MMWR News Synopsis

Articles

Impact of COVID-19 on Cervical Cancer Screening Rates Among Women Aged 21-65 Years in a Large Integrated Health Care System — Southern California, January 1–September 30, 2019, and January 1–September 30, 2020

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A California stay-at-home order to contain the spread of COVID-19 that reduced access to outpatient medical visits resulted in an 80% drop in cervical cancer screening rates in Kaiser Permanente’s Southern California region. . As the pandemic continues, ensuring that women receive preventive services, including cancer screening and appropriate follow-up in a safe and timely manner, remains important.

A new CDC study shows cervical cancer screening rates declined about 80% in women ages 21-65 during a spring 2020 statewide stay-at-home order to slow the spread of COVID-19 in Southern California. The study, conducted in collaboration with Kaiser Permanente Southern California (KPSC), used electronic medical records of about 1.5 million women to determine cervical cancer screening rates before, during, and after the stay-at-home order. Similar changes in rates were seen in all racial and ethnic groups. Rates returned  to near normal after the stay-at-home order was lifted. Sustained disruptions could lead to increased risk for cervical cancers and precancers.  As the pandemic continues, ensuring that women receive preventive services, including cancer screening and appropriate follow-up in a safe and timely manner, remains important to avoid increased incidence of advanced cancers from delayed detection. Focusing health systems’ efforts on bringing higher risk populations back to screening first, such as women with abnormal results or increased risk for precancers and cancers, is suggested.

Trends in Outbreak-Associated Cases of COVID-19 — Wisconsin, March–November 2020

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An investigation into the rapid increase in COVID-19 cases in Wisconsin during fall 2020 found that the surge in cases was preceded by outbreaks at colleges and universities in late August. During  September and November, Wisconsin experienced widespread community transmission of COVID-19 and outbreaks in other congregate settings (long-term-care facilities and jails). Spread of COVID-19 on college and university campuses might represent an early driver of community transmission. This highlights the need for colleges and universities to work with public health officials and students to strengthen effective mitigation strategies and prevent the spread of COVID-19. From late August to mid-November 2020, the rate of COVID-19 cases in Wisconsin increased by average of 24% each week. The growth rate during this time was the highest to date in Wisconsin and among the highest in the United States during that time. To identify reasons for the increase, investigators analyzed reported outbreaks in Wisconsin that occurred during March 4–November 16, 2020. During this time, at total of 57,991 confirmed COVID-19 cases in Wisconsin were linked to 5,757 outbreaks across the state in four main settings, including manufacturing or food-processing facilities, long-term care settings, correctional facilities, and college/universities. Cases linked to outbreaks accounted for nearly 1 in 5 (18.3%) of confirmed cases in Wisconsin during this timeframe. Prior to August, outbreaks were most often associated with manufacturing and food processing facilities or long-term-care facilities. However, starting in mid-August, the time when students returned to campus, there was a rapid increase in cases associated with outbreaks at colleges and universities in Wisconsin.  Health departments should monitor cases of COVID-19 on college and university campuses. An increase in the number of cases could be used as an early warning for broader community spread. Health departments should work with long-term-care facilities, prisons and jails, and colleges and universities to promptly identify cases,  and take steps to prevent further spread of COVID-19.

Response to a COVID-19 Outbreak on a University Campus — Indiana, August 2020

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During the fall 2020 semester, a university in the Midwest reduced the number of new cases during a COVID-19 outbreak by using a combination of testing, contact tracing, robust data systems, and effective educational efforts. This highlights the need for strict adherence to mitigation efforts. Going into the fall semester 2020, guidance for institutions of higher education related to COVID-19 largely focused on mitigation strategies, case investigation and contact tracing, as well as approaches to testing. A university with approximately 12,000 students, of whom 85% live on campus, implemented various public health measures to reduce the spread of COVID-19. Despite these measures, the university experienced an outbreak involving 371 cases during the first few weeks of the fall semester. Rather than sending students home, the university switched to online instruction and instituted a series of campus restrictions for a two-week period. During this time, it substantially enhanced testing, contact tracing, isolation and quarantine programs, as well as educational efforts. Immediate, aggressive efforts to reduce disease spread through enhancing testing, timely contact tracing, ensuring spaces are available for patients to isolate and contacts to  quarantine, expanding screening of people without symptoms, and promoting adherence to mitigation strategies can help control COVID-19 outbreaks while minimizing disruptions to in-person instruction.

Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Moderna COVID-19 Vaccine — United States, December 21, 2020–January 10, 2021 (Early Release January 22, 2021)

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Implementation and Evolution of Mitigation Measures, Testing, and Contact Tracing in the National Football League, August 9–November 21, 2020 (Early Release January 25, 2021)

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COVID-19 Cases and Transmission in 17 K–12 Schools — Wood County, Wisconsin, August 31–November 29, 2020 (Early Release January 26, 2021)

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SARS-CoV-2 Transmission Associated with High School Wrestling Tournaments — Florida, December 2020–January 2021 (Early Release January 26, 2021)

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• An Outbreak of West Nile Virus — Arizona, 2019

This investigation and public health response may help inform future West Nile virus public health prevention efforts and outbreaks responses. The Arizona Department of Health Services (AZDHS) reported the highest West Nile virus rate in Maricopa County since 2004: 3.7 cases/100,000 people. Additionally, statewide, 23 viremic or asymptomatic blood donors who tested positive for West Nile virus during routine blood product screening were reported in 2019, 52% higher than the historical median for available years (2006–2018). In response to the outbreak, the Arizona Department of Health Services and Maricopa County informed health care providers and the public; they also distributed educational materials and mosquito repellent across the state. Lastly, they increased capacity throughout Arizona to trap and test mosquitoes to increase West Nile virus surveillance and control efforts.

• Percentage of Women Who Have Ever Used Emergency Contraception Among Women Aged 22–49 Years Who Have Ever Had Sexual Intercourse, by Education — National Survey of Family Growth, United States, 2017–2019

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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.