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    The McMaster Department of Philosophy has now put together the following notice commemorating Barry: Barry Allen: A Philosophical Life Barry…

What contact tracing reveals about the transmissibility of the new coronavirus

This is an extremely illuminating Twitter thread from a St. Andrews infectious diseases specialist; a few excerpts:

2147 close contacts of 157 #COVID19 cases were followed up: Overall infection rate was 6%, higher infection rate among friends (22%) and household (18%), and main risk factors include contact in household (13%), transport (11%), dining (7%) [BL:  note that only 18% of household contacts were infected!]

[In another study] 445 close contacts of 10 #COVID19 cases were followed up, of those 54 (12%) developed symptoms, suggesting secondary attack rate of 0.45%, household attack rate of 10.5%. No other close contacts incl community members, HCWs were positive.

Based on 1286 close contacts of 319 #COVID19 cases [in another study]; household and transport contacts had higher risk of transmission (80% of infections caused by 9% of cases), household attack rate of 11.5%, children were as likely to be infected….

Among 392 household contacts of 105 index #COVID19 cases, overall household attack rate was 16%, the secondary attack rate was highest in spouse (28%), all adults (17%) and was lower in <18 age group (4%)…

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.

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!

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.

Finally, these studies indicate that most transmission is caused by close contact with a symptomatic case, highest risk within first 5d of symptoms.

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One response to “What contact tracing reveals about the transmissibility of the new coronavirus”

  1. It isn't clear when the paragraphs below were added, but they're important. In particular, the second paragraph explains why working in close quarters or eating in restaurants would still be risky at this point:

    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. END

    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.

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