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Excellent review of this preprint study!

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Please make clear which bivalent is being referred to. In Canada we have the BA.1 bivalent and the BA.5 bivalent. Most USA creators are referring to THE bivalent. This has the potential to mislead Canadians, for example, who got the BA.1 bivalent.

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Excellent point, I will update. Since the study was done in Ohio, it is safe to assume it is the Bivalent containing the BA4/5 antigen and the original Wuhan variant.

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Am I reading the study correctly? Where it says:

"Since the health system never had a requirement for systematic asymptomatic employee test screening, most of the positive tests during the study period would have been tests done to evaluate suspicious symptoms. Some would have been to evaluate known exposures. A small proportion could have been tests done as part of pre-operative or pre-procedural screening."

Doesn't this mean a lot of testing was voluntary? Doesn't this introduce a known bias? That is, vaccinated persons and front-line persons are more likely to volunteer for testing compared to unvaccinated persons?

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This is one of the sources of bias in their study population.

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