Aug 1, 2020
Reviewed by Christopher J. Graber, M.D., MPH, FIDSA
As the COVID-19 pandemic continues to rage throughout the United States, a better understanding is needed regarding the demographics of SARS-CoV-2-related test positivity, disease, and hospitalization in order to develop preventive public health measures on local, regional, state, and national levels.
A recent paper published in Clinical Infectious Diseases describes the experience of a regional health care system that was responsible for approximately 15% of SARS-CoV-2 nasopharyngeal/oropharyngeal testing in the greater New York City region (the five counties of New York City plus Nassau, Suffolk, and Westchester) from March 2 – April 10, 2020. Of 46,793 people residing in this region who were tested, 26,735 (57.1%) had at least one positive test for SARS-CoV-2. Test positivity was highest among Black males (72.1%), followed by Asian males (71.6%), Black females (64.4%), and White males (61.9%). SARS-CoV-2 infection was already widely dispersed across the region at the onset of testing, though incidence varied widely by magnitude and time according to zip code; 8,174 (30.6%) of positive patients were admitted to acute care hospitals.
Estimation of the population-normalized distribution of cases throughout the region demonstrated disproportionate positivity rates in males (1.6% case incidence at age 25 to 6.0% for age 85 and above) vs. females (1.7% at age 25 to 4.7% at age 85 and above). While people from lower income, higher population density zip codes had higher positivity rates (despite comparable access to testing than higher income, lower population density zip codes) with a strong trend observed in average annual income by zip code from $25,000 to $125,000, the authors note that statistical sampling variability may have at least partially confounded the association.
While this report is limited primarily by an absence of information on Latino/Hispanic ethnicity and limitations on test capacity early in the testing period, it provides a useful snapshot of how the SARS-CoV-2 pandemic differentially affected the New York City region according to demographics and area of residence. As SARS-CoV-2 continues to expose disparities inherent in our health care system, data such as these will be critical in allocating resources and organizational efforts moving forward.