Clinical Characteristics and Transmission of COVID-19 in Children and Youths During 3 Waves of Outbreaks in Hong Kong

Question  What were the major sources of infection among children and youths with COVID-19 in Hong Kong in 2020?

Findings  In this cross-sectional study of 397 children and youths with COVID-19 in the first 3 waves of outbreaks in Hong Kong, in 2020, the largest group had no recent international travel, and nearly all individuals were reported to have other family members with COVID-19. Three students studying in the same school contracted COVID-19, and few children or youths with no recent international travel reported unknown contact histories.

Meaning  These findings suggest that households and not schools were the major route of transmission among children and youths with COVID-19 in Hong Kong.


Factors Associated With Access to and Timing of Coronavirus Testing Among US Adults After Onset of Febrile Illness

Question  How often do persons with new febrile illness access coronavirus testing and receive a test result within 7 days of illness onset?

Findings  In this cohort study, generally low rates of coronavirus testing were observed in 2679 participants reporting new onset of febrile illness. Although testing rates improved somewhat during the study period, timely coronavirus test results were sought and received by only 25.9% of newly febrile persons at the end of the study analysis period in late October 2020.

Meaning  Our results suggest systematic underuse of coronavirus testing in patients with febrile illness that may contribute to community transmission.

(J. Harris: Which is to say that we need to expand access to responsible Covid testing as we continue to immunize vulnerable folks, develop “herd immunity,” and re-immunize for mutants if and when it becomes necessary and possible to do so. We must test, trace, and track infectious cases. In our vast and diversified country, tracking will be a state and LOCAL responsibility, which means in backward or irresponsibly governed areas,  it won’t be done. We will survive, but I believe I’ll hang on to my masks.)


1. Fully Vaccinated Adults 65 and Older Are 94% Less Likely to Be Hospitalized with COVID-19 Both mRNA COVID-19 vaccines (Pfizer-BioNTech and Moderna) authorized and recommended in the United States protect against COVID-19-related hospitalization among adults 65 years and older, according to a new CDC assessment that finds fully vaccinated adults 65 years and older were 94% less likely to be hospitalized with COVID-19 than people of the same age who were not vaccinated. People 65 and older who were partially vaccinated were 64% less likely to be hospitalized with COVID-19 than people who were not vaccinated. People were considered “partially vaccinated” two weeks after their first dose of mRNA vaccine and “fully vaccinated” two weeks after their second dose. These are the first real-world findings in the United States confirming clinical trial data showing mRNA vaccines prevent severe COVID-19 illness. (CDC, 4/28/2021)

2. PRESS RELEASE: CMS Proposes to Enhance the Medical Workforce in Rural and Underserved Communities to Support COVID-19 Recovery and Beyond The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1752-P) for inpatient and long-term care hospitals that builds on the Biden Administration’s key priorities to close health care equity gaps and provide greater accessibility to care. Major provisions in the proposed rule would fund medical residency positions in hospitals in rural and underserved communities to address workforce shortages, and require hospitals to report COVID-19 vac

3. RESEARCH: Monitoring SARS-CoV-2 Circulation and Diversity through Community Wastewater Sequencing, the Netherlands and Belgium Wastewater-based epidemiology has been proposed as an addition to disease-based surveillance because virus is shed in the feces of ≈40% of infected persons. Researchers used next-generation sequencing of sewage samples to evaluate the diversity of SARS-CoV-2 at the community level in the Netherlands and Belgium. Phylogenetic analysis revealed the presence of the most prevalent clades (19A, 20A, and 20B) and clustering of sewage samples with clinical samples from the same region. They distinguished multiple clades within a single sewage sample by using low-frequency variant analysis. In addition, several novel mutations in the SARS-CoV-2 genome were detected. (CDC EID, May 2021)



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