Community-Based Testing for SARS-CoV-2 — Chicago, Illinois, May–November 2020

Abstract

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

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“…From September 2020 to June 2021, CDPH and IDPH operated a combined 10 static and 167 mobile community-based diagnostic testing sites in the city of Chicago that collected data on symptom status and date of symptom onset (Figure 2A) . These testing sites targeted communities experiencing high COVID-19 incidence and demographic groups and geographic areas underrepresented in testing by other clinical providers [29]. Testing sites focused specifically on serving Hispanic/Latino residents because this population had the highest daily incidence of COVID-19 of any racial/ethnic group during the study period (Figure 3) .…”

“…From May 13, 2020, CDPH and IDPH operated community-based SARS-CoV-2 diagnostic testing sites throughout Chicago. These sites were primarily intended to increase access to diagnostic testing among communities disproportionately affected by COVID-19 and those with the least access to diagnostic testing through other providers [29]. This study focuses on the period from September 27, 2020, to June 13, 2021, when these sites held consistent hours and reliably collected information on symptoms.…”