Quantifying asymptomatic infection and transmission of COVID-19 in New York City using observed cases, serology, and testing capacity
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Abstract
As health officials face another wave of COVID-19, they require estimates of the proportion of infected cases that develop symptoms, and the extent to which symptomatic and asymptomatic cases contribute to community transmission. Recent asymptomatic testing guidelines are ambiguous. Using an epidemiological model that includes testing capacity, we show that many infections are nonsymptomatic but contribute substantially to community transmission in the aggregate. Their individual transmissibility remains uncertain. If they transmit as well as symptomatic infections, the epidemic may spread at faster rates than current models often assume. If they do not, then each symptomatic case generates, on average, a higher number of secondary infections than typically assumed. Regardless, controlling transmission requires community-wide interventions informed by extensive, well-documented asymptomatic testing.
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SciScore for 10.1101/2020.10.16.20214049: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.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:One limitation of early contact tracing studies is that estimates of transmissibility may over-sample symptomatic index cases and contacts, particularly during the early phase of an epidemic(15, 53). In certain studies, only symptomatic contacts are further investigated. Ideally, one would use frequent systematic community testing for …
SciScore for 10.1101/2020.10.16.20214049: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.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:One limitation of early contact tracing studies is that estimates of transmissibility may over-sample symptomatic index cases and contacts, particularly during the early phase of an epidemic(15, 53). In certain studies, only symptomatic contacts are further investigated. Ideally, one would use frequent systematic community testing for studies identifying both symptomatic and asymptomatic potential index cases for further contact tracing and testing of all contacts regardless of symptoms. Furthermore, fixing the probability that an infection becomes symptomatic based on the results of serology-informed models such as ours, could increase the precision with which contact tracing studies can estimate the strength of asymptomatic transmission. Colleges that are currently reopening may be ideal test locations for this kind of combined approach, which may also help detect super-spreading events. While it cannot capture all testing intricacies, our frame-work illustrates how transmission models can incorporate daily changes in testing capacity and identify parameters that were previously difficult to estimate such as the probability that an infection will become symptomatic. While we do not explicitly denote differences between labs, hospitals, or diagnostic tests, we account for this variation by including additional measurement noise after simulating the RT-PCR testing process. We also consider how sampling individuals without COVID-19 may deplete the daily testing capacity. In pa...
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.
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