COVID-19 Prevalence Study

Description of the video:

Description of the video:

Paul Halverson: Thank you, Dr. Box. I want to express our gratitude to both you and Governor Holcomb for leading Indiana’s response to COVID-19.

As Dr. Box mentioned, I’m Dr. Paul Halverson, founding dean of the IU Richard M. Fairbanks School of Public Health at IUPUI. Founded in 2012, the Fairbanks School of Public Health is committed to protecting and advancing the health of Hoosiers in Indiana and beyond. In the last eight years, our faculty and staff have responded to public health and health administration issues with evidence-based research and practice – from the opioid and tobacco crises to rising health care costs; from developing maternal and child health interventions to leading a large-scale response to chronic diseases like diabetes – we have been on the frontlines of Hoosier health in Indiana. 

We are also pleased to support Indiana’s local public health departments through our support of the local health officer association as well as in training individuals who will be our public health leaders of tomorrow. In addition, we are proud to work closely with both Dr. Box and her leadership team here at ISDH as well as Dr. Caine, our local Marion County Health Officer (all of whom are doing an incredible job supporting our state during these very challenging times).

Since the emergence of the virus, our school has been supporting the state’s response to COVID-19. Working with public health officials and hospital leaders, including at the Indiana Hospital Association, we created forecasting models to predict the spread of COVID-19 in Indiana and understand hospital surge capacity. With this knowledge, we developed capacity planning models for hospitals and health systems. Now, our school is leading the random sample testing initiative across Indiana for the virus that causes COVID-19 and its antibodies.

Nir Menachemi: Thank you, Dr. Halverson. I am pleased to lead the scientific team in our partnership with the State which includes multiple agencies and private organizations that Dr. Box will soon mention. The team from the Fairbanks School includes leading biostatisticians, epidemiologist, informatics, and clinical infectious disease experts. Together with the State we are taking a critical step toward understanding how COVID-19 has affected the population of Indiana.

I want to highlight an important distinction in how this testing initiative differs for existing testing endeavors. To date, almost all of the testing that has occurred has come from patients with serious symptoms or other high-risk individuals including our frontline health care workers. Existing tests were purposefully focused on clinical settings to support clinical decisions affecting individual patients. Because these tests only focused on sick or high-risk individuals, we lack an understanding of how many people in our state have been infected especially if they were not formally tested or had no symptoms.

This is where our work comes in. We will obtain scientifically valid results of the proportion of state residents that are currently infected (regardless of symptoms) and those that may have already been infected with the virus based on antibodies. We will finally obtain an understanding of the true prevalence of COVID-19. The individuals we will test have been selected randomly to represent everyone in the state above the age of 12. Each selected individual will be asked to volunteer their participation with parental approval, as necessary. Those agreeing will provide both a nasal swab- to test for active viral infection, and a blood draw- to allow for antibody testing.

Whereas existing tests have supported clinical decisions of individual patients; our approach will allow for a community-level understanding of the virus’ impact. This will enable better evidence-based policies—including the complex decisions surrounding social distancing orders.

We have identified a representative sample of Indiana residents by randomly selecting people, in each district of the state, from a list of all residents. Our randomization protocol was carefully calibrated to ensure the ability to draw conclusions about the impact of COVID-19 by each of the state’s districts, sex, race, and ethnicity; as well as overall rates for the state. For this reason, if you are selected, please consider participating so that your community, however you define it, can be represented in our data.

Our overall plan is to conduct multiple waves of data collection that will occur months apart. Wave 1 will start immediately and provide critical information including establishing a baseline. Each additional wave of testing will allow us to examine how changes in the prevalence of the disease is progressing in Indiana and how it is affecting the groups I just mentioned. For each wave, we will enroll 5 to 7 thousand individuals statewide. In order to adhere to the scientific protocol, only those contacted by ISDH will be able to participate. Unfortunately, we will not be able to test others at our drive-thru testing locations.

Before turning it over back to Dr. Box, who will describe the logistical and operational plan, I want to reiterate the importance of our study in determining the true count of infections, including mild cases, which represents important information not currently widely available in any state. By being among the first states, we will get a head start in understanding the epidemic’s true trajectory, identify and address disparities, and be able to make wiser decisions on how to deploy our limited resources. Thank you, Governor Holcomb, and Dr. Box, for your leadership during these challenging times. We look forward to playing our part in advancing Indiana towards a sense of normalcy. Dr. Box, back to you.

I am pleased to introduce Dr. Nir Menachemi who is leading this population health scientific testing effort. Dr. Menachemi is the Fairbanks Endowed Chair of Public Health and leads our Department of Health Policy and Management. He is also a scientist at the Regenstrief Institute. Professor Menachemi is one of the most widely respected health services researchers in the country. Dr. Menachemi’s research has led to numerous organizational and societal decisions that have made enduring contributions to improving people’s health in Indiana and beyond.