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SARS-CoV-2: An Empirical Investigation of Rose's Population-based Logic
Tim Bruckner1,2, Abhery Das1, Parvati Singh3
1From the Program in Public Health, University of California, Irvine, CA.
Background:
Geoffrey Rose's paper "Sick Individuals, Sick Populations" highlights the counterintuitive finding that the largest share of morbidity arises from populations engaging in low- to moderate-risk behavior. Scholars refer to this finding as the prevention paradox. We examine whether this logic applies to SARS-CoV-2 infected persons considered low to moderate risk.
Methods:
We conducted a population-representative survey and sero-surveillance study for SARS-CoV-2 among adults in Orange County, California. Participants answered questions about health behaviors and provided a finger-pin-prick sample from 10 July to 16 August 2020.
Results:
Of the 2979 adults, those reporting low- and moderate-risk behavior accounted for between 78% and 92% of SARS-CoV-2 infections. Asymptomatic individuals, as well as persons with low and moderate scores for self-reported likelihood of having had SARS-CoV-2, accounted for the majority of infections.
Conclusions:
Our findings support Rose's logic, which encourages public health measures among persons who self-identify as unlikely to have SARS-CoV-2. See video abstract at, http://links.lww.com/EDE/B860.
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