Corpus overview


MeSH Disease

Human Phenotype

Fever (10)

Cough (10)

Obesity (7)

Anosmia (4)

Pneumonia (4)


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    Phylogenomic analysis of SARS-CoV-2 genomes from western India reveals unique linked mutations

    Authors: Dhiraj Paul; Kunal Jani; Janesh Kumar; Radha Chauhan; Vasudevan Seshadri; Girdhari Lal; Rajesh Karyakarte; Suvarna Joshi; Murlidhar Tambe; Sourav Sen; Santosh Karade; Kavita Bala Anand; Shelinder Pal Singh Shergill; Rajiv Mohan Gupta; Manoj Kumar Bhat; Arvind Sahu; Yogesh S Shouche

    doi:10.1101/2020.07.30.228460 Date: 2020-07-31 Source: bioRxiv

    India has become the third worst-hit nation by the COVID-19 pandemic caused by the SARS-CoV-2 virus. Here, we investigated the molecular, phylogenomic, and evolutionary dynamics of SARS-CoV-2 in western India, the most affected region of the country. A total of 90 genomes were sequenced. Four nucleotide variants, namely C241T, C3037T, C14408T (Pro4715Leu), and A23403G (Asp614Gly), located at 5UTR, Orf1a, Orf1b, and Spike protein regions of the genome, respectively, were predominant and ubiquitous (90%). Phylogenetic analysis of the genomes revealed four distinct clusters, formed owing to different variants. The major cluster (cluster 4) is distinguished by mutations C313T, C5700A, G28881A are unique patterns and observed in 45% of samples. We thus report a newly emerging pattern of linked mutations. The predominance of these linked mutations suggests that they are likely a part of the viral fitness landscape. A novel and distinct pattern of mutations in the viral strains of each of the districts was observed. The Satara district viral strains showed mutations primarily at the 3' end of the genome, while Nashik district viral strains displayed mutations at the 5' end of the genome. Characterization of Pune strains showed that a novel variant has overtaken the other strains. Examination of the frequency of three mutations i.e., C313T, C5700A, G28881A in symptomatic versus asymptomatic TRANS patients indicated an increased occurrence in symptomatic cases, which is more prominent in females TRANS. The age TRANS-wise specific pattern of mutation is observed. Mutations C18877T, G20326A, G24794T, G25563T, G26152T, and C26735T are found in more than 30% study samples in the age group TRANS of 10-25. Intriguingly, these mutations are not detected in the higher age TRANS range 61-80. These findings portray the prevalence SERO of unique linked mutations in SARS-CoV-2 in western India and their prevalence SERO in symptomatic patients. ImportanceElucidation of the SARS-CoV-2 mutational landscape within a specific geographical location, and its relationship with age TRANS and symptoms, is essential to understand its local transmission TRANS dynamics and control. Here we present the first comprehensive study on genome and mutation pattern analysis of SARS-CoV-2 from the western part of India, the worst affected region by the pandemic. Our analysis revealed three unique linked mutations, which are prevalent in most of the sequences studied. These may serve as a molecular marker to track the spread of this viral variant to different places.

    Incidence and outcomes of healthcare-associated COVID-19 infections MESHD: significance of delayed diagnosis and correlation with staff absence

    Authors: Kirstin Khonyongwa; Surabhi K Taori; Ana Soares; Nergish Desai; Malur Sudhanva; William Bernal; Silke Schelenz; Lisa A Curran

    doi:10.1101/2020.07.24.20148262 Date: 2020-07-30 Source: medRxiv

    Background: The sudden increase in COVID-19 admissions in hospitals during the SARS-CoV2 pandemic of 2020 has led to onward transmissions TRANS among vulnerable inpatients. Aims: This study was performed to evaluate the prevalence SERO and clinical outcomes of Healthcare-associated COVID-19 infections MESHD (HA-COVID-19) during the 2020 epidemic and study factors which may promote or correlate with its incidence and transmission TRANS in a London Teaching Hospital Trust. Methods: Electronic laboratory, patient and staff self-reported sickness records were interrogated for the period 1st March to 18th April 2020. HA-COVID-19 was defined as symptom onset TRANS >14d of admission. Test performance SERO of a single combined throat and nose swab (CTNS) for patient placement and the effect of delayed RNA positivity (DRP, defined as >48h delay) on patient outcomes was evaluated. The incidence of staff self-reported COVID-19 sickness absence, hospital bed occupancy, community incidence and DRP was compared HA-COVID-19. The incidence of other significant hospital-acquired bacterial infections MESHD (OHAI) was compared to previous years. Results: 58 HA-COVID-19 (7.1%) cases were identified. As compared to community-acquired cases, significant differences were observed in age TRANS (p=0.018), ethnicity (p<0.001) and comorbidity burden (p<0.001) but not in 30d mortality. CTNS negative predictive value SERO was 60.3%. DRP was associated with greater mortality (p=0.034) and 34.5% HA-COVID-19 cases could be traced TRANS to delayed diagnosis in CA-COVID-19. Incidence of HA-COVID-19 correlated positively with DRP (R=0.7108) and staff sickness absence (R=0.7815). OHAI rates were similar to previous 2 years. Conclusion: Early diagnosis and isolation of COVID-19 would help reduce transmission TRANS. A single CTNS has limited value in segregating patients into positive and negative pathways.

    The relationship between demographic, psychosocial and health-related parameters and the impact of COVID-19: a study of twenty-four Indian regions

    Authors: Ravi Philip Rajkumar

    doi:10.1101/2020.07.27.20163287 Date: 2020-07-30 Source: medRxiv

    Objectives: The impact of the COVID-19 pandemic has varied widely across nations and even in different regions of the same nation. Some of this variability may be due to the interplay of pre-existing demographic, psychological, social and health-related factors in a given population. Methods: Data on the COVID-19 prevalence SERO, crude mortality and case fatality rates were obtained from official government statistics for 24 regions of India. The relationship between these parameters and demographic, social, psychological and health-related indices in these states was examined using both bivariate and multivariate analyses. Results: A variety of factors - state population, sex ratio, and burden of diarrhoeal disease MESHD and ischemic heart disease MESHD - were associated with measures of the impact of COVID-19 on bivariate analyses. On multivariate analyses, prevalence SERO and crude mortality rate were both significantly and negatively associated with the sex ratio. Conclusions: These results suggest that the transmission TRANS and impact of COVID-19 in a given population may be influenced by a number of variables, with demographic factors showing the most consistent association.

    EUAdb: a resource for COVID-19 test development

    Authors: Alyssa Woronik; Henry W Shaffer; Karin Kiontke; Jon M Laurent; Ronald Zambrano; Jef D Boeke; David H.A. Fitch

    doi:10.1101/2020.07.30.228890 Date: 2020-07-30 Source: bioRxiv

    Due to the sheer number of COVID-19 ( coronavirus disease MESHD 2019) cases, the prevalence SERO of asymptomatic TRANS cases and the fact that undocumented cases appear to be significant for transmission TRANS of the causal virus, SARS-CoV-2 ( severe acute respiratory syndrome MESHD coronavirus 2), there is an urgent need for increased SARS-CoV-2 testing capability that is both efficient and effective1. In response to the growing threat of the COVID-19 pandemic in February, 2020, the FDA (US Food and Drug Administration) began issuing Emergency MESHD Use Authorizations (EUAs) to laboratories and commercial manufacturers for the development and implementation of diagnostic tests1. So far, the gold standard assay for SARS-CoV-2 detection is the RT-qPCR (real-time quantitative polymerase chain reaction) test2. However, the authorized RT-qPCR test protocols vary widely, not only in the reagents, controls, and instruments they use, but also in the SARS-CoV-2 genes they target, what results constitute a positive SARS-CoV-2 infection MESHD, and their limit of detection (LoD). The FDA has provided a web site that lists most of the tests that have been issued EUAs, along with links to the authorization letters and summary documents describing these tests1. However, it is very challenging to use this site to compare or replicate these tests for a variety of reasons. First, at least 12 of 18 tests that were issued EUAs prior to March 31, 2020, are not listed there. Second, the data are not standardized and are only provided as longhand prose in the summary documents. Third, some details (e.g. primer sequences) are absent from several of the test descriptions. Fourth, for tests provided by commercial manufacturers, summary documents are completely missing. To address at least the first three issues, we have developed a database, EUAdb (, that holds standardized information about EUA-issued tests and is focused on RT-qPCR diagnostic tests, or "high complexity molecular-based laboratory developed tests"1. By providing a standardized ontology and curated data in a relational architecture, we seek to facilitate comparability and reproducibility, with the ultimate goal of consistent, universal and high-quality testing nationwide. Here, we document the basics of the EUAdb data architecture and simple data queries. The source files can be provided to anyone who wants to modify the database for his/her own research purposes. We ask that the original source of the files be made clear and that the database not be used in its original or modified forms for commercial purposes.

    Serial population based serosurvey of antibodies to SARS-CoV-2 SERO in a low and high transmission TRANS area of Karachi, Pakistan

    Authors: Muhammad Imran Nisar; Nadia Ansari; Mashal Amin; Farah Khalid; Aneeta Hotwani; Najeeb Rehman; Arjumand Rizvi; Arslan Memon; Zahoor Ahmed; Ashfaque Ahmed; Junaid Iqbal; Ali Faisal Saleem; Uzma Bashir Aamir; Daniel B Larremore; Bailey Fosdick; Fyezah Jehan

    doi:10.1101/2020.07.28.20163451 Date: 2020-07-29 Source: medRxiv

    Background Pakistan is among the first low- and middle-income countries affected by COVID-19 pandemic. Monitoring progress through serial sero-surveys SERO, particularly at household level, in densely populated urban communities can provide insights in areas where testing is non-uniform. Methods Two serial cross-sectional household surveys were performed in April (phase 1) and June (phase 2) 2020 each in a low- (District Malir) and high- transmission TRANS (District East) area of Karachi, Pakistan. Household were selected using simple random sampling (Malir) and systematic random sampling (East). Individual participation rate from consented households was 82.3% (1000/1215 eligible) in phase 1 and 76.5% (1004/1312 eligible) in phase 2. All household members or their legal guardians answered questions related to symptoms of Covid-19 and provided blood SERO for testing with commercial Elecsys Anti-SARS-CoV-2 immunoassay SERO targeting combined IgG and IgM. Seroprevalence SERO estimates were computed for each area and time point independently. Given correlation among household seropositivity values, a Bayesian regression model accounting for household membership, age TRANS and gender TRANS was used to estimate seroprevalence SERO. These estimates by age TRANS and gender TRANS were then post-stratified to adjust for the demographic makeup of the respective district. The household conditional risk of infection TRANS risk of infection TRANS infection MESHD was estimated for each district and its confidence interval were obtained using a non-parametric bootstrap of households. Findings Post-stratified seroprevalence SERO was estimated to be 0.2% (95% CI 0-0.7) in low-and 0.4% (95% CI 0 - 1.3) in high- transmission TRANS areas in phase 1 and 8.7% (95% CI 5.1-13.1) in low- and 15.1% (95% CI 9.4 -21.7) in high- transmission TRANS areas in phase 2, with no consistent patterns between prevalence SERO rates for males TRANS and females TRANS. Conditional risk of infection TRANS risk of infection TRANS infection MESHD estimates (possible only for phase 2) were 0.31 (95% CI 0.16-0.47) in low- and 0.41(95% CI 0.28-0.52) in high- transmission TRANS areas. Of the 166 participants who tested positive, only 9(5.4%) gave a history of any symptoms. Interpretation A large increase in seroprevalence SERO to SARS-CoV-2 infection MESHD is seen, even in areas where transmission TRANS is reported to be low. Mostly the population is still seronegative. A large majority of seropositives do not report any symptoms. The probability that an individual in a household is infected, given that another household member is infected is high in both the areas. These results emphasise the need to enhance surveillance activities of COVID-19 especially in low- transmission TRANS sites and provide insights to risks of household transmission TRANS in tightly knit neighbourhoods in urban LMIC settings.

    Longitudinal COVID-19 Surveillance and Characterization in the Workplace with Public Health and Diagnostic Endpoints

    Authors: Manjula Gunawardana; Jessica Breslin; John M Cortez; Sofia Rivera; Simon Webster; F Javier Ibarrondo; Otto O Yang; Richard B Pyles; Christina M Ramirez; Amy P Adler; Peter A Anton; Marc M Baum

    doi:10.1101/2020.07.25.20160812 Date: 2020-07-28 Source: medRxiv

    Background The rapid spread of severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) and the associated coronavirus disease MESHD 2019 (COVID-19) have precipitated a global pandemic heavily challenging our social behavior, economy, and healthcare infrastructure. Public health practices currently represent the primary interventions for managing the spread of the pandemic. We hypothesized that frequent, longitudinal workplace disease MESHD surveillance would represent an effective approach to controlling SARS-CoV-2 transmission TRANS among employees and their household members, reducing potential economic consequences and loss of productivity of standard isolation methods, while providing new insights into viral-host dynamics. Methodology and Findings On March 23, 2020 a clinical study (OCIS-05) was initiated at a small Southern California organization. Results from the first 3 months of the ongoing study are presented here. Study participants (27 employees and 27 household members) consented to provide frequent nasal or oral swab samples that were analyzed by RT-qPCR for SARS-CoV-2 RNA using CDC protocols. Only participants testing negative were allowed to enter the "safe zone" workplace facility. Optional blood SERO samples were collected at baseline and throughout the 3-month study. Serum SERO virus-specific antibody SERO concentrations (IgG, IgM, and IgA) were measured using a selective, sensitive, and quantitative ELISA assay SERO developed in house. A COVID-19 infection MESHD model, based on traditional SEIR compartmental models combined with Bayesian non-linear mixed models and modern machine learning, was used to predict the number of employees and household members who would have become infected in the absence of workplace surveillance. Two study participants were found to be infected by SARS-CoV-2 during the study. One subject, a household member, tested positive clinically by RT-qPCR prior to enrollment and experienced typical COVID-19 symptoms that did not require hospitalization. While on study, the participant was SARS-CoV-2 RNA positive for at least 71 days and had elevated virus-specific antibody SERO concentrations (medians: IgM, 9.83 ug mL-1; IgG, 11.5 ug mL-1; IgA, 1.29 ug mL-1) in serum samples SERO collected at three timepoints. A single, unrelated employee became positive for SARS-CoV-2 RNA over the course of the study, but remained asymptomatic TRANS with low associated viral RNA copy numbers. The participant did not have detectable serum SERO IgM and IgG concentrations, and IgA concentrations decayed rapidly (half-life: 1.3 d). The employee was not allowed entry to the safe zone workplace until testing negative three consecutive times over 7 d. No other employees or household members contracted COVID-19 over the course of the study. Our model predicted that under the current prevalence SERO in Los Angeles County without surveillance intervention, up to 7 employees (95% CI = 3-10) would have become infected with at most 1 of them requiring hospitalizations and 0 deaths MESHD. Conclusions Our clinical study met its primary objectives by using intense longitudinal testing to provide a safe work environment during the COVID-19 pandemic, and elucidating SARS-CoV-2 dynamics in recovering and asymptomatic TRANS participants. The surveillance plan outlined here is scalable and transferrable. The study represents a powerful example on how an innovative public health initiative can be dovetailed with scientific discovery.

    Comparison of viral levels in individuals with or without symptoms at time of COVID-19 testing among 32,480 residents and staff of nursing homes and assisted living facilities in Massachusetts.

    Authors: Niall J Lennon; Roby P Bhattacharyya; Michael J Mina; Heidi L Rehm; Deborah T Hung; Sandra Smole; Ann Woolley; Eric S Lander; Stacey B Gabriel

    doi:10.1101/2020.07.20.20157792 Date: 2020-07-26 Source: medRxiv

    Background Transmission TRANS of COVID-19 from people without symptoms poses considerable challenges to public health containment measures. The distribution of viral loads in individuals with and without symptoms remains uncertain. Comprehensive cross-sectional screening of all individuals in a given setting provides an unbiased way to assess viral loads independent of symptoms, which informs transmission risks TRANS. COVID-19 cases initially peaked in Massachusetts in mid-April 2020 before declining through June, and congregate living facilities were particularly affected during this early surge. We performed a retrospective analysis of data from a large public health-directed outbreak response initiative that involved comprehensive screening within nursing homes and assisted living facilities in Massachusetts to compare nasopharyngeal (NP) viral loads (as measured by RT-PCR cycle threshold (Ct) levels) in residents and staff to inform our ability to detect SARS-CoV-2 in individuals with or without symptoms in the population. Methods Between April 9 and June 9, 2020, we tested NP swabs from 32,480 unique individuals comprising staff and residents of the majority of nursing homes and assisted living facilities in Massachusetts. Under the direction of the MA Department of Public Health (MDPH), symptomatology at the time of sampling and demographic information was provided by each facility for each individual to facilitate reporting to health officials. NP swabs were collected, RNA extracted, and SARS-CoV-2 testing performed using quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR). Results The nursing home and assisted living facilities resident cohort (N =16,966) was 65% female TRANS with a mean age TRANS of 82 years (SD 13 yrs). The staff cohort (N = 15,514) was 76% female TRANS with a median age TRANS of 45 (SD 15 yrs). A total 2654 residents (15.5%) and 624 staff (4.1%) tested positive for SARS-CoV-2. 12.7% of residents and 3.7% of staff without symptoms tested positive for SARS-CoV-2, compared to 53.1% of residents and 18.2% of staff with symptoms. Of the individuals who tested positive, 70.8% of residents and 92.4% of staff lacked symptoms at the time of testing. In aggregate, the distributions of Cts for viral probes used in the qRT-PCR assay were very similar, with a statistically but not meaningfully different mean ({triangleup}Ct 0.71 cycles, p = 0.006) and a similar range (12-38 cycles), between populations with and without symptoms over the entire time period, across all sub-categories examined ( age TRANS, race, ethnicity, sex, resident/staff). Importantly, the Ct mean values and range were indistinguishable between the populations by symptom class during the peak of the outbreak in Massachusetts, with a Ct gap appearing only later in the survey period, reaching >3 cycles (p [≤] 0.001) for facilities sampled during the last two weeks of the study. Conclusions In a large cohort of individuals screened for SARS-CoV-2 by qRT-PCR, we found strikingly similar distributions of viral load in patients with or without symptoms at the time of testing during the local peak of the epidemic; as the epidemic waned, individuals without symptoms at the time of testing had lower viral loads. The size of the study population, including both staff and residents spanning a wide range of ages TRANS, provides a comprehensive cross-sectional point prevalence SERO measurement of viral burden in a study spanning 2 months. Because the distributions of viral loads in infected individuals irrespective of symptomatology are very similar, existing testing modalities that have been validated for detection of SARS-CoV-2 RNA in symptomatic patients should perform similarly in individuals without symptoms at the time of testing.

    SARS-CoV-2 antibody SERO prevalence SERO in health care workers: Preliminary report of a single center study

    Authors: Michael Brant-Zawadzki; Deborah Fridman; Philip Robinson; Matthew Zahn; Randy German; Marcus Breit; Junko Hara

    doi:10.1101/2020.07.20.20158329 Date: 2020-07-25 Source: medRxiv

    SARS-CoV-2 has driven a pandemic crisis. Serological surveys have been conducted to establish prevalence SERO for covid-19 antibody SERO in various cohorts and communities. However, the prevalence SERO among healthcare workers is still being analyzed. The present study reports on initial sero-surveillance conducted on healthcare workers at a regional hospital system in Orange County, California, during May and June, 2020. Study participants were recruited from the entire hospital employee workforce and the independent medical staff. Data were collected for job title, location, covid-19 symptoms, a PCR test history, travel TRANS record since January 2020, and existence of household contacts TRANS with covid-19. A blood SERO sample was collected from each subject for serum SERO analysis for IgG antibodies SERO to SARS-CoV-2. Of 3,013 tested individuals, a total 2,932 were included in the analysis due to some missing data. Observed prevalence SERO of 1.06% (31 antibody SERO positive cases), adjusted prevalence SERO of 1.13% for test sensitivity SERO and specificity were identified. Significant group differences between positive vs. negative were observed for age TRANS (z = 2.65, p = .008), race (p = .037), presence of fever MESHD fever HP (p < .001) and loss of smell (p < .001). Possible explanation for this low prevalence SERO includes a relatively low local geographic community prevalence SERO (~4.4%) at the time of testing, the hospital's timely procurement of personal protective equipment, rigorous employee education, patient triage and treatment protocol development and implementation. In addition, possible greater presence of cross-reactive adaptive T cell mediated immunity in healthcare workers vs. the general population may have contributed. Determining antibody SERO prevalence SERO in front-line workers, and duration of antibody SERO presence may help stratify the workforce for risk, establish better health place policies and procedures, and potentially better mitigate transmission TRANS.

    Prevalence SERO of mask wearing in northern Vermont in response to SARS-CoV-2

    Authors: Brian Beckage; Thomas Buckley; Maegan E Beckage

    doi:10.1101/2020.07.23.20158980 Date: 2020-07-25 Source: medRxiv

    Mask wearing is integral to reducing the spread of SARS-CoV-2. Information on prevalence SERO of face mask usage is required both to model disease MESHD disease spread TRANS spread and to improve compliance with mask usage through targeted messaging. We sought to (1) estimate the prevalence SERO of mask usage in the most populous county of Vermont (Chittenden County;>25% of state population) and to (2) assess the effect of age TRANS and sex on mask use. We monitored the entrances to eight different business types and visually assessed individuals' age TRANS, gender TRANS, and mask use from a distance. We collected 1004 observations from 16 May through 30 May 2020 as businesses began to reopen following an extended state-wide lock down. We analyzed these data using a Bayesian random effects logistic regression model. We found that overall 75.5% of individuals used a mask with significant effects of age TRANS and gender TRANS on mask usage. Females TRANS were more likely to wear masks than males TRANS (83.8%, n=488 vs. 67.6%, n=516 mask usage, respectively); the odds of a male TRANS wearing a mask was 53% that of the female TRANS odds. Across age groups TRANS, the elderly TRANS were most likely to wear a mask (91.4%, n=209) followed by young adults TRANS (74.8%, n=246), middle- aged TRANS adults TRANS (70.7%, n=519) and children TRANS (53.3%, n=30). The odds of an elderly TRANS person wearing a mask were 16.7 times that of a child TRANS, while the odds for young adults TRANS and middle- aged TRANS adults TRANS were {approx}3 times greater than a child TRANS. Highest mask usage was in elder females TRANS (96.3%, n=109) and lowest mask usage was in male TRANS children TRANS (43.8%, n=16).

    A Framework for SARS-CoV-2 Testing on a Large University Campus: Statistical Considerations

    Authors: Paul J Rathouz; Catherine A Calder

    doi:10.1101/2020.07.23.20160788 Date: 2020-07-24 Source: medRxiv

    We consider testing strategies for active SARS-CoV-2 infection MESHD for a large university community population, which we define. Components of such a strategy include individuals tested because they self-select or are recommended for testing by a health care provider for their own health care; individuals tested because they belong to a high-risk group where testing serves to disrupt transmission TRANS; and, finally, individuals randomly selected for testing from the university community population as part of a proactive community testing, or surveillance, program. The proactive community testing program is predicated on a mobile device application that asks individuals to self-monitor COVID-like symptoms daily. The goals of this report are (i) to provide a framework for estimating prevalence SERO of SARS-CoV-2 infection MESHD in the university community wherein proactive community testing is a major component of the overall strategy, (ii) to address the issue of how many tests should be performed as part of the proactive community testing program, and (iii) to consider how effective proactive community testing will be for purposes of detection of new disease MESHD clusters. We argue that a comprehensive prevalence SERO estimate informed by all testing done of the university community is a good metric to obtain a global picture of campus SARS-CoV-2 infection MESHD rates at a particular point in time and to monitor the dynamics of infection MESHD over time, for example, estimating the population-level reproductive number TRANS, R0 TRANS). Importantly, the prevalence SERO metric can be useful to campus leadership for decision making. One example involves comparing campus prevalence SERO to that in the broader off-campus community. We also show that under some reasonable assumptions, we can obtain valid statements about the comprehensive prevalence SERO by only testing symptomatic persons in the proactive community testing component. The number of tests performed for individual-level and high-risk group-level needs will depend on the disease MESHD dynamics, individual needs, and testing availability. For purposes of this report, we assume that, for these groups of individuals, inferential precision --- that is, the accuracy with which we can estimate the true prevalence SERO from testing a random sample of individuals --- does not drive decisions on the number of tests. On the other hand, for proactive community testing, the desired level of inferential precision {in a fixed period of time can be used to justify the number of tests to perform {in that period. For example, our results show that, if we establish a goal of ruling out with 98\% confidence a background prevalence SERO of 2\% {in a given week, and the actual prevalence SERO is 1\% among those eligible for proactive community testing, we would need to test 835 randomly-selected symptomatics (i.e., those presenting with COVID-like symptoms) per week via the proactive community testing program in a campus of 80k individuals. In addition to justifying decisions about the number of tests to perform, inferential precision can formalize the intuition that testing of symptomatic individuals should be prioritized over testing asymptomatic TRANS individuals in the proactive community testing program.

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MeSH Disease
Human Phenotype

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