New papers show wastewater’s predictive value: This week, I noted three recently-published papers that all demonstrate wastewater surveillance’s value for flagging changes in COVID-19 trends before other metrics, such as hospitalizations. One paper, in Nature, found that wastewater trends preempted hospitalization trends by one to four weeks, in 150 U.S. counties. Another paper, in JAMA Network Open, found that wastewater trends tracked with case trends in 268 U.S. counties from January through September 2022; however, the correlation became weaker with reduced clinical testing over time. And a third paper, in PNAS, shares an algorithm that can flag community-level COVID-19 surges before they show up in other metrics, using data from North Carolina’s wastewater surveillance.
Long COVID’s impact on employment: The Urban Institute, a think tank focused on economic and social policy research, published a report exploring employment challenges and related hardships among people with Long COVID. The researchers (a group that included Lisa McCorkell from the Patient-Led Research Collaborative) analyzed results from Long COVID questions included in an Urban Institute survey, conducted among more than 7,500 American adults across the country in December 2022. Among the findings: 10% of adults with Long COVID stopped working for a period due to their symptoms while another 5% reduced their work hours; 24% limited activities outside of work; 42% reported food insecurity in the last year; 20% reported difficulty paying their rent or mortgage.
Characterizing potential Long COVID phenotypes: Another Long COVID study from this week, published in The Lancet: a research consortium including several medical centers across Europe tracked patients over time, seeking to better understand different subtypes of the condition. The study included about 1,000 people with at least one Long COVID symptom, tracked over one year from their initial COVID-19 diagnosis. Researchers found four potential subtypes: one similar to ME/CFS (including fatigue and cognitive symptoms), one with respiratory symptoms, one with chronic pain, and one with changes to taste and smell. The researchers also noted some patient characteristics and aspects of acute illness that may contribute to increased risk of different subtypes.
Outdoor transmission at a night market: One more notable new paper: researchers at local health agencies in China’s Zhejiang province reported on coronavirus transmission at an outdoor night market, in Frontiers in Public Health. In one day at the night market, three infected visitors led to 131 secondary cases, the researchers found. Based on samples from both people at the market and surfaces, the researchers estimated that particles of an Omicron BA.5 strain could linger for over an hour and still be contagious. The study suggests that, even in outdoor settings, transmission is still possible when other precautions aren’t taken.
Acute Hospital at Home data: The Data Liberation Project, which collects and shares data from public records requests, recently published a dataset from a COVID-era program by the Centers for Medicare and Medicaid Services (CMS) which allowed hospitals to treat patients in their homes. Early this year, the project filed a FOIA request for data indicating which hospitals applied to participate in the program and how their patients fared. CMS completed the request in June, and DLP is working to process and understand the resulting data. If you’re interested in using the data, you can check out the documentation and sign up for updates.
Diagnosis challenges with alpha-gal syndrome: Finally, a bit of non-COVID public health news: the CDC recently released some data showing challenges with diagnosing alpha-gal syndrome—a disease transmitted by tick bites that leads to new allergies—despite recent increases in its spread. The CDC estimates that up to 450,000 people in the U.S. may have been impacted by this disease, potentially developing new allergies to meat and other animal products. Yet in one CDC study, the majority of health providers surveyed were not confident in their ability to diagnose the syndrome. This trend reflects similar challenges for other chronic diseases that might be new or unfamiliar to providers, such as Long COVID.