Pharmacology, Toxicology and Environmental Health Commons^™

Sustainable Management Of Facemask Waste Generated From Covid-19 Pandemic In Bhutan, Tshering Yangdon, Twisuk Punpeng, Sirima Mongkolosomit, Kampol Nanthapong, Kinzang Yangden

Journal of Health Research

Background: The rise in facemask waste with the uncertainty of deposition data and all its concomitant pressure on management has resulted in new risks and challenges for achieving sustainable development goals (SDGs). The purpose of this mixed methods study was to estimate facemask waste generation and examine management in Bhutan since the COVID-19 pandemic.

Method: One thousand five hundred and twenty-seventh (1,527) consenting members of the public from Class A Thromdes (self-governing municipalities) were surveyed online from February to April 2022, to estimate mask waste using descriptive statistics. This was supported by the waste characterization conducted in Memelhakha, the biggest …

Wastewater-Informed Public Health Intervention Playbook

Sustain Magazine

As the SARS-CoV-2 pandemic quickly spread from country to country and continent to continent in 2020, governments and scientists needed a way to track COVID-19 through populations in order to position public health interventions in the most impactful locations. Having a decision-based risk framework may help to guide policy creation that could minimize or prevent possible outbreaks and surges of infection within communities. The University of Louisville in partnership with Louisville’s Department of Public Health and Wellness tested this strategy in 2021 and 2022. This Wastewater-Informed Public Health Intervention Playbook describes the decisions and actions of that academic and public …

Implementation Of A Drive-Through Covid-19 Mass Vaccination Site: Experiences From Louvax–Broadbent In Louisville, Kentucky, Ruth Carrico, Sarah Beth Hartlage, Valenchia Brown Msn, Aprn, Fnp-C, Sarah M. Bishop, Luanne Didelot, William Hayden, Beverly Williams Coleman, Sarah Tan, Delanor Manson, Kellie Kane, Dawn Balcom, Paul Kern

The University of Louisville Journal of Respiratory Infections

Background: Response to the COVID-19 pandemic has required innovative approaches to vaccination, including methods to rapidly and safely immunize communities. A major challenge to such a response involved access to untapped healthcare worker resources. The Louisville, Kentucky, response involved the use of a large volunteer workforce to supplement local public health employees in planning and implementing a large-scale drive-through vaccination event. The objective of this manuscript was to outline processes involved in training a mass immunization workforce and implementating a large-scale COVID-19 community vaccination.

Approach: Competency-based and standardized training was provided for every volunteer before working their shift. Volunteers worked …

Combining Community Wastewater Genomic Surveillance With State Clinical Surveillance: A Framework For Sars-Cov-2 Public Health Practice, Ted Smith, Rochelle H. Holm, Ray Yeager, Joseph B. Moore Iv, Eric C. Rouchka, Kevin J. Sokoloski, Daymond Talley, Vaneet Arora, Sarah Moyer, Aruni Bhatnagar

Faculty Scholarship

Study objective: To garner a framework for combining community wastewater surveillance with state clinical surveillance that influence confirmation of SARS-CoV-2 variants within the community, and recommend how the flow of such research evidence could be expanded and employed for public health response. Design, setting, and participants: This work involved analyzing wastewater samples collected weekly from 17 geographically resolved locations in Louisville/Jefferson County, Kentucky from February 10 to November 29, 2021. Genomic surveillance and RT-qPCR platforms were used as screening to identify SARS-CoV-2 in wastewater, and state clinical surveillance was used for confirmation. Main results: The results demonstrate increased epidemiological value …

Public Awareness And Support For Use Of Wastewater For Sars-Cov-2 Monitoring: A Community Survey In Louisville, Kentucky, Rochelle H. Holm, J. Michael Brick, Alok R. Amraotkar, Joy L. Hart, Anish Mukherjee, Jacob Zeigler, Adrienne M. Bushau-Sprinkle, Lauren B. Anderson, Kandi L. Walker, Daymond Talley, Rachel J. Keith, Shesh N. Rai, Kenneth E. Palmer, Aruni Bhatnagar, Ted Smith

Faculty Scholarship

The majority of sewer systems in the United States and other countries, are operated by public utilities. In the absence of any regulation, public perception of monitoring wastewater for population health biomarkers is an important consideration for a public utility commission when allocating resources for this purpose. In August 2021, we conducted a survey as part of an ongoing COVID-19 community prevalence study in Louisville/Jefferson County, KY. The survey comprised of seven questions about awareness of and privacy concerns and was sent to 32,000 households randomly distributed within the county. A total of 1,220 sampled adults participated in the probability …

The Rapid Assessment Of Aggregated Wastewater Samples For Genomic Surveillance Of Sars-Cov-2 On A City-Wide Scale, Eric C. Rouchka, Julia H. Chariker, Kumar Saurabh, Sabine Waigel, Wolfgang Zacharias, Mei Zhang, Daymond Talley, Ian Santisteban, Madeline Puccio, Sarah Moyer, Rochelle H. Holm, Ray A. Yeager, Kevin J. Sokoloski, Joshua Fuqua, Aruni Bhatnagar, Ted Smith

Faculty Scholarship

Throughout the course of the ongoing SARS-CoV-2 pandemic there has been a need for approaches that enable rapid monitoring of public health using an unbiased and minimally invasive means. A major way this has been accomplished is through the regular assessment of wastewater samples by qRT-PCR to detect the prevalence of viral nucleic acid with respect to time and location. Further expansion of SARS-CoV-2 wastewater monitoring efforts to include the detection of variants of interest/concern through next-generation sequencing has enhanced the understanding of the SARS-CoV-2 outbreak. In this report, we detail the results of a collaborative effort between public health …

Sars-Cov-2 Impairs Dendritic Cells And Regulates Dc-Sign Gene Expression In Tissues, Guoshuai Cai, Mulong Du, Yohan Bossé, Helmut Albrecht, Fei Qin, Xizhi Luo, Xiao Michelle Androulakis, Chao Cheng, Mitzi Nagarkatti, Prakash Nagarkatti, David C. Christiani, Michael L. Whitfield, Christopher I. Amos, Feifei Xiao

Faculty Publications

The current spreading coronavirus SARS-CoV-2 is highly infectious and pathogenic. In this study, we screened the gene expression of three host receptors (ACE2, DC-SIGN and L-SIGN) of SARS coronaviruses and dendritic cells (DCs) status in bulk and single cell transcriptomic datasets of upper airway, lung or blood of COVID-19 patients and healthy controls. In COVID-19 patients, DC-SIGN gene expression was interestingly decreased in lung DCs but increased in blood DCs. Within DCs, conventional DCs (cDCs) were depleted while plasmacytoid DCs (pDCs) were augmented in the lungs of mild COVID-19. In severe cases, we identified augmented types of immature DCs (CD22+ …

Wastewater Sample Site Selection To Estimate Geographically Resolved Community Prevalence Of Covid-19: A Sampling Protocol Perspective, R. Yeager, R. H. Holm, K. Saurabh, J. L. Fuqua, D. Talley, A. Bhatnagar, T. Smith

Faculty Scholarship

Wastewater monitoring for virus infections within communities can complement conventional clinical surveillance. Currently, most SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) clinical testing is voluntary and inconsistently available, except for a few occupational and educational settings, and therefore likely underrepresents actual population prevalence. Randomized testing on a regular basis to estimate accurate population-level infection rates is prohibitively costly and is hampered by a range of limitations and barriers associated with participation in clinical research. In comparison, community-level fecal monitoring can be performed through wastewater surveillance to effectively surveil communities. However, epidemiologically defined protocols for wastewater sample site selection are lacking. …

Environmentally Marginalized Populations: The "Perfect Storm" For Infectious Disease Pandemics, Including Covid-19, Gabriella Y. Meltzer, Oyemwenosa Avenbuan, Christina Awada, Oluwakemi B. Oyetade, Tricia Blackman, Simona Kwon Drph, Mph, Esther Erdei Phd, Judith T. Zelikoff Phd

Journal of Health Disparities Research and Practice

COVID-19 has exacted a severe toll on the United States population’s physical and mental health and its effects have been felt most severely among people of color and low socioeconomic status. Using illustrative case studies, this commentary argues that in addition to COVID-19 health disparities created by psychosocial stressors such as the inability to socially distance and access quality healthcare, environmental justice communities have the additional burden of disproportionate exposure to toxic contaminants that contribute to their higher risk of COVID-19. Environmental contaminants including heavy metals and persistent organic pollutants found contaminating their nearby environments can alter the immune response, …

A Letter To Reconsider The Conditions For Testing Decontaminated N95 Respirators For Emergency Reuse To Address Shortage, Eric P. Vejerano, Jeonghyeon Ahn

Faculty Publications

The battle with COVID-19 pandemic has resulted in the shortage of personal protective equipment, particularly, N95 respirators. Healthcare workers who reused N95 respirators may resort to unproven methods of cleaning/sterilization that can severely compromise the respirators’ filtration efficiency. A recently issued guideline will test decontaminated N95 respirators against particles with a median diameter of 0.075 ± 0.020 µm at a flow rate of 85 L min–1. For emergency reuse, these conditions may be too stringent. N95 respirators tested at this flow rate had predicted efficiencies of < 69%, assuming complete degradation of their electrostatic coating. Experimental efficiencies were ~15% lower. For emergency reuse, we recommend to either adjust the flow rate closer to normal breathing, or the size of the test particle should reflect that of virus-laden respiratory aerosols (~> 0.5 µm). By reconsidering the test conditions, a substantial fraction of used/decontaminated respirators can …