One in eight Americans have been infected with COVID-19


An illustration of a man standing in a COVID-19 shaped spotlight while others move about him in shadow.

In a first-of-its-kind nationwide survey, Rollins researchers found that one in eight residents of the US—more than 39 million people—had been infected with SARS-CoV-2 by the end of October 2020.

Participants were randomly selected from a US Postal Service database and sent invitations to provide samples via a home testing kit that included nasal swabs and dried blood from a finger prick. More than 4,600 people completed surveys and returned samples to a central laboratory by mail.

“Early estimates of national prevalence had been developed among people who were symptomatic, who had some reason to be tested for the virus, or who were seeking care for other medical conditions,” says lead author Dr. Patrick Sullivan, Charles Howard Candler Professor of Epidemiology. “This was an effort to minimize those biases as much as possible. By mailing out test kits, we were able to include people who might not have experienced symptoms or might not have been tested.” 

The study found that people living in metropolitan areas were 2.5 times more likely to have been infected than those living in non-metropolitan areas. Also, Blacks and Hispanics were more likely than whites to have experienced SARS-CoV-2 infection (2.2 times and 3.1 times more, respectively). Roughly one in six of those infected at some point had been diagnosed with COVID-19 and reported to health departments, based on comparisons with CDC reports. 

In addition, in a survey of participants’ attitudes toward vaccination, the study found that 32 percent said they were unsure or unwilling to receive a COVID-19 vaccine. However, most of these respondents were not “strongly opposed” to vaccination, which represents an opportunity for public health interventions.

The COVIDVu study was supported by the National Institute of Allergy and Infectious Diseases and the Woodruff Foundation. It was developed from expertise gained by AIDSVu.