Hundreds of volunteers from throughout the county lined up in cars in an unusual procession at First Presbyterian Church in Mountain View on Saturday morning, participants in a Stanford University survey that could help us understand how many people actually have COVID-19 virus, even if they aren't showing symptoms.
The volunteers, who had responded to an online survey from Stanford that was distributed locally, proceeded through a drive-thru site at the church, where each submitted to a finger-prick test. Over the weekend, the blood collected during this drive-thru will be analyzed for antibodies, a key indicator of whether a person is – or has been – infected with COVID-19.
Jay Bhattacharya, a professor of medicine at Stanford University who is involved with the project, told the Weekly on Saturday that the research team is taking 2,500 tests at the three sites throughout the county – in Mountain View, Los Gatos and San Jose. A similar experiment is also being conducted in southern California, led by Neeraj Sood, vice dean for research at University of Southern California School of Public Policy.
Stanford is conducting tests over a two-day period on Friday and Saturday, with the goal of analyzing the results by the end of Sunday, Bhattacharya said. They had set up a lab at Stanford and have a team of medical students and doctoral students assisting with the analysis, he said.
"We need to understand how widespread the disease actually is," Bhattacharya told the Weekly. "To do that, we need to understand how many people are infected. The current test people use to check whether they have the condition – the PCR (polymerase chain reaction) test – it just checks whether you currently have the virus in you. It doesn't check whether you had it and recovered. An antibody test does both."
The study, which is led by Eran Bendavid, associate professor of medicine at Stanford, is aiming to get results from a representative sample of county's residents. Volunteers filled out surveys and were targeted through Facebook to participate in the study.
The project, which was assembled in a matter of weeks, has been generating great interest from researchers around the world who are eager to learn about the extent of coronavirus infections in the United States. Researchers in other nations are conducting similar studies, and the World Health Organization has launched an initiative called Solidarity II, a coordinated study in which nations around the globe will be gauging antibody levels in their respective populations.
While the number of reported COVID-19 infections has been steadily increasing in Santa Clara County, which had reported 1,148 such cases as of Saturday afternoon, Bendavid and Bhattacharya have argued that the reported numbers don't fully capture how widespread the virus is, nor the accurate rate of fatalities. In a March 24 editorial in the Wall Street Journal, the two Stanford researchers maintained that the World Health Organization's estimate that the fatality rate from COVID-19 is between 2% and 4% may be far too high.
"If the number of actual infections is much larger than the number of cases – orders of magnitude larger – then the true fatality rate is much lower as well. That's not only plausible but likely based on what we know so far," Bendavid and Bhattacharya wrote.
While Bendavid couldn't be reached for comment Saturday, his emailed response states "the facts to date are consistent with a wide range of uncertainty regarding the fatality rate from COVID-19."
"We desperately need a population-representative estimate of the seroprevalence of the disease so we can reduce that uncertainty and make better policy on the basis of our improved knowledge," Bendavid wrote.
To help with the effort, the Stanford team quickly raised funds for the two-day survey, appealing to residents to donate through the university's online portal. They had also issued a survey asking residents to submit to blood tests. The survey quickly filled up with willing participants and was closed as of late Friday evening.
"I just think we need more information about everything," said volunteer Marisa Cannon as she dangled her arm out the window of her car while her blood got drawn. "The more data we have, the better it is for everyone."
Her 6-year-old son, seated behind her, was up next for a finger-prick.
Other participants shared her sentiment. Alona Drori said that she "just wanted to do something good," while she and her 12-year-old daughter each stuck an arm out a window of their parked car to have about 10 drops of blood drawn. The process took five minutes.
Bhattacharya said the research team has received great support from over the nation. The team is also hoping to conduct more tests at a later date, though those plans have not yet been finalized.
The project by Stanford and USC researchers is one of numerous efforts currently in progress across the globe that are looking to serology to shed light on the reach and lethality of COVID-19. Maria Van Kerkhobe, COVID-19 technical lead at the World Health Organization, said at a March 27 briefing that there are more than a dozen countries that are conducting epidemiologic studies that involve serology. There are also at least four ongoing studies in different countries that involve analysis of specimens that have already been collected, including blood samples from people who have been hospitalized for other reasons.
"We are eagerly anticipating these results so that we can better understand: What is the seroprevalence? What are the antibody levels among people in different age groups, in different parts of the world," Van Kerkhobe said at the briefing. "This is critical for us to really understand what level of circulation this virus may have or may have had in people that may have had a subclinical infection – infection (in which they had) mild disease and maybe didn't seek care or they weren't picked up through the current surveillance systems."
Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.