Cumulative Incidence of SARS-CoV-2 Infections Among Adults in Georgia, United States, August to December 2020
This article has been Reviewed by the following groups
Discuss this preprint
Start a discussion What are Sciety discussions?Listed in
- Evaluated articles (ScreenIT)
Abstract
Background
Reported coronavirus disease 2019 (COVID-19) cases underestimate true severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Data on all infections, including asymptomatic infections, are needed. To minimize biases in estimates from reported cases and seroprevalence surveys, we conducted a household-based probability survey and estimated cumulative incidence of SARS-CoV-2 infections adjusted for antibody waning.
Methods
From August to December 2020, we mailed specimen collection kits (nasal swabs and blood spots) to a random sample of Georgia addresses. One household adult completed a survey and returned specimens for virus and antibody testing. We estimated cumulative incidence of SARS-CoV-2 infections adjusted for waning antibodies, reported fraction, and infection fatality ratio (IFR). Differences in seropositivity among demographic, geographic, and clinical subgroups were explored with weighted prevalence ratios (PR).
Results
Among 1370 participants, adjusted cumulative incidence of SARS-CoV-2 was 16.1% (95% credible interval [CrI], 13.5%–19.2%) as of 16 November 2020. The reported fraction was 26.6% and IFR was 0.78%. Non-Hispanic black (PR, 2.03; 95% confidence interval [CI], 1.0–4.1) and Hispanic adults (PR, 1.98; 95% CI, .74–5.31) were more likely than non-Hispanic white adults to be seropositive.
Conclusions
As of mid-November 2020, 1 in 6 adults in Georgia had been infected with SARS-CoV-2. The COVID-19 epidemic in Georgia is likely substantially underestimated by reported cases.
Article activity feed
-
-
SciScore for 10.1101/2021.05.06.21256407: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Field Sample Permit: Sampling: Our sampling methods have been previously described as part of the national COVIDVu study. Sex as a biological variable not detected. Randomization (4) We oversampled Fulton and Dekalb counties to facilitate estimation of seroprevalence in the City of Atlanta. Survey and Laboratory Procedures: One adult ≥18 years in each household listed household members by gender and age, and an adult household member was then randomly selected for participation by the electronic data system. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers …
SciScore for 10.1101/2021.05.06.21256407: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Field Sample Permit: Sampling: Our sampling methods have been previously described as part of the national COVIDVu study. Sex as a biological variable not detected. Randomization (4) We oversampled Fulton and Dekalb counties to facilitate estimation of seroprevalence in the City of Atlanta. Survey and Laboratory Procedures: One adult ≥18 years in each household listed household members by gender and age, and an adult household member was then randomly selected for participation by the electronic data system. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The data obtained through this household-based, representative survey complement data on reported COVID-19 cases and overcome key limitations associated with data available through traditional state-based COVID-19 surveillance activities and seroprevalence surveys. Because our household sampling strategy was not restricted to individuals experiencing COVID-19 symptoms or seeking SARS-CoV-2 testing, biases associated with testing availability, test-seeking behaviors and the inability to identify asymptomatic individuals were minimal. Additionally, because these data are obtained from a random, representative sample of Georgia residents, the findings can provide reliable inference to all adult Georgia residents. Due to the finding that, as of mid-November 2020, Georgia had only recognized approximately 26% of adults infected with SARS-CoV-2, there is an ongoing need to lower barriers for testing. Our data also validate efforts made thus far in the pandemic response to encourage and invest in frequent, ample testing, despite pushback by lawmakers and certain segments of the general public who may have viewed public health mitigation strategies to have been excessive.(16) Population-based COVID-19 data at the state level allows for a more nuanced understanding of the continuum of infection, diagnosis and mortality and the relationship of these metrics to programmatic priorities. For example, as of November 16, 2020, Georgia’s estimated case fatality ratio (CFR) was 2.1%.(17) Beca...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
-
