On Jun. 16, 2020, a consortium that includes many of San Diego’s top medical and scientific research institutes launched a large-scale COVID-19 screening effort to better understand the spread and prevalence of the virus in the local community, with an initial focus on evaluating healthcare workers and first responders.

Known as the San Diego Epidemiology and Research for COVID Health (SEARCH) alliance, the cross-institutional collaboration is co-led by scientists and clinical researchers at Rady Children’s Hospital-San Diego, Rady Children’s Institute for Genomic Medicine, Scripps Research and University of California San Diego.

The research project was applying innovative technologies and screening strategies to paint a more comprehensive picture of how widely COVID-19 has spread—and continues to spread—throughout the San Diego area. All data collected contributed to an epidemiological study that will encompass active cases of COVID-19 as well as its “silent spread” to people who never developed symptoms.

As COVID-19 cases in San Diego began to rapidly increase in late March, the collaborators sprang into action. Through emails and Zoom meetings, they formulated a research proposal and created a scalable testing framework that would enable them to screen symptomatic individuals as well as people who may have COVID-19 without showing symptoms.

In the initial phase of the program, nasopharyngeal swabs were used to collect samples from study participants at a local drive-up site and the samples are screened at research laboratories at Scripps Research and UC San Diego. Any positive results were then confirmed by Rady Children’s Institute of Genomic Medicine’s nationally accredited and certified clinical laboratory.

In addition, the researchers were conducting “serosurvey” studies that look for antibodies to the virus. Serosurveys, short for serological surveys, involve finger-prick blood tests of people who haven’t been diagnosed with COVID-19 to gauge the extent to which SARS-CoV-2 has spread undetected. The program relied heavily on automation for screening, with the capacity to screen thousands of individuals daily while keeping costs low.

Since the study launched, SEARCH had enrolled more than 10,000 participants who are asymptomatic or mildly symptomatic. Thus far, researchers found that an average of two participants per every 1,000 enrolled had a positive result for the SARS-CoV-2 virus.