JAMA network open
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiology of coronavirus disease 2019 (COVID-19), is readily transmitted person to person. Optimal control of COVID-19 depends on directing resources and health messaging to mitigation efforts that are most likely to prevent transmission, but the relative importance of such measures has been disputed. ⋯ In this decision analytical model of multiple scenarios of proportions of asymptomatic individuals with COVID-19 and infectious periods, transmission from asymptomatic individuals was estimated to account for more than half of all transmissions. In addition to identification and isolation of persons with symptomatic COVID-19, effective control of spread will require reducing the risk of transmission from people with infection who do not have symptoms. These findings suggest that measures such as wearing masks, hand hygiene, social distancing, and strategic testing of people who are not ill will be foundational to slowing the spread of COVID-19 until safe and effective vaccines are available and widely used.
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Accurate racial/ethnic identity measurement is needed to understand the effectiveness of outreach, recruitment, and programs to support American Indian and Alaska Native (AIAN) people becoming physicians. ⋯ Changing the method of race/ethnicity data collection captured more AIAN applicants, matriculants, and graduates. Yearly trends indicate concerning although nonsignificant differences after the change for AIAN graduates. These findings should inform diversity efforts.
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Comparative Study
Association of Helicopter vs Ground Emergency Medical Transportation With 1-Year Mortality in Denmark.
Appropriate use of helicopter emergency medical service (HEMS) is important in ensuring that patients with critical illness or injury receive adequate treatment. ⋯ This study found that 1 year after dispatch, the use of HEMS, compared with the use of GEMS, was not associated with a statistically significant difference in mortality overall or mortality among patients with critical illness or injury. Further research is needed to determine whether optimized dispatch systems may be associated with further improvements in survival among selected patients.
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Descriptive data have revealed significant racial/ethnic disparities in coronavirus disease 2019 (COVID-19) cases in the US, but underlying mechanisms of disparities remain unknown. ⋯ In this cross-sectional study, a wide range of sociodemographic risk factors, including socioeconomic status, racial/ethnic minority status, household composition, and environmental factors, were significantly associated with COVID-19 incidence and mortality. To address inequities in the burden of the COVID-19 pandemic, these social vulnerabilities and their root causes must be addressed.
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Violence is a significant public health problem that has become entwined with the coronavirus disease 2019 (COVID-19) pandemic. ⋯ In this analysis of findings from the 2020 California Safety and Well-being Survey, the COVID-19 pandemic was associated with increases in self-reported worry about violence for oneself and others, increased firearm acquisition, and changes in firearm storage practices. Given the impulsive nature of many types of violence, short-term crisis interventions may be critical for reducing violence-related harm.