Impact of a Firearm Safety Device Distribution Intervention on Storage Practices After an Emergent Mental Health Visit.

OBJECTIVE: To determine if providing firearm storage devices with training during clinical care improves safe storage practices in household members of children who present to a pediatric hospital with an emergent mental health complaint. METHODS: Prospective, pre-post study. Enrollment occurred in the emergency department or the inpatient psychiatric unit. Participants in the observation phase received usual care. Participants in the intervention phase were randomized to be offered a firearm storage device at either no or low ($5) cost and trained in its use. We surveyed participants at enrollment, 7, & 30 days post visit. Our primary outcome was triple-safe storage (TSS) - storing firearms unloaded, locked, and with ammunition stored and locked separately. RESULTS: About 256 participants enrolled. In the observation phase TSS increased from 21% (95% confidence interval [CI] 14%-30%) at baseline to 31% (95% CI 21%-42%) at 7 and 31% (95% CI 21%-43%) at 30 days. In the intervention phase, TSS increased from 32% (95% CI 25%-39%) at baseline to 56% (95% CI 48%-64%) at 7 and 56% (95% CI 47%-64%) at 30 days. Among those not practicing TSS at baseline, 7-day TSS was higher in the intervention (38%) versus the observation phase (14%, P = .001). CONCLUSIONS: Distribution and training in the use of firearm storage devices increased TSS in the study population, improves pediatric safety and should be part of the routine care of these high-risk patients.

Prevalence of Health Care and Hospital Worker SARS-CoV-2 IgG Antibody in a Pediatric Hospital.

OBJECTIVES: Asymptomatic transmission of coronavirus disease 2019 (COVID-19) in health care settings is not well understood. In this study, we aimed to determine the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) antibodies in health care and hospital workers (HCHWs) and assess how antibody levels change over time. METHODS: Cross-sectional study of employed HCHWs at a freestanding, urban pediatric tertiary care hospital. Employed HCHWs ≥18 years old who were asymptomatic and worked in clinical hospital locations were eligible to participate. Participants completed blood draws and surveys at baseline (between May 4, 2020, and June 2, 2020) and 2 months later (between July 6, 2020, and August 7, 2020). Surveys collected demographic information, SARS-CoV-2 exposures, and previous COVID-19 diagnosis. RESULTS: In total, 530 participants enrolled in and completed baseline study activities. The median age was 37 years (range 19-67 years); 86% identified as female, and 80% identified as white. Two months later, 481 (91%) HCHWs completed another survey and blood draw. Four of 5 (0.9%) seropositive subjects at baseline remained seropositive at 2 months, although 3 had decreasing IgG indices. Five (1.0%) seropositive individuals, including 4 who were previously seropositive and 1 newly seropositive, were detected 2 months later. History of positive SARS-CoV-2 polymerase chain reaction testing results (P < .001) and history of COVID-19 exposure (P < .001) were associated with presence of SARS-CoV-2 antibodies. CONCLUSIONS: SARS-CoV-2 antibodies were detected in 1% of HCHWs in an urban pediatric hospital in a city with moderate SARS-CoV-2 prevalence. Participants with a known previous COVID-19 diagnosis showed a decline or loss of IgG antibodies over 2 months. These results have implications for identifying those with previous exposure and for ongoing public health recommendations for ensuring workplace safety.