Large COVID-19 outbreaks have occurred in high-density workplaces, such as food processing facilities (1). Alaska's seafood processing industry attracts approximately 18,000 out-of-state workers annually (2). Many of the state's seafood processing facilities are located in remote areas with limited health care capacity. On March 23, 2020, the governor of Alaska issued a COVID-19 health mandate (HM10) to address health concerns related to the impending influx of workers amid the COVID-19 pandemic (3). HM10 required employers bringing critical infrastructure (essential) workers into Alaska to submit a Community Workforce Protective Plan.* On May 15, 2020, Appendix 1 was added to the mandate, which outlined specific requirements for seafood processors, to reduce the risk for transmission of SARS-CoV-2, the virus that causes COVID-19, in these high-density workplaces (4). These requirements included measures to prevent introduction of SARS-CoV-2 into the workplace, including testing of incoming workers and a 14-day entry quarantine before workers could enter nonquarantine residences. After 13 COVID-19 outbreaks in Alaska seafood processing facilities and on processing vessels during summer and early fall 2020, State of Alaska personnel and CDC field assignees reviewed the state's seafood processing-associated cases. Requirements were amended in November 2020 to address gaps in COVID-19 prevention. These revised requirements included restricting quarantine groups to ≤10 persons, pretransfer testing, and serial testing (5). Vaccination of this essential workforce is important (6); until high vaccination coverage rates are achieved, other mitigation strategies are needed in this high-risk setting. Updating industry guidance will be important as more information becomes available.On May 15, 2020, the state issued HM10 Appendix 1, detailing three entry quarantine options for onshore seafood processors: 1) quarantine workers for 14 days before travel to Alaska (pretravel quarantine), 2) quarantine workers in an Alaskan community with a general acute care or critical access hospital (midtravel quarantine), or 3) quarantine workers at the destination community after arrival (posttravel quarantine) (Table 1). These options also included requirements for safe * https://covid19.alaska.gov/unified-command/protective-plans/

Exposure to whole-body vibration (WBV) is common among agricultural workers and is associated with musculoskeletal health outcomes such as low back pain. Little is known, however, about the characteristics of exposure experienced during actual production practices. We measured WBV levels during agricultural machinery use among a sample of farmers (n = 55) performing routine agricultural activities and explored machinery attributes that may explain WBV summary measures. We also measured trunk posture to provide additional information about physical exposures during machinery operation. Measurements were made on-farm and during actual work conditions of a sample of agricultural machines (n = 112), including tractors, combines, heavy utility vehicles, and all-terrain vehicles (ATVs). Results indicated the presence of high levels of vibration (median frequency-weighted root-mean-square acceleration of approximately 0.8 m s-2) with time signatures that include high-amplitude mechanical shocks (median crest factor of nearly 23). Compared to other machinery types, combines exhibited the lowest WBV levels and among the most favorable trunk postures. Substantial variability was observed in both the WBV and trunk posture summary measures, suggesting for future studies that alternative sampling strategies are needed to fully capture temporal patterns of machinery use.

Background Globally, emergency nutrition program adaptations were implemented as part of COVID-19 mitigation strategies, but the implications of the adoption of all protocol changes at scale in the context of deteriorating food security are not yet well characterized. With ongoing conflict, widespread floods, and declining food security, the secondary impacts of COVID-19 on child survival in South Sudan is of great concern. In light of this, the present study aimed to characterize the impact of COVID-19 on nutrition programming in South Sudan. Methods A mixed methods approach including a desk review and secondary analysis of facility-level program data was used to analyze trends in program indicators over time and compare two 15-month periods prior to the onset of COVID-19 (January 2019 – March 2020; “pre-COVID period”) and after the start of the pandemic (April 2020 – June 2021; “COVID” period) in South Sudan. Results The median number of reporting Community Management of Acute Malnutrition sites increased from 1167 pre-COVID to 1189 during COVID. Admission trends followed historic seasonal patterns in South Sudan; however, compared to pre-COVID, declines were seen during COVID in total admissions (− 8.2%) and median monthly admissions (− 21.8%) for severe acute malnutrition. For moderate acute malnutrition, total admissions increased slightly during COVID (1.1%) while median monthly admissions declined (− 6.7%). Median monthly recovery rates improved for severe (92.0% pre-COVID to 95.7% during COVID) and moderate acute malnutrition (91.5 to 94.3%) with improvements also seen in all states. At the national level, rates also decreased for default (− 2.4% for severe, − 1.7% for moderate acute malnutrition) and non-recovery (− 0.9% for severe, − 1.1% for moderate acute malnutrition), with mortality rates remaining constant at 0.05–0.15%. Conclusions Within the context of the ongoing COVID-19 pandemic in South Sudan, improved recovery, default, and non-responder rates were observed following adoption of changes to nutrition protocols. Policymakers in South Sudan and other resource-constrained settings should consider if simplified nutrition treatment protocols adopted during COVID-19 improved performance and should be maintained in lieu of reverting to standard treatment protocols.

Background. Globally, emergency nutrition program adaptations were implemented as part of COVID-19 mitigation strategies, but the implications of the adoption of all protocol changes at scale in the context of deteriorating food security are not yet well characterized. With ongoing conflict, widespread floods, and declining food security, the secondary impacts of COVID-19 on child survival in South Sudan is of great concern. Methods. A mixed methods approach including a desk review and secondary analysis of facility-level program data was used to analyze trends in program indicators over time and compare two 15-month periods prior to the onset of COVID-19 (January 2019 – March 2020; “pre-COVID period”) and after the start of the pandemic (April 2020 – June 2021; “COVID” period) in South Sudan. Results. The median number of reporting CMAM sites increased from 1,167 pre-COVID to 1,189 during COVID. Admission trends followed historic seasonal patterns in South Sudan; however, compared to pre-COVID, declines were seen during COVID in total admissions (-8.2%) and median monthly admissions (-21.8%) for SAM. For MAM, total admissions increased slightly during COVID (1.1%) while median monthly admissions declined (-6.7%). States with the largest admission declines also saw reductions in the number of treatment facilities during COVID. Median monthly recovery rates improved for SAM (92.0% pre-COVID to 95.7% during COVID) and MAM (91.5–94.3%); all states saw improvements in median monthly recovery rates for both SAM and MAM. At the national level, rates also decreased for default (-2.4% for SAM, -1.7% for MAM) and non-recovery (-0.9% for SAM, -1.1% for MAM), with mortality rates remaining constant at 0.05–0.15%. While median monthly mortality rates were stable for both SAM and MAM, the total number of SAM deaths fell by 35.2% and the total number of MAM deaths decreased by 42.1%. Conclusions. Within the context of the ongoing COVID-19 pandemic in South Sudan, improved recovery, default, and non-responder rates were observed following adoption of changes to nutrition protocols. Policymakers in South Sudan and other resource-constrained settings should consider if simplified nutrition treatment protocols adopted during COVID-19 improved performance and should be maintained in lieu of reverting to standard treatment protocols.

compared with normoxia. However, the expression of Nox2 was increased in Nrf2 2/2 mice exposed to hyperoxia. Conclusion: These results demonstrate that hyperoxia-induced Nox4 expression and ROS production is regulated by Nrf2 in lung endothelium.