TY - JOUR AU - Parker, Daniel AU - Bruckner, Tim AU - Vieira, VerĂ³nica AU - Medina, Catalina AU - Minin, Vladimir AU - Felgner, Philip AU - Dratch, Alissa AU - Zahn, Matthew AU - Bartell, Scott AU - Boden-Albala, Bernadette T1 - Predictors of Test Positivity, Mortality, and Seropositivity during the Early Coronavirus Disease Epidemic, Orange County, California, USA T2 - Emerging Infectious Disease journal PY - 2021 VL - 27 IS - 10 SP - 2604 SN - 1080-6059 AB - We conducted a detailed analysis of coronavirus disease in a large population center in southern California, USA (Orange County, population 3.2 million), to determine heterogeneity in risks for infection, test positivity, and death. We used a combination of datasets, including a population-representative seroprevalence survey, to assess the actual burden of disease and testing intensity, test positivity, and mortality. In the first month of the local epidemic (March 2020), case incidence clustered in high-income areas. This pattern quickly shifted, and cases next clustered in much higher rates in the north-central area of the county, which has a lower socioeconomic status. Beginning in April 2020, a concentration of reported cases, test positivity, testing intensity, and seropositivity in a north-central area persisted. At the individual level, several factors (e.g., age, race or ethnicity, and ZIP codes with low educational attainment) strongly affected risk for seropositivity and death. KW - COVID-19 KW - coronavirus disease KW - SARS-CoV-2 KW - severe acute respiratory syndrome coronavirus 2 KW - viruses KW - respiratory infections KW - zoonoses KW - test positivity KW - mortality KW - seropositivity KW - California KW - Orange County KW - United States KW - health equity DO - 10.3201/eid2710.210103 UR - https://wwwnc.cdc.gov/eid/article/27/10/21-0103_article ER - End of Reference