Studies today led by Centers for Disease Control and Prevention (CDC) investigators highlight US transmission patterns of COVID-19 and show that close contact with confirmed cases and eating out at restaurants were linked to an increased likelihood of contracting the novel virus, while children in three Utah daycare centers were more likely to spread the virus to household members than among each other.
Both studies were published in Morbidity and Mortality Weekly Report.
Exposure tied to restaurants, bars, close contacts
The first study looked at positive, symptomatic adults diagnosed as having COVID-19 at 11 US outpatient health facilities in July.
Patients were asked about mask use and possible community exposure activities (gatherings with 10 or more people in a home; shopping; dining at a restaurant; going to an office setting, salon, gym, bar/coffee shop, or church/religious gathering; or using public transportation) during the 14 days before illness onset. Patients were also asked about known contact with COVID-19 patients.
Among patients with COVID-19, 42% had close contact with confirmed cases in the 2 weeks prior to testing, compared with 4% among a control group of adults with negative tests. The researchers found adults with positive SARS-CoV-2 test results were almost twice as likely to have reported dining at a restaurant than those with negative SARS-CoV-2 test results.
"Participants with and without COVID-19 reported generally similar community exposures, with the exception of going to locations with on-site eating and drinking options," the authors said. Dining at a restaurant included indoor, patio, and outdoor seating.
"Reports of exposures in restaurants have been linked to air circulation. Direction, ventilation, and intensity of airflow might affect virus transmission, even if social distancing measures and mask use are implemented according to current guidance," the authors added. "Masks cannot be effectively worn while eating and drinking, whereas shopping and numerous other indoor activities do not preclude mask use."
When the researchers restricted their analysis to participants without known close contact with a person with confirmed COVID-19, case-patients were three to four times more likely to report dining at a restaurant or going to a bar or coffee shop than were control-participants.
Daycare outbreak dynamics
In the second study, researchers looked at transmission dynamics during outbreaks at three Utah childcare centers. During the outbreaks, 12 children contracted COVID-19, with transmission documented to at least 12 (26%) of 46 non-facility contacts (confirmed or probable cases), including household contacts.
One parent was hospitalized. The researchers noted transmission from two of three children with confirmed, asymptomatic COVID-19.
The study helps describe transmission patterns in children under the age of 10, the authors write. Most of the children who contracted the virus at childcare settings had no or mild symptoms, but transmission to adults was possible.
The authors conclude, "Testing of contacts of laboratory-confirmed COVID-19 cases in child care settings, including children who might not have symptoms, could improve control of transmission from child care attendees to family members."
Case counts worsen in college communities
Yesterday the United States reported 35,286 new COVID-19 cases and 907 deaths, according to the Johns Hopkins COVID-19 tracker. The US total is now 6,430,860, including 192,616 deaths.
According to USA Today, among the 25 US communities with the most active current outbreaks, 19 are college towns or communities, which have seen case counts climb in recent weeks as classes have resumed.
The New York Times maintains a college and university COVID-19 tracker, which shows that 1,190 colleges and universities have reported more than 88,000 cases since the pandemic began. Georgia, Texas, and Alabama have reported the most cases linked to universities.
Even in college towns where students are taking predominantly online courses, crowded bars and apartment complexes have become sites of outbreaks.
In related news, Florida Governor Ron DeSantis announced yesterday that after a summer surge of virus activity but a recent drop in emergency department visits, his state is ready to reopen indoor bars and restaurants at 50% capacity starting Monday.
PPE shortage; protecting workers
- US healthcare workers are still reporting a shortages of N95 respirators, the Associated Press said. One main cause is the lack of availability of meltblown textile, the dense mesh that filters out virus particles.
- Smithfield Foods failed to adequately protect workers from the coronavirus, the US Labor Department said yesterday. The company is fined $13,494, the maximum allowed by law.