Geographic and demographic heterogeneity of SARS-CoV-2 diagnostic testing in Illinois, USA, March to December 2020

Holden, Tobias M; Richardson, Reese A.K.; Arevalo, Philip; Duffus, Wayne A.; Runge, Manuela; Whitney, Elena; Wise, Leslie; Ezike, Ngozi; Patrick, Sarah; Cobey, Sarah; Gerardin, Jaline

doi:10.1186/s12889-021-11177-x

Cited by 23 publications

(19 citation statements)

References 26 publications

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“…Test positivity rates (TPR) for Black and Hispanic/Latinx populations were much higher than in the White population at this time (Fig. 3 B), suggesting relatively insufficient testing in Black and Hispanic/Latinx demographics despite their slightly higher rate of per capita testing [ 16 ]. TPR exceeded 35% in all Hispanic/Latinx populations over 10 and Black populations over 18 in interval 1, compared with peak values of around 20% in White.…”

Section: Resultsmentioning

confidence: 99%

Structural racism and COVID-19 response: higher risk of exposure drives disparate COVID-19 deaths among Black and Hispanic/Latinx residents of Illinois, USA

et al. 2022

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Background Structural racism has driven and continues to drive policies that create the social, economic, and community factors resulting in residential segregation, lack of access to adequate healthcare, and lack of employment opportunities that would allow economic mobility. This results in overall poorer population health for minoritized people. In 2020, Black and Hispanic/Latinx communities throughout the United States, including the state of Illinois, experienced disproportionately high rates of COVID-19 cases and deaths. Public health officials in Illinois implemented targeted programs at state and local levels to increase intervention access and reduce disparities. Methods To quantify how disparities in COVID outcomes evolved through the epidemic, data on SARS-CoV-2 diagnostic tests, COVID-19 cases, and COVID-19 deaths were obtained from the Illinois National Electronic Disease Surveillance System for the period from March 1 to December 31, 2020. Relative risks of COVID-19 cases and deaths were calculated for Black and Hispanic/Latinx vs. White residents, stratified by age group and epidemic interval. Deaths attributable to racial/ethnic disparities in incidence and case fatality were estimated with counterfactual simulations. Results Disparities in case and death rates became less drastic after May 2020, but did not disappear, and were more pronounced at younger ages. From March to May of 2020, the risk of a COVID-19 case for Black and Hispanic/Latinx populations was more than twice that of Whites across all age groups. The relative risk of COVID-19 death reached above 10 for Black and Hispanic/Latinx individuals under 50 years of age compared to age-matched Whites in the early epidemic. In all Illinois counties, relative risk of a COVID-19 case was the same or significantly increased for minoritized populations compared to the White population. 79.3 and 86.7% of disparities in deaths among Black and Hispanic/Latinx populations, respectively, were attributable to differences in age-adjusted incidence compared to White populations rather than differences in case fatality ratios. Conclusions Racial and ethnic disparities in the COVID-19 pandemic are products of society, not biology. Considering age and geography in addition to race/ethnicity can help to identify the structural factors driving poorer outcomes for certain groups. Studies and policies aimed at reducing inequalities in disease exposure may reduce disparities in mortality more than those focused on drivers of case fatality.

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Section: Resultsmentioning

confidence: 99%

Structural racism and COVID-19 response: higher risk of exposure drives disparate COVID-19 deaths among Black and Hispanic/Latinx residents of Illinois, USA

et al. 2022

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“…Many different approaches to high throughput testing have been deployed in support of such comprehensive testing 4,[15][16][17] , but these are expensive and difficult to scale and maintain. There is also a risk that such resource-intensive testing programs will perpetuate inequalities in the distribution of COVID-19 testing access [18][19][20][21][22][23] .…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 and other respiratory pathogens are detected in continuous air samples from congregate settings

Ramuta

Newman

Brakefield

et al. 2022

Preprint

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Two years after the emergence of SARS-CoV-2, there is still a need for better ways to assess the risk of transmission in congregate spaces. We deployed active air samplers to monitor the presence of SARS-CoV-2 in real-world settings across communities in the Upper Midwestern states of Wisconsin and Minnesota. Over 29 weeks, we collected 527 air samples from 15 congregate settings and detected 106 SARS-CoV-2 positive samples, demonstrating SARS-CoV-2 can be detected in air collected from daily and weekly sampling intervals. We expanded the utility of air surveillance to test for 40 other respiratory pathogens. Surveillance data revealed differences in timing and location of SARS-CoV-2 and influenza A virus detection in the community. In addition, we obtained SARS-CoV-2 genome sequences from air samples to identify variant lineages. Collectively, this shows air surveillance is a scalable, cost-effective, and high throughput alternative to individual testing for detecting respiratory pathogens in congregate settings.

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“…Incident cases, the fraction of diagnostic tests that return a positive result (test positivity rate, TPR), or any other metric based on diagnostic testing in the general population is subject to bias due to fluctuating access to, availability of, and demand for diagnostic testing. These factors vary across time, geography, age, and racial and ethnic groups, and the data needed to control for these biases is often unavailable [1,[13][14][15][16][17]. The timeliness of data can also be hampered by long turn-around-times and delays in vendors' reporting of test results to health agencies [14].…”

Section: Introductionmentioning

confidence: 99%

Tracking changes in SARS-CoV-2 transmission with a novel outpatient sentinel surveillance system in Chicago, USA

Richardson

Jorgensen

Arevalo

et al. 2022

Preprint

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Public health indicators typically used for COVID-19 surveillance can be biased or lag changing community transmission patterns. The United States city of Chicago opportunistically investigated whether sentinel surveillance of recently symptomatic individuals receiving outpatient diagnostic testing for SARS-CoV-2 could accurately assess the instantaneous reproductive number R(t) and provide early warning of changes in transmission. Patients tested at community-based diagnostic testing sites between September 2020 and June 2021, and reporting symptom onset within four days preceding their test, formed the sentinel population. R(t) calculated from sentinel cases agreed well with R(t) from other indicators. Retrospectively, trends in sentinel cases did not precede trends in COVID-19 hospital admissions by any identifiable lead time. In deployment, sentinel surveillance held an operational recency advantage of nine days over hospital admissions. The promising performance of opportunistic sentinel surveillance suggests that deliberately designed outpatient sentinel surveillance would provide robust early warning of increasing transmission.

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Geographic and demographic heterogeneity of SARS-CoV-2 diagnostic testing in Illinois, USA, March to December 2020

Cited by 23 publications

References 26 publications

Structural racism and COVID-19 response: higher risk of exposure drives disparate COVID-19 deaths among Black and Hispanic/Latinx residents of Illinois, USA

Structural racism and COVID-19 response: higher risk of exposure drives disparate COVID-19 deaths among Black and Hispanic/Latinx residents of Illinois, USA

SARS-CoV-2 and other respiratory pathogens are detected in continuous air samples from congregate settings

Tracking changes in SARS-CoV-2 transmission with a novel outpatient sentinel surveillance system in Chicago, USA

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