Johns Hopkins Center for Health Security Releases a New Report: Developing a National Strategy for SARS-CoV-2 Serosurveys in the United States

June 18, 2020 –  The Johns Hopkins Center for Health Security has released a new report that provides recommendations for the U.S. government and states for performing serosurveys (antibody studies) for SARS-CoV-2 infections with the goal of deriving value from them in a national action plan.

According to the report, “Developing a National Strategy for SARS-CoV-2 Serosurveys in the United States,” there are now millions of confirmed cases of COVID-19, caused by the SARS-CoV-2 virus. But there may have been many more unconfirmed infections. Estimating the true prevalence of infection and recovery is important for decision makers and public health workers at national, state, and local levels. Using the complete number of confirmed infections is important, as it leads to the opportunity to achieve better outcomes, such as:

• Sound decisions can be made about allocation of personal protective equipment (PPE), mitigation efforts, and, ultimately, vaccine procurement and prioritization.
• The immediate effectiveness of various public health interventions in limiting virus spread can be assessed and compared.
• The true case fatality rate of SARS-CoV-2 infections can be determined.
• Long-term questions regarding lingering medical consequences that may require specific interventions can be addressed.

Notably in terms of data collection and analysis, the authors also warn of the potential for misuse of existing studies. Given the many scientific unknowns about antibodies and immunity to SARS-CoV-2, the plethora of inaccurate tests still being used, and the potential for false-positive and false-negative results, the authors strongly recommended that antibody tests not be used to justify individual decision making, including work clearance decisions and release from physical distancing.

Among the recommendations by the authors to increase the value of these antibody studies for public health and decision making, now and in the future, are the following:

• The U.S. government should create a central repository for serosurveys.
• The CDC should lead a consistent, standardized effort to perform serosurveys nationwide.
• The Food and Drug Administration (FDA), the National Institutes of Health (NIH), the CDC, and the National Cancer Institute (NCI) should release the results of their antibody test validation studies because many results reported from manufacturers are not accurate.
• Large employers and universities that are using antibody tests should be strongly encouraged to register their studies in the central repository.
• State and local health departments should focus first on serial, cross-sectional serosurveys, followed by longitudinal cohort studies to get the most information at the lowest cost.

You can access the new report with executive summary here.