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Community Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Disproportionately Affects the Latinx Population During Shelter-in-Place in San FranciscoGabriel Chamie et al. Clin Infect Dis. 2021.
. 2021 Jul 30;73(Suppl 2):S127-S135. doi: 10.1093/cid/ciaa1234. Authors Gabriel Chamie 1 , Carina Marquez 1 , Emily Crawford 1 2 , James Peng 1 , Maya Petersen 3 , Daniel Schwab 4 , Joshua Schwab 3 , Jackie Martinez 1 , Diane Jones 5 , Douglas Black 1 , Monica Gandhi 1 , Andrew D Kerkhoff 1 , Vivek Jain 1 , Francesco Sergi 1 , Jon Jacobo 6 , Susana Rojas 6 , Valerie Tulier-Laiwa 6 , Tracy Gallardo-Brown 6 , Ayesha Appa 1 , Charles Chiu 1 , Mary Rodgers 7 , John Hackett 7 ; CLIAhub Consortium; Amy Kistler 2 , Samantha Hao 2 , Jack Kamm 2 , David Dynerman 2 , Joshua Batson 2 , Bryan Greenhouse 1 , Joe DeRisi 1 2 , Diane V Havlir 1 AffiliationsItem in Clipboard
AbstractBackground: There is an urgent need to understand the dynamics and risk factors driving ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission during shelter-in-place mandates.
Methods: We offered SARS-CoV-2 reverse-transcription polymerase chain reaction (PCR) and antibody (Abbott ARCHITECT IgG) testing, regardless of symptoms, to all residents (aged ≥4 years) and workers in a San Francisco census tract (population: 5174) at outdoor, community-mobilized events over 4 days. We estimated SARS-CoV-2 point prevalence (PCR positive) and cumulative incidence (antibody or PCR positive) in the census tract and evaluated risk factors for recent (PCR positive/antibody negative) vs prior infection (antibody positive/PCR negative). SARS-CoV-2 genome recovery and phylogenetics were used to measure viral strain diversity, establish viral lineages present, and estimate number of introductions.
Results: We tested 3953 persons (40% Latinx; 41% White; 9% Asian/Pacific Islander; and 2% Black). Overall, 2.1% (83/3871) tested PCR positive: 95% were Latinx and 52% were asymptomatic when tested; 1.7% of census tract residents and 6.0% of workers (non-census tract residents) were PCR positive. Among 2598 tract residents, estimated point prevalence of PCR positives was 2.3% (95% confidence interval [CI], 1.2%-3.8%): 3.9% (95% CI, 2.0%-6.4%) among Latinx persons vs 0.2% (95% CI, .0-.4%) among non-Latinx persons. Estimated cumulative incidence among residents was 6.1% (95% CI, 4.0%-8.6%). Prior infections were 67% Latinx, 16% White, and 17% other ethnicities. Among recent infections, 96% were Latinx. Risk factors for recent infection were Latinx ethnicity, inability to shelter in place and maintain income, frontline service work, unemployment, and household income <$50 000/year. Five SARS-CoV-2 phylogenetic lineages were detected.
Conclusions: SARS-CoV-2 infections from diverse lineages continued circulating among low-income, Latinx persons unable to work from home and maintain income during San Francisco's shelter-in-place ordinance.
Keywords: asymptomatic SARS-CoV-2 infection; community-based SARS-CoV-2 testing; ethnic disparities; phylogenetic analysis; shelter-in-place.
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
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