SARS-CoV-2 Seroprevalence among First Responders in the District of Columbia, May – July 2020

  1. Jacqueline Reuben
  2. Adrienne Sherman
  3. James A. Ellison
  4. Jayleen K. L. Gunn
  5. Anthony Tran
  6. Matthew McCarroll
  7. Pushker Raj
  8. Patricia Lloyd
  9. Preetha Iyengar
  10. Fern Johnson-Clarke
  11. John Davies-Cole
  12. LaQuandra Nesbitt

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Abstract

First responders are at increased risk of occupational exposure to SARS-CoV-2 while providing frontline support to communities during the COVID-19 pandemic. In the District of Columbia (DC), first responders were among the first people exposed to and infected with SARS-CoV-2, with over 200 first responders diagnosed with COVID-19 by May 15, 2020. From June – July 2020, DC Health conducted a serologic survey to estimate SARS-CoV-2 seroprevalence and assess risk factors and occupational exposures among a convenience sample of first responders in DC. Of the 310 first responders tested, 3.5% (n = 11) had anti-SARS-CoV-2 antibodies. Seropositivity varied by occupation, with 4.8% (3/62) of firefighters; 3.6% (8/220) of police officers; and no paramedics (0/10) or administration and support staff (0/18) testing positive. Type and consistency of personal protective equipment (PPE) use also varied: all paramedics (n=10) reported wearing a N95 respirator all or most of the time, compared to 83.3% of firefighters, 38.8% of police officers, and 23.5% of administration and support staff (p<0.001). All paramedics reported wearing gloves all or most of the time, compared to 80.0% of firefighters, 27.8% of administration and support staff, and 24.3% of police (p<0.001). The relatively low seroprevalence among first responders highlights the benefits of continuous training on and reinforcement of the proper use of PPE while performing job duties to mitigate potential transmission within and between first responders and the community.

Summary

Understanding occupational exposure to and infection with SARS-CoV-2 among first responders is important for workforce planning and emergency preparedness and response. Seroprevalence among first responders (3.5%; 11/310) who participated in a survey conducted by the District of Columbia Department of Health (DC Health) from May 28 – July 15 was 48% lower than reported in the DC community (6.7%; 876/12990). The lower prevalence of SARS-CoV-2 among first responders highlights the importance of continuous training on and reinforcement of the proper use of personal protective equipment (PPE). Proper use of PPE is a critical mitigation strategy to reduce transmission among and between first responders and the community.

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  1. ScreenIT

    SciScore for 10.1101/2020.11.25.20225490: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: All participants provided informed consent.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Serologic testing was conducted using the DiaSorin LIAISON® XL assay (DiaSorin Inc., Stillwater, MN), a qualitative chemiluminescent assay for determination of immunoglobulin G (IgG) antibodies to the spike protein (anti-S1 and anti-S2) of SARS-CoV-2.
    IgG
    suggested: None
    anti-S1
    suggested: None
    anti-S2
    suggested: None
    Software and Algorithms
    SentencesResources
    Questionnaire data were collected and managed using the secure Research Electronic Data Capture (REDCap) application.
    REDCap
    suggested: (REDCap, RRID:SCR_003445)
    Statistical analyses were performed using SAS software (version 9.4; SAS Institute).
    SAS Institute
    suggested: (Statistical Analysis System, RRID:SCR_008567)

    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:
    Despite these limitations, to our knowledge this is one of the first SARS-CoV-2 seroprevalence surveys conducted specifically among a cohort of first responders including law enforcement, thus providing valuable information to the agencies responding to the pandemic in the District of Columbia and adding to the limited literature surrounding PPE use and SARS-CoV-2 seroprevalence in this population. In recognition of the important role that face coverings play in reducing the spread of COVID-19, DC Mayor Bowser issued Mayor’s Order 2020-080 on July 22, 2020, mandating face masks or face coverings to be worn outside the home by all individuals in the District. This mandate requires not only DC residents, but also visitors and employees (inclusive of first responders) working in the District to wear a face covering at all times when not at home.

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.11.25.20225490v1 on medRxiv