US emergency sick leave act reduced COVID-19 cases, study finds

The emergency sick leave provision of the Mar 18 bipartisan Families First Coronavirus Response Act (FFCRA) appears to have reduced the spread of the virus. A Health Affairs study yesterday found that states where workers could get up to 2 weeks of paid sick leave showed 417 fewer confirmed cases per day, or an average of 1 prevented case per day per 1,300 workers.

The lack of universal access to paid sick leave in the United States makes it an outlier among nations in Europe and the Americas. Twenty-seven percent of all US workers and more than half of food and accommodation industry workers are ineligible for paid sick leave. The emergency sick leave provision of the FFCRA is estimated to provide paid sick leave benefits to roughly half of the US workforce.

Previous studies of flu transmission showed higher rates of “presenteeism”—working sick with a contagious disease—among employees lacking paid sick leave. The study authors sought to evaluate whether FFCRA emergency sick-leave provisions reduced presenteeism and decreased the number of reported new COVID-19 cases in states where workers gained access to the benefit.

Using a variety of statistical models and controlling for state differences in testing and stay-at-home orders, the study authors found significant decreases in the number of reported new COVID-19 cases in states where workers gained paid sick leave as a result of FFCRA (376 to 495 fewer cases per day). The authors highlighted an average decrease of 56% in new cases per day, in line with previous studies showing a 40% reduction in influenza-like-illness with sick pay mandates.

“Although our findings suggest that the U.S. emergency sick leave provision was a highly effective policy tool to flatten the curve in the short-run, it only contains up to two weeks of paid sick leave and is set to expire at the end of 2020,” the study authors noted.

“If employees take their emergency sick leave as a precautionary measure or because they are quarantined for the standard time of two weeks, they obviously are unable to take paid sick leave again, which may force them to work sick and potentially spread the virus in the future,” the authors warned.
 Oct 15 Health Aff study

 

Rural residents, men, young people more mask-averse; mandates effective

A PLOS One study yesterday showed that gender, age, and location factor into voluntary mask-wearing, with females, older individuals, and urban or suburban residents more likely to comply. The study also demonstrated that mask mandates established in July and August brought mask-wearing to levels above 90% for all groups.

Masks have been shown to be effective in reducing the spread of COVID-19, but significant public resistance to mask-wearing exists. The observational study of 9,935 Wisconsin retail shoppers from June through August examined the demographics of mask wearers and resisters before and after the implementation of mask mandates.

In June, 41.5% of shoppers in grocery or big-box retail stores wore a mask, a figure less than half that demonstrated to significantly reduce the spread of COVID-19 (85%). Females wore masks more than males (45% versus 38%), and individuals older than age 65 were more likely to wear masks than middle-aged (ages 30 to 65) people (57% versus 41%) or younger (ages 2 to 30) people (37%).

The odds of observing someone in urban or suburban areas wearing a mask were around four times higher than in rural locations (urban odds ratio [OR], 3.847, 95% confidence interval [CI], 3.157 to 4.689; suburban OR, 4.124, 95% CI, 3.418 to 4.975).

Mask-wearing compliance increased from June to late July with the imposition of store mask mandates (93% compliance from Jul 22 to Jul 31). After the Aug 1 state mandate, researchers found mask-wearing compliance at 96% overall, with 2% of shoppers continuing to resist mask-wearing.

Higher rates of mask wearing among older people may reflect an awareness of the increased risk of severe COVID-19 in this group. The authors hypothesize that gender differences may reflect a perception of mask-wearing as a sign of fragility or weakness among some men, as suggested in previous studies. “In this case, public health messaging that focuses on aligning masks with masculinity would likely be beneficial to improve usage among males in the United States,” the authors noted.
Oct 15 PLOS One study

 

New polio cases in the Middle East and west Africa

Six countries—Afghanistan, Pakistan, Ivory Coast, Guinea, Mali, and Niger—confirmed 26 new polio cases in this week’s update from the Global Polio Eradication Initiative. This marks an increase from last week, when 18 cases were reported across Afghanistan, Chad, and Burkina Faso. (The latter did report a circulating vaccine-derived poliovirus type 2 acute flaccid paralysis case this week).

In Asia, Afghanistan had 1 more wild poliovirus type 1 (WPV1) case in Khost province, raising the country’s total for the year to 52 WPV1 cases, compared with last year’s 16. Pakistan confirmed 3 more WPV1 cases, with 1 in Balochistan province and 2 in Punjab province. The country now has 77 total WPV1 cases this year; in 2019, it had 72 WPV1 cases at this time and 147 cases overall.

In 2019, Ivory Coast, Guinea, and Mali all had no cases of polio, but this week’s report showed continued cases of circulating vaccine-derived poliovirus type 2 (cVDPV2). Ivory Coast had 4 new cVDPV2 cases, with 1 each in the provinces of Gbokle-Nawa-San-Pedro, Loh-Djiboua, Poro-Tchologo-Bagoue, and Tonkpi, raising the year’s total to 33. Guinea reported 11 cVDPV2 cases, which increased the year’s total by 61% to 29. Of the new cases, most are in Kankan (5) and N’zerekore (3) provinces. Mali had 4 new cases, with one each in Bamako and Mopti and 2 in Sikasso, making for 5 total in the year.

Also in Africa, Niger reported 3 new cases, with 1 each in the Dosso, Niamey, and Tahoua provinces. Compared with 1 cVDPV2 case last year, the country has had 7 thus far this year.
Oct 13 GEPI weekly report

 

CDC: Peach-linked Salmonella outbreak appears to be over

The Centers for Disease Control and Prevention (CDC) said today that a Salmonella Enteritidis outbreak linked to fresh peaches appears to be over, with 23 more illnesses and 5 more affected states noted in its final update on the investigation.

The new cases bring the outbreak’s overall total to 101 illnesses and the number of affected states to 17. Twenty eight people were hospitalized, and no deaths were reported.

The CDC first reported the outbreak in the middle of August. Illness onsets ranged from Jun 29 to Aug 27. Canada also reported 57 related illnesses from two provinces.

Investigators said the outbreak was likely linked to loose and bagged peaches packed or supplied by Prima Wawona or Wawona Packing Co. and sold at multiple grocery stores. The company recalled the products on Aug 22, and they are now past their shelf life.
Oct 16 CDC final outbreak notice
Oct 15 Public Health Agency of Canada
update

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