Outbreak of SARS-CoV-2 in a teenage discotheque in Northern Ireland-November 2021.

OBJECTIVES: To report key findings associated with an outbreak of SARS-CoV-2 following a teenage disco in Northern Ireland. STUDY DESIGN: Observational case series. METHODS: A case was defined as an individual who attended the event with a positive SARS-CoV-2 result between 6th and 20th November 2021. Demographic and clinical information, including symptom status, date of onset and school attended, were recorded during contact tracing. Vaccination status was derived from the COVID-19 Vaccine Management System. Forty-five samples associated with the outbreak were sequenced as part of the NI Whole Genome Sequencing (WGS) programme. RESULTS: Only 2.4% (5/205) of cases received a COVID-19 vaccine more than 14 days before the event. 84.9% (174/205) had received no vaccine at the time of the event and 12.7% (26/205) had been vaccinated within 14 days, offering only limited disease protection. The AY4.2.2 lineage of two cases who attended the event after symptom onset was found in 69% of sequenced outbreak cases. CONCLUSIONS: This study demonstrates extensive COVID-19 transmission in largely unvaccinated teenagers in an indoor venue with limited social distancing, close social contact and mixing, limited ventilation and singing and shouting. Public Health authorities developing COVID-19 entertainment regulations should consider congregations of teenagers in these settings, especially if vaccination rates are low in this group or they are not eligible for vaccination at that time. Public communications should be developed to ensure young people with COVID-19 symptoms follow public guidance regarding self-isolation and in particular avoid indoor events with larger numbers.

Validation of a screening survey to assess local public health performance.

The study seeks to validate an abbreviated protocol for measuring local public health performance. Primary data were collected during 1993 on a series of indicators keyed to defined public health core functions and their associated practices. The data were obtained from responses provided by local health department directors and were reviewed for accuracy by respective state health department personnel. All local public health jurisdictions (370) in six states were surveyed with a screening protocol. A sample of 36 of these jurisdictions was then resurveyed by means of a full-length protocol using 84 different indicators of public health performance. Correlations between scores obtained from the screening survey and those from the reference survey were high for overall public health performance, for each of the three functions, and for some of the ten practices. A group of only four queries was shown to predict reliably the overall scores. Findings support the conclusion that public health practice can be defined, measured, and monitored. A proposed surveillance system is feasible.

A screening survey to assess local public health performance.

Current studies are attempting to develop a national surveillance system to measure the extent that populations are served by local departments carrying out the core functions of public health. Early phases of the study featured observations on 14 health departments that have been subjects of a longitudinal study. These departments were surveyed using a protocol with 81 different indicators. The results permitted distinctions to be made among the departments on levels of performance according to core functions and their associated practices. To simplify the survey protocol so that it might be suitable for use with a large number of local public health jurisdictions, a subset of 26 indicators was selected from the previously developed protocol. Each indicator in the subset was linked with one of the three core functions of public health and with one of the associated practices. In an effort to display correlation between scores on the simplified survey and those in the full survey, scatter plots were prepared for overall scores and for those pertaining to each function and practice. Stepwise regressions were done to determine which queries or groups of queries were most predictive of variations in the screening responses. Four questions accounted for 96 percent of the variance in responses for overall performance. Results suggest that a three-tiered approach to the evaluation of local public health performance might be feasible. For the study departments, responses to four questions could be used to screen overall public health performance; responses to 26 questions could be used to yield information about performance of each of the three core public health functions; and responses to 84 questions could be used to yield more detailed information about performance for each of 10 public health practices. Experience with a larger set of departments might revise the number and nature of the screening queries.

Chemical impairment in colleagues: perceptions of Western New York nurses.

The purpose of this study was to determine nurses' perceptions about substance abuse in professional colleagues, opinions about strategies for dealing with substance abuse, and knowledge about resources available for dealing with the problem of chemical impairment. Subjects included a convenience sample of 161 nurses from Western New York. Data were gathered by a questionnaire that included "The Perceptions of Nursing Impairment Inventory" and items regarding respondents' background characteristics, suspicions about alcohol and drug abuse in nurse colleagues, and knowledge about and use of peer assistance services available through District I of the New York State Nurses Association. The major outcome of the study was identification of a knowledge deficit on the extent of the substance abuse problem in nursing, ability to recognize an impaired colleague, and awareness of services available. These data substantiate the need for implementing educational programs to increase nurses' basic knowledge of, and sensitivity to, the problem of chemical dependency.

Implementation of the school nurse practitioner role: barriers and facilitators.

The purpose of this descriptive pilot study was to begin an exploration of the role determinants that facilitate or cause barriers to the implementation of the school nurse practitioner (SNP) role. Utilizing a two-step design, 16 SNPs from different school districts were surveyed to determine if their assignment included doing school physical exams. Thirteen indicated that they were functioning as SNPs. The three "no" districts were matched with three of the "yes" districts. An SNP, a school health administrator and a school physician from each district were interviewed individually using a structured questionnaire. The focus of the questions was on organizational structure of the school health services, indicators of administrative support for SNPs and the assigned function of the SNP. Responses were matched for the "yes" and "no" districts and for the three types of professionals. The major facilitator of SNP role implementation was if the idea had originated with the administrator or physician decision maker. Role change and boundary encroachment were the main barriers identified.

Parental expectations of school health services.

Parents, as consumers of health care for their children, have the opportunity to incorporate available school health services as part of their child's total health care. This study investigated whether parental expectations of school health services supported the role of health services in the school as part of a total health care delivery system. It also sought to establish differences in the level of parental expectations of school health services as they relate to family size, parental structure in the home, method of family medical payment and current mode of health care management. A three-part questionnaire was developed to elicit data about parental expectations of school health, family characteristics and current choice of health care. Data analysis showed that parents do expect and accept school health services to be a part of their child's total health care management. No significant relationship was found between parental expectations and family demographic factors or if the child's current health management was maintenance-oriented or crisis-oriented. The study suggests that opportunities for parental input into school health programming should be provided. Positive perceptions of school health services may be incorporated into program advocacy in the event of political and financial threats.