Design for a Mail Survey to Determine Prevalence of SARS-CoV-2 (COVID-19) Antibodies in the United States

Although counts of the novel Coronavirus (SARS-CoV-2) infections and deaths are reported by several sources online, precise estimation of the exposed proportion of the population is not possible in most areas of the world. Estimates of other disease prevalence in the United States are often obtained through in-person seroprevalence surveys. The availability of testing only for individuals with symptoms, combined with stay-at-home and social distancing mandates to stem the spread of the disease, limit in-person data collection options. A probability-based mail survey with at-home, self-administered testing is a feasible method to safely estimate SARS-CoV-2 antibody prevalence within the United States while also easing burden on the U.S. public and health care system. This mail survey could be a one-time, cross-sectional design, or a repeated cross-sectional or longitudinal survey. We discuss several options for designing and conducting this survey.