I wanted to give a basic picture of why #TestTraceIsolate is so important to the control of the #COVID19 epidemic and why we need to move quickly when testing and contact tracing in order to create an effective intervention. 1/14
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The core idea of why this is so important is that we have evidence that a substantial fraction of transmission occurs in the ~2 days before symptom onset. Figure from
@lucaferrettievo et al (https://science.sciencemag.org/content/early/2020/04/09/science.abb6936 …). 2/14pic.twitter.com/lPPwxOyRpN
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Similarly, He et al (https://www.nature.com/articles/s41591-020-0869-5 …) estimate 44% (95% confidence interval from 25% to 69%) of transmission events occur presymptomatically, with these generally occurring between 0 and 2 days before symptom onset. 3/14
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A disappointing thing about that paper is that they don't say how they decided when "symptom onset" was. Seems entirely possible that these "presymptomatic" patients actually did feel something bad coming on, and that better public education as to the "presymptoms" could help.
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