Our National COVID-19 Antibody Study

Epicentre News • 20 May 2021

Learn more about how South Africa is taking on COVID-19 in this exciting and groundbreaking antibody study.

COVID-19 is a new disease that has affected the lives of all South Africans. There is still a lot to learn about COVID-19 and how it has affected communities. Our primary aim is to:

• Determine the extent of COVID-19 virus infection in the general population and age-specific infection prevalence, as determined by seropositivity (testing positive for COVID on an COVID-19 antibody test)
• Determine the amount/percentage of asymptomatic or subclinical COVID-19 infections;
• To determine the incidence rate of COVID-19 infections as determined by change from negative to positive serostatus in an embedded cohort of respondents in metropolitan municipalities (viz., Cape Town, Durban, Johannesburg and Nelson Mandela Bay).

This information is important to guide in planning and decision-making for preventing future waves of the pandemic in South Africa, as well as to help ensure that health facilities are available to those who need it.

Our secondary aims are to:

• Determine risk factors for COVID-19 virus infection
• Estimate the prevalence of Covid-19 antibodies in age and sex sub-groups
• Assess antibody levels quantitatively and neutralising antibody concentrations for future comparisons with correlates of protection for herd immunity estimations
• & to assess cytotoxic T-cell responses in a sub-group of respondents who have and do not have antibody responses, in order to identify what proportion of individuals may have been infected with SARS-CoV-2 but do not have detectable antibodies.

What is NCAS?

NCAS or the National COVID-19 Antibody Study is a research study that aims to find out:

• How the Coronavirus has impacted the lives of South Africans
• & How many South Africans have been infected with COVID-19.

Will NCAS visit me?

The NCAS team might be visiting your home if:

• You are in one of the communities we have listed that week
• & you have been pre-selected randomly by the Human Sciences Research Council (HSRC)’s scientists

Can I sign up for the study?

• You cannot be added to the study if you have not been randomly selected in advance by the Human Sciences Research Council (HSRC)

When will I know if I have been selected?

• When our NCAS team enters your area we will visit your home & leave you with some information on our study
• After you have some time to look at the information we will ask you if you want to be part of the study

If I get selected, what will the NCAS team want me to do?

• The NCAS team will ask you some questions they read on their tablet. These questions are multiple choice and very easy.
• The NCAS team will also ask if they can take a small amount of your blood to send to our lab at the National Institute for Communicable Diseases to test for COVID-19 antibodies.

What if I don’t want to give blood and only want to answer questions?

• That is fine
• The information you can give on its own is very valuable
• But it would be very helpful to test your blood as you may not know you had COVID-19 as some people had no symptoms

Will I find out my results of the COVID-19 Antibody Laboratory test

• Yes we will send you your results

Do I have to take part in NCAS if I have been selected?

• NO, you do not have to participate we cannot force you to do anything
• But your participation would help scientists protect your community in the future against COVID-19 and viruses like it

How is NCAS anonymous?

• All participants’ details are kept private so that participants cannot be identified.
• To do this we link participants to a barcode not their name.
• NCAS has gone through a very strict ‘ethical review’ with several independent ethical comities for every part of the study. We have to protect every participant and follow a very strict plan about what happens to each person’s information (in terms of where it goes & who sees it). Which are explained in detail to every person who participates.
• & each data collector on the NCAS project, are required to sign a confidentiality agreement when they begin working on the project.
• So they may not discuss this information or disclose it to any outside parties.

How will getting information on 19 000 people give us information on 58.56 million South African’s COVID-19 status?

• One word statistics
• By randomly selecting many different communities and homes within those areas we are able to get a very wide range of South Africans living in rural villages all the way to apartments in central business district Cape Town.
• By getting a wide range and a large number (19 000 could be seen as quite a lot of people for a research study) we can make an accurate prediction on what other South Africans have experienced with COVID-19.

Why is it important for people to participate

• Every person who participates gives us more information on how this infection has impacted South Africans like you around the country.
• If a home we visit says no we can’t replace them, we can’t go to a neighbour or a house down the road because each house needs to be randomly pre-selected.
• That information is lost forever and our prediction about how COVID-19 has impacted SA becomes less accurate

Has there been other research studies on COVID-19 in South Africa?

• Yes, Genesis Analytics, Epicentre & the National Institute for Communicable Diseases has just finished HUTS or the Healthcare UTilisation and Seroprevalence Survey
• This survey was similar to NCAS in that it also looked at the effects of COVID-19 on South African and studied their antibodies
• But it was more in depth, asking more questions and focusing on 3 communities Edendale in KZN, Mitchelles Plain in WC, and Klerksdorp in North West.
• For more information & the early findings of this study visit https://epicentre.org.za/2021/03/11/huts/

Does NCAS have anything to do with the vaccine?

• NO, NCAS has nothing to do with the vaccine

If I don’t like the vaccine should I take part in NCAS?

• Yes, NCAS only takes a small amount of blood from you
• This is to get information (anonymously) on your COVID-19 antibodies, this is to see if you had COVID-19 before. This will provide you useful information on your COVID-19 status.
• If you are sceptical about COVID-19 non-government organizations looking into the virus is a good thing

Where can I get more information on NCAS?

• You can take a look at our in depth look at NCAS on our website here https://epicentre.org.za/2020/11/17/ncas/
• Or our shorter article on the study on our website here https://epicentre.org.za/sacovid-research/
• & we have a version of this page that is ‘data free’ won’t use any of your data to use here https://antibodyresearch.datafree.co/sacovid-research/

This study will have two Cross-Sectional Surveys that will be conducted 8 weeks apart

• First Survey (complete):
  • We will be visiting 6,540 households in 436 communities nationally
• Second survey (in progress):
  • We will be visiting 6,540 households in 400 communities nationally 
  • In the cities the same participants will be visited again
  • In other communities new houses in the same areas will be visited

In total 19,620 individuals will be asked to participate in each wave of the surveys

Since the beginning of 2020, the majority of countries in the world have been facing the global public health pandemic of coronavirus disease (COVID-19) which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

To date, very little is known internationally and nationally about the magnitude and determinants of this epidemic; as prevalence is estimated from confirmed cases based on polymerase chain reaction (PCR) testing for patients who have mild to serious symptoms.

The proportion of asymptomatic cases in the general population is unknown and this study will shed crucial light on this important issue.

The HSRC is committed to cutting-edge research that supports development nationally, in the Southern African Development Community (SADC) and in Africa. Their commitment to the dissemination of that research demonstrates the remarkable and measurable impact of our work.

The South African Medical Research Council (SAMRC) was established in 1969 with a mandate to improve the health of the country’s population, through research, development and technology transfer, so that people can enjoy a better quality of life. With a strategic objective to help strengthen the health systems of the country – in line with that of the Department of Health, the SAMRC constantly identifies the main causes of death in South Africa.

Our study will be visiting all 9 provinces, and we need you to tell everyone about Epicentre, so we can get as many randomly selected people to say yes as possible.

We need people to be on the look out for the Epicentre brand so when they see us it is not the first time they’ve heard about us. We need every South Africans support to beat COVID-19 and this is one easy way you can help us achieve that goal!

How can you help?

• Take part in this ground-breaking study if we knock at your door.

• Take a selfie with our team and use the #COVIDstudy
• Share this post & tell your friends, family, and neighbours about the study
• Get others to participate and help spread the word as a proud South African.

Epicentre has been conducting data collection successfully for researchers for 20 years. But what sets us apart from other data collectors is our extremely low participant refusal rate and our happiness to embrace new technology and innovation.

Our surveys are informing national policy on disease in Southern Africa such as

• South Africa’s National Strategic plan for HIV, TB and STIs 2017-2022&

& Informing international public health responses by

• the Centre for Disease Control (CDC),
• the World Health Organization (WHO),
• & President’s Emergency Plan for AIDS Relief (PEPFAR)