Covert coronavirus infections could be seeding new outbreaks

Qiu, Jane

doi:10.1038/d41586-020-00822-x

Cited by 230 publications

(214 citation statements)

References 6 publications

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“…One of the main challenges with COVID-19 are the people that show mild to no symptoms and hence might not be detected as infected [57]. A study has shown that more than 59% of the cases of COVID-19 in Wuhan were not confirmed, asserting the presence of potential asymptomatic and mild-symptomatic cases that may be contagious [58].…”

Section: Challenges Faced Due To Sars-cov-2mentioning

confidence: 99%

Novel Coronavirus: Current Understanding of Clinical Features, Diagnosis, Pathogenesis, and Treatment Options

2020

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Since December 2019, coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in devastating consequences worldwide and infected more than 350,000 individuals and killed more than 16,000 people. SARS-CoV-2 is the seventh member of the coronavirus family to affect humans. Symptoms of COVID-19 include fever (88%), cough (68%), vomiting (5%) and diarrhoea (3.7%), and transmission of SARS-CoV-2 is thought to occur from human to human via respiratory secretions released by the infected individuals when coughing and sneezing. COVID-19 can be detected through computed tomography scans and confirmed through molecular diagnostics tools such as polymerase chain reaction. Currently, there are no effective treatments against SARS-CoV-2, hence antiviral drugs have been used to reduce the development of respiratory complications by reducing viral load. The purpose of this review is to provide a comprehensive update on the pathogenesis, clinical aspects, diagnosis, challenges and treatment of SARS-CoV-2 infections.

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Section: Challenges Faced Due To Sars-cov-2mentioning

confidence: 99%

Novel Coronavirus: Current Understanding of Clinical Features, Diagnosis, Pathogenesis, and Treatment Options

2020

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“…What is more shocking is that researchers used the reported data in China in conjunction with mobility data and inferred that appropriately 86% of all infections in China were undocumented before the travel restrictions since January 23 (Li et al, 2020b). As scientists were setting out on estimating the proportion of people with mild or no symptoms (Qiu, 2020), we estimated the ratio of asymptomatic cases to be about 17% in Shenzhen, by calculating the proportion of all asymptomatic cases among the clustering cases using the field epidemiological investigation data. The ratio is much lower than the previous studies, probably because the cases with mild symptoms were not included for calculating; second, since the medical resources were relatively sufficient in Shenzhen, the medical care-seeking behaviors were more active in the infected people.…”

Section: Discussionmentioning

confidence: 99%

Evolving Epidemiology and Effect of Non-pharmaceutical Interventions on the Epidemic of Coronavirus Disease 2019 in Shenzhen, China

Huang

Zhang

et al. 2020

Preprint

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Previous studies have demonstrated the characteristics of patients with 2019 novel coronavirus disease . However, the effect of non-pharmaceutical interventions on the epidemic in Shenzhen, China remains unknown. Individual data of 417 cases were extracted from the epidemiological investigations and the National Infectious Disease Information System between January 1, 2020 and February 29, 2020. On the basis of important interventions, the epidemic was divided into four periods (January 1-15, January 16-22, January 23-February 5 and after February 6). We used a susceptible-exposed-infectious-asymptomatic-recovered model to evaluate the effect of interventions. Results suggested that about 53.7% were imported from Wuhan. The median age was 47 years and 52.8% were women. Severity risk increased with age and associated with male and co-existing disorders. The attack rate peaked in the third period and drastically decreased afterwards across sex, age groups and geographic regions. Children younger than 5 years showed a higher attack rate than those aged of 6~19. The effective reproductive number decreased from 1.44 to 0.05 after the highest level emergency response since January 23. Overall, the non-pharmaceutical interventions have effectively mitigated the COVID-19 outbreak in Shenzhen, China. These findings may facilitate the introduction of public health policies in other countries and regions.

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“…Equation (1) asserts the susceptible to be infected by coming into contact with the asymptomatic cohort ( ) as well as the symptomatic cohort ( ) at a time-dependent rate of transmission ( ). The latent cohort was set to be 50% as infectious, according to previous literature [24][25][26][27][28][29] . The asymptomatic cases are converted to the symptomatic, at an average rate of 1/ as seen in Equation (2) and Equation (3), where is the incubation period and s is the period of infectivity.…”

Section: Seir Model Specificationmentioning

confidence: 99%

“…Furthermore, all population in the ( ) and ( ) cohort, without medical intervention, face a chance of spontaneously losing infectivity due to either recovery or COVID-19-related mortality, the average rate of which is define as 1/ s 6,30 . Removal from the ( ) population via such a route adequately accounts for the increasing evidence for asymptomatic yet infectious COVID-19 cases [24][25][26][27][28][29] .…”

Section: Seir Model Specificationmentioning

confidence: 99%

The focus and timing of COVID-19 pandemic control measures under healthcare resource constraints

Wei

Wang

Liang

et al. 2020

Preprint

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Generalizing COVID-19 control strategies in one community to others is confounded by community's unique demographic and socioeconomic attributes. Here we propose a tailored dynamic model accounting for community-specific transmission controls and medical resource availability. We trained the model using data from Wuhan and applied it to other countries. We show that isolating suspected cases is most effective in reducing transmission rate if the intervention starts early. Having more hospital beds provides leverage that diminishes with delayed intervention onset. The importance of transmission control in turn increases by 65% with a 7-day delay. Furthermore, prolonging outbreak duration by applying an intermediate, rather than strict, transmission control would not prevent hospital overload regardless of bed capacity, and would likely result in a high ratio (21% ~ 84%) of the population being infected but not treated. The model could help different countries design control policies and gauge the severity of suppression failure.

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Covert coronavirus infections could be seeding new outbreaks

Cited by 230 publications

References 6 publications

Novel Coronavirus: Current Understanding of Clinical Features, Diagnosis, Pathogenesis, and Treatment Options

Novel Coronavirus: Current Understanding of Clinical Features, Diagnosis, Pathogenesis, and Treatment Options

Evolving Epidemiology and Effect of Non-pharmaceutical Interventions on the Epidemic of Coronavirus Disease 2019 in Shenzhen, China

The focus and timing of COVID-19 pandemic control measures under healthcare resource constraints

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