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During July 2021, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.617.2 variant infections, including vaccine breakthrough infections, occurred after large public gatherings in Provincetown, Massachusetts, USA, prompting a multistate investigation. Public health departments identified primary and secondary cases by using coronavirus disease surveillance data, case investigations, and contact tracing. A primary case was defined as SARS-CoV-2 detected < 14 days after travel to or residence in Provincetown during July 3–17. A secondary case was defined as SARS-CoV-2 detected < 14 days after close contact with a person who had a primary case but without travel to or residence in Provincetown during July 3–August 10. We identified 1,098 primary cases and 30 secondary cases associated with 26 primary cases among fully and non–fully vaccinated persons. Large gatherings can have widespread effects on SARS-CoV-2 transmission, and fully vaccinated persons should take precautions, such as masking, to prevent SARS-CoV-2 transmission, particularly during substantial or high transmission.

Objective A cancer diagnosis can prompt an examination and reevaluation of life’s meaning, purpose, and priorities. There is evidence that Mindfulness-Based Stress Reduction (MBSR) may help facilitate the meaning-making process. This study examined the influence of meaning in life on willingness to participate (WTP) in MBSR and identified factors associated with the search for and/or presence of meaning. Methods A cross-sectional survey study of 300 patients undergoing radiation therapy was conducted. WTP in MBSR was dichotomized into yes/no by asking: “Would you participate in an MBSR program if it was offered at the cancer center?” The search for, and the presence of, meaning were assessed using the Meaning in Life Questionnaire. Results Eighty patients (27%) indicated WTP in MBSR. In a multivariate logistic regression model, search for meaning was the only significant predictor of WTP in MBSR [AOR=1.04, p=<0.001, CI=1.01–1.08]. Identifying as non-white (Adj β = 4.62; 95% CI, 2.22 to 7.02; p < .001), and reporting subclinical (Adj β = 3.59; 95% CI, 0.84 to 6.34; p = .01) or clinical levels (Adj β = 5.52; 95% CI, 2.41 to 8.63; p = .001) of anxiety were the strongest predictors of search for meaning. Conclusion Our study indicates that patients searching for meaning are receptive to MBSR. Nonwhite patients and those experiencing high levels of anxiety are most likely to endorse a search for meaning. Future research is needed to understand how best to support patients who are searching for meaning and remove barriers to evidence-based programs like MBSR.

Background Rapid antigen tests (e.g., Abbott’s BinaxNOW) are cheaper and faster than nucleic acid amplification tests (e.g., real-time reverse transcription polymerase chain reaction [RT-PCR]) for SARS-CoV-2 infection, with variable reported sensitivity. A horse racetrack in California experienced a COVID-19 outbreak among staff and used BinaxNOW to supplement RT-PCR. Utility of BinaxNOW in detecting SARS-CoV-2 infection in a workplace outbreak was assessed. Methods Between November 25–December 22, 2020, anterior nasal swabs were collected from racetrack staff for six rounds of paired BinaxNOW and RT-PCR tests. BinaxNOW tests were interpreted according to manufacturer instructions. RT-PCR was performed at the state public health lab using the ThermoFisher TaqPath COVID-19 Combo Kit. Staff with positive results on either test were isolated and removed from subsequent testing. Viral cultures were attempted on specimens with cycle threshold (Ct) &lt; 30. Results Overall, 769 paired results from 342 staff were analyzed. Most were of Hispanic ethnicity (62.0%) and ages ranged from 18 to 92 years (median 52). BinaxNOW performance compared to RT-PCR (95% CI) was as follows: positive percent agreement (PPA) 43.3% (34.6%–52.4%); negative percent agreement (NPA) 100% (99.4%–100%); positive predictive value (PPV) 100% (93.5%–100%); negative predictive value 89.9% (87.5%–92.0%). Among 127 RT-PCR-positive specimens, those with paired BinaxNOW-positive results (n = 55) had a lower mean Ct value than those with paired BinaxNOW-negative results (n = 72) (17.8 vs. 28.5) (p &lt; 0.001). In dual positive pairs, median time from specimen collected to RT-PCR result reported was 4 days (range 1-6), compared to the 15-minute BinaxNOW reporting time. Of 100 Ct &lt; 30 specimens, 51 resulted in positive virus isolation, 45 (88.2%) of which were BinaxNOW-positive. Conclusion High NPA and PPV support immediate isolation of BinaxNOW-positive individuals, while low PPA supports confirmatory testing following BinaxNOW-negative results. BinaxNOW performed better in paired specimens with lower Ct value and positive viral cultures, which could suggest that among RT-PCR-positive specimens, those that are BinaxNOW-negative may be less likely to contain infectious virus than those that are BinaxNOW-positive. Disclosures David Seftel, M.D., M.D., M.B.A., Enable Biosciences, Inc (Board Member, Employee, Scientific Research Study Investigator, Shareholder)

R apid antigen tests, such as Abbott BinaxNOW (https://www.abbott.com) test kits, offer a less expensive and faster alternative to nucleic acid amplifi cation tests, such as real-time reverse transcription PCR (rRT-PCR), in the diagnosis of coronavirus disease (COVID-19) (1,2). Previous studies of BinaxNOW compared with rRT-PCR have demonstrated a high negative percent agreement (NPA) (99.4%-100%) but variable positive percent agreement (PPA) (52.5%-89.0%). Performance was better among symptomatic persons, specimens with cycle threshold (C t ) <30 (suggestive of higher viral loads), and specimens with positive viral cultures (3-8). These reports have focused on community testing sites and outbreaks in healthcare facilities.Throughout the pandemic, certain nonhealthcare occupational groups (e.g., meat and poultry processing workers) have experienced higher risk of contracting COVID-19; this higher risk is attributable to workplace hazards, such as lack of appropriate personal protective equipment, densely populated work areas, poorly ventilated workspaces, and prolonged close contact (9,10). These workplaces might benefi t from effective rapid antigen tests that enable employers to quickly identify persons infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for isolation and to guide contact tracing, thereby reducing workplace transmission. Despite the need for research on this topic, information on the performance of BinaxNOW in the setting of nonhealthcare workplace outbreaks is lacking.During October 20, 2020-January 15, 2021, a horse racetrack (the facility) in California, USA, experienced a COVID-19 outbreak among its 563 employees and independent contractor workers (hereafter collectively called facility staff). Nearly half (n = 278; 49.4%) of the staff lived onsite in facilityprovided housing, and many performed essential