Infectivity, susceptibility, and risk factors associated with SARS-CoV-2 transmission under intensive contact tracing in Hunan, China

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Abstract

Several mechanisms driving SARS-CoV-2 transmission remain unclear. Based on individual records of 1178 potential SARS-CoV-2 infectors and their 15,648 contacts in Hunan, China, we estimated key transmission parameters. The mean generation time was estimated to be 5.7 (median: 5.5, IQR: 4.5, 6.8) days, with infectiousness peaking 1.8 days before symptom onset, with 95% of transmission events occurring between 8.8 days before and 9.5 days after symptom onset. Most transmission events occurred during the pre-symptomatic phase (59.2%). SARS-CoV-2 susceptibility to infection increases with age, while transmissibility is not significantly different between age groups and between symptomatic and asymptomatic individuals. Contacts in households and exposure to first-generation cases are associated with higher odds of transmission. Our findings support the hypothesis that children can effectively transmit SARS-CoV-2 and highlight how pre-symptomatic and asymptomatic transmission can hinder control efforts.

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  1. SciScore for 10.1101/2020.07.23.20160317: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.


    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study is not without limitations. First, it suffers from the classic limitations of any epidemiological field investigation. Despite the longitudinal and in-depth investigation of each case and her/his contacts, we could not always accurately reconstruct the entire transmission chain and fully avoid recall bias in individual records. Also, the imperfect sensitivity of PCR testing should be taken into consideration, especially as it highly depends on the delay between the time of infection and specimen collection 53. Unfortunately, we do not have a representative sample for the date of sample collection, thus we cannot correct for this factor, possibly leading to an underestimation of the number of SARS-CoV-2 infected asymptomatic individuals. Moreover, we cannot rule out the possibility of indirect exposures (e.g., contaminated surfaces), which may affect the identification of epidemiological links. High-resolution genomic and virologic surveillance data would be needed to decrease the uncertainty on the links identified by the epidemiological investigation and to better distinguish direct vs. community transmission 54,55. Second, the duration of per-contact exposure was not reported in the dataset and we were thus unable to correct for this factor. This may contribute to explain the importance attributed to household contacts in our regression analysis and why individuals with more contacts have lower transmission risk per contact. Third, despite controlling known factor...

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.