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COVID-19 survey examines fall infection rate

At least one out of every 100 St. Louis County adult residents had an active COVID-19 infection earlier this fall, while about five out of every 100 adults had contracted the disease at some earlier point, according to test results of a representative sample of county residents.

Those results were released by the St. Louis County Department of Public Health on Monday, Nov. 23. The survey was commissioned by the health department and launched by the Institute of Public Health at Washington University in St. Louis.

The testing measured active COVID-19 infection based on nasal swab tests. Past infections were determined by antibody/ blood tests. The findings suggest that over the course of the testing period, from mid- August through mid-October, about 1.2% of St. Louis County adult residents – some 9,500 – had an active COVID-19 infection at any given point, and 5% of adult residents, or about 39,000, had COVID-19 antibodies, indicating past infection.

Working with the county, the Institute for Public Health teamed with other local public health and healthcare providers to conduct a phone survey of a representa- tive sample of St. Louis County residents. Participants were offered free COVID-19 testing at convenient locations across the county, regardless of whether they had symptoms. They could choose to receive diagnostic testing to detect active COVID- 19 infection or antibody testing to detect previous infection. Transportation to and from testing sites was provided free of charge to those who needed it.

Over the course of the survey, more than 1,300 St. Louis County residents received a diagnostic test (PCR nasal swab) and/or an antibody test (blood test). More than 3,300 residents completed questionnaires to gauge how the pandemic had affected their lives. While detailed results of the ques- tionnaire are forthcoming, initial analyses show that a quarter of those surveyed had experienced wage reduction or job loss due to COVID-19, highlighting the pandemic’s wide-ranging impact.

The St. Louis County Department of Public Health allocated $1.99 million of its share of federal CARES Act funding to pay for the survey, as part of its efforts to respond to the pandemic. The department ultimately will use the project data and results to help inform decisions about public health and healthcare delivery during the pandemic and possible future public health emergencies.

The Institute for Public Health at Wash- ington University in St. Louis managed the project and coordinated data flow and anal- ysis. Collaborators for the COVID-19 testing included BJC HealthCare, SSM Health, Mercy and the St. Louis County Department of Public Health. The University of Mis- souri helped design and conduct the survey. The St. Louis Integrated Health Network provided consultation to the team related to community engagement and assisted in the delivery of follow-up services.

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