Evolving Transmission Network Dynamics of COVID-19 Cluster Infections in South Korea: a descriptive study
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Abstract
Background
Extensive contact tracing and testing in South Korea allows us to investigate the transmission dynamics of the COVID-19 into diverse local communities.
Objective
Understand the critical aspects of transmission dynamics in a different age, sex, and clusters with various activities.
Methods
We conducted a retrospective observational study with 3,127 confirmed cases’ contact tracing data from the Center for Disease and Prevention (CDC) of South Korea. We investigated network property concerning infected persons’ demographics and different infection clusters.
Findings
Overall, women had higher centrality scores than men after week four, when the confirmed cases rapidly increased. Older adults have higher centrality than young/middle-aged adults after week 9. In the infection clusters, young/middle-aged adults’ infection clusters (such as religious gatherings and gym facilities) have higher average path lengths and diameter than older adult’s nursing home infection clusters.
Interpretation
Some women had higher reproduction numbers and bridged successive transmission than men when the confirmed cases rapidly increased. Similarly, some older adults (who were not residents of nursing homes) had higher reproduction numbers and bridged successive transmission than young/middle-aged adults after the peak has passed. The young/middle-aged adults’ religious gatherings and group workout have caused long successive transmissions. In contrast, the older adults’ nursing homes were a small world where the transmissions within a few steps can reach out to many persons.
Funding
UT Startup award, UT STARs award, and Cancer Prevention Research in Texas, and National Institute of General Medical Sciences
Research in context
Evidence before this study:
On May 1, 2020, PubMed query (“COVID-19” OR “SARS-nCoV-2” OR “novel coronavirus” OR “nCoV”) AND (“transmission network” OR “transmission dynamics” OR “transmission pattern” OR “centrality”) AND (“cluster” OR “community”) yield eight peer-reviewed papers. These papers have provided an evolving epidemiology and transmission dynamics via estimated reproduction number. However, most of them have focused on the entire system in one location and there was no comparison between transmission dynamics of different clusters.
Added value of this study:
This study, to the best of our knowledge, is the first to compare the transmission dynamics of different cluster infections. We present the transmission dynamic with varying levels of granularity: entire country vs cluster infections as a longitudinal view. From the whole country-level analysis, we found that females have higher centrality (degree or betweenness) than males. From the cluster infection view, we found that young/middle-aged adults’ infection clusters (such as religious gatherings and gym facilities) have higher average path lengths and diameter than older adult’s nursing home infection clusters.
Implications of all the available evidence:
This study sheds light on different transmission dynamics concerning demographics (age and sex) and diverse behavior in cluster infections. These findings are essential for planning tailored policies to diverse communities. Our analysis code is publicly available to adapt to newly reported cases.
Article activity feed
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SciScore for 10.1101/2020.05.07.20091769: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not 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:The sparsity limitation was inherited from the contact tracing containing the increasing number of unknown transmission paths in local communities. Thus our estimate on network property (degree, betweenness, diameter, and path …
SciScore for 10.1101/2020.05.07.20091769: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not 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:The sparsity limitation was inherited from the contact tracing containing the increasing number of unknown transmission paths in local communities. Thus our estimate on network property (degree, betweenness, diameter, and path length) should be interpreted as a lower bound. The main finding from network centrality analysis was that women had higher centrality (in both degree and betweenness) than men had as the instances rapidly increased. This implies not only that women’s reproduction number was larger than men’s, but also that some women bridged the long successive transmissions. A possible explanation might be that men are more likely to die or critically ill than women, and consequently men have less opportunity to shed the virus.(19) Note that the higher portion of confirmed cases does not necessarily cause higher centrality. The second finding is that older adults had high centrality after the peak has passed around week 9. Note that these older adults with high reproduction numbers were not related to nursing homes. Older adults are more vulnerable to critical illness.(20) Based on our findings, they were not active super-spreaders in the early days. Still, after the virus propagated into local communities, the older adults were more likely to be infected by the virus and be super-spreaders. A breakdown into smaller infection clusters allowed us to find common network characteristics within similar activities. There were three major types of clusters: religious gather...
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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