Risk Profile of Thanksgiving Gatherers and Subsequent SARS-CoV2 Testing and Diagnosis

  1. William You
  2. Madhura Rane
  3. Rebecca Zimba
  4. Amanda Berry
  5. Sarah Kulkarni
  6. Drew Westmoreland
  7. Angela Parcesepe
  8. Mindy Chang
  9. Andrew Maroko
  10. Shivani Kochhar
  11. Chloe Mirzayi
  12. Christian Grov
  13. Denis Nash

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Abstract

Background

During Fall 2020 in the United States (U.S.), despite high COVID-19 case numbers and recommendations from public health officials not to travel and gather with individuals outside one’s household, millions of people gathered for Thanksgiving. The objective of this study was to understand if individuals’ behaviors and risk perceptions influenced their decision to gather, and if they did gather, their subsequent test seeking and diagnoses.

Methods

Participants were part of the CHASING COVID Cohort study - a U.S. national prospective cohort. The study sample consisted of participants who completed routine questionnaires before and after Thanksgiving. Non-pharmaceutical interventions (NPIs) use informed behavioral risk scores and a score of perceived risk of COVID-19 were assigned to each participant. Multinomial logistic regression models were used to assess the association between higher risk behaviors and gathering with other households, and the association of gathering with subsequent testing and test positivity.

Results

A total of 1,932 (40.5%) cohort participants spent Thanksgiving with individuals from at least one other household. Participants with higher behavioral risk scores had greater odds of gathering with one other household (aOR: 2.35, 95% CI: 2.0, 2.7), two other households (aOR: 4.54, 95% CI: 3.7, 5.6), and three or more other households (aOR: 5.44, 95% CI: 4.1, 7.2). Participants perceiving COVID-19 as a low-risk to themselves and others had greater odds of gathering with one other household (aOR: 1.12, 95% CI: 0.97, 1.3), two other households (aOR: 1.39, 95% CI: 1.1, 1.7), and three or more other households (aOR: 1.86, 95% CI: 1.4, 2.4). Those who spent Thanksgiving with one or more other households had 1.23 times greater odds (95% CI: 1.1, 1.4) of having a COVID-19 test afterward. There was no association between gathering for Thanksgiving and subsequent COVID-19 test positivity or developing COVID-19 symptoms.

Conclusions

Those who gathered with other households for Thanksgiving tended to engage in higher-risk activities. Thanksgiving gathering with other households was not associated with subsequently testing positive for COVID-19, but only a small proportion obtained post-travel testing. Public health messaging should emphasize behavior change strategies that promote safer gathering.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2021.04.22.21255631: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsField Sample Permit: The study conducted six rounds of routine data collection (Visit 1-Visit 6) in Project Year 1.
    IRB: The Institutional Review Board at the City University of New York (CUNY) approved the study protocol.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Several limitations should be considered when evaluating the results of this study. We used a self-administered survey and the data on both risk behaviors and COVID-19 infection status could be subject to self-report bias. Participants’ answers on gathering and testing behaviors may have also been impacted by social desirability bias. Additionally, only a limited number of participants reported getting tested before and after Thanksgiving. Hence, it is difficult to estimate the actual incidence of COVID-19 infection due to gathering with other households. However, by assessing other behaviors and COVID-19 symptoms, we were able to assess the potential risk of transmission. Finally, it is possible that risk-averse participants are more likely to get tested and test negative. Therefore, the positivity rate among testers after Thanksgiving gatherings could have been an underestimate of the true positivity rate among Thanksgiving gatherers in our study. CONCLUSIONS:

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2021.04.22.21255631 on medRxiv