Social Epidemiology of COVID-19

修改项目摘要/摘要部分 博士Richardson是一名传染病医生，拥有人类学博士学位，他正在成为埃博拉病毒和SARS-CoV-2等新兴传染病的临床和社会科学研究的年轻研究者。该K08奖项将为Richardson博士提供必要的支持，以实现以下目标：（1）在撒哈拉以南非洲地区开展COVID-19的临床和社会科学调查;（2）通过整合严格的人种学和流行病学证据，学习为新兴传染病设计更有效的遏制策略;（3）在2019年，我们将为您提供支持。（3）成为低收入环境中新发传染病的社会流行病学专家;（4）发展独立的临床研究事业。Richardson博士在临床传染病和人类学方面有很强的背景。这一职业发展奖将使他能够解决几个剩余的差距，具体到他的职业目标的培训。具体来说，他寻求在（1）流行病学和（2）生物统计学的高级培训，并将通过课程在哈佛公共卫生学院完成。为了进一步实现他的培训目标，Richardson博士组建了一个由以下人员组成的指导团队：主要导师：进行人类学全球健康研究的Paul Farmer博士和世界知名的社会流行病学专家Ichiro Kawachi博士;顾问：传染病传播动力学专家Megan Murray博士，利比里亚国家公共卫生研究所（NPHIL）主任Mosoka Fallah博士，Phyllis Kanki博士，他在西非有几十年的病毒学经验。导致COVID-19的新型冠状病毒于二零一九年十二月首次在中国湖北省报告。在随后的4个月里，疫情蔓延到世界上几乎每个国家。严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）的发病率表明，全球50 - 60%或更多的人口可能会被感染，因为它假设几乎所有人都是免疫学上的新手。尽管用于检测感染患者病毒的实时逆转录聚合酶链反应（RT-PCR）检测技术发展迅速，但关于SARS-CoV-2血清阳性率和传播动力学仍存在许多问题。这是因为许多感染病例虽然具有传染性，但仍然没有症状。此外，由于RT-PCR检测规模扩大缓慢，许多有症状的感染没有被发现。这些动态对医疗环境产生了最大的影响，因为医疗工作者是少数几个不能保持社交距离的人群之一。了解这些人群的发病率，对加强感染预防和控制，减少病毒的院内传播具有重要意义。在资源有限的环境中，这一点变得更加重要，因为很难获得最佳的PPE库存。在这种情况下，可能需要开发新的医疗保健互动策略。因此，本研究将通过血清监测（目标1）确定非洲卫生工作者在各种环境中无症状SARS-CoV-2感染的比例和发病率。它还将评估社会和流行病学因素在SARS-CoV-2感染中的作用（目标2）。这项研究将为群体免疫和SARS-CoV-2疫苗推广对未来大流行波的影响的纵向研究奠定基础。

Modified Project Summary/Abstract Section Dr. Richardson is an infectious disease physician with doctoral training in anthropology who is establishing himself as a young investigator in clinical and social scientific research of emerging infectious diseases such as Ebola virus and SARS-CoV-2. This K08 award will provide Dr. Richardson with the support necessary to accomplish the following goals: (1) to conduct clinical and social scientific investigations of COVID-19 in sub-Saharan Africa; (2) to learn to design more effective containment strategies for emerging infectious diseases by integrating rigorous ethnographic and epidemiological evidence; (3) to become an expert in the social epidemiology of emerging infectious diseases in low-income settings; and (4) to develop an independent clinical research career. Dr. Richardson has a strong background in clinical infectious diseases and anthropology. This career development award will enable him to address several remaining gaps in the training specific to his career goals. Specifically, he seeks advanced training in (1) epidemiology and (2) biostatistics and will accomplish through coursework at the Harvard School of Public Health. To further achieve his training goals, Dr. Richardson has assembled a mentoring team comprised of: Primary mentors: Dr. Paul Farmer, who conducts anthropological global health research, and Dr. Ichiro Kawachi, a world renown expert in social epidemiology; Advisers: Dr. Megan Murray, an expert in infectious disease transmission dynamics, Dr. Mosoka Fallah, Director of the National Public Health Institute of Liberia (NPHIL), and Dr. Phyllis Kanki, who has decades of virology experience in West Africa. The novel coronavirus which causes COVID-19 was first reported in Hubei Province, China in December 2019. In the ensuing 4 months, the outbreak spread to nearly every country in the world. The arrack rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) suggests that 50-60% or more of the global population may become infected as it assumed that nearly all are immunologically naïve. Despite the rapid development of real-time reverse transcription polymerase chain reaction (RT-PCR) testing for detection of virus in infected patients, many questions remain about SARS-CoV-2 seroprevalence and transmission dynamics. This is because many infected cases remain asymptomatic albeit contagious. Moreover, many symptomatic infections go undetected on account of the slow scale-up of RT-PCR testing. These dynamics have their greatest ramifications for healthcare settings, since healthcare workers are one of the few populations that cannot practice social distancing. It is important to know the attack rate in these groups in order to improve infection prevention and control and decrease nosocomial transmission of the virus. This becomes more important in resource-constrained settings, where optimal PPE stocks are difficult to come by. Novel strategies for healthcare interactions may need to be developed in such cases. Accordingly, this study will determine the proportion of asymptomatic SARS-CoV-2 infection and the attack rate amongst African healthcare workers in various settings through serosurveillance (Aim 1). It will also evaluate the role of social and epidemiologic factors in the acquisition of SARS-CoV-2 infection (Aim 2). This research will form the basis for a longitudinal study of the impact of herd immunity and SARS-CoV-2 vaccine rollouts on future pandemic waves.