SARS-CoV-2: An empirical investigation of Rose's population-based logic.

<bold>Background: </bold>Geoffrey Rose's paper "Sick Individuals, Sick Populations" highlights the counterintuitive finding that the largest share of morbidity arises from populations engaging in low- to moderate-risk behavior. Scholars refer to this finding as the prevention paradox. We examine whether this logic applies to SARS-CoV-2 infected persons considered low to moderate risk.<bold>Methods: </bold>We conducted a population-representative survey and sero-surveillance study for SARS-CoV-2 among adults in Orange County, California. Participants answered questions about health behaviors and provided a finger pin-prick sample from 10 July-16 August 2020.<bold>Results: </bold>Of the 2,979 adults, those reporting low- and moderate- risk behavior accounted for between 78% to 92% of SARS-CoV-2 infections. Asymptomatic individuals, as well as persons with low- and moderate- scores for self-reported likelihood of having had SARS-CoV-2, accounted for the majority of infections.<bold>Conclusions: </bold>Our findings support Rose's logic, which encourages public health measures among persons who self-identify as unlikely to have SARS-CoV-2. [ABSTRACT FROM AUTHOR]