Testing

This N.Y. Times article describes difficulties in obtaining timely and nearby testing for children and the implications for public health mitigation efforts. In many instances, existing free testing sites set a minimum age that does not include many school-age children, creating challenges for isolating and tracking cases and for obtaining negative test results to allow a child to return to school (and to allow parents or caregivers to return to work if they have stayed home to provide care). Pediatricians’ offices are more likely to provide testing for young children but have much more limited capacity to do so. While children typically do not appear to suffer significant symptoms of infection in most cases, they can contract and spread the disease to others.

Supplies

This NPR piece explains why N95 respirators remain in short supply 6 months into the pandemic. Many other supplies, such as face shields and basic surgical masks, are now readily available, but some PPE remains scarce, notably including N95 masks. N95s are more difficult to produce compared to some other PPE and require additional time, money, and effort to reconfigure manufacturing at firms that do not already make them. Firms that already produce them, like 3M and Honeywell, are simply unable to keep pace with demand, while smaller manufacturers are still in the process of trying to ramp up production. Additionally, competition between buyers – large hospital chains, small hospitals, schools, and others – creates further difficulty in obtaining scarce supplies absent broader coordination efforts.

Disparities

This article by Connor et al. addresses risks and outcomes disproportionately affecting women during the pandemic. While men appear to be suffering greater morbidity and mortality from SARS-CoV-2 infection, the authors find that women suffer disproportionate negative impacts in exposure and disease risks and overall health status as a result of gender-base differences in health care workforce participation, reproductive health needs, lack of inclusion in drug development, gender-based violence, and mental health. Among other findings, women are a sizeable majority of the health care workforce (76%) and are particularly concentrated in roles with close patient contact, placing them at increased risk of exposure, especially in light of ongoing PPE shortages and continuing challenges with appropriate PPE fit using “unisex” products. Additional gender-based differences create inequities across a number of other dimensions, consistent with identification of gender as a social determinant of health that intersects with other determinants, compounding inequities for women who also identify as members of other marginalized or disadvantaged populations based on characteristics such as race, socioeconomic status, immigration status, age, geography, disability, and LGBTQIA identity.