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Open AccessArticle

Time from Symptom Onset to Hospitalisation of Coronavirus Disease 2019 (COVID-19) Cases: Implications for the Proportion of Transmissions from Infectors with Few Symptoms

1
Mathematical Institute, University of Oxford, Oxford OX2 6GG, UK
2
Christ Church, University of Oxford, Oxford OX1 1DP, UK
3
School of Public Health, Tel Aviv University, Tel Aviv 6997801, Israel
4
Porter School of the Environment and Earth Sciences, Tel Aviv University, Tel Aviv 6997801, Israel
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(5), 1297; https://doi.org/10.3390/jcm9051297
Received: 11 March 2020 / Revised: 15 April 2020 / Accepted: 26 April 2020 / Published: 1 May 2020
Interventions targeting symptomatic hosts and their contacts were successful in bringing the 2003 SARS pandemic under control. In contrast, the COVID-19 pandemic has been harder to contain, partly because of its wide spectrum of symptoms in infectious hosts. Current evidence suggests that individuals can transmit the novel coronavirus while displaying few symptoms. Here, we show that the proportion of infections arising from hosts with few symptoms at the start of an outbreak can, in combination with the basic reproduction number, indicate whether or not interventions targeting symptomatic hosts are likely to be effective. However, as an outbreak continues, the proportion of infections arising from hosts with few symptoms changes in response to control measures. A high proportion of infections from hosts with few symptoms after the initial stages of an outbreak is only problematic if the rate of new infections remains high. Otherwise, it can simply indicate that symptomatic transmissions are being prevented successfully. This should be considered when interpreting estimates of the extent of transmission from hosts with few COVID-19 symptoms. View Full-Text
Keywords: COVID-19; symptoms; infectiousness; presymptomatic transmission; infectious period; symptom onset to hospitalisation; reproduction number COVID-19; symptoms; infectiousness; presymptomatic transmission; infectious period; symptom onset to hospitalisation; reproduction number
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Thompson, R.N.; Lovell-Read, F.A.; Obolski, U. Time from Symptom Onset to Hospitalisation of Coronavirus Disease 2019 (COVID-19) Cases: Implications for the Proportion of Transmissions from Infectors with Few Symptoms. J. Clin. Med. 2020, 9, 1297.

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