Background The Delta variant of SARS-CoV-2 is now the predominant variant worldwide. However, its transmission dynamics remain unclear. Methods We analyzed 405 local case-patients infected with the Delta variant of SARS-CoV-2 and temporal patterns of viral shedding identified between 22 June and 31 July 2021 in Daejeon, South Korea. Results Overall, 20% were presymptomatic at the time of epidemiological investigation. We identified six clustered outbreaks, and all were associated with indoor facilities. In 23 household contacts, the secondary attack rate was 63%. We estimated the mean serial interval as 3.26 days (95% credible interval, 2.92–3.60), and 15% (95% confidence interval, 13–18%) of cases seeded 80% of all local transmission. Analysis of the nasopharyngeal swab samples identified virus shedding from the presymptomatic patients, and the highest viral load was observed two days after symptom onset. Conclusions Our findings suggest that the Delta variant is highly transmissible in indoor settings and households. Rapid contact tracing, isolation of the asymptomatic contacts, strict adherence to public health measures, and increased uptake of COVID-19 vaccination including booster doses are needed to reduce the community transmission of the Delta variant.

No abstract

IMPORTANCE The incidence of invasive infections caused by group B Streptococcus (GBS) continues to increase in the United States. Although diabetes is a key risk factor for invasive GBS, the influence of long-term glycemic control is not well characterized; other risk factors and mortality rates associated with specific types of invasive GBS infections are unknown. OBJECTIVE To investigate risk factors and mortality rates associated with specific invasive GBS infectious syndromes.

Background We aim to describe the outcomes of Geriatric Emergency Room Innovations for Veterans (GERI‐VET), the first comprehensive Veterans Affairs Geriatric ED program. Methods In this prospective observational cohort study at an urban Veterans Affairs Medical Center ED, participants included Veterans aged 65 years and older treated in the ED from January 7, 2017 to February 29, 2020. Veterans with an Identification of Seniors At Risk (ISAR) score >2 were considered eligible for GERI‐VET, receiving geriatric screens and care coordination in addition to standard ED treatment. The control group included GERI‐VET eligible Veterans who did not receive GERI‐VET care. Propensity score matching was used to compare outcomes in the GERI‐VET group (N = 725) and a matched control group (n = 725). Key measures included ED resource utilization, outpatient referrals, ED admission, and 30‐day admission. Results In the ED, the GERI‐VET group received more consults to pharmacy (315 [43.4%] vs. 195 [26.9%], p < 0.001) and social work (399 [55.0%] vs. 132 [18.2%], p < 0.001). The GERI‐VET group had higher referral rates to Geriatrics (64 [17.7%] vs. 18 [5.8%], p < 0.001) and Home Based Primary Care (110 [30.4%] vs. 24 [7.8%], p < 0.001). Key outcome measures included lower rates of ED admission (363 [50.1%] vs. 417 [n = 57.5%], p = 0.003) and 30‐day hospital admission (412 [56.8%] vs. 464 [64.0%], p = 0.004) without increasing ED length of stay (5.4 ± 2.2 vs. 5.4 ± 2.6 h, p = 0.85) or 72‐h ED revisits (23 [3.2%] vs. 16 [2.2%], p = 0.25) in the GERI‐VET group. Conclusions A program designed to screen for geriatric syndromes and coordinate care among at‐risk older Veterans was associated with increased multidisciplinary resource utilization and reduced ED and 30‐day admissions without increasing ED length of stay or re‐visitation.