The COVID-19 Symptom to Isolation Cascade in a Latinx Community: A Call to Action

Abstract

Background Rapid COVID-19 diagnosis and isolation of infectious persons is critical to stopping forward transmission, and the care cascade framework can identify gaps in the COVID-19 response. Methods We described a COVID-19 symptom to isolation cascade and barriers among symptomatic persons who tested PCR positive for 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 thresholds (Ct) to assess likelihood of infectiousness on the day of testing and during missed isolation days. Results Among 145 persons, 97% were Latinx and 81% had an income of <$50,000. Median time from symptom onset to isolation was 7 days (IQR 5-10), leaving a median of 3 days (IQR 0-6) 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 (4, IQR 2-9) and test to results notification (3, IQR 2-4). Access to a test site was the most common barrier to testing, and food and income-loss for isolation. Conclusions 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 turn-around time, plus support for isolation, are needed for epidemic control of SARS-CoV-2 in highly impacted communities.

Association between Preferred Language and Risk of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children in the United States

“…14 Immigrant families frequently live in large, multigenerational households, increasing risk of transmission to vulnerable populations. 14,15 Lack of access to preventative services increases the risk of developing chronic conditions associated with poor outcomes from COVID-19. 6,14 Immigrants also lack adequate access to SARS-CoV-2 testing.…”

“…In the absence of a positive test, these individuals are less likely to quarantine, preventing control of the spread of COVID-19. 15 Finally, lack of access to language-concordant public health information may allow misinformation to spread and increase risk of virus transmission. 17 To address these issues, every effort should be made to conduct large-scale studies of the impact of language on the risk for SARS-CoV-2 infection.…”

A multi-component, community-based strategy to facilitate COVID-19 vaccine uptake among Latinx populations: from theory to practice

“…Unidos en Salud ("United in Health", UeS) is a community-academic-public health partnership founded in April 2020 to respond to and support the Latinx community in San Francisco during the COVID-19 pandemic. The partnership provides ongoing SARS-CoV-2 testing and surveillance [1,[15][16][17][18]. The partnership includes the San Francisco Latino Task Force on COVID-19 (LTF), the University of California, San Francisco (UCSF), the University of California, Berkeley, the Chan Zuckerberg Biohub, locally owned Bay Area Phlebotomy and Laboratory Services (BayPLS), Primary.Health, and the San Francisco Department of Public Health (SFDPH).…”

Psychometric Properties of a Vaccine Hesitancy Scale Adapted for COVID-19 Vaccination Among People with HIV

“…Vaccines are effective in stopping the spread of disease and prevent an estimated 2–3 million deaths each year [ 1 ]. However, there has been an increase in vaccine hesitancy on a national and global level prior to and during the phased roll out of the COVID-19 vaccine [ 2 – 4 ]. Vaccine hesitancy refers to a reluctance or refusal to get vaccinated despite available services [ 5 ].…”