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Trends in U.S. Emergency Department Visits Related to Suspected or Confirmed Child Abuse and Neglect Among Children and Adolescents Aged <18 Years Before and During the COVID-19 Pandemic — United States, January 2019–September 2020

CDC Media Relations
404-639-3286

A report looking at trends in emergency department (ED) visits highlights the need to better understand the effect of the COVID-19 pandemic on child abuse and neglect. The COVID-19 pandemic has increased the risk for child abuse and neglect as a result of heightened levels of stress from school closures, increased parental childcare and schooling responsibilities, significant job and income losses, social isolation, and increased substance use and mental health conditions among some adults. The pandemic has also disrupted the process of official reporting of suspected child abuse and neglect due to decreased in-person contact between children and mandated reporters, such as teachers. To assess the pandemic’s impact on victims of suspected child abuse and neglect presenting to acute care settings, investigators used real-time data of ED visits from January 6, 2019 to September 6, 2020. ED visits related to suspected or confirmed child abuse and neglect decreased during the early pandemic period. The 53% decrease in ED visits related to child abuse and neglect among children and adolescents aged <18 years in early 2020 compared with the number of visits during early 2019 mirrors trends reported for all ED visits. Although the total number of ED visits related to child abuse and neglect decreased, the proportion of these visits per 100,000 ED visits increased, suggesting that health care-seeking patterns shifted during the pandemic, with ED visits for other causes declining more than ED visits for child abuse and neglect. Despite the ongoing pandemic, caregivers were more likely to take children to EDs for evaluation of complaints related to child abuse and neglect relative to other chief complaints. This pattern might reflect decreased health care-seeking for other medical complaints or a need to seek medical care because of persistent or worsening child abuse and neglect. The consistent number of visits related to child abuse and neglect requiring hospitalization from 2019 to 2020, despite the decreased number of ED visits related to child abuse and neglect, suggests that injury severity did not decrease during the pandemic.

Racial and Ethnic Differences in Parental Attitudes and Concerns About School Reopening During the COVID-19 Pandemic — United States, July 2020

CDC Media Relations
404-639-3286

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COVID-19 Mortality Among American Indian and Alaska Native Persons — 14 States, January–June 2020

Jeremy Arieh
Council of State and Territorial Epidemiologist
770-458-3811
jarieh@cste.org

People who are American Indians or Alaska Natives (AI/AN) have experienced increased illness and death from COVID-19 compared with non-Hispanic white people. This increased risk, especially for AI/AN men and people aged 20-49 years, should be considered when planning for vaccine allocation and other prevention activities to reduce the impact of COVID-19 on these communities. During July 22–September 3, 2020, investigators collected data on confirmed COVID-19 deaths that occurred during January 1–June 30, 2020 from 14 participating states. Based on these data, the rate of deaths from COVID-19 (after adjusting for age) among AI/AN people was almost two times that among non-Hispanic white people. Males accounted for 55% of AI/AN deaths and 52% of deaths in white people. AI/AN adults also died at younger ages than white people; 35% of AI/AN COVID-19 deaths were among people under 60 years old, compared with 6% of deaths among non-Hispanic white people. Barriers including access to health care, education, employment, socioeconomic factors, and insurance coverage contribute to health disparities that put indigenous peoples at higher risk for severe illness and death from COVID-19. Public health agencies should engage with AI/AN people through tribal consultations and confer with AI/AN communities in urban areas to improve health outcomes.

The Advisory Committee on Immunization Practices’ Interim Recommendation for Allocating Initial Supplies of COVID-19 Vaccine — United States, 2020 (Early Release December 3, 2020)

CDC Media Relations
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Summary of Guidance for Public Health Strategies To Address High Levels of Community Transmission of SARS-CoV-2 and Related Deaths, December 2020 (Early Release December 4, 2020)

CDC Media Relations
404-639-3286

Implementing Mitigation Strategies in Early Care and Education Settings for Prevention of SARS-CoV-2 Transmission — Eight States, September–October 2020 (Early Release December 7, 2020)

CDC Media Relations
404-639-3286

• Understanding Smoke Exposure in Communities and Fire Camps Affected by Wildfires— California and Oregon, 2020

High levels of wildfire smoke pose a significant health risk to both fire personnel and communities. Observations made by CDC staff members deployed as Air Resource Advisors for wildfire incidents in California and Oregon shed light on environmental and occupational risk factors from wildfires. This report summarizes CDC’s response efforts and describes public health issues that prevail in communities and fire camps affected by wildfire smoke. Although smoke from wildfires drifted long distances and affected downwind communities, the brunt of poor air quality was observed in communities adjacent to wildfire incidents. Fire personnel who camped and rested between work shifts at nearby fire camps were also exposed to poor air quality levels. These fire-camp exposures contribute to higher overall cumulative smoke exposure and, along with other occupational risk factors such as fatigue and stress, could limit recovery that is much needed for fire personnel while away from the active fire perimeter. Environmental hazards such as extreme heat and higher concentrations of ambient carbon monoxide were prevalent during days with heavy smoke and after extreme fire growth days.

• First Case in the United States of Neisseria gonorrhoeae Harboring Emerging Mosaic penA60 Allele, Conferring Reduced Susceptibility to Cefixime and Ceftriaxone

The identification of an antibiotic-resistant strain of gonorrhea in Nevada in 2019 reiterates the utility and importance of surveillance programs, like the Gonococcal Isolate Surveillance Project (GISP), as an effective tool in identifying emerging antimicrobial-resistant pathogens. In November 2019 as part of the Gonococcal Isolate Surveillance Project (GISP), the Southern Nevada Public Health Laboratory of the Southern Nevada Health District (SNHD) and the Texas Department of State Health Services Laboratory identified a gonorrhea sample demonstrating possible resistance to two cephalosporin antibiotics, the last effective class of antibiotics currently used to treat this sexually transmitted infection. Further testing by CDC revealed this culture had a mutation which increases the risk of treatment failure and has been found in several countries since 2015. This is the first known case with this mutation in the U.S. The patient from whom the sample was taken was successfully treated with the recommended treatment. To date, spread of this mutation has not been seen in the U.S.

• Percentage of Emergency Department (ED) Visits Made by Adults with Influenza and Pneumonia That Resulted in Hospital Admission, by Age Group — United States, 2017–2018

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CDC works 24/7 protecting America’s health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.