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  • How will country-based miti...
    Anderson, Roy M; Heesterbeek, Hans; Klinkenberg, Don; Hollingsworth, T Déirdre

    The Lancet (British edition), 03/2020, Letnik: 395, Številka: 10228
    Journal Article

    For the 2009 influenza A H1N1 pandemic, in most infected people these epidemiological quantities were short with a day or so to infectiousness and a few days of peak infectiousness to others.3 By contrast, for COVID-19, the serial interval is estimated at 4·4–7·5 days, which is more similar to SARS.4 First among the important unknowns about COVID-19 is the case fatality rate (CFR), which requires information on the denominator that defines the number infected. ...the effect of seasons on transmission of COVID-19 is unknown;11 however, with an R0 of 2–3, the warm months of summer in the northern hemisphere might not necessarily reduce transmission below the value of unity as they do for influenza A, which typically has an R0 of around 1·1–1·5.12 Closely linked to these factors and their epidemiological determinants is the impact of different mitigation policies on the course of the COVID-19 epidemic. A key issue for epidemiologists is helping policy makers decide the main objectives of mitigation—eg, minimising morbidity and associated mortality, avoiding an epidemic peak that overwhelms health-care services, keeping the effects on the economy within manageable levels, and flattening the epidemic curve to wait for vaccine development and manufacture on scale and antiviral drug therapies. Avoiding large gatherings of people will reduce the number of super-spreading events; however, if prolonged contact is required for transmission, this measure might only reduce a small proportion of transmissions. ...broader-scale social distancing is likely to be needed, as was put in place in China.