Knowledge, Attitudes, and Practices Regarding Smoke-Free Policies in Multi-Unit Housing in Georgia

Background: Nonsmokers living in multi-unit housing (MUH) without a smoke-free (SF) policy are vulnerable to secondhand and thirdhand smoke exposure. This study aimed to investigate the presence and type of SF policies in MUH in Georgia. Another aim was to explore knowledge, beliefs, and attitudes of property managers and owners (PM/Os) regarding SF MUH policies, including e-cigarettes. Methods: Throughout 2015 PM/Os of MUH in Savannah and Atlanta were surveyed regarding SF policies in MUH. A list with contact information of PM/Os was obtained from the ASDE Survey Sampler. The participants were mailed an invitation letter and were called one week later to schedule the interview. To be eligible, the participant must have been an English-speaking adult working as a PM/O in MUH. The survey administered was adapted from a survey designed by CDC’s Office on Smoking and Health. All survey data were entered into SPSS and analyzed using SAS. Results: The greatest number of the 91 PM/Os surveyed were female (70.3%) and/or white (48.4%), with an average age of 41.7 years. Most properties were market-rate (71.3%) or were a mix of market-rate and subsidized units (17.2%). Forty-one PM/Os reported some smoking restriction, while 50 had no policy. Properties mainly prohibited smoking in common outdoor areas (n=18) or inside individual apartments (n=13). Policies included bans of non-cigarette combustible products (n=19), hookah (n=12), e-cigarettes (n=7), and smokeless tobacco (n=5). Most PM/Os reported high compliance and positive resident reactions to the policy. Comparing responses by policy status, no differences in knowledge nor support for tobacco control legislation were found, except for SF outdoor seating in restaurants, which was more frequently supported by PM/Os with smoking restrictions. Personal beliefs on restricting use of cigarettes and e-cigarettes in MUH did not differ significantly by policy status, but those with a SF policy were more supportive of prohibiting smokeless tobacco use in MUH. Conclusions: Implementing smoke-free policies in multi-unit housing is feasible and is generally supported by residents

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Knowledge, Attitudes, and Practices Regarding Smoke-Free Policies in Multi-Unit Housing in Georgia

Background: Nonsmokers living in multi-unit housing (MUH) without a smoke-free (SF) policy are vulnerable to secondhand and thirdhand smoke exposure. This study aimed to investigate the presence and type of SF policies in MUH in Georgia. Another aim was to explore knowledge, beliefs, and attitudes of property managers and owners (PM/Os) regarding SF MUH policies, including e-cigarettes. Methods: Throughout 2015 PM/Os of MUH in Savannah and Atlanta were surveyed regarding SF policies in MUH. A list with contact information of PM/Os was obtained from the ASDE Survey Sampler. The participants were mailed an invitation letter and were called one week later to schedule the interview. To be eligible, the participant must have been an English-speaking adult working as a PM/O in MUH. The survey administered was adapted from a survey designed by CDC’s Office on Smoking and Health. All survey data were entered into SPSS and analyzed using SAS. Results: The greatest number of the 91 PM/Os surveyed were female (70.3%) and/or white (48.4%), with an average age of 41.7 years. Most properties were market-rate (71.3%) or were a mix of market-rate and subsidized units (17.2%). Forty-one PM/Os reported some smoking restriction, while 50 had no policy. Properties mainly prohibited smoking in common outdoor areas (n=18) or inside individual apartments (n=13). Policies included bans of non-cigarette combustible products (n=19), hookah (n=12), e-cigarettes (n=7), and smokeless tobacco (n=5). Most PM/Os reported high compliance and positive resident reactions to the policy. Comparing responses by policy status, no differences in knowledge nor support for tobacco control legislation were found, except for SF outdoor seating in restaurants, which was more frequently supported by PM/Os with smoking restrictions. Personal beliefs on restricting use of cigarettes and e-cigarettes in MUH did not differ significantly by policy status, but those with a SF policy were more supportive of prohibiting smokeless tobacco use in MUH. Conclusions: Implementing smoke-free policies in multi-unit housing is feasible and is generally supported by residents

Establishment of CDC Global Rapid Response Team to Ensure Global Health Security

The 2014–2016 Ebola virus disease epidemic in West Africa highlighted challenges faced by the global response to a large public health emergency. Consequently, the US Centers for Disease Control and Prevention established the Global Rapid Response Team (GRRT) to strengthen emergency response capacity to global health threats, thereby ensuring global health security. Dedicated GRRT staff can be rapidly mobilized for extended missions, improving partner coordination and the continuity of response operations. A large, agencywide roster of surge staff enables rapid mobilization of qualified responders with wide-ranging experience and expertise. Team members are offered emergency response training, technical training, foreign language training, and responder readiness support. Recent response missions illustrate the breadth of support the team provides. GRRT serves as a model for other countries and is committed to strengthening emergency response capacity to respond to outbreaks and emergencies worldwide, thereby enhancing global health security