COVID19 transmission dynamics

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martinkil
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Joined: Sun Jan 11, 2015 9:55 am

COVID19 transmission dynamics

Postby martinkil » Tue May 05, 2020 10:50 am

A lot of discussion recently about transmission dynamics, most of which are extrapolated from viral loads & estimates. What does contact tracing/community testing data tell us about actual probability of #COVID19 transmission(infection rate), high risk environments/age?

Dr Muge Cevik @mugecevik - Infectious Diseases / Virology Clinician & Researcher @univofstandrews • #HIV #TB #emerginginf #GlobalHealth • #SciComm • #veganSeedling• RT ≠ endorsement Scotland, UK, EU

https://twitter.com/mugecevik/status/1257392347010215947
Thread unrolled as an article https://threadreaderapp.com/thread/1257392347010215947.html

15/ In summary:
While the infectious inoculum required for infection is unknown, these studies indicate that close & prolonged contact is required for #COVID19 transmission. The risk is highest in enclosed environments; household, long-term care facilities and public transport.

16/ High infection rates seen in household, friend & family gatherings, transport suggest that closed contacts in congregation is likely the key driver of productive transmission. Casual, short interactions are not the main driver of the epidemic though keep social distancing!

17/ Increased rates of infection seen in enclosed & connected environments is in keeping with high infection rates seen in megacities, deprived areas, shelters. A recent preprint demonstrates that #COVID19 epidemic intensity is strongly shaped by crowding

18/ Although limited, these studies so far indicate that susceptibility to infection increases with age (highest >60y) and growing evidence suggests children are less susceptible, are infrequently responsible for household transmission, are not the main drivers of this epidemic.

19/ Finally, these studies indicate that most transmission is caused by close contact with a symptomatic case, highest risk within first 5d of symptoms. To note: this preprint suggests that most infections are not asymptomatic during infection

20/ In conclusion, contact tracing data is crucial to understand real transmission dynamics. Cautionary note: This data & interpretation is based on the available evidence as of May 4th. Our understanding might change based on community testing/lifting lockdown measures.

Addendum: While we have limited data, similar high risk transmission pattern could be seen in other crowded & connected indoor environments such as crowded office spaces, other workplace environment, packed restaurants/cafes, cramped apartment buildings etc.

Conclusion 2: (a) we need to redesign our living/working spaces & rethink how to provide better, ventilated living/working environment for those who live in deprived & cramped areas; (b) avoid close, sustained contact indoors & in public transport, & maintain personal hygiene.

A related study missed from the analysis - https://wwwnc.cdc.gov/eid/article/26/8/20-1274_article

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