The CDC says people who are fully vaccinated may get together with other fully vaccinated individuals in small groups without masks. USA TODAY
Consuelo Hermosillos 22-year-old granddaughter didnt want to get a COVID-19 vaccine.
The office worker at a special needs center was afraid the shot would prevent her from ever getting pregnant.
The mistrust didnt form out of thin air.
In 1973, Hermosillo, an immigrant from Mexico, worked a smallcatering business at home while her husband bartended and unloaded appliances at a department store. In November of that year, the 24-year-old went to a hospital for an emergency caesarian section to give birth to her third child.
The baby would be her last.
Hermosillo was sterilized without informed consent atthe Los Angeles County-University of Southern California Medical Center.
You better sign, or your baby is going to die, she said a nurse told her.
What does victory against the COVID-19 pandemic look like?USA TODAY's vaccine panel weighs in
Her signature is scribbled on aform allowing the procedure, but she doesnt remember signing, saying she was medicated. She didn't know she was sterilized until a doctor's appointment later when sheasked for birth control.
A whistleblower a residentphysician later let go by the hospital leaked that the practice occurred on many women. Hermosillo became one of 10 Mexican and Chicana plaintiffs in the landmark Madrigal v. Quilliganfederal class-action case, which grabbed headlines in the mid-1970s.The judge sided with Dr. Edward James Quilligan, and the women lost, but the case inspired legislation passed in 1979to abolish the practice in California.
The Los AngelesCounty Board of Supervisors issuedan apology in 2018 for the coerced sterilizations, but the women did not receive reparation money as victims did in other states, such as Virginia and North Carolina.
"As far as justice, they never received that," said Virginia Espino, who documentedthe women's stories as co-producer of a filmcalled "No Mas Bebs," ("No More Babies" in Spanish).
Consuelo Hermosillo says she was sterilized at a hospital without her knowledge.(Photo: Claudio Rocha)
Espino, a professor at the University of California, Los Angeles, and an expert in reproductive injustice, saidits unclear how many womenwere sterilized at the LAC-USC medical center. The lawyer for the women who brought the lawsuit estimated "hundreds.
Many didnt speak fluent English and didnt understand forms they signed, and in some cases, they werecoerced into signing.Many hadlabor complicationsand were told lies that they or their babies would die if they didn't sign.
Insidious sterilizations didnt occur inside that hospital only. Throughout the 20th century, about 20,000 women and men were sterilized in California alone under state eugenics policies, according to researchers, including University of Michigan professor Alexandra Minna Stern.The policies targeted patients ofstate-run asylums or group homes. A disproportionate number were Hispanic.
As COVID-19 vaccine rollout continues, hesitancy among vulnerable communities, including Hispanic people, is piqued and history is unearthed.
Experts and those within the communities say the skepticism partly stems from unethical medical practices that targeted people of color. Unwanted sterilizations didnt occur just in California among Mexican womenbut among Black women in the South, as well as Native American women.
'It's not a pretty picture': Why the lack of racial data around COVID-19 vaccines is 'massive barrier' to better distribution
From the 1930s through the 1970s, for example, about a third of the female population in Puerto Rico was sterilized under population control policies that coerced women into postpartum sterilization after their second child's birth,according to theUniversity of Wisconsin's Office of the Gender and Women's Studies Librarian annotated bibliography on the topic.
The first large-scale clinical trial for contraceptives involved Puerto Rican women: In 1956, the pills were tested on poor women inRio Pidras, a housing projectin San Juan,according to a historical review published in the Canadian Family Physician journal. The women didn't know they were experimental.
"Women who stepped forward to describe side effects of nausea, dizziness, headaches, and blood clots were discounted as unreliable historians,wrote Dr. Pamela Verma Liao and Dr. Janet Dollin. Theclinical trials involved pills with much higher hormone levelsthan today's contraceptives.
"Despite the substantial positive effect of the pill, its history is marked by a lack of consent, a lack of full disclosure, a lack of true informed choice, and a lack of clinically relevant research regarding risk," the authors said. "These are the pills cautionary tales."
Angelina Zayas, a pastor at Grace and Peace Community Church that servesChicago's majority-Hispanic Belmont Cragin enclave, says many Puerto Rican women in her community are afraid to take COVID-19 vaccines, citing memories of the sterilizations and experiments.
The biggest one is fear, saidZayas, who is Puerto Rican. That's something that they remember, which affects their judgment in getting the vaccination. They're like, Well, how can I trust?
Consuelo Hermosillo listens to a recording of her voice from a trial three decades ago.(Photo: Claudio Rocha)
History'scautionary tales didn't stop the injustices from happening again.
Allegations of unwanted hysterectomies performed on mostly Hispanic women at Georgia's Irwin Detention Center surfaced last year. From 2006 to 2010, more than 100 incarcerated women in California prisons, mostly Black and Latina,underwent hysterectomies without their consent. The Center for Investigative Reporting broke the news in 2013.
Researchers weren't surprised.
"If certain conditions are in place, and these are conditions that often include marginalized populations incarceral spaces, with little oversight of the authorities,those types of conditions can be ripe for sterilization abuse,"said Stern, author of the book "Eugenic Nation: Faults and Frontiers of Better Breeding in Modern America."
Essential health care: For the most vulnerable Americans, these clinics are trusted, accessible and vital to vaccine rollout
We are still very much living with ... eugenic ideas of worth, she said. Who is worthy of having children, and who is worthy of raising children? Those are very much eugenic ideas that are alive and well, and they affect policy and harm certain people.
Under these policies, from 1907 through the 1970s,about 60,000 people underwent compulsory sterilizations nationwide.
Stern is studying a dataset of 30,000 sterilization records. She found thatLatina patients in California were 59% more likely to be sterilized than non-Latinas. Hispanic men were 20% more likely to be sterilized than non-Hispanic men.
The disproportionate operations,Stern said, were rooted in a racist ideology that certain attributes criminal behavior, homosexuality, poor health, welfare usage or education levels were hereditary and could be minimized through preventing procreation.
An institutional evaluation of Andrea Garcia, 19, circa 1940, recommends sterilization.(Photo: BACKSTAGE LIBRARY WORKS/California state archives)
Andrea Garcia, 19, from a Mexican family, was sterilized after being admitted into Pacific Colony, a psychiatric institution, for what evaluators called"truancy" and a low IQ test score.
"Mentally deficient. Sex delinquent girl. Unfit home," reads her evaluation, an archival copy of which is included in Stern's analyses. "Father was illiterate; mother subnormal ... one brother, four sisters thot to be subnormal."
At Pacific Colony, sterilization was a precondition for release another coercive factor, Stern noted. Sometimes people were released back to family members, sent to be helpers in households orperform menial labor jobs.
Garcia's mother took legal actionbut lost the case.
Often,white women at the facilitycould escapethe process, Stern said.
"What you have is a system in place that is stratified in such a way that is most likely to bring in certain people. A young white girl with truancy could get away with it. Unlike Andrea Garcia. She didnt have that luxury, a safety net, she didn't have anything," Stern said, calling the policies and practices "dehumanizing."
Espino, the historian who co-producedthe No Mas Bebs documentary,said the abuses put women in unique difficulties. Some spouses didn't trust that their wives were unwitting and thought they wanted the operations to be promiscuous. Factory worker Dolores Madrigal, the lead plaintiff in Madrigal v. Quilligan, said herhusband took his anger out on her.
The sterilizations sent negative messages to women of color "that their mothering is not valued in the same way," Espino said, "that theyre really only valued when theyre in the service of others: taking care of other peoples childrenor cooking for their masters. ... Women of colors bodies typically are valued when theyre used in the service of making other people wealthy."
The women, Espino said,were "robbed of their decision-making when it comes to the kind of family they want to have."
This man survived COVID-19: His treatment odyssey shows how complicated that can be.
On a recent morningin California, Hermosillo, 71, took a break from babysitting and running the kitchens in her son's four restaurants. Sitting on herporch in Venice, she reflected on the treatment of her and women like her.
"I think they were doing it to lower the value of us Mexicans," Hermosillo said. "That's what I think."
She isgrateful for her three childrenbut dreamed of having more. As one of her fellowplaintiffs said,"Se me acabo la cancion" "My song is finished."
Hermosillo's older sisters had more children. As the family grew, shed fall quiet when relatives asked when she would have more kids. She battled feelings of shame and embarrassment.
I hated baby showers, she said. Something happened to me.
As a girl in Mexico, she lived between her grandmothers house and foster homes. She learned to be a mom at a very young age. As a teenager, she immigrated to the USA with her motherand spent her days looking after her baby brother.
She didn't tell her sisters or friends what happened at the hospital, sharing her story for the first timeduring the trial. She translated her love of babies and motherhood to working at theWomen, Infants and Children (WIC) program for seven years, teaching breastfeeding classes to new moms.
She wears a diamond necklace around her neck that she and her husband bought from one of her clients to help her with rent money.
The struggle stayswith her.
So many years passed," she said, "but you dont forget.
Reach Nada Hassanein at nhassanein@usatoday.com or on Twitter @nhassanein_.
Autoplay
Show Thumbnails
Show Captions
Read or Share this story: https://www.usatoday.com/story/news/health/2021/03/16/covid-19-vaccine-hesitancy-latino-sterilizations-coronavirus/6834662002/
TAIPEI, Taiwan (AP) China has approved a new COVID-19 vaccine for emergency use, one that was developed by the head of its Center for Disease Control, adding a fifth shot to its arsenal.
Gao Fu, the head of Chinas CDC, led the development of a protein subunit vaccine that was approved by regulators last week for emergency use, the Chinese Academy of Sciences Institute of Microbiology said in a statement Monday.
It is the fifth coronavirus vaccine approved in China and the fourth to be given emergency use approval. Three of those given emergency approval have since been approved for general use. All were developed by Chinese companies.
The latest vaccine was developed jointly by Anhui Zhifei Longcom Biopharmaceutical Co. Ltd. and the Chinese Academy of Sciences. The team finished phase 1 and phase 2 clinical trials in October and is currently conducting the last phase of trials in Uzbekistan, Pakistan and Indonesia, according to the statement.
The vaccine was approved for use in Uzbekistan on March 1. Its a three-dose shot that is spaced out with one month each between shots, a company spokesperson said. Like other vaccines China has developed so far, it can be stored at normal refrigeration temperatures.
There is no publicly available information in peer-reviewed scientific journals about the clinical trial data showing efficacy or safety. A spokesperson for the company said that the data could not be shared at this time but that the company was providing the information to health authorities.
The protein subunit vaccine is similar to many of the other vaccines that have been approved globally in that it trains the body to recognize the spike protein that covers the surface of the coronavirus, although the difference lies in how it tells the body to recognize the protein. Scientists grow a harmless version of the protein in cells and then purify it, before it is assembled into a vaccine and injected.
China has been slow in vaccinating its population of 1.4 billion people, despite having four vaccines approved for general use. The latest numbers, according to government officials at a press briefing Monday in Beijing, is that it has administered 64.98 million doses of vaccines.
China has targeted what it considers key populations for vaccination thus far, namely health care workers, those who work at the border or customs, and specific industries the government has selected. Other groups that have been notably absent thus far in comparison to many other countries are the elderly and those with pre-existing conditions.
The approved vaccines have previously been limited to adults 18-59 years old, as officials cited a lack of clinical trial data for those who are older, although the government appears to be signaling the limits are now being set aside.
We will promptly carry out mass vaccination of relevant populations, Li Bin, a vice chair on the National Health Commission, said Monday.
Chinas official Xinhua News Agency reported over the weekend that in certain neighborhoods in Beijing, local health centers started to offer the vaccines to those aged 60 and older.
___
This story has been corrected to show that the vaccine trains the body to recognize the spike protein that covers the surface of the coronavirus, not the surface of the coronavirus vaccine.
TAMPA, Fla. (WFLA) If youre under 60 and living in Florida, you might be wondering when itll be your turn to get the COVID-19 vaccine.8 On Your Side found out it partly depends on what happened on Monday.
When the coronavirus vaccine first became available to Floridas seniors, websites crashed and phone lines jammed as those who were eligible tried to book appointments.
Months later, the eligibility age has now dropped to 60, and David Medina is opting out of booking an appointment.Instead, the 62 year-old will walk up to the FEMA-supported site in Tampa.
It was just so frustrating so I said, no were not going to do that,' said Mr. Medina.
Investigator Mahsa Saeidi asked him how his life is going to change once he gets the shot.
Well, I just found out my wife got stage 2 cancer so this alleviates a lot, said Mr. Medina. It brings a lot of ease to someones mind.
The vaccine is injecting new hope into his life and the lives of at least 1.5 million others now able to sign up. 8 On Your Side checked and confirmed Floridians age 60 to 64 can now register online at CVS, Publix, Walmart andMyVaccine.FL.Gov
Thus far, 8 On Your Side hasnt seen any major problems.
The infrastructure thats in place now is fantastic, Gov. Ron DeSantis said during a news conference in Sebastian on Friday.
Gov. DeSantis said the announcement to drop the vaccine age to 55 could come this week. By next month, Florida could open vaccinations to all.
But dont expect to register on one centralized site.
Ours is a more decentralized approach befitting a very big state, said Gov. DeSantis. We have the retail pharmacies which are really expanded but that is not [a] sign up on a government list.
Mr. Medina and his wife will both soon be fully vaccinated, able to stay positive and focus on the fight ahead.
Ive been married to her for 30 years, so Im blessed, said Mr. Medina.
Florida is getting hundreds of thousands of vaccine doses each week. The infrastructure in place seems to be working and, for now, were on track to meet Gov. DeSantis goals.
The clinic plans to offer the one-shot Johnson & Johnson vaccine on Thursdays and the two-shot Pfizer and Moderna vaccines the rest of the week.
BOISE, Idaho St. Luke's Health System will open a new dedicated COVID-19 vaccination site in downtown Boise on Thursday.
The St. Luke's Plaza vaccine clinic at 800 East Park Boulevard will be in addition to the health system's other clinics around Southwest Idaho.
Vaccine appointments at the new site will be available Monday through Friday.
Patients who prefer the new Johnson & Johnson vaccine can select an appointment on Thursdays. According to St. Luke's, the one-dose vaccine will be offered on Thursdays, as long as supply remains stable.
The Pfizer vaccine will be administered Mondays through Wednesdays, while the Moderna vaccine will be administered on Fridays. Both Moderna and Pfizer are two-dose vaccines.
Appointments for the Johnson & Johnson vaccine, also known as the Janssen vaccine, are now available for Thursday, March 18. Anyone in the state's eligible groups can schedule an appointment directly through myChart. No walk-ins will be allowed.
People unable to access myChart online can call St. Luke's Connect at 208-381-9500 to schedule an appointment. If there are no appointments available, people will have the option to fill out a vaccine questionnaire and they will be contacted when it's time to schedule an appointment.
Patients receiving their vaccine at St. Luke's Plaza are asked to park in the lots north of the building and enter through the back entrance, as the front entrance is closed. A map is available on St. Luke's website.
On Monday, Idahoans age 55 and older with at least one pre-existing health condition became eligible to receive the vaccine. Also eligible are: all Idahoans age 65 and older; healthcare workers, long-term care facility staff and residents; first responders; teachers and school staff; and frontline essential workers.
All Idahoans age 55 and older will be eligible for the vaccine starting on Monday, March 22.
See our latest updates in our YouTube playlist:
A government-provided vaccination site, such as a community health center or public health department, may be a safer bet if you're worried about surprise medical bills or don't want to reveal your citizenship or immigration status. They tend to be free too. In our research for this article, we found that many of them say on their websites that they don't ask for health insurance information, proof of insurance, or immigration status. Check with your local facilities to make sure.
Step 4: What to Bring to Get Vaccinated
Vaccines are typically covered by your health insurance, but it pays to check with your insurance provider and the office before you commit to an appointment. Surprise bills are a problem in this country. If your profession is what grants you eligibility, bring proof of employment, such as a work ID, letter of employment, or pay stub. If you're eligible because of underlying health conditions, you may need proof of your medical condition, such as a letter from your doctor.
Private practices and retail locations, such as pharmacies, usually require you to bring an ID and health insurance card and may ask for the name of your primary care physician. Vaccination sites run by government services, such as at community health centers and public health departments, don't typically ask for health insurance info, but you'll likely need proof of state residency. Depending on your state, school records, samples of mail addressed to you, or a statement from another person may substitute for a government-issued ID. Check with the specific vaccination site you've decided upon.
Step 5: Getting Your Vaccine
In the United States, the three vaccines available to the public right now via emergency authorization by the FDA are from Moderna, Pfizer-BioNTech, and Johnson & Johnson Janssen. The mechanisms by which they work differ, and two of them require second doses at different times.
In its clinical trial, the Johnson & Johnson vaccine had a lower overall efficacy than the Moderna and Pfizer-BioNTech, but all three are great atpreventing severe cases of Covid-19 that would lead to hospitalization or death.
On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (P.L. 117-2), a $1.9 trillion stimulus package, into law. Among other things, this latest relief bill, the nations sixth, infuses new funding for critical COVID-19 public health activities, including vaccine distribution, testing, contact tracing, surveillance, and the public health workforce, building on prior emergency relief funding provided by Congress (other provisions of the bill expand the Affordable Care Act by making marketplace and private health insurance more affordable and by providing new incentives to states that have not yet expanded their Medicaid programs to do so). Funding for COVID-19 public health focused activities in the bill totals almost $93 billion, most of which has been made available until expended. The main public health provisions are as follows:
`;// articleContent = document.querySelector(".article-content");// articleContent.innerHTML = articleContent.innerHTML + formbox;let firstParagraph = document.querySelector("div.article-content > p:nth-child(1)");if (firstParagraph !== null) {firstParagraph.insertAdjacentHTML("afterend", formbox);}function waitForElement(id, callback){var goStahp = setInterval(function(){if(document.getElementById(id)){clearInterval(goStahp);callback();}}, 100);}waitForElement("JotFormIFrame-202185815209151", function(){const expandButton = document.querySelector('h3.expand_box_click_to_open_covid_form');expandButton.addEventListener('click', function() {let box = document.querySelector('.corona_form_expand_box_covid_form');let first = 'opening';let second = 'open';let buttonAction = 'Hide story tip submission form';let deviceAction = "Tap";if (window.innerWidth > 666) {deviceAction = "Click";}// console.log(window.innerWidth);if(box.classList.contains(first)) {[first, second] = [second, first];buttonAction = `${deviceAction} to submit a coronavirus story tip`;}expandButton.innerHTML = buttonAction;box.classList.toggle(first);setTimeout(() => {box.classList.toggle(second);}, 0);});var ifr = document.getElementById("JotFormIFrame-202185815209151");if(window.location.href && window.location.href.indexOf("?") > -1) {var get = window.location.href.substr(window.location.href.indexOf("?") + 1);if(ifr && get.length > 0) {var src = ifr.src;src = src.indexOf("?") > -1 ? src + "&" + get : src + "?" + get;ifr.src = src;}}window.handleIFrameMessage = function(e) {if (typeof e.data === 'object') { return; }var args = e.data.split(":");if (args.length > 2) { iframe = document.getElementById("JotFormIFrame-" + args[(args.length - 1)]); } else { iframe = document.getElementById("JotFormIFrame"); }if (!iframe) { return; }switch (args[0]) {case "scrollIntoView":iframe.scrollIntoView();break;case "setHeight":console.log(`case: setHeight`);iframe.style.height = parseInt(args[1]) + 15 + "px";break;case "collapseErrorPage":console.log(`case: collapseErrorPage`);if (iframe.clientHeight > window.innerHeight) {iframe.style.height = window.innerHeight + "px";}break;case "reloadPage":window.location.reload();break;case "loadScript":var src = args[1];if (args.length > 3) {src = args[1] + ':' + args[2];}var script = document.createElement('script');script.src = src;script.type = 'text/javascript';document.body.appendChild(script);break;case "exitFullscreen":if (window.document.exitFullscreen) window.document.exitFullscreen();else if (window.document.mozCancelFullScreen) window.document.mozCancelFullScreen();else if (window.document.mozCancelFullscreen) window.document.mozCancelFullScreen();else if (window.document.webkitExitFullscreen) window.document.webkitExitFullscreen();else if (window.document.msExitFullscreen) window.document.msExitFullscreen();break;}var isJotForm = (e.origin.indexOf("jotform") > -1) ? true : false;if(isJotForm && "contentWindow" in iframe && "postMessage" in iframe.contentWindow) {var urls = {"docurl":encodeURIComponent(document.URL),"referrer":encodeURIComponent(document.referrer)};iframe.contentWindow.postMessage(JSON.stringify({"type":"urls","value":urls}), "*");}};if (window.addEventListener) {window.addEventListener("message", handleIFrameMessage, false);} else if (window.attachEvent) {window.attachEvent("onmessage", handleIFrameMessage);}});//
Even as the COVID-19 vaccine roll-out is accelerating across the country, the public health and economic effects of the pandemic continue to affect the well-being of many Americans. The American Rescue Plan includes additional funding not only to address the public health crisis of the pandemic, but also to provide economic support to many low-income people struggling to make ends meet. Millions have lost jobs or income in the past year, making it difficult to pay expenses including basic needs like food and housing. These challenges will ultimately affect peoples health and well-being, as they influence social determinants of health. This brief provides an overview of social determinants of health and a look at how adults are faring across an array of measures one year into the pandemic.
Social determinants of health are the conditions in which people are born, grow, live, work, and age. They include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care (Figure 1).
Though health care is essential to health, research shows that health outcomes are driven by an array of factors, including underlying genetics, health behaviors, social and environmental factors, and financial distress and all of its implications. While there is currently no consensus in the research on the magnitude of the relative contributions of each of these factors to health, studies suggest that health behaviors and social and economic factors are the primary drivers of health outcomes, and social and economic factors can shape individuals health behaviors. There is extensive research that concludes that addressing social determinants of health is important for improving health outcomes and reducing health disparities. Prior to the pandemic there were a variety of initiatives to address social determinants of health both in health and non-health sectors. The COVID-19 pandemic exacerbated already existing health disparities for a broad range of populations, but specifically for people of color.
Across a wide range of metrics, large shares of people are experiencing hardship. The Census Bureaus Household Pulse Survey was designed to quickly and efficiently collect and compile data about how peoples lives have been impacted by the coronavirus pandemic. For this analysis we looked at a range of measures over the course of the pandemic. Since the start of the pandemic, shares of people reporting hardship across various measures has been relatively constant, with a slight peak for the December reporting periods (Figure 2). For the most recent period, February 3-February 15:
Black and Hispanic adults fare worse than White adults across nearly all measures, with large differences in some measures. For example, just over 75% of Black and Hispanic adults reported difficulty paying household expenditures compared to 53% of White adults; about 13% of Black and Hispanic adults reported no confidence in their ability to make next months housing payment compared to 5% of White adults, and 20% of Black adults and 18% of Hispanic adults reported food insufficiency in the household compared to 8% of White adults. While these disparities in social determinants of health existed prior to the pandemic, the high current levels among certain groups highlights the disproportionate burden of the pandemic on people of color.
While variation across age and gender was not as stark, in general younger adults (ages 18 to 44) and women fared worse on most measures compared to older adults and men. For example, higher shares of younger adults and women reported symptoms of anxiety and depression as well as difficulty paying for usual household expenses. Higher shares of younger adults reported food insufficiency in their household and higher shares of women reported delaying medical care in the last four weeks due to the pandemic. As with race/ethnicity, some of these differences in social determinants were present even before the pandemic, but understanding them in the context of heightened levels of need over the past year highlights these differences and who may benefit most from assistance.
Across most measures, adults with children in their household fared worse compared to overall adults. For example, 53% of adults with children in the household experienced loss of employment income in the household compared to 47% of adults overall, and just over two-thirds of adults with children in the household reported difficulty paying for household expenses compared to the overall population of 61%. Notably, adults in households with children were more likely to report food insufficiency than the general population.
The American Rescue Plan provides $1.9 trillion in funding to address the ongoing health and economic effects of the pandemic. Some of the provisions that provide key economic support for individuals include direct stimulus payments to individuals, an extension of federal unemployment insurance payments, a child tax credit of up to $300 per child per month from July through the end of the year, additional funding to address food insecurity, emergency rental assistance, and emergency housing vouchers. In terms of provisions to address COVID and health care, the plan provides additional funding for The Centers for Disease Control (CDC) related to administration and distribution of COVID-19 vaccines as well as increased funding for testing and tracing coronavirus infections as well as testing supplies and personal protective equipment. The plan includes provisions to make health insurance more affordable by temporarily expanding and increasing Marketplace subsidies and fiscal incentives to encourage states that have not adopted the Medicaid expansion to do so.
Additional funding and policy changes could lead to improvements in many of the indicators related to economic security and health access highlighted in this brief. In addition, as more people receive the vaccine, state restrictions may continue to ease and economic activity may increase. Future data from the Pulse survey may reflect these changes. Many of the problems and disparities highlighted in this data existed prior to the pandemic, but the economic crisis has heightened the level of challenge faced by many. Changes to address COVID-related and underlying economic security issues tied to poverty, access to food and housing have direct links to improvements in health and can also help to address health disparities. While addressing these underlying social determinants of health can be difficult and would likely require significant government spending, we are unlikely to make significant progress in narrowing health inequities without doing so.
A lab scientist scans bar codes on saliva samples collected from members of the CU Boulder community. (Credit: Glenn Asakawa/CU Boulder)
A few super carriers with off-the-charts viral loads are likely responsible for the bulk of COVID-19 transmissions, while about half of infected people arent contagious at all at the time of diagnosis, suggests a new CU Boulder analysis of more than 72,000 test samples.
A second, related study lends further credence to the idea that viral load, or the amount of virus particles a person carries, drives contagion. It found that only one in five university students who tested positive while living in a residence hall infected their roommate. And their viral load was nearly seven times higher than those who didnt spread the virus.
The takeaway from these studies is that most people with COVID dont get other people sick, but a few people get a lot of people sick, said Sara Sawyer, a professor of molecular, cellular and developmental biology and senior author of the first study. If you dont have a viral super-carrier sitting near you at dinner, you might be OK. But if you do, youre out of luck. Its a game of roulette so you have to continue to be careful.
For the studiesamong the largest to date to examine trends in asymptomatic peopleresearchers analyzed saliva samples collected from students, and some faculty and staff, on the CU Boulder campus between Aug. 17 and Nov. 25.
A member of the CU Boulder community hands over a saliva sample for COVID-19 surveillance testing. (Credit: CU Boulder)
Asymptomatic students in residence halls are required to test weekly, using a free, highly-sensitive saliva-based screening test called RT-qPCR (reverse transcription polymerase chain reaction), which detects and quantifies genetic material from the virus that causes COVID-19.
In the fall, out of 72,500 samples taken from asymptomatic people, 1,405 cases of COVID-19 were identified.
What is so special about these samples is that they are all from infected people with no symptomsa snapshot of all these seemingly healthy people you assume it is safe to be around, said Sawyer.
Sawyer and her team quantified just how many viral particles, or virions, each of those samples contained, plotted it and compared it to samples from hospitalized patients. A few surprising patterns emerged. First, the distribution of viral loads in the asymptomatic sample was indistinguishable from that of highly symptomatic patients.
This means that symptoms tell you very little about what is going on inside a persons body, said Sawyer. Some of these asymptomatic people are carrying a viral load as high as someone who is intubated with COVID in a hospital bed.
Just 2% of all the COVID-positive individuals at CU Boulder carried 90% of the circulating virus. One student with the highest load carried 5%.
Meanwhile, about half of those who tested positive had viral loads so low (below 106 virions per millilieter) that they were probably not carrying live virus anymoreinstead they may have just been shedding viral fragments from tissue under repair. Thus, they were probably not contagious.
This provides another example of why you dont necessarily need super sensitive tests that may take longer to process, said coauthor Roy Parker, director of the BioFrontiers Institute and Howard Hughes Medical Institute investigator. Even a faster but less sensitive test will catch all the people who are contagious.
For a second study, researchers used the same samples to explore how often one roommate infected another.
In all, 1,058 students living in the dorms tested positive, constituting 16.5% of the population.
Students in single rooms were about half as likely to be infected. But this was not because the virus was spreading between roommates. (Previous research has shown that students who live alone tend to have fewer social contacts).
In fact, only 20% of infected studentsthose with significantly higher viral loadstransmitted the virus to their roommate.
Notably, CU Boulderwhile allowing students to have roommates in the fallrequired that students diagnosed with COVID-19 move into a dedicated isolation dorm for 10 days. But it can take time for a student flagged through screening to get a follow-up diagnostic, get notified and move out.
One might think that students who were co-housed with another student longer before isolating would be more likely to transmit the virus to their roommate but we saw no impact, said lead author Kristen Bjorkman, COVID scientific director for CU Boulder.
This does not mean that isolation has no impact at all on the spread of the virus, she said, but it does provide a ray of optimistic news for people who want to live with other people but are worried about safety.
This is important for us and other universities to know because it tells us we can continue to offer on-campus housing and roommate pairing, she said.
The findings may also offer relief to those who have received a positive COVID-19 test and fear for people they live with.
People feel a lot of guilt about this but our study suggests that getting a positive test is not a guarantee you will infect your loved ones or roommates, Bjorkman said.
Neither paper has been published in a peer-reviewed journal yet.
Collectively, the research shows that, in some cases it might be prudent to contact those with high viral loads fastand encourage them to isolate quickly.
This could go a long way in preventing large outbreaks, said Bjorkman.
