CASES Project: COVID-19 Arapahoe SErosurveillance Study

What is the CASES Project?

The COVID-19 Arapahoe SErosurveillance Study (CASES) project aims to measure exposure to SARS-CoV-2, the virus that causes the disease called COVID-19, in Arapahoe County. The CASES project was split into two phases. The first round of Phase 1, where we tested Arapahoe County first responders (firefighters, emergency personnel, police officers etc.) for history of SARS-CoV-2 infection through blood tests to measure antibodies to the virus, was completed in August 2020. During phase 2, which ended October 2020, we expanded our testing to the Arapahoe County general community members.

The CASES Project is supported by Arapahoe County Office of Emergency Management, in consultation with the Tri-County Health Department.

CASES Contact Information

If you would like more information about the CASES Project please email us at: CASESProject@cuanschutz.edu. You can also call Dr. Rosemary Rochford, the study principal investigator, at (303) 724-0996.

To be connected with a broad range of COVID information for providers, businesses, and the public, you can contact the Tri-County Health Department’s COVID-19 call center Monday-Friday from 8 a.m.-5 p.m. at 303-220-9200 or by emailing callcenter@tchd.org.

This protocol was approved by the Colorado Multiple Institutional Review Board (COMIRB Protocol # 20-1279). If you have any questions or concerns for them, please call (303) 724-1055.

CASES Project - Phase 1 (First Responders)

Early reports from China raised concerns that health care workers were at higher risk for COVID-19, the disease caused by SARS-CoV-2. In the US, it is assumed that First Responders including firefighters, police and emergency medical service employees, similar to healthcare practitioners, are at high risk for exposure to SARS-CoV-2. However, little is known about COVID-19 in this population. To ensure the health and safety of First Responders, both at work and in the community, we need to understand the prevalence (the percent of people who were infected with the virus) of SARS-CoV-2 within this population and how that prevalence changes over time.

During phase 1 we tested Arapahoe County first responders (firefighters, emergency personnel, police officers, etc.) for history of SARS-CoV-2 infection through blood tests to measure antibodies to the virus. Phase 1 will be split into two rounds of testing. The first round of testing was completed in August 2020. The second round of testing has begun and will end by the end of November 2020. The objectives of phase 1 of the CASES project are to:

Determine a baseline prevalence (the percent of people who were infected with the virus) of the novel coronavirus (SARS-CoV-2) antibodies among first responders in Arapahoe County.
Determine if there is a change in prevalence of SARS-CoV-2 antibodies among this same population after the transition to the safer-at-home policy.
Compare venous blood draw methods to finger prick methods for detection of antibodies to SARS-CoV-2.

CASES Project - Phase 2 (Arapahoe County Community)

During Phase 2 of the CASES project we selected random households throughout the county. Anyone living in a selected home and over the age of five was eligible to participate. We also offered free testing to others in the community. Phase 2 was completed in October 2020.

COVID-19 which stands for coronavirus disease 2019, was first identified in Wuhan, China. In late December 2019, doctors identified a cluster of patients with a viral pneumonia syndrome in Wuhan which became the first cases of known COVID-19. COVID-19 is a respiratory disease that can cause a range of symptoms with some individuals having mild while others have more severe illness.

Shortly after the first cases of COVID-19 were seen in Wuhan, the virus causing the disease was identified. SARS-CoV-2, the virus that causes COVID-19, is a novel coronavirus, meaning that it is a virus never seen before in humans. It is thought to spread mostly from person-to-person through respiratory droplets when someone infected with the virus sneezes, coughs, or talks. When people are in close contact with each other (within about 6 feet) it is more likely to spread and infect someone new. The virus can also spread indirectly by touching an object that is contaminated with the virus and then touching your face.

After the virus was discovered in China, SARS-CoV-2 quickly spread to the rest of the world, leading to the current COVID-19 pandemic, and reached the United States with the first documented case in Snohomish County, Washington on January 20, 2020 The United States now has community spread of SARS-CoV-2 which is why we want to understand who in the community has had the viral infection and where it has spread within our community.

Since SARS-CoV-2, the virus that causes COVID-19 disease, is a novel virus that infects humans we need to learn more about how the immune system responds to viral infection. We will test first responders at multiple timepoints to understand how the virus spreads and how antibodies change over time among a higher risk community.

Since SARS-CoV-2, the virus that causes COVID-19 disease, is a novel virus that infects humans we need to learn more about how the immune system responds to viral infection. We will test participants at multiple timepoints to understand how the virus spreads and how antibodies change over time in the community.

Sensitivity and specificity are measures of how well a test provides an accurate result. The sensitivity of a test tells us how good that test is at identifying people who are “true-positives”, or the percent who test positive, among those who truly have the disease. The specificity tells us how good the test is at identifying people who are “true-negatives”, or the percent who test negative, among those who truly do not have the disease. The ELISA Assay (the “best” test)we will be using in the CASES study has a sensitivity of 90%-100% and a specificity near 100%. The high sensitivity and specificity of this test reveal that it is very good for figuring out who is truly negative and truly positive. However, no test is 100% accurate and there is the possibility that the results can be incorrect. Therefore, it is important to talk to your healthcare provider about your test results.

If you test positive for antibodies to SARS-CoV-2 it can mean several things. You most likely were exposed to the virus, had the COVID-19 infection and now have antibodies to the virus in your blood. You could also have a current infection, however most people who have had COVID-19 will recover by the time antibodies show up in the blood. Since no tests are 100% accurate, you could also have a false positive. The CDC does not recommend modifying workplace or living situations based only on serologic test results. In addition, a positive result does not mean you are immune to the virus. If you have a positive antibody test result and are having COVID-19 symptoms (cough, fever, shortness of breath etc.) you should speak with your medical provider.

There are several things you can do to keep yourself and others safe. Educate yourself on how the virus is spread. Wash your hands often with soap and water for at least 20 seconds and use hand sanitizer. Avoid touching your nose, eyes, and mouth. Avoid close contact with anyone who is sick, whether inside or outside of your home. Wear a mask to cover your nose and mouth when you are around others which will help to prevent spreading COVID-19 to others even if you do no feel ill. Clean and disinfect surfaces that you touch daily using soap and water and a household disinfectant. Finally, monitor your health and be alert for COVID-19 like symptoms like fever, cough, shortness of breath, and other symptoms as stated by the CDC

Because the virus SARS-CoV-2 and the disease COVID-19 are new in the human population, scientists around the world are rapidly reporting new information. This can make it seem difficult to keep up on the latest information. To learn more about COVID-19 and SARS-CoV-2 please ensure you are getting information from trusted sources, including official public health and safety authorities.

The US Centers for Disease Control and Prevention: Coronavirus Disease 2019 – Frequently Asked Questions

FEMA Coronavirus Rumor Control: FEMA Coronavirus Rumor Control

The US Centers for Disease Control and Prevention: CDC: COVID-19 Serology Surveillance Strategy

Arapahoe CO CARES

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CASES Project: COVID-19 Arapahoe SErosurveillance Study

What is the CASES Project?

CASES Project - Phase 1 (First Responders)

CASES Project - Phase 2 (Arapahoe County Community)

CASES Project: COVID-19 Arapahoe SErosurveillance Study

What is the CASES Project?

CASES Project - Phase 1 (First Responders)

CASES Project - Phase 2 (Arapahoe County Community)

What is COVID-19 and SARS-CoV-2?

Why do we want to test first responders at multiple timepoints?

What type of testing will be done?

How do we measure how a test works?

What should I do if I test positive for antibodies to SARS-CoV-2?

What steps can I take to keep myself and others around me safe?

Where do I go to learn more about COVID-19?