News Scan for Jun 21, 2021

COVID vaccination site deserts may affect rollout, study reveals

In Brooklyn, New York, communities with higher rates of poverty and minorities may have less access to COVID-19 vaccination sites, according to a JAMA Network Open research letter late last week.

The researchers looked at Brooklyn’s 18 communities and found 87 COVID-19 vaccination sites for its population of 2,604,747. A little over half of the people (51.7%) were Latino or Black, 52.6% were female, and the median age was 35.1 years.

In districts where the population was at least 40% White, there was a median of 6 vaccination sites—compared with 4 in districts where White people made up less than 40%. Additionally, of the 9 districts with the highest poverty levels, the median population density per square mile per site was 11,263.4; the 9 districts with lower poverty levels had to serve about half that number (6,793.6 persons per square mile per site). The researchers add that district 16 had the highest percentage of population below the poverty threshold (29.4%) but no vaccination sites.

“With many preliminary barriers to vaccination uptake, including supply issues, scheduling multiple doses, and a delay for scheduling appointments, vaccine rollout has been slow,” the researchers write. “Furthermore, early COVID-19 vaccination efforts in NYC have been focused primarily in White, middle-to-upper class neighborhoods, with the greatest access occurring in these areas. The analysis presented is generally suggestive of disparities in vaccination site access.”

The study does not report any direct data on Brooklyn COVID-19 vaccination rates, although the researchers say that, as of Mar 10, 2021, 19% of White people were at least partially vaccinated for COVID-19, compared with 9% of those of Black or Hispanic descent in New York City as a whole.
Jun 18 JAMA Netw Open study


Birthdays associated with more COVID-19 outbreaks

Birthdays—a potential indicator of small, informal social gatherings—were associated with COVID-19 case increases, according to a study today in JAMA Internal Medicine.

The researchers looked at nationwide data covering about 2.9 million households and 6.5 million people with private health insurance from Jan 1 to Nov 9, 2020, and found that households with a birthday up to 2 weeks prior were associated with increased positive diagnoses. The COVID-19 prevalence rate for birthday households was 8.6 more diagnoses per 10,000 individuals. Compared with households in the 90th percentile for COVID-19 cases, which had 27.8 cases per 10,000 individuals, this was still a 31% relative increase.

The data also showed that household birthdays were associated with 0.9 more diagnoses per 10,000 individuals for counties in at least the 80th percentile of COVID-19 cases. No differences were seen for milestone birthdays, county precipitation levels (which could have moved outdoor gatherings inside), county political leanings, or state shelter-in-place orders.

“For each decile of COVID-19 prevalence, the change in household COVID-19 infection rates was larger in magnitude for households with a child’s birthday than for households with an adult birthday,” the researchers add, noting that risk was probably unevenly distributed as many households may have followed COVID mitigations. “Thus, the 31% relative increase is likely to be disproportionately borne by a smaller number of households, implying that the increased relative risk associated with a single additional gathering could be considerably larger.”
Jun 21 JAMA Intern Med study


Guinea’s Ebola outbreak declared over after 4 months

Guinea’s health ministry on Jun 19 declared the end of the country’s Ebola outbreak, which lasted about 4 months and was the first since West Africa’s massive outbreak of 2014-2016.

The outbreak began on Feb 14 following a cluster of seven cases in the southeastern N’Zerekore prefecture, the same area near the border with Liberia and Sierra Leone where West Africa’s earlier outbreak began. Genomic sequencing revealed that the virus that fueled the new outbreak was very closely related to the Ebola virus that circulated in Guinea in 2014, raising the possibility that the source was a survivor of the earlier outbreak.

In a Jun 19 statement, the World Health Organization (WHO) said in-depth epidemiological investigation into the source of the outbreak hasn’t yet identified a conclusive hypothesis. The index patient wasn’t a known survivor but was at risk for contracting the virus.
The outbreak resulted in 23 cases, 16 confirmed and 7 probable. Twelve deaths were reported. Five of the patients were health workers, and one was a traditional healer.

By the end of May, 10,873 people were vaccinated, including 885 contacts and 2,779 frontline health workers.

The WHO said the detection of Ebola cases in Guinea isn’t surprising as the virus is endemic in some animal populations and can persist in certain body fluids of survivors. Though 42 days have passed since the last confirmed case tested negative for a second time, there’s still a chance of unrecognized transmission chains in the community based on surveillance difficulties in hard-to-reach outbreak areas. The agency also said COVID-19 activity and a recent yellow fever outbreak challenge Guinea’s ability to rapidly detect and respond to a new Ebola outbreak.
Jun 19 WHO statement


CDC bans imported dogs from high-risk nation after rabies variant detected

The US Centers for Disease Control and Prevention (CDC) has temporarily suspended the import of dogs from high-risk countries and recently launched a multistate investigation based on the detection of a rabies variant detected in a rescue dog from Azerbaijan.

The 1-year suspension will begin on Jul 14.

“The importation of just one dog infected with CRVV [canine rabies virus variants] risks re-introduction of the virus into the United States resulting in a potential public health risk with consequent monetary cost and potential loss of human and animal life,” said a notice from the Federal Register.

Until this detection, the United States had been free of CRVV since 2007. But CRVV are still in more than 120 countries. The dog in question, a 6-month-old mixed-breed puppy, was imported in a pack of 33 rescue dogs on Jun 10 that traveled through Chicago’s O’Hare Airport, according to the Washington Post. The dog was living in Pennsylvania and has since been euthanized.

At least 12 people were exposed to the dog, and other animals in that group are being kept in quarantine.

Rabies is one of the deadliest animal diseases in the world, causing an estimated 59,000 human deaths globally annually. The virus is transmitted through animal bites.
Jun 16 Federal Register
Jun 14 CDC notice, FAQs, and import changes
Jun 19 Washington Post

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