SARS-CoV-2: An Empirical Investigation of Rose's Population-based Logic

Tim Bruckner; Abhery Das; Parvati Singh; Bernadette Boden-Albala

doi:10.1097/EDE.0000000000001405

SARS-CoV-2: An Empirical Investigation of Rose's Population-based Logic

Epidemiology. 2021 Nov 1;32(6):807-810. doi: 10.1097/EDE.0000000000001405.

Authors

Tim Bruckner^{1

2}, Abhery Das¹, Parvati Singh³, Bernadette Boden-Albala¹

Affiliations

¹ From the Program in Public Health, University of California, Irvine, CA.
² Center for Population, Inequality, and Policy, University of California, Irvine, CA.
³ Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH.

Abstract

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.

Publication types

Research Support, Non-U.S. Gov't
Video-Audio Media

MeSH terms

Adult
COVID-19*
Humans
Logic
Risk Factors
SARS-CoV-2*