Geographic and demographic heterogeneity of SARS-CoV-2 diagnostic testing in Illinois, USA, March to December 2020.
Geographic and demographic heterogeneity of SARS-CoV-2 diagnostic testing in Illinois, USA, March to December 2020.
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DOI：
10.1186/s12889-021-11177-x
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发表时间：
2021-06-10
影响因子：
4.5
通讯作者：
Gerardin J
中科院分区：
文献类型：
--
作者：
Holden TM;Richardson RAK;Arevalo P;Duffus WA;Runge M;Whitney E;Wise L;Ezike NO;Patrick S;Cobey S;Gerardin J
SARS-CoV-2检测在美国的可用性(美国)在新冠肺炎大流行的过程中，包括美国伊利诺伊州在内，疫情一直在波动。尽管检测量大幅增加，但获得SARS-CoV-2检测的机会仍然有限，不同种类，不足以控制传播。我们比较了2020年3月至12月期间伊利诺伊州不同地理区域、不同时间以及人口统计特征(即年龄和种族/民族)的SARS-CoV-2检测率。我们比较了年龄匹配的病例死亡率和感染死亡率随时间的变化，以估计通过诊断检测发现的SARS-CoV-2感染的比例。到2020年底，测试率的最初地理差异已基本缩小。伊利诺伊州非西班牙裔黑人和西班牙裔/拉丁裔人口的病死率高于非西班牙裔白人人口，这表明在最初的疫情浪潮中，测试不足以准确地捕捉到新冠肺炎病在少数族裔人口中的真实负担。虽然测试差距在2020年期间有所下降，但西班牙裔/拉丁裔人口始终是测试最少的，每天每1000人进行1.87次测试，而在2020年底，非西班牙裔黑人和非西班牙裔白人分别为2.58和2.87次。尽管自第一波疫情开始以来，检测的规模有了很大的扩大，但我们估计，超过一半(50%-80%)的SARS-CoV-2感染没有通过诊断检测发现，并继续逃避监测。识别相对检测不足的地理区域和人口群体的系统方法，可能使政策制定者能够定期监测和评估诊断检测格局的变化，使官员能够优先分配检测资源，以减少新冠肺炎负担的差异，并最终减少SARS-CoV-2的传播。网上版载有补充材料，可在10.1186/s12889-021-11177-x查阅。
Availability of SARS-CoV-2 testing in the United States (U.S.) has fluctuated through the course of the COVID-19 pandemic, including in the U.S. state of Illinois. Despite substantial ramp-up in test volume, access to SARS-CoV-2 testing remains limited, heterogeneous, and insufficient to control spread. We compared SARS-CoV-2 testing rates across geographic regions, over time, and by demographic characteristics (i.e., age and racial/ethnic groups) in Illinois during March through December 2020. We compared age-matched case fatality ratios and infection fatality ratios through time to estimate the fraction of SARS-CoV-2 infections that have been detected through diagnostic testing. By the end of 2020, initial geographic differences in testing rates had closed substantially. Case fatality ratios were higher in non-Hispanic Black and Hispanic/Latino populations in Illinois relative to non-Hispanic White populations, suggesting that tests were insufficient to accurately capture the true burden of COVID-19 disease in the minority populations during the initial epidemic wave. While testing disparities decreased during 2020, Hispanic/Latino populations consistently remained the least tested at 1.87 tests per 1000 population per day compared with 2.58 and 2.87 for non-Hispanic Black and non-Hispanic White populations, respectively, at the end of 2020. Despite a large expansion in testing since the beginning of the first wave of the epidemic, we estimated that over half (50–80%) of all SARS-CoV-2 infections were not detected by diagnostic testing and continued to evade surveillance. Systematic methods for identifying relatively under-tested geographic regions and demographic groups may enable policymakers to regularly monitor and evaluate the shifting landscape of diagnostic testing, allowing officials to prioritize allocation of testing resources to reduce disparities in COVID-19 burden and eventually reduce SARS-CoV-2 transmission. The online version contains supplementary material available at 10.1186/s12889-021-11177-x.