Prevalence of SARS-CoV-2 Antibodies in First Responders and Public Safety Personnel, New York City, New York, USA, May-July 2020

Abstract

We conducted a serologic survey in public service agencies in New York City, New York, USA, during May-July 2020 to determine prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among first responders. Of 22,647 participants, 22.5% tested positive for SARS-CoV-2-specific antibodies. Seroprevalence for police and firefighters was similar to overall seroprevalence; seroprevalence was highest in correctional staff (39.2%) and emergency medical technicians (38.3%) and lowest in laboratory technicians (10.1%) and medicolegal death investigators (10.8%). Adjusted analyses demonstrated association between seropositivity and exposure to SARS-CoV-2-positive household members (adjusted odds ratio [aOR] 3.52 [95% CI 3.19-3.87]), non-Hispanic Black race or ethnicity (aOR 1.50 [95% CI 1.33-1.68]), and severe obesity (aOR 1.31 [95% CI 1.05-1.65]). Consistent glove use (aOR 1.19 [95% CI 1.06-1.33]) increased likelihood of seropositivity; use of other personal protective equipment had no association. Infection control measures, including vaccination, should be prioritized for frontline workers.

Keywords: 2019 novel coronavirus disease; COVID-19; New York; New York City; SARS-CoV-2; United States; coronavirus disease; emergency responders; personal protective equipment; public safety; respiratory infections; seroepidemiologic studies; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.

Figure 1

Percentage of respondents who were seropositive for severe acute respiratory syndrome coronavirus 2 IgG, by occupation, in a study of first responders and public safety personnel, New York City, New York, USA, May 18–July 2, 2020. Numbers within bars indicate percentage of seropositive respondents. Error bars indicate 95% CIs. Other includes students or trainees, pharmacists, medical registrars, orderlies, dietitians, medical assistants, counselors, social workers, dietary services staff, environmental services staff, and participants who selected this category and were not reassigned to an existing category. Firefighters includes fire inspectors and fire marshals. Other direct patient care providers include dentists, diagnostic imaging technicians, midlevel clinicians, nurses, nurse assistants, occupational therapists, speech therapists, physical therapists, phlebotomists, physicians, respiratory therapists, and therapy aides. EMS, emergency medical service.

Figure 2

Unadjusted percentage of respondents who were seropositive for severe acute respiratory syndrome coronavirus 2 IgG, by aerosol-generating procedure frequency (A) and use of personal protective equipment (B), in a study of first responders and public safety personnel, New York City, New York, USA, May 18–July 2, 2020. Numbers within bars indicate percentage of seropositive respondents. Error bars indicate 95% CIs. First responders and public safety personnel include police, medicolegal death investigators, firefighters, correctional staff, security guards, traffic officers, police dispatchers, firefighters or medical first responders, paramedics, emergency medical technicians, dispatchers (emergency medical service or fire), and other direct patient-care providers. COVID-19, coronavirus disease.

Figure 3

Adjusted odds ratios of seropositivity for severe acute respiratory syndrome coronavirus 2 IgG in a study of first responders and public safety personnel, New York City, New York, USA, May 18–July 2, 2020. Adjusted model includes all variables shown. Black boxes indicate statistically significant results; error bars indicate 95% CIs. Participants of other racial or ethnic groups or who declined to provide their race or ethnicity are included in the models but not shown as separate categories. Variables for exposure to person with COVID-19 are not mutually exclusive. AGP, aerosol-generating procedure; COVID-19, coronavirus disease; EMS, emergency medical service; ref, referent; PAPR, powered air-purifying respirator; PPE, personal protective equipment.