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    SARS-CoV-2 shifting transmission dynamics and hidden reservoirs potentially limit efficacy of public health interventions in Italy

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    Author
    Giovanetti, Marta
    Cella, Eleonora
    Benedetti, Francesca
    Rife Magalis, Brittany
    Fonseca, Vagner
    Fabris, Silvia
    Campisi, Giovanni
    Ciccozzi, Alessandra
    Angeletti, Silvia
    Borsetti, Alessandra
    Tambone, Vittoradolfo
    Sagnelli, Caterina
    Pascarella, Stefano
    Riva, Alberto
    Ceccarelli, Giancarlo
    Marcello, Alessandro
    Azarian, Taj
    Wilkinson, Eduan
    de Oliveira, Tulio
    Alcantara, Luiz Carlos Junior
    Cauda, Roberto
    Caruso, Arnaldo
    Dean, Natalie E
    Browne, Cameron
    Lourenco, Jose
    Salemi, Marco
    Zella, Davide
    Ciccozzi, Massimo
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    Date
    2021-04-21
    Journal
    Communications Biology
    Publisher
    Springer Nature
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1038/s42003-021-02025-0
    Abstract
    We investigated SARS-CoV-2 transmission dynamics in Italy, one of the countries hit hardest by the pandemic, using phylodynamic analysis of viral genetic and epidemiological data. We observed the co-circulation of multiple SARS-CoV-2 lineages over time, which were linked to multiple importations and characterized by large transmission clusters concomitant with a high number of infections. Subsequent implementation of a three-phase nationwide lockdown strategy greatly reduced infection numbers and hospitalizations. Yet we present evidence of sustained viral spread among sporadic clusters acting as "hidden reservoirs" during summer 2020. Mathematical modelling shows that increased mobility among residents eventually catalyzed the coalescence of such clusters, thus driving up the number of infections and initiating a new epidemic wave. Our results suggest that the efficacy of public health interventions is, ultimately, limited by the size and structure of epidemic reservoirs, which may warrant prioritization during vaccine deployment.
    Keyword
    COVID-19--epidemiology
    SARS-CoV-2--genetics
    Italy
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/15528
    ae974a485f413a2113503eed53cd6c53
    10.1038/s42003-021-02025-0
    Scopus Count
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    UMB Open Access Articles
    UMB Coronavirus Publications

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