Study: Homeless had lower incidence of COVID-19 than general population
A new study offers a complex picture of COVID-19 incidence among the US homeless population and illustrates the difficulty of tracking disease spread among this population. The study was published today in JAMA Network Open and found the incidence of the disease lower than among the general population.
The goal of the study was to compare the incidence of COVID-19 among homeless US populations compared to the general population from Jan 1, 2020 through Sep 30, 2021, before the advent of the Omicron variant. Investigators gathered data from surveys conducted in 25 states, districts, and territories, among which 18 states (72.0%) and 27 localities reported COVID-19 data among people who were experiencing homelessness (PEH.)
The authors found the annual incidence rate of COVID-19 among PEH at the state level was 567.9 per 10,000 person-years (95% confidence interval [CI], 560.5 to 575.4), compared with 715.0 per 10,000 person-years (95% CI, 714.5 to 715.5) in the general population.
At the local level, the incidence rate of COVID-19 among PEH was 799.2 per 10,000 person-years (95% CI, 765.5 to 834.0), compared with 812.5 per 10,000 person-years (95% CI, 810.7 to 814.3) in the general population.
The results contradict what is known about infectious diseases and homelessness—namely, that homeless populations are more at risk for disease. In a commentary on the study, Sarah Axelrath, MD, of the Colorado Coalition for the Homeless in Denver, said this is likely because the study was based on point-in-time estimates of homelessness, and because for every 1 PEH surveyed, there were likely 2 to 3 more not captured by the study methods.
"Ultimately, inconsistency between the findings of Meehan et al and experiences of public health and medical professionals on the ground illuminate the failures at the local, state, and national levels to adequately capture homelessness data within the existing public health data reporting systems," Axelrath concluded. "There is urgent need for improved coordination among public health jurisdictions to ensure consistency in definitions of homelessness."
Aug 18 JAMA Netw Open study
Aug 18 JAMA Netw Open commentary
WHO advisers recommend French COVID vaccine, second booster doses
Today the World Health Organization (WHO) Strategic Advisory Group of Experts on Immunization (SAGE) recommended Valneva's inactivated, whole-virus, adjuvanted COVID-19 vaccine for emergency use and also recommended second COVID vaccine boosters for some risk groups.
The Valneva vaccine, VLA2001, is built on a vero cell platform. On Jun 23 the European Medicines Agency approved it for sale in the European Union for adults 18 to 50 years old, the sixth vaccine to gain such authorization. The company is based in Saint-Herblain, France.
The booster recommendation applies to all nine COVID-19 vaccines that have received WHO emergency use listing as of Aug 11. It is aimed at those at a higher risk of serious disease, including older people, those with severe immune compromise, those with underlying conditions, pregnant women, and healthcare workers.
The SAGE experts said in their recommendations, "There is increasing evidence on the benefits of a second booster dose of COVID-19 vaccines in terms of restoring waning vaccine effectiveness (VE). The data mainly exist for mRNA vaccines with very limited data for other COVID-19 vaccines."
Aug 18 SAGE Valneva recommendations
Aug 18 SAGE booster recommendations
CDC investigating E coli O157 outbreak in Michigan, Ohio
The Centers for Disease Control and Prevention (CDC) said yesterday that it is helping investigators in Michigan and Ohio track down the source of an Escherichia coli O157:H7 outbreak.
The outbreak of Shiga toxin–producing E coli (STEC) has to date sickened 29 people in the two states, with 15 illnesses reported in Michigan and 14 in Ohio. Illnesses started on dates ranging from Jul 26 to Aug 6. The ages of the infected vary from 6 to 91 years.
Of the 17 people with information available, nine have been hospitalized, and no deaths have been reported. No food has been identified as the source of the outbreak, but state and local public health officials are interviewing people about foods they ate in the week prior to getting sick.
The CDC says the true number of sick people in the outbreak is likely higher, as both states have reported large increases in E coli infections. Public health officials are using the CDC's PulseNet, which manages a national database of DNA fingerprints from foodborne bacteria, to determine how many of those illnesses are related to the outbreak.
People with STEC infections experience severe stomach cramps, diarrhea (often bloody), and vomiting, with symptoms typically starting 3 to 4 days after ingesting the bacteria.
Aug 17 CDC press release
Aug 17 CDC investigation notice
