Public Health Measures and SARS-CoV-2 Cases in the Juvenile Justice System: Implications for Pandemic Response in the Detention Setting.

OBJECTIVE: The purpose of this study was to examine severe acute respiratory syndrome-coronavirus-2 case positivity in juvenile justice facilities of two different states alongside institutional, local, and state public health policies during the first 6 months of the coronavirus disease 2019 pandemic. METHODS: This retrospective chart review examined two large, urban juvenile justice centers in California and Texas. Positive intake or day 12 tests were considered suggestive of community-acquired severe acute respiratory syndrome-coronavirus-2 infection. Researchers examined state and county restrictions, closings, and openings. The study included all of the youths 10 to 18 years residing in the facilities between March and August 2020. The main outcomes measured case positivity in each facility and compared it with community positivity rates and state public health measures. RESULTS: In total, 530 youth were included (Texas, n = 319; California, n = 211). The Texas facility reported a higher number of positive cases (24) versus the California facility (3) (P < 0.05). Of the positive youth, 70% were asymptomatic, and none required hospitalization. Intake and day 12 tests were positive in <1% of California youth compared with a rate of 4% in Texas (P < 0.05). California and Texas instituted mask mandates in May and July 2020, respectively. California restricted indoor capacity until August, but Texas varied from 25% to 75% capacity through July. CONCLUSIONS: The Texas facility reported a higher percentage of community-acquired infections compared with California, coinciding with reopening measures in Texas. Texas also enacted a mask mandate later than California. These public health measures, among other factors, likely contributed to higher community rates in Texas, thereby affecting rates among the detained youth.

Juvenile Detention and Primary Care Utilization: Are They Related?

There is little information on the health care utilization habits of juvenile justice-involved youth. We evaluated whether health care utilization trends after discharge from a juvenile detention facility are associated with a decreased risk of future detention. A retrospective chart review was conducted for youth admitted to a juvenile detention facility from November 1, 2017, to October 31, 2018. Youth who accessed primary care (PC) appeared less likely to be readmitted to juvenile detention compared to those who did not access PC, with the greatest increase in readmissions occurring between days 30 and 60 and slowing after day 90. PC access and health care utilization may be associated with a decreased risk of future detention; however, additional research is needed to further explore this potential linkage.

Detecting Disease Transmission: Comparing SARS-CoV-2 Cases in a County Jail and the Surrounding Community.

Early detection of infectious disease transmission is an important public health tool. We sought to evaluate how positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases, identified within 14 days of admission to a jail setting, are linked to local county incidence. Data were extracted from the electronic health record and publicly accessible websites. We compared positive cases of SARS-CoV-2 identified in the Santa Clara County (SCC) jail within 14 days of admission (250 cases) with positive cases reported in SCC (141,841 cases) between March 15, 2020, and October 2, 2021. There was a strong, positive correlation between cases of SARS-CoV-2 identified within 14 days of jail admission and SCC cases the following week (r = .785). Our findings show that admission SARS-CoV-2 testing data from jails may be useful for detecting disease transmission in the surrounding community.

Mental healthcare for young and adolescent LGBTQ+ individuals in the Indian subcontinent.

The coronavirus disease (COVID-19) pandemic has led to a significant change in the way healthcare is dispensed. During the pandemic, healthcare inequities were experienced by various sections of society, based on gender, ethnicity, and socioeconomic status. The LGBTQ individuals were also affected by this inequity. There is a lack of information on this topic especially in the developing countries. Hence this issue requires further exploration and understanding. Previous literature briefly explored the mental, physical, and emotional turmoil faced by the LGBTQ community on a regular basis. They feared rejection by family and friends, bullying, physical assault, and religious biases. These issues prevented them from publicly speaking about their sexual orientation thereby making it difficult to collect reliable data. Although they require medical and psychological treatment, they are afraid to ask for help and access healthcare and mental health services. Being mindful of these difficulties, this article explores the various underlying causes of the mental health problems faced by LGBTQ individuals, especially, in the Indian subcontinent. The article also examines the status of healthcare services available to Indian sexual minorities and provides recommendations about possible remedial measures to ensure the well-being of LGBTQ individuals.

Factors associated with COVID-19 vaccine acceptance and hesitancy among residents of Northern California jails.

Carceral facilities are high-risk settings for COVID-19 transmission. Factors associated with COVID-19 vaccine acceptance and hesitancy among incarcerated individuals are poorly understood, especially among jail residents. Here, we conducted a retrospective review of electronic health record (EHR) data on COVID-19 vaccine uptake in custody and additionally administered a survey to assess reasons for vaccine hesitancy, sources of COVID-19 information, and medical mistrust among residents of four Northern California jails. We performed multivariate logistic regression to determine associations with vaccine acceptance. Of 2,564 jail residents offered a COVID-19 vaccine between March 19, 2021 and June 30, 2021, 1,441 (56.2%) accepted at least one dose. Among vaccinated residents, 497 (34.5%) had initially refused. Vaccine uptake was higher among older individuals, women, those with recent flu vaccination, and those living in shared housing. Among 509 survey respondents, leading reasons for vaccine hesitancy were concerns around side effects and suboptimal efficacy, with cost and the need for an annual booster being other hypothetical deterrents to vaccination. Vaccine hesitancy was also associated with mistrust of medical personnel in and out of jail, although this association varied by race/ethnicity. Television and friends/family were the most common and most trusted sources of COVID-19 information, respectively. Overall, vaccine acceptance was much lower among jail residents than the local and national general population. Interventions to increase vaccination rates in this setting should utilize accessible and trusted sources of information to address concerns about side effects and efficacy, while working to mitigate medical and institutional mistrust among residents.

COVID-19 and Psychological Disaster Preparedness - An Unmet Need.

OBJECTIVE: The coronavirus disease (COVID-19) pandemic is a disaster of unprecedented proportions with global repercussions. Psychological preparedness, the primed cognitive awareness and anticipation of dealing with emotional responses in an adverse situation, has assumed a compelling relevance during a health disaster of this magnitude. METHODS: An anonymized eSurvey was conducted in India to assess psychological preparedness toward the ongoing pandemic with a focus on knowledge, management of own and others' emotional response, and anticipatory coping mechanisms among the survey population. An adapted version of the qualitative Psychological Preparedness for Natural Disaster Scale validated by the World Health Organization was widely circulated over the Internet and various social media platforms for assessment. Results are expressed as median ± standard deviation. Descriptive statistics were used and figures downloaded from surveymonkey.com. RESULTS: Of the 1120 respondents (M:F 1.7:1, age 35 years ±14.1), most expressed a high level of perceived knowledge and confidence of managing COVID-19, such as awareness of the symptoms of the illness (95.1%), actions needed (94.4%), hospital to report to (88.9%), and emergency contact number (89.1%). A majority (95%) monitored regularly the news bulletins and scientific journals regarding COVID-19. However, nearly one-third (29.2%) could not assess their likelihood of developing COVID-19, and 17.5% were unaware of the difference between a mild and severe infection. Twenty-three percent (23.3%) were unfamiliar with the materials needed in an acute illness situation. CONCLUSION: Psychological disaster preparedness is reasonable, although lacking in specific domains. Timely but focused interventions can be a cost-efficient administrative exercise, which federal agencies may prioritize working on.