The Indiana State Department of Health (ISDH) is collaborating with the Indiana University Richard M. Fairbanks School of Public Health at IUPUI to conduct a scientific study to measure current and past extent of COVID-19 infection throughout the state.
Unlike most current testing nationwide, which has focused on individuals who are actively ill and healthcare workers exposed to COVID-19, the Indiana study will evaluate randomly selected individuals statewide to see if they have the virus but are asymptomatic or if they have had the virus in the past. This information on current infections and antibody presence will provide a clearer and more nuanced picture of disease prevalence and how it has spread through Indiana.
Led by the Fairbanks School of Public Health, an interdisciplinary team of IU and Regenstrief Institute scientists, physicians and epidemiologists has designed the study and developed the scientific plan for execution by state agencies. The IU team will also analyze the study results and provide scientific interpretations of the data to the state.
“This is a critical step toward understanding how COVID-19 has affected the population of Indiana,” said Nir Menachemi, PhD, MPH, professor and Fairbanks Endowed Chair in the Fairbanks School of Public Health, principal investigator for the study and a Regenstrief Institute research scientist. “Our results will contribute valuable information to the complex considerations necessary for relaxing the stay-at-home order and other social-distancing policies.”
Regenstrief Institute and Fairbanks School of Public Health researcher Brian Dixon, PhD, MPA, is also a member of the study team.
“What we don’t know is how bad each community within our state is infected or has been infected, Dr. Menachemi said at a press conference on April 24. “Again, if we are only testing people with the most serious symptoms, it seems like we’re only looking at the tip of the iceberg. What our study allows us to do is look before the water and see the entire iceberg and try to get a sense of how large it is and how it’s affecting different communities perhaps differently.”
ISDH and IU will perform scientifically valid random sampling of Hoosiers in tests conducted in four phases in late April 2020, in late May 2020, in October 2020 and in April 2021. In total, at least 20,000 randomly selected Hoosiers will be tested for the study. Participation is by invitation to ensure that the sampling is representative of the geographic, racial and ethnic diversity of the state’s population.
Testing for the study will be conducted at eight fixed and 10 mobile sites around the state. Additional sampling may be added later depending on initial participation levels.
The first round of testing, this month, begins with a pool of at least 5,000 Hoosiers randomly selected from across Indiana’s 10 emergency preparedness districts. The study will include both nasopharyngeal (nose) swabs and blood draws. Nose swabs will be tested for COVID-19 within 72 to 96 hours, while the blood samples will be tested at a later date for antibodies to determine if an individual has had COVID-19 in the past.
“Data is key in guiding our response in the fight against COVID-19, and our partnership with Fairbanks School of Public Health researchers will provide high quality information to help shape our decision making,” Governor Eric J. Holcomb said. “I want to encourage Hoosiers who are selected to participate to step forward and help us gather the critical information for this groundbreaking scientific study.”
Indiana University Health and Eli Lilly and Co. will process nasal samples and report results to ISDH. Participants can choose the method by which they receive their results when they register. Registration and delivery of results will be managed by Indianapolis-based Zotec Partners.
State Health Commissioner Kris Box, M.D., FACOG, said the study is key to understanding the impact of the virus among Hoosiers.
“Having the ability to not only test for the presence of this virus, but also to learn more about people who have been exposed in the past and may have antibodies that indicate past infection, will help us fine-tune our work to keep Hoosiers safe from this pandemic,” Dr. Box said. ”We are grateful that this partnership will help make that happen.”
Participants will be notified of their eligibility for the study by mail, text message, email or phone and will be directed to the testing site closest to their residence. Registrants will receive a unique code that they will show at the testing site as proof of participation.
Support for the testing operation is being provided by the Indiana National Guard, Indiana Department of Transportation, state Emergency Medical Services personnel and other state and private partners.
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