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Transmission of corona virus disease 2019 during the incubation period may lead to a quarantine loophole
Xingjuan Ding
Xingjie Fang
Feng Qiu
Jiaolong Ma
Chunhui Li
Yu Zhang
Aizhen Wang
Yuling Xing
Shunqing Xu
Yuanyuan Li
Xi Qian
Xiaojie Sun
Hongbo Xu
Gaga Mahai
Xin Zhao
Qing Xu
Hanjin Wang
Jiying Xiao
Wei Xia
Lisha Shi
Juan Liu
Ling Yu
Meng Wang
Qianqian Wang
Asmagvl Namat
Ying Li
Jingyu Qu
Qi Liu
Xiaofang Lin
Jiaqiang Liao
Shuting Cao
Shu Huan
Fengyu Ruan
Novel Coronavirus
Acceso Abierto
Background: The ongoing outbreak of novel corona virus disease 2019 (COVID-19) in Wuhan, China, is arousing international concern. This study evaluated whether and when the infected but asymptomatic cases during the incubation period could infect others. Methods: We collected data on demographic characteristics, exposure history, and symptom onset day of the confirmed cases, which had been announced by the Chinese local authorities. We evaluated the potential of transmission during the incubation period in 50 infection clusters, including 124 cases. All the secondary cases had a history of contact with their first-generation cases prior to symptom onset. Results: The estimated mean incubation period for COVID-19 was 4.9 days (95% confidence interval [CI], 4.4 to 5.4) days, ranging from 0.8 to 11.1 days (2.5th to 97.5th percentile). The observed mean and standard deviation (SD) of serial interval was 4.1±3.3 days, with the 2.5th and 97.5th percentiles at -1 and 13 days. The infectious curve showed that in 73.0% of the secondary cases, their date of getting infected was before symptom onset of the first-generation cases, particularly in the last three days of the incubation period. Conclusions: The results indicated the transmission of COVID-9 occurs among close contacts during the incubation period, which may lead to a quarantine loophole. Strong and effective countermeasures should be implemented to prevent or mitigate asymptomatic transmission during the incubation period in populations at high risk. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement No external funding was received. ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data are publicly available.All the information about the cases is released by local authorities in China.
Cold Spring Harbor Laboratory Press
Appears in Collections:Artículos científicos

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