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A Survey and Test Kit Delivered in the Mail Could Determine the Prevalence of COVID-19 in the United States

RESEARCH TRIANGLE PARK, N.C. — A recent paper published in Survey Research Methods, a peer reviewed journal of the European Survey Research Association, by researchers at RTI International, a nonprofit research institute, outlines the design for a population-based mail survey containing a self-test kit and questionnaire as a feasible and safe method to estimate the proportion of the population exposed to COVID-19.

The proposed survey would increase the understanding of the pandemic and set the stage for discourse with policymakers regarding the programs and initiatives necessary to mitigate its burden.

“A population-based SARS-CoV-2 antibody prevalence estimate would allow public health officials and policymakers to allocate resources where immunity prevalence is low, re-assess strategies like stay-at-home orders and guide vaccination program implementation and planning while keeping everyone safe and physically distant,” said Alicia Frasier, MPH, lead researcher of the study and a Senior Survey Director at RTI.

Stay-at-home orders and social distancing measures have limited the feasibility of in-person data collection. The survey would build upon previously successful survey administrations using at-home testing to test for disease prevalence. At-home testing would reduce the burdens of waiting in line and taking time off work while simultaneously relieving pressure off of health care systems by eliminating the time used for testing patients and allowing more time to care for those in need. It would also allow testing of individuals who have not experienced common COVID-19 symptoms, often necessary for testing in the clinical environment.

“From the testing data available so far, we’ve seen significant disparities, such as race and underlying chronic health conditions, in people who are hospitalized with severe symptoms,” said Heidi Guyer, PhD, Senior Public Health Research Scientist at RTI International. “What we do not know is the actual infection rate amongst these groups. This method of testing could help determine the infection rate, which will lead to a better understanding of the transmission and transgression of the virus.”

Although counts of the novel Coronavirus infections and deaths are reported by several online sources, a precise estimation of the exposed population is not possible in most areas across the world.

The study design is flexible, allowing it to be adapted and accommodated to local and international audiences to increase the statistical power and generalizability of the results. The sample size could be increased to allow estimates for additional groups such as essential workers, racial minorities, or the elderly.

The paper outlines how a mail survey offers a fast and efficient method to deliver a brief questionnaire and a test kit to a random sample of U.S. adults. The proposed survey could be scalable from 5,000 to 100,000 or more participants and would include a brief questionnaire to capture demographics, exposure, and any symptoms experienced—helping to further understand the symptomology profile of this virus.

Aggregate results would be reported to local and state health officials.

To read the paper, visit: https://ojs.ub.uni-konstanz.de/srm/article/view/7757