Section Dr. Richardson is an infectious disease physician with doctoral training in anthropology who is establishing himself as a young investigator in clinical and social scientific research of emerging infectious diseases such as Ebola virus and SARS-CoV-2. This K08 award will provide Dr. Richardson with the support necessary to accomplish the following goals: (1) to conduct clinical and social scientific investigations of COVID-19 in sub-Saharan Africa; (2) to learn to design more effective containment strategies for emerging infectious diseases by integrating rigorous ethnographic and epidemiological evidence; (3) to become an expert in the social epidemiology of emerging infectious diseases in low-income settings; and (4) to develop an independent clinical research career. Dr. Richardson has a strong background in clinical infectious diseases and anthropology. This career development award will enable him to address several remaining gaps in the training specific to his career goals. Specifically, he seeks advanced training in (1) epidemiology and (2) biostatistics and will accomplish through coursework at the Harvard School of Public Health. To further achieve his training goals, Dr. Richardson has assembled a mentoring team comprised of: Primary mentors: Dr. Paul Farmer, who conducts anthropological global health research, and Dr. Ichiro Kawachi, a world renown expert in social epidemiology; Advisers: Dr. Megan Murray, an expert in infectious disease transmission dynamics, Dr. Mosoka Fallah, Director of the National Public Health Institute of Liberia (NPHIL), and Dr. Phyllis Kanki, who has decades of virology experience in West Africa. The novel coronavirus which causes COVID-19 was first reported in Hubei Province, China in December 2019. In the ensuing 4 months, the outbreak spread to nearly every country in the world. The arrack rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) suggests that 50-60% or more of the global population may become infected as it assumed that nearly all are immunologically nave. Despite the rapid development of real-time reverse transcription polymerase chain reaction (RT-PCR) testing for detection of virus in infected patients, many questions remain about SARS-CoV-2 seroprevalence and transmission dynamics. This is because many infected cases remain asymptomatic albeit contagious. Moreover, many symptomatic infections go undetected on account of the slow scale-up of RT-PCR testing. These dynamics have their greatest ramifications for healthcare settings, since healthcare workers are one of the few populations that cannot practice social distancing. It is important to know the attack rate in these groups in order to improve infection prevention and control and decrease nosocomial transmission of the virus. This becomes more important in resource-constrained settings, where optimal PPE stocks are difficult to come by. Novel strategies for healthcare interactions may need to be developed in such cases. Accordingly, this study will determine the proportion of asymptomatic SARS-CoV-2 infection and the attack rate amongst African healthcare workers in various settings through serosurveillance (Aim 1). It will also evaluate the role of social and epidemiologic factors in the acquisition of SARS-CoV-2 infection (Aim 2). This research will form the basis for a longitudinal study of the impact of herd immunity and SARS-CoV-2 vaccine rollouts on future pandemic waves.
Section The data collected from this study can be used to 1) characterize the key epidemiological variables associated with undocumented infection SARS-CoV-2 infection; 2) help understand spread the spread of SARS-CoV-2 and its impact on communities; and 3) refine/update recommendations for COVID-19 containment. Improved understanding of the epidemiology of COVID-19 as well as reasons for containment failures are of critical importance for future surveillance efforts and for preventing severe pandemics.