Transmission heterogeneities, kinetics, and controllability of SARS-CoV-2

Science. 2021 Jan 15;371(6526):eabe2424. doi: 10.1126/science.abe2424. Epub 2020 Nov 24.

Abstract

A long-standing question in infectious disease dynamics concerns the role of transmission heterogeneities, which are driven by demography, behavior, and interventions. On the basis of detailed patient and contact-tracing data in Hunan, China, we find that 80% of secondary infections traced back to 15% of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primary infections, which indicates substantial transmission heterogeneities. Transmission risk scales positively with the duration of exposure and the closeness of social interactions and is modulated by demographic and clinical factors. The lockdown period increases transmission risk in the family and households, whereas isolation and quarantine reduce risks across all types of contacts. The reconstructed infectiousness profile of a typical SARS-CoV-2 patient peaks just before symptom presentation. Modeling indicates that SARS-CoV-2 control requires the synergistic efforts of case isolation, contact quarantine, and population-level interventions because of the specific transmission kinetics of this virus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Asymptomatic Infections*
  • COVID-19 / prevention & control*
  • COVID-19 / transmission*
  • Chain of Infection / prevention & control*
  • Child
  • Child, Preschool
  • China / epidemiology
  • Contact Tracing
  • Family Characteristics
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Quarantine
  • SARS-CoV-2*
  • Social Interaction
  • Virus Shedding
  • Young Adult