The impact of state paid sick leave policies on weekday workplace mobility during the COVID-19 pandemic.

OBJECTIVES: This study aimed to evaluate whether the Families First Coronavirus Response Act (FFCRA) modified the association between pre-existing state paid sick leave (PSL) and weekday workplace mobility between February 15 and July 7, 2020. STUDY DESIGN: This was a longitudinal, observational study. METHODS: The 50 US states and Washington, D.C., were divided into exposure groups based on the presence or absence of pre-existing state PSL policies. Derived from Google COVID-19 Community Mobility Reports, the outcome was measured as the daily percent change in weekday workplace mobility. Mixed-effects, interrupted time series regression was performed to evaluate weekday workplace mobility after the implementation of the FFCRA on April 1, 2020. RESULTS: States with pre-existing PSL policies exhibited a greater drop in mobility following the passage of the FFCRA (ß = -8.86, 95% confidence interval: -11.6, -6.10, P < 001). This remained significant after adjusting for state-level health, economic, and sociodemographic indicators (ß = -3.13, 95% confidence interval: -5.92, -0.34; P = .039). CONCLUSIONS: Pre-existing PSL policies were associated with a significant decline in weekday workplace mobility after the FFCRA, which may have influenced local health outcomes. The presence of pre-existing state policies may differentially influence the impact of federal legislation enacted during emergencies.

Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015.

OBJECTIVES: As of 1 November 2015, the Saudi Ministry of Health had reported 1273 cases of Middle East respiratory syndrome (MERS); among these cases, which included 9 outbreaks at several hospitals, 717 (56%) patients recovered, 14 (1%) remain hospitalised and 543 (43%) died. This study aimed to determine the epidemiological, demographic and clinical characteristics that distinguished cases of MERS contracted during outbreaks from those contracted sporadically (ie, non-outbreak) between 2012 and 2015 in Saudi Arabia. DESIGN: Data from the Saudi Ministry of Health of confirmed outbreak and non-outbreak cases of MERS coronavirus (CoV) infections from September 2012 through October 2015 were abstracted and analysed. Univariate and descriptive statistical analyses were conducted, and the time between disease onset and confirmation, onset and notification and onset and death were examined. RESULTS: A total of 1250 patients (aged 0-109 years; mean, 50.825 years) were reported infected with MERS-CoV. Approximately two-thirds of all MERS cases were diagnosed in men for outbreak and non-outbreak cases. Healthcare workers comprised 22% of all MERS cases for outbreak and non-outbreak cases. Nosocomial infections comprised one-third of all Saudi MERS cases; however, nosocomial infections occurred more frequently in outbreak than non-outbreak cases (p<0.001). Patients contracting MERS during an outbreak were significantly more likely to die of MERS (p<0.001). CONCLUSIONS: To date, nosocomial infections have fuelled MERS outbreaks. Given that the Kingdom of Saudi Arabia is a worldwide religious travel destination, localised outbreaks may have massive global implications and effective outbreak preventive measures are needed.

New digital technologies for the surveillance of infectious diseases at mass gathering events.

Outbreaks of infectious diseases at mass gatherings can strain the health system of the host region and pose a threat to local and global health. In addition to strengthening existing surveillance systems, most host nations also use novel technologies to assess disease risk and augment traditional surveillance approaches. We review novel approaches to disease surveillance using the Internet, mobile phone applications, and wireless sensor networks. These novel approaches to disease surveillance can result in prompt detection.

Immunocompetence of marginally nourished women on hormonal contraceptives.

PIP: The immunocompetence of 30 marginally malnourished, low-income women in Bangladesh who were receiving injectable contraceptives (either 150 mcg of medroxyprogesterone acetate or 200 mcg of norethisterone enanthate) for the 5th-17th time was compared to that among 20 controls who were not on any form of contraception. Study participants were randomly selected from attendees at the Mohammadpur Fertility Services and Training Center in Dhaka. There were no significant differences between subjects and controls in terms of rosette-forming lymphocytes; however, blast transformation of lymphocytes (expressed in terms of stimulation indices) was significantly lower (p0.001) among women receiving both types of injectables than among controls. Phytohemagglutinin-induced lymphocyte transformation, a measure of lymphocyte function, has been found to be reduced as well among oral contraceptive users in developed countries. The even more prominent effect of hormonal agents noted in this study most likely reflects the poorer nutritional status of the Bangladeshi women. The finding that the T cell lymphocyte population is unaffected in users of hormonal contraception, even given borderline nutritional status, is consistent with that of previous studies. Overall, these findings should alert family planning providers that, in marginally nourished women, steroidal contraceptives can cause a significant depression of cell-mediated immune status.^ieng