SARS-CoV-2 antibody prevalence in England following the first peak of the pandemic

Abstract

England has experienced a large outbreak of SARS-CoV-2, disproportionately affecting people from disadvantaged and ethnic minority communities. It is unclear how much of this excess is due to differences in exposure associated with structural inequalities. Here, we report from the REal-time Assessment of Community Transmission-2 (REACT-2) national study of over 100,000 people. After adjusting for test characteristics and re-weighting to the population, overall antibody prevalence is 6.0% (95% CI: 5.8-6.1). An estimated 3.4 million people had developed antibodies to SARS-CoV-2 by mid-July 2020. Prevalence is two- to three-fold higher among health and care workers compared with non-essential workers, and in people of Black or South Asian than white ethnicity, while age- and sex-specific infection fatality ratios are similar across ethnicities. Our results indicate that higher hospitalisation and mortality from COVID-19 in minority ethnic groups may reflect higher rates of infection rather than differential experience of disease or care.

Fig. 1. Reconstruction of epidemic curve from REACT-2 alongside national reported deaths from COVID-19.

Number of symptomatic infections by week (dotted line; right y axis) based on the date of onset among 3493 antibody-positive participants who reported symptoms in the REACT-2 study, compared with deaths by week in England (solid line; left y axis. Data from Office for National Statistics). Source data are provided with this paper.

Fig. 2. Proportion of infections by employment and month of symptom onset.

Proportion of total monthly symptomatic infections based on the date of onset among 3493 antibody-positive participants who reported symptoms in the REACT-2 study, by employment status and month of symptom onset. Source data are provided with this paper.