!-- \n\n\n\n\n\n\n\n\n\n\n\n<div class=\"su-post-meta\">\n\t\t\t\t\t: \t\t\t\t<\/div>\n\n\n\n\n\n\n\n\n\n\n\n --><\/p>\n<div class=\"su-post-excerpt\">\n<ul>\n<li style=\"font-weight: 400\"><i><span style=\"font-weight: 400\">[Pre-print, not peer-reviewed]<\/span><\/i><span style=\"font-weight: 400\"> Mandatory in-person instruction without universal mask mandates may contribute to increased community transmission of SARS-CoV-2, according to a comparative case study that examined weekly incidence among children ages 0-19 years in Canada&#8217;s three largest cities from August 2020 to January 2021. The highest incidence among children ages 0-19 years by the end of the study period was observed in Montreal, where mask mandates were delayed as late as January 2021 in elementary schools. Trends show that incidence among adults 30-49 years old were preceded by increases among school-aged children, suggesting in-person schooling may have contributed to community transmission. In contrast, no such patterns exist in Toronto and Calgary, where mask mandates were implemented at the beginning of the school year. <\/span><i><span style=\"font-weight: 400\">[EDITORIAL NOTE: Uncontrolled ecological comparisons such as this are limited in their ability to attribute differences in incidence between cities to a specific policy.]<\/span><\/i><\/li>\n<\/ul>\n<p><i><span style=\"font-weight: 400\">Bignami et al.\u00a0(Mar 23, 2021). In-Person Schooling and COVID-19 Transmission in Canada\u2019s Three Largest Cities. Pre-print downloaded Mar 25 from <\/span><\/i><a href=\"https:\/\/doi.org\/10.1101\/2021.03.21.21254064\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.1101\/2021.03.21.21254064<\/span><\/a><\/p>\n<\/p>\n<\/div>\n<p>\t\t\t\t\t\t\t\t\t<!-- <a href=\"\" class=\"su-post-comments-link\"><\/a> --><\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"js-accordion__panel\" >\n<h2 class=\"js-accordion__header\">Geographic Spread<\/h2>\n<div class=\"su-posts su-posts-default-loop\">\n<div id=\"su-post-7654\" class=\"su-post\">\n<h5 class=\"su-post-title\">Emergence of the E484K Mutation in SARS-CoV-2 Lineage B.1.1.220 in Upstate New York<\/h5>\n<p>\t\t\t\t<!-- \n\n\n\n\n\n\n\n\n\n\n\n<div class=\"su-post-meta\">\n\t\t\t\t\t: \t\t\t\t<\/div>\n\n\n\n\n\n\n\n\n\n\n\n --><\/p>\n<div class=\"su-post-excerpt\">\n<ul>\n<li style=\"font-weight: 400\"><i><span style=\"font-weight: 400\">[Pre-print, not peer-reviewed]<\/span><\/i><span style=\"font-weight: 400\"> A novel SARS-CoV-2 variant (assigned name B.1.1.220) was detected by ongoing surveillance in samples collected in early February in four patients in upstate New York. B.1.1.220 was characterized with the E484K substitution in the spike protein, also present in the B.1.351 variant that was first described in South Africa and the P.1 variant that was first described in Brazil, along with four other amino acid substitutions. A search of online databases identified 12 other B.1.1.220 samples, all of which were detected in New York since December 2020.<\/span><\/li>\n<\/ul>\n<p><i><span style=\"font-weight: 400\">Lesho et al.\u00a0(Mar 23, 2021). Emergence of the E484K Mutation in SARS-CoV-2 Lineage B.1.1.220 in Upstate New York. Pre-print downloaded Mar 25 from <\/span><\/i><a href=\"https:\/\/doi.org\/10.1101\/2021.03.11.21253231\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.1101\/2021.03.11.21253231<\/span><\/a><\/p>\n<\/p>\n<\/div>\n<p>\t\t\t\t\t\t\t\t\t<!-- <a href=\"\" class=\"su-post-comments-link\"><\/a> --><\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"js-accordion__panel\" >\n<h2 class=\"js-accordion__header\">Testing and Treatment<\/h2>\n<div class=\"su-posts su-posts-default-loop\">\n<div id=\"su-post-7658\" class=\"su-post\">\n<h5 class=\"su-post-title\">B.1.526 SARS-CoV-2 Variants Identified in New York City Are Neutralized by Vaccine-Elicited and Therapeutic Monoclonal Antibodies<\/h5>\n<p>\t\t\t\t<!-- \n\n\n\n\n\n\n\n\n\n\n\n<div class=\"su-post-meta\">\n\t\t\t\t\t: \t\t\t\t<\/div>\n\n\n\n\n\n\n\n\n\n\n\n --><\/p>\n<div class=\"su-post-excerpt\">\n<ul>\n<li style=\"font-weight: 400\"><i><span style=\"font-weight: 400\">[Pre-print, not peer-reviewed]<\/span><\/i><span style=\"font-weight: 400\"> Neutralizing activity elicited by prior SARS-CoV-2 infection, mRNA vaccines (Pfizer-BioNTech and Moderna), or the Regeneron monoclonal antibody cocktail (REGN10933 and REGN10987) were similar against the B.1.526 variant with the S477N mutation compared to the widely circulating strain with the D614G mutation. In contrast, similar to other E484K harboring variants, the B.1.526 variant with the E484K mutation reduced neutralizing titers of sera from convalescent and vaccinated individuals by nearly 4-fold. REGN10933 alone had a 12-fold reduction in neutralizing activity, but the combined Regeneron cocktail was able to neutralize the B.1.526 E484K variant. Both versions of the B.1.526 variant (S477N mutation and E484K mutation) were first identified in New York City in November 2020, and rapidly spread to account for 12% of detected genomes by mid-February 2021.<\/span><\/li>\n<\/ul>\n<p><i><span style=\"font-weight: 400\">Zhou et al.\u00a0(Mar 24, 2021). B.1.526 SARS-CoV-2 Variants Identified in New York City Are Neutralized by Vaccine-Elicited and Therapeutic Monoclonal Antibodies. Pre-print downloaded Mar 25 from <\/span><\/i><a href=\"https:\/\/doi.org\/10.1101\/2021.03.24.436620\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.1101\/2021.03.24.436620<\/span><\/a><\/p>\n<\/p>\n<\/div>\n<p>\t\t\t\t\t\t\t\t\t<!-- <a href=\"\" class=\"su-post-comments-link\"><\/a> --><\/p>\n<\/div>\n<div id=\"su-post-7656\" class=\"su-post\">\n<h5 class=\"su-post-title\">Detection of Mutations Associated with Variants of Concern Via High Throughput Sequencing of SARS-CoV-2 Isolated from NYC Wastewater<\/h5>\n<p>\t\t\t\t<!-- \n\n\n\n\n\n\n\n\n\n\n\n<div class=\"su-post-meta\">\n\t\t\t\t\t: \t\t\t\t<\/div>\n\n\n\n\n\n\n\n\n\n\n\n --><\/p>\n<div class=\"su-post-excerpt\">\n<ul>\n<li style=\"font-weight: 400\"><i><span style=\"font-weight: 400\">[Pre-print, not peer-reviewed]<\/span><\/i><span style=\"font-weight: 400\"> Genomic analysis of wastewater samples from New York City obtained from January to March 2021 found that the SARS-CoV-2 mutations occurring at the highest frequencies where associated with known variants of concern. Mutations occurring at high frequencies include L452R, present in the CAL.20C variant first described in California, E484K, present in the B.1.351 and P.1 variants first described in South Africa and Brazil, and N50Y1 present in the B.1.1.7 variant first described in the UK as well as the B.1.351 and P.1 variants.<\/span><\/li>\n<\/ul>\n<p><i><span style=\"font-weight: 400\">Smyth et al.\u00a0(Mar 23, 2021). Detection of Mutations Associated with Variants of Concern Via High Throughput Sequencing of SARS-CoV-2 Isolated from NYC Wastewater. Pre-print downloaded Mar 25 from <\/span><\/i><a href=\"https:\/\/doi.org\/10.1101\/2021.03.21.21253978\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.1101\/2021.03.21.21253978<\/span><\/a><\/p>\n<\/p>\n<\/div>\n<p>\t\t\t\t\t\t\t\t\t<!-- <a href=\"\" class=\"su-post-comments-link\"><\/a> --><\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"js-accordion__panel\" >\n<h2 class=\"js-accordion__header\">Vaccines and Immunity<\/h2>\n<div class=\"su-posts su-posts-default-loop\">\n<div id=\"su-post-7666\" class=\"su-post\">\n<h5 class=\"su-post-title\">Genomic Evidence of SARS-CoV-2 Reinfection Involving E484K Spike Mutation, Brazil<\/h5>\n<p>\t\t\t\t<!-- \n\n\n\n\n\n\n\n\n\n\n\n<div class=\"su-post-meta\">\n\t\t\t\t\t: \t\t\t\t<\/div>\n\n\n\n\n\n\n\n\n\n\n\n --><\/p>\n<div class=\"su-post-excerpt\">\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">SARS-CoV-2 reinfection with a variant harboring the E484K mutation (occurring in the P.2 variant) was confirmed by genome sequencing in a case study in Brazil. The primary infection occurred in May 2020 by a widely circulating variant B.1.1.33 without the E484K mutation, while the reinfection occurred 147 days later in October 2020. Findings from this case study corroborate experimental studies suggesting that variants containing the E484K mutation have the potential to escape neutralizing antibodies.<\/span><\/li>\n<\/ul>\n<p><i><span style=\"font-weight: 400\">Nonaka et al.\u00a0(Feb 19, 2021). Genomic Evidence of SARS-CoV-2 Reinfection Involving E484K Spike Mutation, Brazil. Emerging Infectious Diseases. <\/span><\/i><a href=\"https:\/\/wwwnc.cdc.gov\/eid\/article\/27\/5\/21-0191_article\"><span style=\"font-weight: 400\">https:\/\/wwwnc.cdc.gov\/eid\/article\/27\/5\/21-0191_article<\/span><\/a><\/p>\n<\/p>\n<\/div>\n<p>\t\t\t\t\t\t\t\t\t<!-- <a href=\"\" class=\"su-post-comments-link\"><\/a> --><\/p>\n<\/div>\n<div id=\"su-post-7664\" class=\"su-post\">\n<h5 class=\"su-post-title\">COVID-19 Infection Risk amongst 14104 Vaccinated Care Home Residents A National Observational Longitudinal Cohort Study in Wales United Kingdom December 2020 to March 2021<\/h5>\n<p>\t\t\t\t<!-- \n\n\n\n\n\n\n\n\n\n\n\n<div class=\"su-post-meta\">\n\t\t\t\t\t: \t\t\t\t<\/div>\n\n\n\n\n\n\n\n\n\n\n\n --><\/p>\n<div class=\"su-post-excerpt\">\n<ul>\n<li style=\"font-weight: 400\"><i><span style=\"font-weight: 400\">[Pre-print, not peer-reviewed]<\/span><\/i><span style=\"font-weight: 400\"> Only 1% of over 14,000 nursing home residents in the UK who have received the first dose of either the Pfizer-BioNTech or Oxford-AstraZeneca vaccines reported a positive SARS-CoV-2 PCR test in an observational study from December 2020 to March 2021. 90% of infections occurred within 28 days of the first dose. At 7 days post vaccination, those with prior infection had a 46% reduced hazard of a having a positive PCR. Those who received the Pfizer-BioNTech vaccine had a 3.8-fold higher hazard of having a positive test as compared to recipients of the Oxford-AstraZeneca vaccine. At 21 days post-vaccination, individuals with low or intermediate frailty (compared to high frailty) had 4.6- and 4.9-fold higher hazard of a positive PCR test, respectively.<\/span><\/li>\n<\/ul>\n<p><i><span style=\"font-weight: 400\">Hollinghurst et al.\u00a0(Mar 24, 2021). COVID-19 Infection Risk amongst 14104 Vaccinated Care Home Residents A National Observational Longitudinal Cohort Study in Wales United Kingdom December 2020 to March 2021. Pre-print downloaded Mar 25 from <\/span><\/i><a href=\"https:\/\/doi.org\/10.1101\/2021.03.19.21253940\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.1101\/2021.03.19.21253940<\/span><\/a><\/p>\n<\/p>\n<\/div>\n<p>\t\t\t\t\t\t\t\t\t<!-- <a href=\"\" class=\"su-post-comments-link\"><\/a> --><\/p>\n<\/div>\n<div id=\"su-post-7662\" class=\"su-post\">\n<h5 class=\"su-post-title\">Antibody Responses after a Single Dose of SARS-CoV-2 mRNA Vaccine<\/h5>\n<p>\t\t\t\t<!-- \n\n\n\n\n\n\n\n\n\n\n\n<div class=\"su-post-meta\">\n\t\t\t\t\t: \t\t\t\t<\/div>\n\n\n\n\n\n\n\n\n\n\n\n --><\/p>\n<div class=\"su-post-excerpt\">\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Among healthcare workers who received a single dose of the Pfizer-BioNTech vaccine, those who had SARS-CoV-2 infection 30-60 days prior to vaccination (n=36) had significantly higher antibody levels and higher levels of antibodies with neutralizing characteristics at 3 weeks post-vaccination than individuals with no prior infection (n=152). After the first vaccine dose, both previously infected and uninfected individuals\u2019 antibody titers were enhanced to all proteins (S1, S2, RBD) with the exception of the nucleocapsid protein, which is not a vaccine antigen. <\/span><i><span style=\"font-weight: 400\">[EDITORIAL NOTE: A pre-print version of this manuscript was summarized in this report on February 8, 2021.]<\/span><\/i><\/li>\n<\/ul>\n<p><i><span style=\"font-weight: 400\">Bradley et al.\u00a0(Mar 23, 2021). Antibody Responses after a Single Dose of SARS-CoV-2 mRNA Vaccine. New England Journal of Medicine. <\/span><\/i><a href=\"https:\/\/doi.org\/10.1056\/NEJMc2102051\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.1056\/NEJMc2102051<\/span><\/a><\/p>\n<\/p>\n<\/div>\n<p>\t\t\t\t\t\t\t\t\t<!-- <a href=\"\" class=\"su-post-comments-link\"><\/a> --><\/p>\n<\/div>\n<div id=\"su-post-7660\" class=\"su-post\">\n<h5 class=\"su-post-title\">BNT162b2 MRNA Covid-19 Vaccine Effectiveness among Health Care Workers<\/h5>\n<p>\t\t\t\t<!-- \n\n\n\n\n\n\n\n\n\n\n\n<div class=\"su-post-meta\">\n\t\t\t\t\t: \t\t\t\t<\/div>\n\n\n\n\n\n\n\n\n\n\n\n --><\/p>\n<div class=\"su-post-excerpt\">\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Weekly incidence of COVID-19 among healthcare workers (HCWs) in a two-campus medical center in Jerusalem steadily declined after commencement of two-dose vaccinations with the Pfizer-BioNTech vaccine in December 2020. Decline in incidence occurred despite a surge of the B.1.1.7 variant (up to 80% of cases) within the community.<\/span><\/li>\n<\/ul>\n<p><i><span style=\"font-weight: 400\">Benenson et al.\u00a0(Mar 23, 2021). BNT162b2 MRNA Covid-19 Vaccine Effectiveness among Health Care Workers. New England Journal of Medicine. <\/span><\/i><a href=\"https:\/\/doi.org\/10.1056\/NEJMc2101951\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.1056\/NEJMc2101951<\/span><\/a><\/p>\n<\/p>\n<\/div>\n<p>\t\t\t\t\t\t\t\t\t<!-- <a href=\"\" class=\"su-post-comments-link\"><\/a> --><\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"js-accordion__panel\" >\n<h2 class=\"js-accordion__header\">Mental Health and Personal Impact<\/h2>\n<div class=\"su-posts su-posts-default-loop\">\n<div id=\"su-post-7668\" class=\"su-post\">\n<h5 class=\"su-post-title\">Prevalence, Risk and Protective Factors Associated with Suicidal Ideation during the COVID-19 Pandemic in U.S. Military Veterans with Pre-Existing Psychiatric Conditions<\/h5>\n<p>\t\t\t\t<!-- \n\n\n\n\n\n\n\n\n\n\n\n<div class=\"su-post-meta\">\n\t\t\t\t\t: \t\t\t\t<\/div>\n\n\n\n\n\n\n\n\n\n\n\n --><\/p>\n<div class=\"su-post-excerpt\">\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">SARS-CoV-2 infection, pre-pandemic psychosocial difficulties, and increased severity in psychiatric symptoms were identified as risk factors for suicidal ideation (SI) among a cohort of veterans with pre-existing psychiatric conditions (n=661). 19% of veterans screened positive for SI during the pandemic, and these veterans had lower income, were more likely to have had SARS-CoV-2 infection, and reported greater financial and social stresses associated with COVID-19. Higher reported pre-pandemic purpose in life and higher income were associated with a lower likelihood of SI during the pandemic.<\/span><\/li>\n<\/ul>\n<p><i><span style=\"font-weight: 400\">Na et al.\u00a0(Mar 16, 2021). Prevalence, Risk and Protective Factors Associated with Suicidal Ideation during the COVID-19 Pandemic in U.S. Military Veterans with Pre-Existing Psychiatric Conditions. Journal of Psychiatric Research. <\/span><\/i><a href=\"https:\/\/doi.org\/10.1016\/j.jpsychires.2021.03.021\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.1016\/j.jpsychires.2021.03.021<\/span><\/a><\/p>\n<\/p>\n<\/div>\n<p>\t\t\t\t\t\t\t\t\t<!-- <a href=\"\" class=\"su-post-comments-link\"><\/a> --><\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"js-accordion__panel\" >\n<h2 class=\"js-accordion__header\">Public Health Policy and Practice<\/h2>\n<div class=\"su-posts su-posts-default-loop\">\n<div id=\"su-post-7672\" class=\"su-post\">\n<h5 class=\"su-post-title\">Continued Proportional Age Shift of Confirmed Positive COVID-19 Incidence over Time to Children and Young Adults: Washington State March\u2014August 2020<\/h5>\n<p>\t\t\t\t<!-- \n\n\n\n\n\n\n\n\n\n\n\n<div class=\"su-post-meta\">\n\t\t\t\t\t: \t\t\t\t<\/div>\n\n\n\n\n\n\n\n\n\n\n\n --><\/p>\n<div class=\"su-post-excerpt\">\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">The age distribution of confirmed COVID-19 cases in Washington State shifted from older age groups to young adults and children between March and August 2020, according to a longitudinal cohort analysis. From March to April, there was a 10% decline in cases among those age 60 years and older and a 20% increase among those age 0-19 and 20-39 years. By August, cases among people under 40 comprised an average of 60% of total cases, with ages 0-19 accounting for 19% of cases and ages 20-39 accounting for 42% of cases. Test positivity during this time shifted towards younger age groups despite less testing in these age groups and expanded testing among older age groups.<\/span><i><span style=\"font-weight: 400\"> [EDITORIAL NOTE: A pre-print version of this manuscript was summarized in this report on November 17, 2020.]<\/span><\/i><\/li>\n<\/ul>\n<p><i><span style=\"font-weight: 400\">Malmgren et al.\u00a0(Mar 24, 2021). Continued Proportional Age Shift of Confirmed Positive COVID-19 Incidence over Time to Children and Young Adults: Washington State March\u2014August 2020. PLOS ONE. <\/span><\/i><a href=\"https:\/\/doi.org\/10.1371\/journal.pone.0243042\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.1371\/journal.pone.0243042<\/span><\/a><\/p>\n<\/p>\n<\/div>\n<p>\t\t\t\t\t\t\t\t\t<!-- <a href=\"\" class=\"su-post-comments-link\"><\/a> --><\/p>\n<\/div>\n<div id=\"su-post-7670\" class=\"su-post\">\n<h5 class=\"su-post-title\">Counties with High COVID-19 Incidence and Relatively Large Racial and Ethnic Minority Populations \u2014 United States, April 1\u2013December 22, 2020<\/h5>\n<p>\t\t\t\t<!-- \n\n\n\n\n\n\n\n\n\n\n\n<div class=\"su-post-meta\">\n\t\t\t\t\t: \t\t\t\t<\/div>\n\n\n\n\n\n\n\n\n\n\n\n --><\/p>\n<div class=\"su-post-excerpt\">\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">US county-level data show that during April 2020 11% of counties (n=3,142) reported high 2-week COVID-19 incidence (&gt;100 new cases per 100,000 persons), which rose to 65% of counties in August, and 99% in December 2020. Counties whose percentages of racial and ethnic minority populations are larger than the respective national percentages were consistently overrepresented among high incidence counties in April (29% of counties with large percentages of Asian persons and 28% of counties with large percentages of Black persons) and in August (92% of counties with large percentages of Black persons and 75% of counties with large percentages of Hispanic persons).<\/span><\/li>\n<\/ul>\n<p><i><span style=\"font-weight: 400\">Lee et al.\u00a0(Mar 24, 2021). Counties with High COVID-19 Incidence and Relatively Large Racial and Ethnic Minority Populations \u2014 United States, April 1\u2013December 22, 2020. MMWR. <\/span><\/i><a href=\"https:\/\/doi.org\/10.15585\/mmwr.mm7013e1\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.15585\/mmwr.mm7013e1<\/span><\/a><\/p>\n<\/p>\n<\/div>\n<p>\t\t\t\t\t\t\t\t\t<!-- <a href=\"\" class=\"su-post-comments-link\"><\/a> --><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<h2>Other Resources and Commentaries<\/h2>\n<ul>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1056\/NEJMc2100362\"><span style=\"font-weight: 400\">New SARS-CoV-2 Variants \u2014 Clinical, Public Health, and Vaccine Implications<\/span><\/a><span style=\"font-weight: 400\"> \u2013 New England Journal of Medicine (Mar 24)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1371\/journal.pone.0249090\"><span style=\"font-weight: 400\">Magnitude of Asymptomatic COVID-19 Cases throughout the Course of Infection: A Systematic Review and Meta-Analysis<\/span><\/a><span style=\"font-weight: 400\"> \u2013 PloS One (Mar 23)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1016\/S0140-6736(21)00470-0\"><span style=\"font-weight: 400\">Rapid Identification and Tracking of SARS-CoV-2 Variants of Concern<\/span><\/a><span style=\"font-weight: 400\"> \u2013 The Lancet (Mar)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1136\/bmj.n771\"><span style=\"font-weight: 400\">Covid-19: Variants and Vaccination<\/span><\/a><span style=\"font-weight: 400\"> \u2013 BMJ (Mar 23)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1002\/14651858.CD013705.pub2\"><span style=\"font-weight: 400\">Rapid, Point-of-Care Antigen and Molecular-Based Tests for Diagnosis of SARS-CoV-2 Infection<\/span><\/a><span style=\"font-weight: 400\"> \u2013 The Cochrane Database of Systematic Reviews (Mar 24)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/wwwnc.cdc.gov\/eid\/article\/27\/5\/21-0050_article\"><span style=\"font-weight: 400\">Risk for International Importations of Variant SARS-CoV-2 Originating in the United Kingdom<\/span><\/a><span style=\"font-weight: 400\"> \u2013 Emerging Infectious Diseases (Mar 24)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1017\/dmp.2021.81\"><span style=\"font-weight: 400\">Discrimination and Bias in State Triage Protocols Towards Populations with Intellectual Disabilities During the COVID-19 Pandemic<\/span><\/a><span style=\"font-weight: 400\"> \u2013 Disaster Medicine and Public Health Preparedness (Mar 25)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1001\/jama.2021.3207\"><span style=\"font-weight: 400\">The Coronavirus Pandemic 1 Year On\u2014What Went Wrong<\/span><\/a><span style=\"font-weight: 400\"> \u2013 JAMA (Mar 23)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1101\/2021.03.23.21254185\"><span style=\"font-weight: 400\">Early Super-Spreader Events Are a Likely Determinant of Novel SARS-CoV-2 Variant Predominance<\/span><\/a><span style=\"font-weight: 400\"> \u2013 MedRxiv (Mar 24)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1080\/15563650.2021.1895202\"><span style=\"font-weight: 400\">Death by Hand Sanitizer: Syndemic Methanol Poisoning in the Age of COVID-19<\/span><\/a><span style=\"font-weight: 400\"> \u2013 Clinical Toxicology (Mar 23)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1136\/jech-2020-215055\"><span style=\"font-weight: 400\">Indigenous Peoples, Concentrated Disadvantage, and Income Inequality in New Mexico: A ZIP Code-Level Investigation of Spatially Varying Associations between Socioeconomic Disadvantages and Confirmed COVID-19 Cases<\/span><\/a><span style=\"font-weight: 400\"> \u2013 Journal of Epidemiology and Community Health (Mar 23)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1016\/j.vaccine.2021.03.015\"><span style=\"font-weight: 400\">Safety Monitoring of COVID-19 Vaccines \u2013 Lessons Learned from the 1976 National Influenza Immunization Program about Detecting Rare Vaccine-Related Severe Adverse Events in Emergency Mass-Vaccination Programs<\/span><\/a><span style=\"font-weight: 400\"> \u2013 Vaccine (Mar 20)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1016\/S0140-6736(21)00527-4\"><span style=\"font-weight: 400\">WHO International Standard for Anti-SARS-CoV-2 Immunoglobulin<\/span><\/a><span style=\"font-weight: 400\"> \u2013 The Lancet (Mar 23)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1111\/josh.13016\"><span style=\"font-weight: 400\">Our Children Are Not \u201cBehind\u201d Due to the COVID -19 Pandemic, but Our Institutional Response Might Be<\/span><\/a><span style=\"font-weight: 400\"> \u2013 Journal of School Health (Mar 22)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1001\/jamanetworkopen.2021.5344\"><span style=\"font-weight: 400\">Trends in Health Care Worker Intentions to Receive a COVID-19 Vaccine and Reasons for Hesitancy<\/span><\/a><span style=\"font-weight: 400\"> \u2013 JAMA Network Open (Mar 23)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1016\/S1474-4422(21)00059-4\"><span style=\"font-weight: 400\">Long COVID: Understanding the Neurological Effects<\/span><\/a><span style=\"font-weight: 400\"> \u2013 The Lancet Neurology (Apr 1)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.3201\/eid2704.204199\"><span style=\"font-weight: 400\">Stability of SARS-CoV-2 RNA in Nonsupplemented Saliva<\/span><\/a><span style=\"font-weight: 400\"> \u2013 Emerging Infectious Diseases (Mar 18)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1108\/IJPH-11-2020-0094\"><span style=\"font-weight: 400\">Incarcerated Individuals\u2019 Experiences of COVID-19 in the United States<\/span><\/a><span style=\"font-weight: 400\"> \u2013 International Journal of Prisoner Health (Mar 24)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1038\/s41598-021-85555-1\"><span style=\"font-weight: 400\">Vaccination Strategies against COVID-19 and the Diffusion of Anti-Vaccination Views<\/span><\/a><span style=\"font-weight: 400\"> \u2013 Scientific Reports (Mar 23)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1002\/hast.1235\"><span style=\"font-weight: 400\">Does a Public Health Crisis Justify More Research with Incarcerated People \u2013<\/span><\/a><span style=\"font-weight: 400\"> The Hastings Center Report (Mar 23)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1001\/jama.2021.3564\"><span style=\"font-weight: 400\">HHS Expands Number of People Who Can Vaccinate Against COVID-19<\/span><\/a><span style=\"font-weight: 400\"> \u2013 JAMA (Mar 23)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1001\/jama.2021.2955\"><span style=\"font-weight: 400\">Another Explanation for Why Cloth Masks Reduce COVID-19 Severity<\/span><\/a><span style=\"font-weight: 400\"> \u2013 JAMA (Mar 23)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33762541\/\"><span style=\"font-weight: 400\">College Students\u2019 Experiences of Race-Related Bias or Hatred in Their Lifetimes and COVID-19 Era<\/span><\/a><span style=\"font-weight: 400\"> \u2013 Journal of Public Health Management and Practice<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1016\/S2589-7500(21)00045-5\"><span style=\"font-weight: 400\">Digital Tools for Mental Health in a Crisis<\/span><\/a><span style=\"font-weight: 400\"> \u2013 The Lancet Digital Health (Apr 1)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33762539\/\"><span style=\"font-weight: 400\">Excess Mortality Associated With the COVID-19 Pandemic\u2014Los Angeles County, March-September 2020<\/span><\/a><span style=\"font-weight: 400\"> \u2013 Journal of Public Health Management and Practice<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1001\/jamanetworkopen.2021.2618\"><span style=\"font-weight: 400\">In-Person and Telehealth Ambulatory Contacts and Costs in a Large US Insured Cohort Before and During the COVID-19 Pandemic<\/span><\/a><span style=\"font-weight: 400\"> \u2013 JAMA Network Open (Mar 23)<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1056\/NEJMc2102153\"><span style=\"font-weight: 400\">Early Evidence of the Effect of SARS-CoV-2 Vaccine at One Medical Center.<\/span><\/a><span style=\"font-weight: 400\"> \u2013 New England Journal of Medicine (Mar 23)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/doi.org\/10.1016\/S0140-6736(21)00469-4\"><span style=\"font-weight: 400\">Guidelines Should Not Pool Evidence from Uncomplicated and Severe COVID-19<\/span><\/a><span style=\"font-weight: 400\"> \u2013 The Lancet (Mar 22)<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Only 1% of over 14,000 nursing home residents in the UK who have received the first dose of either the Pfizer-BioNTech or Oxford-AstraZeneca vaccines reported a positive SARS-CoV-2 PCR test in an observational study from December 2020 to March 2021. 90% of infections occurred within 28 days of the first dose.<\/p>\n<div><a class=\"more\" href=\"https:\/\/depts.washington.edu\/pandemicalliance\/2021\/03\/25\/counties-with-high-covid-19-incidence-and-relatively-large-racial-and-ethnic-minority-populations-united-states-april-1-december-22-2020\/\">Read more<\/a><\/div>\n","protected":false},"author":8,"featured_media":7675,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"categories":[5],"tags":[],"topic":[],"class_list":["post-7648","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-covid-19-literature-situation-report"],"_links":{"self":[{"href":"https:\/\/depts.washington.edu\/pandemicalliance\/wp-json\/wp\/v2\/posts\/7648","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/depts.washington.edu\/pandemicalliance\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/depts.washington.edu\/pandemicalliance\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/depts.washington.edu\/pandemicalliance\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/depts.washington.edu\/pandemicalliance\/wp-json\/wp\/v2\/comments?post=7648"}],"version-history":[{"count":2,"href":"https:\/\/depts.washington.edu\/pandemicalliance\/wp-json\/wp\/v2\/posts\/7648\/revisions"}],"predecessor-version":[{"id":7677,"href":"https:\/\/depts.washington.edu\/pandemicalliance\/wp-json\/wp\/v2\/posts\/7648\/revisions\/7677"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/depts.washington.edu\/pandemicalliance\/wp-json\/wp\/v2\/media\/7675"}],"wp:attachment":[{"href":"https:\/\/depts.washington.edu\/pandemicalliance\/wp-json\/wp\/v2\/media?parent=7648"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/depts.washington.edu\/pandemicalliance\/wp-json\/wp\/v2\/categories?post=7648"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/depts.washington.edu\/pandemicalliance\/wp-json\/wp\/v2\/tags?post=7648"},{"taxonomy":"topic","embeddable":true,"href":"https:\/\/depts.washington.edu\/pandemicalliance\/wp-json\/wp\/v2\/topic?post=7648"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}