The COVID-19 Symptom to Isolation Cascade in a Latinx Community: A Call to Action.
The COVID-19 Symptom to Isolation Cascade in a Latinx Community: A Call to Action.
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DOI：
10.1093/ofid/ofab023
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发表时间：
2021-03
影响因子：
4.2
通讯作者：
Marquez C
中科院分区：
文献类型：
--
作者：
Rubio LA;Peng J;Rojas S;Rojas S;Crawford E;Black D;Jacobo J;Tulier-Laiwa V;Hoover CM;Martinez J;Jones D;Sachdev D;Cox C;Herrera E;Valencia R;Zurita KG;Chamie G;CLIAHUB Consortium;DeRisi J;Petersen M;Havlir DV;Marquez C
2019冠状病毒病（COVID-19）的快速诊断和感染者的隔离对于阻止向前传播至关重要，护理级联框架可以确定COVID-19应对中的差距。我们描述了在旧金山弗朗西斯科低收入拉丁裔社区服务的低屏障检测点，对严重急性呼吸道疾病冠状病毒2型（SARS-CoV-2）聚合酶链反应检测呈阳性的有症状者的COVID-19症状到隔离级联和障碍。级联中的步骤被定义为从症状发作到测试、测试到结果以及结果到自我隔离咨询的天数。我们检查了SARS-CoV-2循环阈值（Ct）值，以评估检测当天和错过隔离日期间感染的可能性。在145人中，97%是拉丁裔，81%的收入低于50 000美元。 从症状发作到隔离的中位时间（四分位距[IQR]）为7（5-10）天，隔离的中位时间（IQR）为3（0-6）天。83%的人有中度到高度的病毒（Ct <33），但到目前为止，23%的人已经脱离了隔离期。最长间隔为症状发作至检查（中位数[IQR]，4 [2-9]天）和检查至结果通知（中位数[IQR]，3 [2-4]天）。进入试验场是阻碍试验的最常见障碍，而粮食和收入损失是阻碍隔离的最常见障碍。到披露时，10天的隔离期已经过去了一半以上，超过五分之一的人在收到结果时可能已经在传染性窗口期之外。在受严重影响的社区，需要改善检测准入和周转时间，并支持隔离，以控制SARS-CoV-2的流行。
Rapid coronavirus disease 2019 (COVID-19) diagnosis and isolation of infectious persons are critical to stopping forward transmission, and the care cascade framework can identify gaps in the COVID-19 response. We described a COVID-19 symptom to isolation cascade and barriers among symptomatic persons who tested polymerase chain reaction positive for severe acute respiratory disease coronavirus 2 (SARS-CoV-2) at a low-barrier testing site serving a low-income Latinx community in San Francisco. Steps in the cascade are defined as days from symptom onset to test, test to result, and result to counseling on self-isolation. We examined SARS-CoV-2 cycle threshold (Ct) values to assess the likelihood of infectiousness on the day of testing and during missed isolation days. Among 145 persons, 97% were Latinx and 81% had an income of <$50 000. The median time from symptom onset to isolation (interquartile range [IQR]) was 7 (5–10) days, leaving a median (IQR) of 3 (0–6) days of isolation. Eighty-three percent had moderate to high levels of virus (Ct <33), but by disclosure 23% were out of their isolation period. The longest intervals were symptom onset to test (median [IQR], 4 [2–9] days) and test to results notification (median [IQR], 3 [2–4] days). Access to a test site was the most common barrier to testing, and food and income loss was the most common barrier to isolation. Over half of the 10-day isolation period passed by the time of disclosure, and over a fifth of people were likely outside the window of infectiousness by the time they received results. Improvements in test access and turnaround time, plus support for isolation, are needed for epidemic control of SARS-CoV-2 in highly impacted communities.
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影响因子：
6.4
作者：
Gil, Raul Macias;Marcelin, Jasmine R.;Piggott, Damani A.
通讯作者：
Piggott, Damani A.
影响因子：
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作者：
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影响因子：
11.8
作者：
Perera RAPM;Tso E;Tsang OTY;Tsang DNC;Fung K;Leung YWY;Chin AWH;Chu DKW;Cheng SMS;Poon LLM;Chuang VWM;Peiris M
通讯作者：
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影响因子：
3.7
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Kerkhoff AD;Sachdev D;Mizany S;Rojas S;Gandhi M;Peng J;Black D;Jones D;Rojas S;Jacobo J;Tulier-Laiwa V;Petersen M;Martinez J;Chamie G;Havlir DV;Marquez C
通讯作者：
Marquez C
影响因子：
11.8
作者：
Bullard, Jared;Dust, Kerry;Poliquin, Guillaume
通讯作者：
Poliquin, Guillaume