Stanford teams with UCSF, Chan Zuckerberg Biohub to study prevalence of COVID-19 in San Francisco Bay Area

The nine-month collaborative studies, funded by the Chan Zuckerberg Initiative, will track the rate of new regional infections, define population immunity levels and help inform how to safely reopen California’s economy.

A large-scale research collaboration between Stanford University, the University of California, San Francisco (UCSF) and the Chan Zuckerberg Biohub (CZ Biohub) aims to better understand the spread of COVID-19 across the San Francisco Bay Area. The Chan Zuckerberg Initiative (CZI) has committed $13.6 million to the collaboration.

Yvonne Maldonado in front of a building on the Stanford campus

Yvonne Maldonado is one of the lead investigators on a study that will investigate the spread of COVID-19 throughout the San Francisco Bay Area. (Image credit: Steve Fisch)

Over the next nine months, the consortium will support two long-term studies. The first, which will sample a broad, representative population of the Bay Area, will provide data crucial for informing policy decisions about how to safely reopen California’s economy and how to make sure transmission remains low while we await a vaccine. The second, which is focused on Bay Area health care workers, will examine whether COVID-19 antibodies protect individuals against reinfection, and if so, for how long. The information could be critical to protecting frontline health care workers around the globe.

“To reopen society in the Bay Area and keep health care workers safe, we need to first understand the epidemiology of this disease,” said CZI co-founder and co-CEO Dr. Priscilla Chan. “How much of our population is currently infected with COVID-19? How prevalent is asymptomatic spread? And how can we use this information to better understand who may still be at risk in the future? There is no shortcut to answering these questions – it will require testing, retesting and the sort of rigorous public health surveying this program is focused on in California. We’re grateful to help accelerate this work and partner with Stanford and UCSF – two of our state’s and the world’s greatest scientific research institutions – to help find these answers.”

Dr. Mark Ghaly, California Health and Human Services Agency Secretary, said, “One of the critical steps for California to begin gradually reopening our economy is wrapping our arms around community surveillance, so that we continue to be guided by science. We are grateful to the Chan Zuckerberg Initiative, the Chan Zuckerberg Biohub, UCSF and Stanford University for adding to this critical body of data.”

In the first study, the consortium, led by principal investigators Yvonne A. Maldonado, MD (Stanford), and George W. Rutherford, MD (UCSF), will contact Bay Area residents by letter, with follow-up phone calls, to recruit a representative sample of roughly 4,000 Bay Area residents. To enroll in this study, participants must have previously tested negative for COVID-19 and be following state-required shelter-in-place guidelines now in place in Alameda, Contra Costa, Marin, San Francisco, San Mateo and Santa Clara counties.

Members of the study cohort will be tested once per month through December 2020 using both polymerase chain reaction (PCR) diagnostic testing to determine the rate of new infections and serological (“antibody”) testing to understand if participants had unknowingly been infected but recovered over the course of a given month. The viral genomes from all positive samples will be sequenced by researchers at the Chan Zuckerberg Biohub in order to identify local transmission chains or introductions of virus from outside the Bay Area, in addition to informing whether co-infections with other pathogens play a significant role. Altogether, the combined data will provide critical insights into the changing rates of COVID-19 infections as the Bay Area begins to return to work.

In a second study – led by infectious disease specialists Sarah Doernberg, MD (UCSF Health), Marisa Holubar, MD (Stanford Medicine), and Vivek Jain, MD, MAS (Zuckerberg San Francisco General Hospital) – the consortium will examine the impact of COVID-19 on health care systems and their workforce.

Researchers will recruit a cohort of roughly 3,500 Bay Area health care workers who previously tested negative for COVID-19 and retest them weekly for at least 12 weeks using PCR and serological testing. The goal is to determine the rate at which health care workers acquire COVID-19 with or without symptoms. Health care workers found to be seropositive on recruitment will be followed in parallel through December 2020 to better understand their immunity and likelihood of reinfection. There are currently significant knowledge gaps regarding the nature of immunity to COVID-19. This study will help surface critical insights to better protect frontline health care workers.

“The knowledge we gain from these studies will be crucial to understanding the effects of COVID-19 on our region and protecting health care workers here and around the world. It’s inspiring to see researchers engaging in the kind of robust collaboration we will need to better understand and manage this crisis,” said Stanford President Marc Tessier-Lavigne. “We are proud to work with UCSF and the Chan Zuckerberg Initiative, who are outstanding partners in advancing biomedical research to solve the world’s toughest challenges.”

UCSF Chancellor Sam Hawgood said, “Though we are still in the midst of responding to the first phases of this pandemic, we must also look to the future. By assembling reliable data on COVID-19 prevalence and exposure in our region, we can help protect our Bay Area health care workforce and better determine when and how we can safely begin to reopen our state’s economy. Through this new partnership with the Chan Zuckerberg Initiative, CZ Biohub and our colleagues at Stanford, we will build a foundation for science-based policies that can guide California and the nation in the challenging months ahead.”

“As California begins to move to a new normal, we need responsible, thoughtful and scientifically sound action to continue protecting our citizens,” said Yvonne Maldonado, professor of pediatrics and of health research and policy at Stanford Medicine. “We are eager to partner with our colleagues at UCSF and the Chan Zuckerberg Initiative to learn whether and how the virus spreads in the coming months and if previous infection confers lasting immunity. This knowledge will be critical in coming months as we explore new treatment and prevention options for the novel coronavirus.”

George Rutherford, professor of epidemiology, preventive medicine and pediatrics at UCSF, said, “The data produced by this study will be not only instrumental in deciding when and how to relax our stringent public health interventions but also to monitor the population for new transmissions going forward. These data will be crucial to informing rational public health practice.”