In this investigation, a confirmed case in a household contact was defined as having received a positive SARS-CoV-2 nucleic acid amplification test result or antigen test result ≤14 days after the index date (date of the index patient's symptom onset or positive SARS-CoV-2 nucleic acid amplification test result or antigen test result), and a probable case in a household contact was defined as the presence of COVID-19-compatible symptoms during the same 14-day period but without a positive SARS-CoV-2 test confirmation. Persons without symptoms and who did not have a positive SARS-CoV-2 test result were not considered to have a case of COVID-19. Analysis of AR among household contacts excluded eight persons with unknown case status (persons for whom it was not known whether COVID-19-compatible symptoms were present and whether SARS-CoV-2 testing had occurred [or if testing occurred, the results were unknown]).

On May 13, 2020, Chicago established a free communitybased testing (CBT) initiative for SARS-CoV-2, the virus that causes COVID-19, using reverse transcription-polymerase chain reaction (RT-PCR). The initiative focused on demographic groups and geographic areas that were underrepresented in testing by clinical providers and had experienced high COVID-19 incidence, including Hispanic persons and those who have been economically marginalized. To assess the CBT initiative, the Chicago Department of Public Health (CDPH) compared demographic characteristics, economic marginalization, and test positivity between persons tested at CBT sites and persons tested in all other testing settings in Chicago. During May 13-November 14, a total of 253,904 SARS-CoV-2 RT-PCR tests were conducted at CBT sites. Compared with those tested in all other testing settings in Chicago, persons tested at CBT sites were more likely to live in areas that are economically marginalized (38.6% versus 32.0%; p<0.001) and to be Hispanic (50.9% versus 20.7%; p<0.001). The cumulative percentage of positive test results at the CBT sites was higher than that at all other testing settings (11.1% versus 7.1%; p<0.001). These results demonstrate the ability of public health departments to establish community-based testing initiatives that reach communities with less access to testing in other settings and that experience disproportionately higher incidences of COVID-19.Because of limited access to SARS-CoV-2 diagnostic testing in the early phase of widespread transmission in Chicago, CBT sites began operations on May 13, 2020. The City of Chicago's CBT initiative, with direction from CDPH and the Racial Equity Rapid Response Team, † located sites at community assets (e.g., schools and parks) in areas accessible to Black and Hispanic communities, and in areas with lower per-capita testing rates; testing was offered at no cost to persons tested. These areas were primarily in northwest and southwest Chicago. The CBT initiative focused specifically on Hispanic § persons, because this population had the highest daily incidence of COVID-19 of any racial/ethnic group in Chicago during May 13-November 14, 2020 (1). Demographic