480 - Outbreak of COVID-19 Among School Auction Attendees: Was it a “Silent Auction” or “Silent Transmission”?

Background: One day after the pandemic was announced, Tennessee declared a state of emergency on March 12, 2020 with implementation of a stay-at-home order on March 23, 2020. Data regarding the routes and patterns of community transmission of SARS-CoV-2 are limited. We initiated an investigation after clusters of confirmed COVID-19 cases attended a large social gathering.

Methods: We were notified of clinical providers who attended a “Silent School Auction” on March 7, 2020, of which several confirmed-cases were identified as targeted participants. To derive a standardized REDCap web-survey, we conducted a hypothesis-generating interview with three confirmed attendees to collect event details. Once finalized, enrollment included collecting sociodemographic, epidemiologic, and clinical data. Attendees were classified as: 1) confirmed if they had a positive SARS-CoV-2 test; 2) suspected if they developed symptoms 21-days before or after the auction; and 3) asymptomatic if no symptoms were noted.

Results: From March 20-June 16, 100/166 (60%) of attendees were enrolled, with a median age of 41 years, 54% female, and 99% white. Of those, 34 and 32 were confirmed- and suspect-cases, respectively. Table 1 compares sociodemographic behaviors of all attendees, with the majority of confirmed-cases eating late in the evening. From March 6 to March 8, 58 participants reported attending other social events, of which three (i.e., church service, women’s retreat, and a birthday party) were common among 43 attendees and five individuals reported onset of mild respiratory symptoms prior to the event (Figure 1). Confirmed-cases were more likely to report having shortness of breath, chest tightness, loss of taste, loss of smell, and fever compared to suspect-cases (Figure 2) and no one required hospitalization. Dining tables from the school auction depicted a clustering of cases occurring at each table, with some individuals visiting more than one table during the event (Figure 3).

Table 1. Demographic and Social Behaviors of Silent School Auction Attendees, by Case Definition
Figure 1. Onset of Respiratory Symptoms for COVID-19 Confirmed- and Suspect-Cases who Attended the School Auction on March 7, 2020
Figure 2. Proportion of COVID-19 Confirmed- and Suspect-Cases by Clinical Symptom Presentation (n=66)


Conclusion: We identified several COVID-19 cases from a single event that occurred prior to social mitigation strategies. Our investigation highlights the importance of staying home when sick and the significance of social distancing to halt transmission of COVID-19.Figure 3. School Auction Dinner Seating Chart, by Case Definition—Confirmed, Suspect, and Asymptomatic Attendees