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dc.contributor.authorMoghadas, Seyed M
dc.contributor.authorFitzpatrick, Meagan C
dc.contributor.authorSah, Pratha
dc.contributor.authorPandey, Abhishek
dc.contributor.authorShoukat, Affan
dc.contributor.authorSinger, Burton H
dc.contributor.authorGalvani, Alison P
dc.date.accessioned2020-08-13T13:23:27Z
dc.date.available2020-08-13T13:23:27Z
dc.date.issued2020-07-28
dc.identifier.urihttp://hdl.handle.net/10713/13534
dc.description.abstractSince the emergence of coronavirus disease 2019 (COVID-19), unprecedented movement restrictions and social distancing measures have been implemented worldwide. The socioeconomic repercussions have fueled calls to lift these measures. In the absence of population-wide restrictions, isolation of infected individuals is key to curtailing transmission. However, the effectiveness of symptom-based isolation in preventing a resurgence depends on the extent of presymptomatic and asymptomatic transmission. We evaluate the contribution of presymptomatic and asymptomatic transmission based on recent individual-level data regarding infectiousness prior to symptom onset and the asymptomatic proportion among all infections. We found that the majority of incidences may be attributable to silent transmission from a combination of the presymptomatic stage and asymptomatic infections. Consequently, even if all symptomatic cases are isolated, a vast outbreak may nonetheless unfold. We further quantified the effect of isolating silent infections in addition to symptomatic cases, finding that over one-third of silent infections must be isolated to suppress a future outbreak below 1% of the population. Our results indicate that symptom-based isolation must be supplemented by rapid contact tracing and testing that identifies asymptomatic and presymptomatic cases, in order to safely lift current restrictions and minimize the risk of resurgence.en_US
dc.description.urihttps://doi.org/10.1073/pnas.2008373117en_US
dc.language.isoen_USen_US
dc.publisherNational Academy of Sciencesen_US
dc.relation.ispartofProceedings of the National Academy of Sciences of the United States of Americaen_US
dc.rightsCopyright © 2020 the Author(s). Published by PNAS.en_US
dc.subjectCOVID-19en_US
dc.subjectcase isolationen_US
dc.subjectcontact tracingen_US
dc.titleThe implications of silent transmission for the control of COVID-19 outbreaksen_US
dc.typeArticleen_US
dc.typeOtheren_US
dc.identifier.doi10.1073/pnas.2008373117
dc.identifier.pmid32632012
dc.source.volume117
dc.source.issue30
dc.source.beginpage17513
dc.source.endpage17515
dc.source.countryUnited States
dc.source.countryUnited States
dc.source.countryUnited States
dc.source.countryUnited States
dc.source.countryUnited States


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