Walgreen Co, Deerfield, IL, United States.
Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI, United States.
Front Public Health. 2024 Sep 11;12:1422914. doi: 10.3389/fpubh.2024.1422914. eCollection 2024.
Several social determinants of health and other structural factors drive racial and ethnic disparities in COVID-19 risk, morbidity, and mortality. Public-private collaborations with community pharmacies have been successful in expanding access to COVID-19 testing and reaching historically underserved communities. The objectives of this study were to describe individuals who sought testing for COVID-19 at a national community pharmacy chain and to understand potential racial and ethnic inequities in testing access, positivity, and infection with emerging variants of concern.
We conducted a cross-sectional study of individuals aged ≥18 who were tested for COVID-19 (SARS-CoV-2) at a Walgreens pharmacy or Walgreen-affiliated mass testing site between May 1, 2021 and February 28, 2022. Positivity was defined as the proportion of positive tests among all administered tests. A geographically balanced random subset of positive tests underwent whole genome sequencing to identify specific viral variants (alpha, delta, and omicron). Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) to compare the likelihood of testing positive and testing positive with an emerging variant of concern across race and ethnicity groups.
A total of 18,576,360 tests were analyzed (16.0% tests were positive for COVID-19; 59.5% of tests were from White individuals and 13.1% were from Black individuals). American Indian or Alaska Native (OR = 1.12; 95%CI = 1.10-1.13), Hispanic or Latino (1.20; 95%CI = 1.120, 1.21), and Black (1.12; 95%CI = 1.12, 1.13) individuals were more likely to test positive for COVID-19 compared to White individuals. Non-White individuals were also more likely to test positive for emerging variants of concern (e.g., Black individuals were 3.34 (95%CI = 3.14-3.56) times more likely to test positive for omicron compared to White individuals during the transition period from delta to omicron).
Using a national database of testing data, we found racial and ethnic differences in the likelihood of testing positive for COVID-19 and testing positive for emerging viral strains. These results demonstrate the feasibility of public-private collaborations with local pharmacies and pharmacy chains to support pandemic response and reach harder to reach populations with important health services.
多种健康社会决定因素和其他结构性因素导致了 COVID-19 风险、发病率和死亡率方面的种族和民族差异。公私合作与社区药店合作，成功扩大了 COVID-19 检测的获取途径，并覆盖到了历史上服务不足的社区。本研究的目的是描述在全国连锁药店寻求 COVID-19 检测的个体，并了解在检测获取、阳性率和新兴关注变异体感染方面可能存在的种族和民族差异。
我们对 2021 年 5 月 1 日至 2022 年 2 月 28 日期间在沃尔格林药店或沃尔格林附属大规模检测点接受 COVID-19（SARS-CoV-2）检测的年龄≥18 岁的个体进行了一项横断面研究。阳性定义为阳性检测在所有检测中的比例。对阳性检测的一个地理平衡随机亚组进行全基因组测序，以确定特定的病毒变异体（alpha、delta 和 omicron）。Logistic 回归估计了比值比（ORs）和 95%置信区间（CIs），以比较不同种族和民族群体检测阳性和检测到新兴关注变异体的可能性。
共分析了 18576360 次检测（16.0%的检测呈 COVID-19 阳性；59.5%的检测来自白人个体，13.1%的检测来自黑人个体）。美国印第安人或阿拉斯加原住民（OR=1.12；95%CI=1.10-1.13）、西班牙裔或拉丁裔（1.20；95%CI=1.120,1.21）和黑人（1.12；95%CI=1.12,1.13）个体与白人个体相比，更有可能检测出 COVID-19 阳性。非白人个体也更有可能检测到新兴关注变异体（例如，在 delta 向 omicron 过渡期间，黑人个体检测出 omicron 的可能性是白人个体的 3.34 倍[95%CI=3.14-3.56]）。
利用全国性的检测数据数据库，我们发现了种族和民族在 COVID-19 检测阳性率和新兴病毒株检测阳性率方面的差异。这些结果表明，公私合作与当地药店和连锁药店合作，支持大流行应对并为重要卫生服务覆盖更难到达的人群是可行的。
