Abstract
The chapter reviews primary-source virological and epidemiological studies to profile the COVID-19 virus. Key epidemiological concepts are introduced and various methods of mitigating viruses are discussed. The social nature of virus communicability and the roles of interpersonal distance and high-contact cultures as media for the transmission of the virus are detailed.
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Notes
- 1.
Severe acute respiratory syndrome coronavirus 2.
- 2.
For reasons of clarity and ease of understanding for readers who are not science professionals, I have chosen to use the abbreviation RE rather than the more technical notation Rt for the effective reproduction rate.
- 3.
Buitrago-Garcia, D.C. et al. (2020, April 29) analysed eight prior studies and estimated on that basis an upper bound for the proportion of asymptomatic cases to be 29%. 40–60% of all SARS-CoV-2 infections, the study estimated, were the result of transmission from pre-symptomatic individuals.
- 4.
Statistik över antal avlidna i covid-19, April 272,020, from Sweden’s National Board of Health. A Chinese study (Xie et al. 2020, April 10) of 168 patients who died in 21 hospitals in Wuhan in January 2020 concluded that “(75.0%) were men. The median (IQR) age was 70 (64–78) years, and 161 patients (95.8%) were older than 50 years… Hypertension was the most common comorbidity (84 patients [50.0%]), followed by diabetes (42 patients [25.0%]), and ischemic heart disease (31 patients [18.5%]).” As of April 14, 2020, 97.4% of persons in New York City whose deaths were related to COVID-19 had an underlying condition. 60% were men (NYC Health 2020, April 14). In Italy as of April 23, 96.4% of persons who had died with COVID-19 had 1–3 comorbidities. The median age of death was 81. 63.6% were men. (SARS-CoV-2 Surveillance Group, 2020)
- 5.
National Health Service, COVID-19 total deaths – weekly summaries, June 11, 2020.
- 6.
See also The Foundation for Research on Equal Opportunity (FREOPP), Reported Deaths from COVID-19 in Long Term Care Facilities. Data used in the current work was reported by May 202,020 and tabulated in FREOPP’s continuously updated spreadsheet: https://docs.google.com/spreadsheets/d/17JmyFzOd3ZEYCGpP0mK5lS_P10yPgCuYF8PYALKuTs8/edit#gid=31142859
- 7.
On March 29, 2020, giving evidence to the UK House of Commons Science and Technology Committee Neil Ferguson, the Imperial College London epidemiologist, put it this way: “We don’t know what the level of ‘excess’ deaths will be, in this epidemic, by excess deaths I mean by the end of the year, what proportion of those people who died from COVID-19 would have died any-how, but it might be as much as half—half to two thirds of the deaths we are seeing from covid-19. Because it is affecting people either at the end of their lives or with poor health conditions.”
- 8.
This is what in effect what Streeck et al. 2020, April 9, recommended after their study of Gangelt in Germany: “[The already-infected] 15 percent of the population reduces the speed (net number of reproductions R in epidemiological models) of a further spread of SARS-CoV-2. By adhering to stringent hygiene measures, it can be expected that the virus concentration in the event of an infection in a person can be reduced to such an extent that the severity of the disease is reduced, while at the same time developing immunity.”
- 9.
The innate immune response of the body causes bodily “inflammation”. When the immune response is uncontrolled, this can result in substantial damage to uninfected body tissue.
- 10.
Centres for Disease Control, Disease Burden of Influenza, Figure 1: Estimated Range of Annual Burden of Flu in the U.S. since 2010.
- 11.
Sweden, Los Angeles, Milan, Luxembourg, France, Indiana, Spain, Switzerland 1 and 2, Czech Republic, Slovenia, Sweden 1 and 2, Idaho, Madrid, Iran, Kobe, Denmark, Sweden, New York 1 and 2, International, Miami-Dade, Northern France 1 and 2, Wuhan, Chelesa Street, Santa Clara, Netherlands, Germany, Finland, Scotland, Denmark, San Francisco, San Miguel. An on-going list of these studies was tabulated by Dr. James M. Todaro at: https://docs.google.com/spreadsheets/d/1zC3kW1sMu0sjnT_vP1sh4zL0tF6fIHbA6fcG5RQdqSc/htmlview?usp=gmail#gid=0
- 12.
“The inferred IFR was obtained by dividing the number of deaths by the number of infected people. A corrected IFR is also presented, trying to account for the fact that only one or two types of antibodies (among IgG, IgM, IgA) might have been used.” Ioannidis 2020, May 19.
- 13.
On March 31, 2020 the biostatistician K. Wittkowski noted that the 2003 SARS virus had run its course in nations and regions for a median period of 44 days (1.4 months) and ranging from 20 days (0.6 months) to 103 days (3.4 months). For the COVID-19 virus his estimate was that it “takes at least a month from the first case entering the country (typically followed by others) for the epidemic to be detected, about three weeks for the number of cases to peak and a month for the epidemic to ‘resolve’”, with an incidental or zero number of cases ongoing—i.e. around three months total. Wittkowski 2020, March 31, p. 15. The current work (Table 1.3) suggests 120 days average—around four months total.
- 14.
As Carl Heneghan and Tom Jefferson of Oxford University’s Centre for Evidence-Based Medicine put it: “In the midst of a pandemic, it is easy to forget Farr’s Law, and think the number infected will just keep rising, it will not… most of all we must remember the message Farr left us: what goes up must come down.” (Heneghan and Jefferson 2020, April 11)
- 15.
An Intensive Care National Audit and Research Centre, London, study looked at 6720 critical care COVID-19 patients. The median age of admission was 62 years-old, 72% were males. Of 4078 admissions with outcomes, 2067 died [50.7%] and 2011 were discharged. Of those receiving advanced respiratory support (mechanical breathing etc.), 65% died. ICNARC 2020, April 24, Table 1 and 9.
- 16.
There is a strong positive correlation between sunshine duration and temperature. See for example Besselaar et al. 2015.
- 17.
“Other households” was used as a proxy for inter-generational households as the category “other households” excludes couple, single parent and sole-person households.
- 18.
Liu et al. (2020, April 27) undertook a study of COVID-19 aerosol (airborne) transmission in the enclosed spaces of a Wuhan hospital and found little evidence of it except in crowded spaces and unventilated spaces including toilet cubicles.
- 19.
As of April 2 the Heinsberg area—where Gangelt is located—had a population of 250,000 and a death rate from COVID-19 of 156 per million, a significant figure.
- 20.
The reference is to after-ski-parties held in Ischgl, Austria, a scene of high-energy revelling in bars, pubs, clubs and discos.
- 21.
The references are to a Champions League football match played in Milan on February 19, 2020 attended by 40,000 fans from nearby Bergamo and to carnival celebrations in Gangelt on February 15, 2020.
- 22.
In the Champions League/Bergamo case, it is surmised that the virus spread was “exacerbated by the outcome of the game, as fans hugged and kissed each time Atalanta (the team from Bergamo) scored” (Avery et al. 2020, April, p. 11).
- 23.
In a study of 3 hospitals in the Hubei region, Li et al. (2020, January 29) identified 105 COVID patients who had a recent history of travel or exposure to high-risk sites and 392 household contacts. Secondary transmission of COVID developed in 64 of the 392 household contacts (16.3%). The secondary attack rate of children was 4% compared to 17.1% for adults.
- 24.
The reference is to the Diamond Princess cruise-ship and the messianic Shincheonji Church of Jesus in Daegu, South Korea, the Pentecostal Bethany Slavic Missionary church in Sacramento, California and the evangelical church of Bourtzwiller in Mulhouse, France, among others. A Singapore study examined three COVID clusters involving 28 transmitted cases. Two of the clusters originated in church congregations and one in a family gathering. Yong et al. 2020, April 21.
- 25.
Fractal refers to a structure whose patterns recur at ever smaller scales.
- 26.
The Swedish Toolkit book series.
- 27.
Cultural Crossing Guide, Sweden, Personal Space & Touching, https://guide.culturecrossing.net/
- 28.
Sweden scores 71 out of 100 for individualism on Geert Hofstede’s 6-dimensions of national culture index. https://www.hofstede-insights.com/country/sweden/
- 29.
Törnqvist’s study focuses only on the small minority of Swedes who live in collective housing but the ethos of this group places in sharp relief a broader social ethos whose mentalities and mores are comparable even if the housing arrangements are different. The small group makes explicit what is implicit and buried in the habits and mentality of the broader society.
- 30.
Hall defined the intimate zone as up to 45 centimetres; the personal as 45–140 cm; 140–365 cm.
- 31.
Very high in the southern counties in and around New York City (such as Suffolk, Bronx, West-Chester) but very low in the northern parts of the state.
- 32.
The study also found only weak correlation coefficients between mean temperature, mean specific humidity, population size and COVID peaks.
References
Anon (2020, April 2). How German scientists hope to find coronavirus answers in country’s worst-hit spot. The Local, April 2.
Arons, M.M. et al. (2020, April 24). “Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility”, The New England Journal of Medicine.
Aronson J. K. et al. (2020, April 14). ‘When will it be over?’: An introduction to viral reproduction numbers, R0 and Re. Centre for Evidence Based Medicine, Oxford University.
Avery, C. et al. (2020, April). Policy Implications of Models of the Spread of Coronavirus: Perspectives and Opportunities for Economists. NBER Working Paper Series, Working Paper 27007. doi:https://doi.org/10.3386/w27007
van den Besselaar, E. J. M. et al. (2015). Relationship between sunshine duration and temperature trends across Europe since the second half of the twentieth century. Journal of Geophysical Research: Atmospheres 120, 10,823–10,836. doi:10.1002/2015JD023640
Bi, Q. et al. (2020, April 27). Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study. The Lancet Infectious Diseases, corrected version May 5, 2020. doi:https://doi.org/10.1016/S1473-3099(20)30287-5
Buitrago-Garcia, D.C. et al. (2020, April 29). The role of asymptomatic SARS-CoV-2 infections: Rapid living systematic review and meta-analysis. medRxiv preprint. https://www.medrxiv.org/content/10.1101/2020.04.25.20079103v1.full.pdf
Burke, R.M. et al. (2020, March 6). Active Monitoring of Persons Exposed to Patients with Confirmed COVID-19—United States, January–February 2020. Morbidity and Mortality Weekly Report 69(9). US Department of Health and Human Services/Centers for Disease Control and Prevention.
Chen, Y. et al. (2020, March 4). The epidemiological characteristics of infection in close contacts of COVID-19 in Ningbo city. Chinese Journal of Epidemiology 41, 2020 preprint. doi:https://doi.org/10.1016/j.ijid.2020.04.034
Cheng, H-Y. et al. (2020, May 1). Contact Tracing Assessment of COVID-19 Transmission Dynamics in Taiwan and Risk at Different Exposure Periods Before and After Symptom Onset. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2020.2020
Comas-Herrera, A. et al. (2020, April 26). Mortality associated with COVID-19 outbreaks in care homes: early international evidence. International Long Term Care Policy Network.
Eisenberg, J. (2020, February 5). R0: How scientists quantify the intensity of an outbreak like coronavirus and predict the pandemic’s spread. The Conversation.
Facher, L. (2020, March 11). NIH official suggests large gatherings should be canceled due to coronavirus outbreak. STAT.
Fauci, A.S. et al. (2020, February 26). Covid-19—Navigating the Uncharted. The New England Journal of Medicine, 382(13). https://doi.org/10.1056/NEJMe2002387
Ferguson, N. F. et al. (2020, March 16). Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. https://www.imperial.ac.uk/media/imperial-college/medicine/mrc-gida/2020-03-16-COVID19-Report-9.pdf
Ghinai, I. et al. (2020, March 13). First known person-to-person transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the USA. The Lancet 395 (10230), 1137–1144. doi:https://doi.org/10.1016/S0140-6736(20)30607-3
Girvan, G. & Roy, A. (2020, May 8 updated May 22). Nursing Homes & Assisted Living Facilities Account for 42% of COVID-19 Deaths. FREOPP.
Hall, E. T. (1966). The Hidden Dimension. Garden City, N.Y.: Doubleday.
Heneghan, C. & Jefferson, T. (2020, April 11). COVID-19: William Farr’s way out of the Pandemic. Centre for Evidence-Based Medicine.
ICNAR Intensive Care National Audit & Research Centre. (2020, April 24). ICNARC report on COVID-19 in critical care.
Ioannidis, J. (2020, May 19). The infection fatality rate of COVID-19 inferred from seroprevalence data. medRxiv preprint. Updated July 14. doi:https://doi.org/10.1101/2020.05.13.20101253
Jing, Q-L. et al. (2020, April 15). Household Secondary Attack Rate of COVID-19 and Associated Determinants. medRxiv preprint. doi:https://doi.org/10.1101/2020.04.11.20056010
Li, Q. et al. (2020, January 29). Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia. The New England Journal of Medicine. doi:https://doi.org/10.1056/NEJMoa2001316
Liu, Y. et al. (2020, April 27). Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals. Nature. https://www.nature.com/articles/s41586-020-2271-3
NYC Health. (2020, April 14). Coronavirus Disease 2019 (COVID-19) Daily Data Summary.
Phaneuf, K. M. (2020, April 20). COVID-19 caused more deaths among CT nursing home residents than initially reported. The CT Mirror.
Qian, H. et al. (2020, April 7). Indoor transmission of SARS-CoV-2. medRxiv preprint. doi:https://doi.org/10.1101/2020.04.04.20053058
Rader, B. et al. (2020, April 20). Crowding and the epidemic intensity of 1 COVID-19 transmission. medRxiv preprint. https://doi.org/10.1101/2020.04.15.20064980
SARS-CoV-2 Surveillance Group. (2020). Characteristics of SARS-CoV-2 patients dying in Italy Report based on available data on April 23th, 2020. Istituto Superiore Sanità.
Sekine, T. et al. (2020, June 29) Robust T cell immunity in convalescent individuals with asymptomatic or mild COVID-19. bioRxiv preprint. https://doi.org/10.1101/2020.06.29.174888
Streeck, H. et al. (2020, April 9). Vorläufiges Ergebnis und Schlussfolgerungen der COVID-19 Case-ClusterStudy (Gemeinde Gangelt). https://www.land.nrw/sites/default/files/asset/document/zwischenergebnis_covid19_case_study_gangelt_0.pdf
Swan, N. (2020, April 13). Interview with Professor Ian Frazer, Faculty of Medicine, University of Queensland. Health Report. Australian Broadcasting Corporation.
Törnqvist, M. (2019). Living Alone Together: Individualized Collectivism in Swedish Communal Housing. Sociology 53(5), 900–915.
Wingerter, M. (2020, April 22). Residents of nursing homes, assisted living facilities now account for 64% of Colorado’s coronavirus deaths. Denver Post.
Wittkowski, K.M. (2020, March 31). The first three months of the COVID-19 epidemic: Epidemiological evidence for two separate strains of SARS-CoV-2 viruses spreading and implications for prevention strategies. medRxiv preprint. doi:https://doi.org/10.1101/2020.03.28.20036715
Xie, J., et al. (2020, April 10). Clinical Characteristics of Patients Who Died of Coronavirus Disease 2019 in China. Research Letter, Critical Care Medicine, JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2020.5619
Yong, S.E.F. et al. (2020, April 21). Connecting clusters of COVID-19: an epidemiological and serological investigation. The Lancet Infectious Diseases. doi:https://doi.org/10.1016/S1473-3099(20)30273-5
Zhu, Y., et al. (2020, March 30). Children are unlikely to have been the primary source of household SARS-CoV-2 infections. medRxiv preprint. doi:https://doi.org/10.1101/2020.03.26.20044826
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Murphy, P. (2020). Social Distance. In: COVID-19. Palgrave Pivot, Singapore. https://doi.org/10.1007/978-981-15-7514-3_1
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