How Wake Forest Baptist Health Plans To Track COVID-19 In North Carolina

A large coronavirus study, led by Wake Forest Baptist Health, has received $20 million from the state legislature. The COVID-19 Community Research Partnership hopes to track the spread of the disease in North Carolina, help predict how many people have had asymptomatic infections, and more.

Dr. John Sanders is the lead investigator and chief of infectious diseases at Wake Forest Baptist. He spoke with WFDD's Bethany Chafin.

Interview Highlights

On the role of volunteer participants:

So every day somebody gets a reminder, 'Please let us know: Have you been sick or have you been in contact with a COVID patient?' And then we are able to take that and link it to our electronic health records and start to put together symptom maps and some background information about the sort of other problems that people have. Now, we are also sending out, to a subset of patients, a serologic survey — an at-home finger-prick test that allows people to check their antibodies to see if maybe they've already been infected. And we link that information back into the information that we're collecting on a daily basis through the Oracle app, and then our electronic health record, to put together pretty complete maps of what's the disease activity in our area and what are the risks and the predictors of outcomes in our area. And we try to feed that information onto our website and out to our volunteers and our community as is as quickly as we can. Our aspiration is to do it almost in real-time.

On what the early data tells us:

Based on what we've seen so far — our syndromic surveillance so far in Forsyth County and Guilford County and our surrounding area — our volunteers have been pretty healthy. Very few reports of fever, very few reports of cough, very few reports of other symptoms. When we've reached into the electronic health records to look for confirmatory data, most of the COVID tests that have been collected were negative. And then based on over 700 serology tests that have come back already, we've only found a seroprevalence of just over 2 percent. It is enough to make some reasonable guesses about what the prevalence of infection has been in Forsyth County, in Guilford County, and we're starting to extend those tests out in the other counties. So I think it's not too early for us to say our prevalence of infection has been very low, not more than about 2 percent, and probably even a little bit less than that of us have already been infected. So we are very early in this epidemic in this area.

On the limitations of this study:

It is no secret at all that a lot needs to be learned about the value of these antibody tests. That is a big reason that we're doing this study so that we can learn exactly how sensitive, how often do they detect that somebody has really had an infection, and what is the meaning of that sort of antibody response? Does it protect you against another infection? We do not know that. How long does it last? We don't know if that's going to be short-lived immunity or long-lived immunity. And does it predict anything about your outcome? Does having a good antibody response or a good immunological response predict a better outcome or does it denote more severe disease? There's a lot of stuff we need to learn, which means that obviously there are a lot of questions about the testing modalities to start with. As we see that we need to change to get more information, we're going to be willing to change. That's scientifically not the best way to do a research study, but we think it blends the public health importance of this study and the urgency to get the data with an opportunity to also answer a number of research questions.

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