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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Setting-specific Transmission Rates: A Systematic Review
Hayley A Thompson1, Andria Mousa1, Amy Dighe1
1MRC Centre for Global Infectious Disease Analysis & World Health Organization Collaborating Centre for Infectious Disease Modelling, Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, UK.
Summary
Understanding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is key. Familiar contacts and longer exposure increase SARS-CoV-2 spread, while asymptomatic cases transmit less.
Area of Science:
- Epidemiology
- Infectious Disease Dynamics
Background:
- Understanding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission drivers is crucial for effective control policies.
- Limited evidence exists on SARS-CoV-2 transmission rates across diverse settings.
Purpose of the Study:
- To systematically review and estimate secondary attack rates (SARs) and observed reproduction numbers (Robs) for SARS-CoV-2.
- To explore variations in transmission by age, symptom status, and exposure duration.
Main Methods:
- Systematic review and meta-analysis.
- Beta-binomial model for pooling SARs and negative-binomial model for estimating Robs.
- Analysis of transmission by contact type, duration, and index case characteristics.
Main Results:
- Households exhibited the highest SARS-CoV-2 transmission, with a pooled SAR of 21.1%.
- Transmission rates were higher with prolonged household exposure (>5 days) and social events compared to casual contacts.
- Asymptomatic and presymptomatic index cases showed significantly lower transmission potential than symptomatic cases.
Conclusions:
- Familiar contact settings and longer exposure durations amplify SARS-CoV-2 transmission.
- Index case symptom status and exposure duration are critical factors for control strategies like contact tracing and isolation.
- Further research is needed on SARS-CoV-2 transmission in workplaces, schools, and care homes.
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