The contribution of pre-symptomatic infection to the transmission dynamics of COVID-2019 [version 1; peer review: 2 approved]
Background: Pre-symptomatic transmission can be a key determinant of the effectiveness of containment and mitigation strategies for infectious diseases, particularly if interventions rely on syndromic case finding. For COVID-19, infections in the absence of apparent symptoms have been reported frequ...
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| Format: | Article |
| Language: | English |
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Wellcome
2020-04-01
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| Series: | Wellcome Open Research |
| Online Access: | https://wellcomeopenresearch.org/articles/5-58/v1 |
| _version_ | 1811221651606470656 |
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| author | Yang Liu Centre for Mathematical Modelling of Infectious Diseases nCoV Working Group Sebastian Funk Stefan Flasche |
| author_facet | Yang Liu Centre for Mathematical Modelling of Infectious Diseases nCoV Working Group Sebastian Funk Stefan Flasche |
| author_sort | Yang Liu |
| collection | DOAJ |
| description | Background: Pre-symptomatic transmission can be a key determinant of the effectiveness of containment and mitigation strategies for infectious diseases, particularly if interventions rely on syndromic case finding. For COVID-19, infections in the absence of apparent symptoms have been reported frequently alongside circumstantial evidence for asymptomatic or pre-symptomatic transmission. We estimated the potential contribution of pre-symptomatic cases to COVID-19 transmission. Methods: Using the probability for symptom onset on a given day inferred from the incubation period, we attributed the serial interval reported from Shenzen, China, into likely pre-symptomatic and symptomatic transmission. We used the serial interval derived for cases isolated more than 6 days after symptom onset as the no active case finding scenario and the unrestricted serial interval as the active case finding scenario. We reported the estimate assuming no correlation between the incubation period and the serial interval alongside a range indicating alternative assumptions of positive and negative correlation. Results: We estimated that 23% (range accounting for correlation: 12 – 28%) of transmissions in Shenzen may have originated from pre-symptomatic infections. Through accelerated case isolation following symptom onset, this percentage increased to 46% (21 – 46%), implying that about 35% of secondary infections among symptomatic cases have been prevented. These results were robust to using reported incubation periods and serial intervals from other settings. Conclusions: Pre-symptomatic transmission may be essential to consider for containment and mitigation strategies for COVID-19. |
| first_indexed | 2024-04-12T08:03:17Z |
| format | Article |
| id | doaj.art-4e7e9c25a6dd4bd28219fbd4f06f58ed |
| institution | Directory Open Access Journal |
| issn | 2398-502X |
| language | English |
| last_indexed | 2024-04-12T08:03:17Z |
| publishDate | 2020-04-01 |
| publisher | Wellcome |
| record_format | Article |
| series | Wellcome Open Research |
| spelling | doaj.art-4e7e9c25a6dd4bd28219fbd4f06f58ed2022-12-22T03:41:14ZengWellcomeWellcome Open Research2398-502X2020-04-01510.12688/wellcomeopenres.15788.117314The contribution of pre-symptomatic infection to the transmission dynamics of COVID-2019 [version 1; peer review: 2 approved]Yang Liu0Centre for Mathematical Modelling of Infectious Diseases nCoV Working GroupSebastian Funk1Stefan Flasche2Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, London, WC1E 7HT, UKCentre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, London, WC1E 7HT, UKCentre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, London, WC1E 7HT, UKBackground: Pre-symptomatic transmission can be a key determinant of the effectiveness of containment and mitigation strategies for infectious diseases, particularly if interventions rely on syndromic case finding. For COVID-19, infections in the absence of apparent symptoms have been reported frequently alongside circumstantial evidence for asymptomatic or pre-symptomatic transmission. We estimated the potential contribution of pre-symptomatic cases to COVID-19 transmission. Methods: Using the probability for symptom onset on a given day inferred from the incubation period, we attributed the serial interval reported from Shenzen, China, into likely pre-symptomatic and symptomatic transmission. We used the serial interval derived for cases isolated more than 6 days after symptom onset as the no active case finding scenario and the unrestricted serial interval as the active case finding scenario. We reported the estimate assuming no correlation between the incubation period and the serial interval alongside a range indicating alternative assumptions of positive and negative correlation. Results: We estimated that 23% (range accounting for correlation: 12 – 28%) of transmissions in Shenzen may have originated from pre-symptomatic infections. Through accelerated case isolation following symptom onset, this percentage increased to 46% (21 – 46%), implying that about 35% of secondary infections among symptomatic cases have been prevented. These results were robust to using reported incubation periods and serial intervals from other settings. Conclusions: Pre-symptomatic transmission may be essential to consider for containment and mitigation strategies for COVID-19.https://wellcomeopenresearch.org/articles/5-58/v1 |
| spellingShingle | Yang Liu Centre for Mathematical Modelling of Infectious Diseases nCoV Working Group Sebastian Funk Stefan Flasche The contribution of pre-symptomatic infection to the transmission dynamics of COVID-2019 [version 1; peer review: 2 approved] Wellcome Open Research |
| title | The contribution of pre-symptomatic infection to the transmission dynamics of COVID-2019 [version 1; peer review: 2 approved] |
| title_full | The contribution of pre-symptomatic infection to the transmission dynamics of COVID-2019 [version 1; peer review: 2 approved] |
| title_fullStr | The contribution of pre-symptomatic infection to the transmission dynamics of COVID-2019 [version 1; peer review: 2 approved] |
| title_full_unstemmed | The contribution of pre-symptomatic infection to the transmission dynamics of COVID-2019 [version 1; peer review: 2 approved] |
| title_short | The contribution of pre-symptomatic infection to the transmission dynamics of COVID-2019 [version 1; peer review: 2 approved] |
| title_sort | contribution of pre symptomatic infection to the transmission dynamics of covid 2019 version 1 peer review 2 approved |
| url | https://wellcomeopenresearch.org/articles/5-58/v1 |
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