reopened. During influenza outbreaks, reopening has been associated with the risk of epidemic resurgence. The best solution for the COVID-19 pandemic is not known. It has been suggested that children who test positive on serologic tests that identify IgG against SARS-CoV-2 could beadmittedtoschool.Itissupposedthatpositivitycouldallowtheidentificationofchildrenwhohavealreadybeeninfected,canbeconsidered protected, and can attend school without posing risks per se to other children. However, the use of this procedure can be strongly criticized. The sensitivity of the presently available antibody tests is suboptimal. Most children have an asymptomatic infection, and as the immune response to SARS-CoV-2 infection has been found to be greater the more serious the disease is, it seems likely that most children will have a low antibody titer that is inadequate for obtaining positivity on tests with relatively low sensitivity. 10 Moreover, even when IgG levels are measured, it is not possible to state whether children are protected or how long the protection may last. The antibody protective level and secondary immune response to SARS-CoV-2 are not known. Taken together, these factors seem to indicate that most children with IgG positivity cannot be identified and, even if identified, cannot be considered protected for the long term. Other criteria, such as a systematic adoption of face masks with some lessons on this issue and on all hygiene measures for COVID-19 prevention, screening with temperature measurements, or closing classrooms with infected students, must be followed when school is resumed.
Objectives We sought to determine if racial disparities in pediatric asthma are explained by material hardship and home ownership. Methods We performed a secondary analysis of the 2011 American Housing Survey. 33,201 households with children age 6-17 years were surveyed regarding childhood asthma diagnosis and ED visits for asthma (for the youngest child with asthma in the household). Material hardship included poor housing quality, housing crowding, lack of amenities, and no vehicle access. We used logistic regression to determine the association between race, material hardship, and asthma diagnosis or ED visits, adjusting for potential confounders. Results Non-Hispanic Black heads of household had a higher odds of having a child diagnosed with asthma in the home in comparison to non-Hispanic White heads of household (OR 1.72, 95%CI 1.50-1.96), and a higher odds of ED visits for asthma (OR 3.02, 95%CI 2.29-3.99). The race-asthma association was decreased but not eliminated after adjusting for material hardship and home ownership (ED Visit AOR 2.07, 95%CI 1.50-2.86). Poor housing quality was independently associated with asthma diagnosis (AOR 1.45, 95%CI 1.28-1.66) and ED visits (AOR 1.59, 95%CI 1.21-2.10). Home ownership was associated with a lower odds of asthma-related ED visits (AOR 0.62, 95% CI 0.46-0.84). Conclusions Observed racial disparities in pediatric asthma are lessened after controlling for material hardship. Poor housing quality in particular is strongly associated with asthma morbidity. Policy makers could target improving housing quality as a means of potentially reducing asthma disparities.
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