Randomized COVID-19 Testing in Vulnerable Communities and Risk Tool Creation (FightCOVIDMKE)

Background: The purpose of this study was to understand true COVID-19 infection levels in Milwaukee County and how infection rates differed across population groups. The project focused on minority, low-income, and older residents since these groups faced higher risks and were often undercounted in early testing efforts. The study aimed to produce accurate community-level estimates of prior infection and to support risk awareness for individuals and families.

Materials/Methods: The study used randomized COVID-19 antibody testing across Milwaukee County to measure the proportion of residents who had been infected and to track changes over time. The team partnered with 20 primary care health centers, local churches, and community agencies to support outreach and engagement. These partnerships helped oversample minority, low-income, and elderly residents to improve precision for these groups. Participants completed health questionnaires, and the study linked these data to state-level datasets to examine clinical outcomes such as symptoms, hospitalizations, ICU care, and death. The team also built a web-based risk assessment tool, available in English and Spanish, that used study findings to estimate infection risk and guide prevention and vaccination decisions.

Outcome/Impact: The study produced detailed estimates of past COVID-19 infection across diverse communities in Milwaukee County and highlighted clear disparities in infection and severe outcomes. Results strengthened understanding of which groups were most at risk and supported targeted mitigation and vaccination strategies. The risk assessment tool gave residents and healthcare providers an accessible way to identify high-risk individuals and support informed decisions that reduced exposure and improved safety.