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Risk of Severe COVID-19 Among Workers and Their Household Members

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Employment-related exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can endanger not only workers, but also their household members.1,2 Using prepandemic data, we examined the prevalence of Centers for Disease Control and Prevention (CDC) risk factors for severe coronavirus disease 2019 (COVID-19). We then estimated how many adults at increased risk of severe COVID-19 held essential jobs and could not work at home (WAH) or who lived in households with such workers.

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Article Information

Accepted for Publication: September 13, 2020.

Published Online: November 9, 2020. doi:10.1001/jamainternmed.2020.6249

Corresponding Author: Thomas M. Selden, PhD, Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, 5600 Fishers Ln, Rockville, MD 20857 (thomas.selden@ahrq.hhs.gov).

Author Contributions: Drs Selden and Berdahl had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: All authors.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: All authors.

Administrative, technical, or material support: Berdahl.

Conflict of Interest Disclosures: None reported.

Funding/Support: There was no external funding associated with this research; it was conducted by Selden and Berdahl as employees of AHRQ as part of AHRQ’s intramural research program.

Role of the Funder/Sponsor: Drs Selden and Berdahl are employees of the US AHRQ. Aside from the internal peer review process, AHRQ had no role in designing and conducting the study; collecting, managing, analyzing and interpreting the data; preparing, reviewing or approving the manuscript; or the decision to submit the manuscript for publication.

Disclaimer: The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the views of the US Department of Health and Human Services or AHRQ.

Additional Contributions: Joel Cohen, PhD, David Meyers, MD, and G. Edward Miller, PhD, provided comments on early versions of the draft. Drs Cohen, Meyers, and Miller work for AHRQ and received no compensation.

References
1.
Selden  TM , Berdahl  TA .  Racial and ethnic disparities in COVID-19 health risk factors and employment-related exposure risk for workers and their household members.   Health Aff (Millwood). 2020;39(9):1624-1632. doi:10.1377/hlthaff.2020.00897PubMedGoogle ScholarCrossref
2.
McCormack  G , Avery  C , Spitzer  AK , Chandra  A .  Economic vulnerability of households with essential workers.   JAMA. 2020;324(4):388-390. doi:10.1001/jama.2020.11366 PubMedGoogle ScholarCrossref
3.
Agency for Healthcare Research and Quality. MEPS HC-201: 2017 full year consolidated data file. Accessed April 7, 2020. https://meps.ahrq.gov/mepsweb/data_stats/download_data_files_detail.jsp?cboPufNumber=HC-201
4.
US Department of Homeland Security Cybersecurity & Infrastructure Security Agency. Advisory memorandum on identification of essential critical infrastructure workers during COVID-19 response. Accessed March 25, 2020. http://web.archive.org/web/20200325163616/https://www.cisa.gov/sites/default/files/publications/CISA_Guidance_on_the_Essential_Critical_Infrastructure_Workforce_508C_0.pdf
5.
Hofferth  SL , Flood  SM , Sobek  M , Backman  D . American Time Use Survey data extract builder: version 2.8 [data set]. Accessed March 19, 2020. https://www.atusdata.org/atus/
6.
Centers for Disease Control and Prevention. Groups at higher risk for severe illness. Accessed July 17, 2020. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/index.html
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