key: cord-0834819-d2r8tgaj
authors: Allan-Blitz, Lao-Tzu; Hertlein, Fred; Turner, Isaac; Klausner, Jeffrey D
title: Heterogenous Exposures May Drive SARS-CoV-2 Positivity Among Different Sub-Populations
date: 2021-04-13
journal: Open Forum Infect Dis
DOI: 10.1093/ofid/ofab183
sha: 9fb0f05904254db56bab9375430fde5559c9985f
doc_id: 834819
cord_uid: d2r8tgaj

nan

A c c e p t e d M a n u s c r i p t Dear editor, given the economic impact of indiscriminate closures (1) , and the heterogeneity with which SARS-CoV-2 infection spreads (2, 3) , interventions aimed towards curbing the pandemic must be targeted in order to maximize impact and minimize consequences. A growing body of evidence supports the idea that there are sub-populations at a disproportionately high risk for SARS-CoV-2 infection (4) (5) (6) . Data are limited, however, with regards to what specifically drives risk in those populations.

We evaluated SARS-CoV-2 test results from 209 publicly-available drive-through testing centers across 68 zip codes in Los Angeles, California between June and December 2020. Data were collected from individuals presenting for testing to an ongoing testing program. Testers completed an online survey (via personal smart-devices or a provided tablet upon presentation), which collected demographic information (age, gender, race and ethnicity) and report of any symptoms. As of September 2020, individuals were also asked about recent exposures to public venues (bars, restaurants, gas stations, public parks, retail stores, grocery stores, place of work, public transit, and place of worship).

Specimens were collected via self-collected oral swabs, which has been previously reported to have a sensitivity and specificity of 100%, and to be non-inferior to cliniciancollected nasopharyngeal swabs (7, 8 ). Those specimens were tested using the same RTpolymerase chain reaction methods reported previously (7) . We calculated risk ratios (RR) and 95% confidence intervals (CI) testing associations of public exposures with SARS-CoV-2 positivity, stratified by ethnicity to control for confounding given the disparate prevalence among minority groups (6) . We used report of visiting a Public Park as the reference group.

Mass General Brigham institutional review board deemed the analysis of de-identified data did not constitute human subjects' research (2020P003530). A c c e p t e d M a n u s c r i p t Limitations of our study include the potential for recall bias, the fact that our population sought testing, and the absence of further exposure information such as time spent in public venue and use of masks while at those venues. Further, our data are exploratory and descriptive, but overall reflect the possibility of identifying specific exposures driving SARS-CoV-2 transmission among sub-populations. M a n u s c r i p t

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