Challenges in control of COVID-19: short doubling time and long delay to effect of interventions
Early assessments of the growth rate of COVID-19 were subject to significant uncertainty, as expected with limited data and difficulties in case ascertainment, but as cases were recorded in multiple countries, more robust inferences could be made. Using multiple countries, data streams and methods,...
| Main Authors: | , , , , , , , , , |
|---|---|
| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
The Royal Society
2021
|
| _version_ | 1797109684444856320 |
|---|---|
| author | Pellis, L Scarabel, F Stage, HB Overton, CE Chappell, LHK Fearon, E Bennett, E Lythgoe, KA House, TA Hall, I |
| author2 | University of Manchester COVID-19 Modelling Group |
| author_facet | University of Manchester COVID-19 Modelling Group Pellis, L Scarabel, F Stage, HB Overton, CE Chappell, LHK Fearon, E Bennett, E Lythgoe, KA House, TA Hall, I |
| author_sort | Pellis, L |
| collection | OXFORD |
| description | Early assessments of the growth rate of COVID-19 were subject to significant uncertainty, as expected with limited data and difficulties in case ascertainment, but as cases were recorded in multiple countries, more robust inferences could be made. Using multiple countries, data streams and methods, we estimated that, when unconstrained, European COVID-19 confirmed cases doubled on average every 3 days (range 2.2-4.3 days) and Italian hospital and intensive care unit admissions every 2-3 days; values that are significantly lower than the 5-7 days dominating the early published literature. Furthermore, we showed that the impact of physical distancing interventions was typically not seen until at least 9 days after implementation, during which time confirmed cases could grow eightfold. We argue that such temporal patterns are more critical than precise estimates of the time-insensitive basic reproduction number <i>R</i><sub>0</sub> for initiating interventions, and that the combination of fast growth and long detection delays explains the struggle in countries' outbreak response better than large values of <i>R</i><sub>0</sub> alone. One year on from first reporting these results, reproduction numbers continue to dominate the media and public discourse, but robust estimates of unconstrained growth remain essential for planning worst-case scenarios, and detection delays are still key in informing the relaxation and re-implementation of interventions. This article is part of the theme issue 'Modelling that shaped the early COVID-19 pandemic response in the UK'. |
| first_indexed | 2024-03-07T07:44:59Z |
| format | Journal article |
| id | oxford-uuid:1b574904-0932-4ccd-a034-78f8c171e549 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:44:59Z |
| publishDate | 2021 |
| publisher | The Royal Society |
| record_format | dspace |
| spelling | oxford-uuid:1b574904-0932-4ccd-a034-78f8c171e5492023-06-02T12:34:45ZChallenges in control of COVID-19: short doubling time and long delay to effect of interventionsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1b574904-0932-4ccd-a034-78f8c171e549EnglishSymplectic ElementsThe Royal Society2021Pellis, LScarabel, FStage, HBOverton, CEChappell, LHKFearon, EBennett, ELythgoe, KAHouse, TAHall, IUniversity of Manchester COVID-19 Modelling GroupEarly assessments of the growth rate of COVID-19 were subject to significant uncertainty, as expected with limited data and difficulties in case ascertainment, but as cases were recorded in multiple countries, more robust inferences could be made. Using multiple countries, data streams and methods, we estimated that, when unconstrained, European COVID-19 confirmed cases doubled on average every 3 days (range 2.2-4.3 days) and Italian hospital and intensive care unit admissions every 2-3 days; values that are significantly lower than the 5-7 days dominating the early published literature. Furthermore, we showed that the impact of physical distancing interventions was typically not seen until at least 9 days after implementation, during which time confirmed cases could grow eightfold. We argue that such temporal patterns are more critical than precise estimates of the time-insensitive basic reproduction number <i>R</i><sub>0</sub> for initiating interventions, and that the combination of fast growth and long detection delays explains the struggle in countries' outbreak response better than large values of <i>R</i><sub>0</sub> alone. One year on from first reporting these results, reproduction numbers continue to dominate the media and public discourse, but robust estimates of unconstrained growth remain essential for planning worst-case scenarios, and detection delays are still key in informing the relaxation and re-implementation of interventions. This article is part of the theme issue 'Modelling that shaped the early COVID-19 pandemic response in the UK'. |
| spellingShingle | Pellis, L Scarabel, F Stage, HB Overton, CE Chappell, LHK Fearon, E Bennett, E Lythgoe, KA House, TA Hall, I Challenges in control of COVID-19: short doubling time and long delay to effect of interventions |
| title | Challenges in control of COVID-19: short doubling time and long delay to effect of interventions |
| title_full | Challenges in control of COVID-19: short doubling time and long delay to effect of interventions |
| title_fullStr | Challenges in control of COVID-19: short doubling time and long delay to effect of interventions |
| title_full_unstemmed | Challenges in control of COVID-19: short doubling time and long delay to effect of interventions |
| title_short | Challenges in control of COVID-19: short doubling time and long delay to effect of interventions |
| title_sort | challenges in control of covid 19 short doubling time and long delay to effect of interventions |
| work_keys_str_mv | AT pellisl challengesincontrolofcovid19shortdoublingtimeandlongdelaytoeffectofinterventions AT scarabelf challengesincontrolofcovid19shortdoublingtimeandlongdelaytoeffectofinterventions AT stagehb challengesincontrolofcovid19shortdoublingtimeandlongdelaytoeffectofinterventions AT overtonce challengesincontrolofcovid19shortdoublingtimeandlongdelaytoeffectofinterventions AT chappelllhk challengesincontrolofcovid19shortdoublingtimeandlongdelaytoeffectofinterventions AT fearone challengesincontrolofcovid19shortdoublingtimeandlongdelaytoeffectofinterventions AT bennette challengesincontrolofcovid19shortdoublingtimeandlongdelaytoeffectofinterventions AT lythgoeka challengesincontrolofcovid19shortdoublingtimeandlongdelaytoeffectofinterventions AT houseta challengesincontrolofcovid19shortdoublingtimeandlongdelaytoeffectofinterventions AT halli challengesincontrolofcovid19shortdoublingtimeandlongdelaytoeffectofinterventions |