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Early Release - Predictors of Test Positivity, Mortality, and Seropositivity during the Early Coronavirus Disease Epidemic, Orange County, California, USA - Volume 27, Number 10—October 2021 - Emerging Infectious Diseases journal - CDC
Document Type
article
Source
Emerging Infectious Diseases. 27(10)
Subject
Public Health
Biomedical and Clinical Sciences
Clinical Sciences
Health Sciences
Prevention
Infectious Diseases
Good Health and Well Being
COVID-19
California
Epidemics
Humans
SARS-CoV-2
Seroepidemiologic Studies
Orange County
United States
coronavirus disease
health equity
mortality
respiratory infections
seropositivity
severe acute respiratory syndrome coronavirus 2
test positivity
viruses
zoonoses
Medical Microbiology
Public Health and Health Services
Microbiology
Clinical sciences
Epidemiology
Health services and systems
Language
Abstract
We conducted a detailed analysis of coronavirus disease in a large population center in southern California, USA (Orange County, population 3.2 million), to determine heterogeneity in risks for infection, test positivity, and death. We used a combination of datasets, including a population-representative seroprevalence survey, to assess the actual burden of disease and testing intensity, test positivity, and mortality. In the first month of the local epidemic (March 2020), case incidence clustered in high-income areas. This pattern quickly shifted, and cases next clustered in much higher rates in the north-central area of the county, which has a lower socioeconomic status. Beginning in April 2020, a concentration of reported cases, test positivity, testing intensity, and seropositivity in a north-central area persisted. At the individual level, several factors (e.g., age, race or ethnicity, and ZIP codes with low educational attainment) strongly affected risk for seropositivity and death.