Adherence to Public Health Measures Mitigates Risk of COVID-19 Infection in Older Adults: A Community-based Study

Juhn, Young J.; Wi, Chung-Il; Ryu, Euijung; Sampathkumar, Priya; Takahashi, Paul Y.; Yao, Joseph D.; Binnicker, Matthew J.; Natoli, Traci L.; Evans, Tamara K.; King, Katherine S.; Volpe, Stephanie; Pirçon, Jean-Yves; Damaso, Silvia; Pignolo, Robert J.

Objective To assess the prevalence and characteristics of COVID-19 cases during the reopening period in older adults. Little is known about the prevalence of coronavirus disease 2019 (COVID-19) after the Stay-at-Home order was lifted in the United States, nor the actual effects of adherence to recommended public health measures (RPHM) on risk of COVID19. Patients and Methods This was a cross-sectional study nested in a parent prospective cohort study, which followed a population-based sample of 2,325 adults aged ≥50 years residing in Southeast Minnesota to assess the incidence of viral infections. Subjects were instructed to self-collect both nasal and oropharyngeal swabs which were tested by RT-PCR-based SARS-CoV-2 assay between May 8, 2020, and June, 30, 2020. We assessed the prevalence of COVID-19 cases and characteristics of study subjects. Results 1,505 eligible subjects participated in the study whose mean age was 68 years with 59% females, 3% racial/ethnic minorities, and 60% with high-risk conditions for influenza. The prevalence of other Coronaviridae (HCoV- 229E, -NL63, and -OC43) during the 2019-2020 flu season was 7%, and none tested positive for SARS-CoV-2. Almost all participants reported adhering to the RPHM (99% for social distancing, 96% for wearing mask in a public space, 98% for hand hygiene, and 96% for staying home mostly). 86% of participants resided in a single-family home. Conclusion We did not identify SARS-COV-2 infection in our study cohort. The combination of participants’ behavior in following the RPHM and their living environment may significantly mitigate the risk of COVID-19.