Behaviors Associated With Household Transmission of SARS-CoV-2 in California and Colorado, January 2021–April 2021
Apophia Namageyo-Funa, PhD,
Jasmine D. Ruffin, MPH,
Marie E. Killerby, VetMB,
Mohamed F. Jalloh, PhD,
Colleen Scott, DrPH,
Kristine Lindell, BA,
Margaret Silver, MPH,
Almea Matanock, MD,
Raymond A. Soto, PhD,
Marisa A.P. Donnelly, PhD,
Noah G. Schwartz, MD,
Meagan R. Chuey, PhD,
Victoria T. Chu, MD,
Mark E. Beatty, MD,
Sarah Elizabeth Totten, DrPH,
Meghan M. Hudziec, BS,
Jacqueline E. Tate, PhD,
Hannah L. Kirking, MD,
Christopher H. Hsu, MD, PhD
Affiliations
Apophia Namageyo-Funa, PhD
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Jasmine D. Ruffin, MPH
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Abt Associates, Atlanta, Georgia; Address correspondence to: Jasmine D. Ruffin, MPH, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, Atlanta GA 30329.
Marie E. Killerby, VetMB
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Mohamed F. Jalloh, PhD
Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
Colleen Scott, DrPH
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Kristine Lindell, BA
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Margaret Silver, MPH
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Almea Matanock, MD
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Raymond A. Soto, PhD
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
Marisa A.P. Donnelly, PhD
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
Noah G. Schwartz, MD
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
Meagan R. Chuey, PhD
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; County of San Diego Health & Human Services Agency, San Diego, California
Victoria T. Chu, MD
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
Mark E. Beatty, MD
County of San Diego Health & Human Services Agency, San Diego, California
Sarah Elizabeth Totten, DrPH
Colorado Department of Public Health & Environment, Denver, Colorado
Meghan M. Hudziec, BS
Colorado Department of Public Health & Environment, Denver, Colorado
Jacqueline E. Tate, PhD
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Hannah L. Kirking, MD
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Christopher H. Hsu, MD, PhD
COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
Introduction: Mitigation behaviors are key to preventing SARS-CoV-2 transmission. We identified the behaviors associated with secondary transmission from confirmed SARS-CoV-2 primary cases to household contacts and described the characteristics associated with reporting these behaviors. Methods: Households with confirmed SARS-CoV-2 infections were recruited in California and Colorado from January to April 2021. Self-reported behaviors and demographics were collected through interviews. We investigated behaviors associated with transmission and individual and household characteristics associated with behaviors using univariable and multivariable logistic regression with generalized estimating equations to account for household clustering. Results: Among household contacts of primary cases, 43.3% (133 of 307) became infected with SARS-CoV-2. When an adjusted analysis was conducted, household contacts who slept in the same bedroom with the primary case (AOR=2.19; 95% CI=1.25, 3.84) and ate food prepared by the primary case (AOR=1.98; 95% CI=1.02, 3.87) had increased odds of SARS-CoV-2 infection. Household contacts in homes ≤2,000 square feet had increased odds of sleeping in the same bedroom as the primary case compared with those in homes >2,000 square feet (AOR=3.97; 95% CI=1.73, 9.10). Parents, siblings, and other relationships (extended family, friends, or roommates) of the primary case had decreased odds of eating food prepared by the primary case compared with partners. Conclusions: Sleeping in the same bedroom as the primary case and eating food prepared by the primary case were associated with secondary transmission. Household dimension and relationship to the primary case were associated with these behaviors. Our findings encourage innovative means to promote adherence to mitigation measures that reduce household transmission.
