Nir Menachemi, the Indiana University chair of the Health Management and Policy Department, reported an estimated 2.8% COVID-19 prevalence rate statewide during a Wednesday press conference in Indianapolis.  Photo by 
Whitney Downard | CNHI Statehouse Reporter
Nir Menachemi, the Indiana University chair of the Health Management and Policy Department, reported an estimated 2.8% COVID-19 prevalence rate statewide during a Wednesday press conference in Indianapolis. Photo by Whitney Downard | CNHI Statehouse Reporter
INDIANAPOLIS – In late April, the state reported that over 17,182 Hoosiers had tested positive for the cornavirus, with 964 deaths bringing the state’s mortality rate to nearly 6%.

But a study from Indiana University’s Richard M. Fairbanks School of Public Health projected that 186,000 Hoosiers had contracted the virus, meaning that less than 1% of those with the virus had died. Researchers used results from 4,611 randomly sampled Hoosiers to calculate a statewide prevalence rate of 2.8% and estimate a total number of infected Hoosiers.

“During the last week of April, 1.7% of participants were positive,” Nir Menachemi, the chair of IU’s Department of Health Management and Policy, said Wednesday. “An additional 1.1% were positive for antibodies.”

The presence of antibodies indicated that a Hoosier had been infected but recovered or never showed symptoms of the virus.

While testing in Indiana prioritizes symptomatic Hoosiers and essential workers, the Fairbanks study used a random sample with an emphasis on recruiting black and Latino Hoosiers proportional to the state’s population.

Conventional testing identified approximately one out of every 11 infections in the state, Menachemi said. Of those who tested positive for the virus, 45% reported no symptoms.

Hispanic and non-white Hoosiers reported higher infection rates, similar to state data. Of the participants, only 2.5% of white Hoosiers were infected while 4.7% of non-white Hoosiers were infected. Hispanic Hoosiers tested at even higher rates, at 8.3%, compared to non-Hispanic Hoosiers, at 2.3%.

Menachemi said those living in a household with an infected family member were 12 times more likely to catch the virus as well.

“Our social distancing policies played a critical role in curbing the spread of the virus and containing it within households as opposed to within the community,” Menachemi said. “By slowing the spread of the virus, we now have bought some time to determine the best way forward. … As we slowly phase back and reopen the economy, we need to be extra vigilant.”

Still, Paul Halverson, the founding dean of the Fairbanks school, cautioned that public health measures, such as masks and social distancing, would need to continue with higher-than-reported infection rates.

“We probably need to assume that we have the virus and that everyone else around us does as well and act accordingly,” Halverson said. “What (we’ve) done to date is working. But what we don’t want to do is say that we’re done.”

Study's impact on policy unclear

When the state announced the Fairbanks partnership, it touted the importance of using that data to inform policy decisions. However, the state decided to phase-in reopening before it received results.

“This is data that we can use as we go forward and we use those guiding principles for how we’re going to gradually and slowly reopen the state of Indiana,” Kris Box, the state health commissioner, said. “It really underscored the fact that our social distancing measures were really working.”

Box highlighted that 45% of the state’s drive-thru testing sites were located in minority communities to ensure easy access for Hoosiers adversely impacted by the virus’ spread. With subsequent phases of the Fairbanks study, Box said she wanted to see the antibody prevalence increase.

Since the school started testing, the state entered into several contracts to increase testing capabilities and contact tracing. However, Box said the state had “some difficulties” in accessing regular shipments of some testing supplies.

Menachemi said that more statistical analysis would be done to determine a margin of error. Though a few hundred Hoosiers in and around South Bend were tested for the virus, none tested positive for the virus in the random sampling.

“As you can imagine, there’s so many data points that we’re still poring through,” Menachemi said. “We want to make sure that when we report something we’re as confident in it as we can be.”

The initial phase tested just 4,611 Hoosiers, short of the 5,000 test goal announced on April 23. In terms of demographic balance with less responses, Menachemi said the results were “scientifically rebalanced” to remain representative and generalized to the state’s population.

Researchers pushed back the second wave of testing, originally scheduled for May 23, to accommodate the Memorial Day weekend and extend the amount of time between phases. Phase 2 should begin in early June.
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