Sequential serological surveys in the early stages of the coronavirus disease epidemic: limitations and perspectives

INTRODUCTION: Estimates of the number of individuals infected by severe acute respiratory syndrome coronavirus 2 are important for health planning and establishment of expectations regarding herd immunity. METHODS: Seven testing rounds of a serological survey were conducted at 1-week intervals between April 19 and May 31, 2020 in Teresina municipality. RESULTS: Over the 7 weeks, serological positivity increased from 0.56% (95% confidence interval [CI]: 0.18%-1.30%) to 8.33% (95% CI: 6.61%-10.33%), representing 33-53 persons infected for each reported case. CONCLUSIONS: Serological screening may be an important tool for understanding the immunity of a population and planning community interventions.