ComPACT Study Internship

Name: Zachary Taylor

Department: East Carolina University Department of Public Health

Course Name & Description: Applied Field Placement MPH 6905

Abstract: On December 31, 2019, there were clusters of a pneumonia of unknown etiology in Wuhan, Hubei Province in China. By January 2, 2020, the number of patients with this disease increased to 41 and these patients were identified as having been infected with COVID-19 or SARS-CoV-2, a novel virus from the coronavirus family. It has since become a global pandemic, with the first case in the United States diagnosed on January 24, 2020. As of July 22, 2020, there are approximately 3.8 million cases of COVID-19 in the US and over 140,000 deaths due to COVID-19. In Pitt County, as of July 19th, there are 1,173 cases with 6 deaths due to COVID-19. In order to gain a holistic picture of the effect of COVID-19 and the preventive measures on the residents of Pitt County, a survey was created. This survey, which is part of the larger ComPACT study, seeks to assess the adherence of Pitt County residents to these preventive measures as well as the social and economic impact of COVID-19 and these preventive measures on Pitt County residents. The survey consists of questions regarding demographics, socioeconomic status, existing medical conditions, adherence to social distancing guidelines, adherence to mask-wearing guidelines, as well as the social and economic impact of the stay-at-home orders. This will help guide the public health response and inform futures studies on COVID-19 prevention, incidence, and prevalence. As of July 22, 2020, there are 377 surveys completed and returned, roughly being representative of the overall Pitt County population. 

This internship was a part of the Pitt County Community Prevention and COVID-19 Testing, or ComPACT study.  The goal of the first phase of the study is to conduct a survey through convenience sample to assess the social, economic, and health effects of the COVID-19 prevention guidelines. 

There are two main objectives of the ComPACT study:

1. Assess Pitt County residents adherence to mitigation and prevention guidance and the social and economic impact of these measures in a large convenience sample
2. Establish a pool of interested/eligible participants for selection in a subsequent cohort study

From December 18, 2019 until December 29, 2019, there were five patients in Wuhan, Hubei Province in China that were admitted to hospitals who were diagnosed with pneumonia of unknown etiology. Between 44% and 66% of the patients in the Hubei Province identified with this virus had contact history with the Huanan seafood market, which sold living wild animals such as poultry, bats, and marmots (Ge et al., 2020). The lung pathology of these patients demonstrated pulmonary edema with diffuse alveolar damage (Ge et al, 2020), similarly to the reports from the Severe Acute Respiratory Syndrome (SARS) outbreak in 2002. By January 2, 2020, the number of patients with this disease increased to 41 and these patients were identified as having been infected with COVID-19 or SARS-CoV-2, a novel virus from the coronavirus family. It is currently estimated that the mortality rate of SARS-CoV-2 is 3.8%, which is lower than that of SARS-CoV, which was 10% (Ahn et al., 2020). However, the number of cases of SARS-CoV-2 is more than 10 times higher than that of SARS-CoV (Ahn et al., 2020).

The first case of COVID-19 in the United States was diagnosed on January 24, 2020, indicating the global spread of the virus. As of July 1, 2020, there are approximately 2.6 million cases of COVID-19 in the US and over 120,000 deaths due to COVID-19. The World Health Organization officially declared the SARS-CoV-2 outbreak to be a Public Health Emergency of International Concern on January 30, 2020. On March 3, 2020, the first case of COVID-19 was diagnosed in North Carolina. In response to the pandemic, North Carolina declared a state of emergency on March 10th and closed all public K-12 schools on March 14th. On March 17th, North Carolina closed all restaurants and bars for dine-in services. On March 27th, North Carolina issued a Stay-At-Home Order that originally lasted from March 30th until April 29th and banned gatherings of more than 10 people and suggested everyone to physically stay six feet from others. The Stay-At-Home Order was lifted on May 20th and was replaced with a Safer-At-Home recommendation which requires people to wear a face covering in public. This Safer-At-Home recommendation currently remains in effect. As of July 6, 2020, there were over 74,000 laboratory-confirmed cases in North Carolina.

Pitt County is located in eastern North Carolina and is a fast-growing county with an estimated population of 180,000 in 2018 (CHNA, 2019). In Pitt County, as of July 19th, there are 1,173 cases with 6 deaths due to COVID-19. 

This cross-sectional study began collecting surveys on June 26th, 2020, utilizing a convenience sampling method. Initially, a 195-question English survey was created in RedCap for completion on a computer. There was an alternate version of the English survey created for completion on a mobile. Both versions were translated into Spanish for completion on a computer or on a mobile. The link to the surveys were attached to the Study website for any Pitt County resident to complete if they meet the selection criteria. 

Recruitment for the study occurred through fliers and posters located in ECU Physicians, ECU Pediatrics, the Pitt County Health Department Clinics, and through email correspondence to Pitt County Community College, AMEXCAN, Chamber of Commerce, local Churches, the Daily Reflector, ECU Graduate Medical Students, Greenville EMS/Fire/Police departments, Pitt County Public Schools, Pitt County Volunteer EMS, Pitt Partners for Health, West Greenville Health Counsel, and Vidant House staff. 

1.Study Website Design

2.Created the English (mobile and computer) Phase 1 study survey in REDcap

PittCountyComPACTStudyPhase1_DataDictionary.pdf

PittCountyComPACTStudyPhase1Ma_DataDictionary_2020-07-27 (1).csv

3.Created the Spanish (mobile and computer) Phase 1 study survey in REDcap

PittCountyComPACTStudyPhase1Sp_DataDictionary_2020-07-27.csv

4.Created the Phase 2 study schedule in REDcap

ComPACTPhase2Setup_InstrumentDesignations_2020-07-27.csv

5.Developed the Phase 2 study Recruitment and Enrollment Log in REDcap

ComPACTPhase2Setup_DataDictionary_2020-07-27.csv

6.Developed the Phase 2 study questionnaires in REDcap

7.Composed drafts of the Phone script and Email script for the Phase 2 Study

ComPACT Study Recruitment Phone and Email Script Draft.docx