Descriptions of coronavirus disease 2019 (COVID-19) in the United States have been primarily targeted at hospitalized patients. Reports documenting exposures to SARS-CoV-2, the virus that causes COVID-19, have sometimes been described in network environments, such as meat and poultry processing plants [1] and long-term care facilities. [2] Understanding the individual behaviors and demographic characteristics of COVID-19 patients and the threat of a serious illness requiring hospitalization may indicate efforts to decrease transmission. From April 15 to May 24, 2020, telephone interviews were conducted with a random pattern of adults 18 years of age or older who tested positive for the polymer chain transcription reaction test (RT-PCR) for the outpatient and hospital SARS. CoV-2 at 11 U.S. college medical centers. In nine states. Respondents were touched 14 to 21 days after the SARS-CoV-2 screening test and were asked about their demographic characteristics, underlying chronic conditions, symptoms at the time of review, and possible exposures to SARS-CoV-2 in the 2 weeks prior to the onset of the disease (or the date of the checkup when they reported no symptoms at check-in). Of the 350 patients interviewed (271 [77%] outpatients and 79 [23%] hospitalized patients were older, most likely Hispanic and reported dyspnoea than outpatients. Fewer inpatients (39%, 20 out of 51) reported a return to fundamental physical condition between 14 and 21 days than outpatients (64%, 150 out of 233) (p -0.001). In general, approximately one part (46%) patients reported known close contact with a user with COVID-19 in the past 2 weeks. Most of the time, they were members of the family circle (45%), co-workers (34%). Approximately two-thirds (64%, 212 out of 333) of participants were employed; only 35 out of 209 (17%) they were able to telework. These effects highlight the need for detection, case research, contact studies, and isolation of inflamed Americans to control the transmission of transmission periods of the SARS-CoV-2 infection network. The need for improved measures to ensure some protection in the workplace, adding social distance and more widespread use of fabric face coverings. [3]
The Severe Disease Influenza Vaccine Effectiveness Network (IVY) is a collaboration of U.S. medical centers. They conduct vaccine efficacy studies and epidemiological studies on influenza, and have recently begun to conduct epidemiological studies on COVID-19. To explore the spectrum of diseases in physical care services and possible exposures to SARS-CoV-2 in communities following the publication of national social estrangement rules on March 16, 2020, [4] 11 university medical centers in nine states conducted telephone surveys of a sample. patients with positive RESULTS in the SARS-VOC-2 check from April 15 to May 24, 2020 (check the dates: March 31 to May 10, 2020). Medical centers submitted lists of other people inflamed with SARS-CoV-2 at Vanderbilt University and were aware of the location of the controls (intensive care unit [ICU], hospitalization of non-intensive care, emergency branch [DE] without admission to the meeting and other outpatient settings). To download a widely representative cohort, a variety of patients were performed using site-specific stratified random sampling through the verification site. The mean proportions sampled were 67% of inpatients and 53% outpatients. CDC staff phoned patients in periods of 14 to 21 days (97%) 28 to 35 days (3%) After verification, up to seven patient-consistent call attempts were made for each period-consistent. The interviews were conducted in English, Spanish, French, Creole, Portuguese, Arabic, Burmese and Somali. Respondents or their agents were asked to provide demographic and socioeconomic data on patients, clinical symptoms and symptoms at the control date, underlying chronic situations, and prospective exposures to SARS-CoV-2 in the 2 weeks prior to initiation of the disease (or 2 weeks prior to control). in patients who reported no symptoms). It was decided that this 14-day exposure consistent with the time period would surround the estimated incubation consistent with the COVID-19 period for the maximum of other people. [5] Patients who responded after 28 to 35 days were asked the same questions, with the exception of symptoms or symptoms at the time of verification, as the delay between the onset of symptoms and the date of the interview increased the threat of introducing a memory bias.
To compare responses between patients who gained hospital and outpatient checks, descriptive statistics were analyzed, using Wilcoxon’s sum-of-range verification for continuous variables and Fisher square or accurate chi verification for category variables. Patients with substitute or deceased sponsors were excluded because the main symptoms, medical situations and history of exposure were unknown. Statistical analyses were performed using Stata software (version 16; StataCorp).
At least one phone call was attempted for 798 randomly chosen patients, 309 inpatients [98 ICU and 211 non-USI] and 489 outpatients [144 emergencies and 345 non-emergencies]) at all 11 sites. Of these, 544 (68%) answered calls and 398 (50%) completed the interviews. Sixty-seven (8%) patients or agents refused, 37 (5%) they were unable to complete the interview due to a language barrier, 42 (5%) they asked for a withdrawal, but they may simply not be contacted in additional appeal attempts; Reportedly 20 (3%) died within 21 days of the check (nine respondents interviewed and 11 refused). A total of 48 interviews were excluded per delegation, leaving 350 out of 398 to analyze. *
Weekly morbidity and mortality report. 2020; (26): 841-846. © 2020 Centers for Disease Control and Prevention (CDC)
Patients with a substitute responder were more likely to have been hospitalized (83% vs. 23%) and be older (average age: 67 versus 43 years) than patients who responded for themselves.
Abbreviations: BMI – table mass index; COPD: chronic obstructive pulmonary disease; IQR: interval between removetiles; RT-PCR – opposite transcription – polymer chain reaction. Patient samples were taken from 11 college medical centers in nine states (University of Washington [Washington], Oregon University of Health and Science [Oregon], University of California, Los Angeles and Stanford University [California], Hennepin County Medical Center [Minnesota], Vanderbilt University [Tennessee], Ohio State University [Ohio], Wake Forest University [North Carolina], Montefiore Medical Center [New York], Beth Israel Deaconess Medical Center and Baystate Medical Center [Massachusetts]). Other non-Hispanics included two Americans who reported being Native Americans/Alaskans, 25 Asians, 3 local Hawaiians/other Pacific Islanders and another 18; five reported Asians and others for the race. Other racial teams were combined due to the small number of such teams compared to other racial/ethnic teams. Excluding 16 (5%) patients who did not answer questions about the underlying medical condition; for those who answered questions about the underlying situations, some respondents lacked knowledge of congestive center failure (one), obesity (3), rheumatological/autoimmune situations (one), neurological situations (one) and psychiatric situations (two); The denominators used to calculate the proportions of respondents with individual underlying fitness disorders excluded patients for which knowledge about the disease was lacking. Unknown for 17 (14 outpatients and 3 inpatients); among those who had used tobacco products in the past, it was not indicated whether they had done so lately. Unknown for 19 (16 outpatients and 3 inpatients).
Abbreviations: IQR – interquartile interval; N/A – no object. Patient samples were taken from 11 college medical centers in nine states (University of Washington [Washington], Oregon University of Health and Science [Oregon], University of California, Los Angeles and Stanford University [California], Hennepin County Medical Center [Minnesota], Vanderbilt University [Tennessee], Ohio State University [Ohio], Wake Forest University [North Carolina], Montefiore Medical Center [New York], Beth Israel Deaconess Medical Center and Baystate Medical Center [Massachusetts]). Of 350 patients who tested positive for SARS-CoV-2 and responded, 19 (5%) who reported a positive test result for SARS-CoV-2 prior to the existing checkup (10 outpatients and nine inpatients) were excluded. Another 15 (4%) were excluded who did not answer questions about symptoms the call 14 to 21 days after verification (five) or who did not answer the follow-up call until 28 to 35 days after verification, which did not arrive. with symptom questions (10). 4% (10 out of 250) of outpatients without symptoms were monitored due to a position requirement (four), being in close contact with a patient with COVID-19 (three), a requirement prior to scheduled surgery (two) and voluntarily verified due to complex problems. underlying age and medical situations (one); 21% (14 out of 66) of hospitalized patients who reported no symptoms checked their hospitalization for independent reasons, adding up six pregnant women hospitalized by childbirth and 8 for other reasons. Among the 292 respondents who reported one or more symptoms, some did not know the individual symptoms: fever (one), shortness of breath (one), cough (three), chest pain (three), abdominal pain (four), nausea (three), vomiting (three), diarrhea (three), chills (two), pains (four), headache (five), confusion (six), fatigue (five), congestion (five), sore throat (five), loss of odor (six), loss of taste (seven); The denominators used to calculate the proportions of respondents with individual symptoms excluded patients who were unaware of the symptoms. Eight answers were missing about a return to fundamental fitness.
Abbreviations: COVID-19 – coronavirus disease 2019; IQR: interval between removetiles. Patient samples were taken from 11 college medical centers in nine states (University of Washington [Washington], Oregon University of Health and Science [Oregon], University of California at Los Angeles and Stanford University [California], Hennepin County Medical Center [Minnesota], Vanderbilt University [Tennessee], Ohio State University [Ohio], Wake Forest University [North Carolina], Montefiore Medical Center [New York]] Beth Israel Deaconess Medical Center and Baystate Medical Center [Massachusetts]). Exposures were activated 2 weeks before the onset of the disease or 2 weeks before the control of asymptomatic patients. Of the 350 patients who responded, 339 were included; 11 (3%) were excluded for not answering any of the exposure-related questions; for the individual exhibitions of the 339 respondents included, some respondents lacked knowledge of close contact with a user with a case of COVID-19 (seven), employment (six), outdoor paintings of the house (11), capacity of telepaints (three), paintings in a gym (one), average number of daily touches outdoors of the house (15), frequency of interaction with others outdoors of the house (23) Organize trips of grocery shopping (20) , attendance at meetings with 10 other people (six) and use of public transport (six); Denominators used to calculate the proportions of respondents with individual exposures or behaviors exclude patients whose exposure or knowledge of the behavior is missing. Other exhibits included in physical care services (18), service apartments (six), neighbors (two), clients in paintings (one), exposure to a correctional facility (one) and roommate in a long-term care center (one) ; Of 24 exposures in physical care services or assisted living services, 22 were reported among others who painted in a physical care facility.
Mark W.Tenforde, MD, PhD1, Erica Billig Rose, PhD1, Christopher J. Lindsell, PhD2, Nathan I. Shapiro, MD3, D. Clark Files, MD4, Kevin W. Gibbs, MD4, Matthew E. Prekker, MD five, Jay S. Steingrub, MD6, Howard A. Smithline, MD6, Michelle N. Gong, MD7, Michael S. Aboodi, MD7, Matthew C. Exline, MD8, Daniel J. Henning, MD9, Jennifer G. Wilson, MD10, Akram Khan, MD1 , Nida QadirArray MD12, William B. Stubblefield, MD2, Manish M. Patel, MD1, Wesley H. Self, MD2 and Leora R. Feldstein, PhD1; RESPONSE Team CDC COVID-19 1 CDC COVID-19 Response Team; 2 Vanderbilt University Medical Center, Nashville, Tennessee; 3 Beth Israel Deaconess Medical Center, Boston, Massachusetts; 4 Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina; five from Hennepin County Medical Center, Minneapolis, Minnesota; 6 Baystate Medical Center, Springfield, Massachusetts; 7Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York; 8 Ohio State University Wexner Medical Center, Columbus, Ohio; 9 University of Washington Medical Center, Seattle, Washington; 10 Stanford University Medical Center, Palo Alto, California; 11 Oregon Health – University of Science, Portland, Oregon; 12UCLA Medical Center, Los Angeles, California.
Correspondent Mark W. Tenforde, [email protected].
All authors completed and submitted the International Committee of Medical Journal Editors’ form for the dissemination of potential conflicts of interest. Daniel J. Henning reports a Baxter grant and a cytoVale consulting fee. Akram Khan reports grants from United Therapeutics, Actcelion Pharmaceuticals, Regneron and Reata Pharmaceuticals. Christopher J. Lindsell reports on grants from the NIH, DoD, Marcus Foundation and knowledge coordination and research contracts with Entergrion, Endpoint Health and BioMerieux. Courtney N. Sciarratta reports on a cooperation agreement between the CDC and the Institute of Public Health. No other possible conflicts of interest were revealed.
CDC COVID-19 Response Team Ahmed M. Kassem, MBBCh, PhD, CDC; Courtney N. Sciarratta, MPH, CDC Institute of Public Health /Global Health Research Fellowship; Nicole Dzuris, MSPH, CDC; Paula L. Marcet, PhD, CDC; Akshita Siddula, MSPH, CDC; Eric P. Griggs, MPH, Oak Ridge Institute of Science and Education; Emily R. Smith, MPH, Oak Ridge Institute of Science and Education; Constance E. Ogokeh, MPH, Oak Ridge Institute of Science and Education; Michael Wu, MSc, Oak Ridge Institute of Science and Education; Sara S. Kim, MPH, Oak Ridge Institute of Science and Education.
What do we already know about this issue?
Exposures to SARS-CoV-2 have sometimes been described in collective contexts than in broader network contexts.
What does this add?
In a multi-state telephone survey of 350 inpatient and outpatient adult patients who tested positive for SARS-CoV-2 infection, only 46% reported having had recent contact with a COVID-19 patient. Most of the participants’ contacts were a member of the family circle (45%) or a co-worker (34%). Two-thirds of the participants were employed; only 17% were for telework.
What are the implications for public practice?
Case investigation, contact search and isolation of inflamed people are to prevent continuous transmission of the network, given the common lack of known contact. Improved measures are warranted to ensure some protection in the workplace, adding social distance and more widespread use of fabric face coverings.
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