TY - JOUR
T1 - Taking account of asymptomatic infections
T2 - A modeling study of the COVID-19 outbreak on the Diamond Princess cruise ship
AU - Huang, Li Shan
AU - Li, Li
AU - Dunn, Lucia
AU - He, Mai
N1 - Funding Information:
The Taiwan Ministry of Science and Technology provided funding for this study in the form of a grant awarded to author LH (MOST 107- 2118-M-007-002-MY2). Indirect support was provided through salaries/facilities use by the home institutions of LH, LD, and MH. AT&T provided support in the form of salary for author LL. The specific roles of these authors are articulated in the 'author contribution' section. The funders did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. There was no additional external funding received for this study.
Publisher Copyright:
© 2021 Huang et al.
PY - 2021/3
Y1 - 2021/3
N2 - The COVID-19 outbreak on the Diamond Princess (DP) cruise ship has provided empirical data to study the transmission potential of COVID-19 with the presence of pre/asymptomatic cases. We studied the changes in R0 on DP from January 21 to February 19, 2020 based on chain binomial models under two scenarios: no quarantine assuming a random mixing condition, and quarantine of passengers in cabins - passengers may get infected either by an infectious case in a shared cabin or by pre/asymptomatic crew who continued to work. Estimates of R0 at the beginning of the epidemic were 3.27 (95% CI, 3.02-3.54) and 3.78 (95% CI, 3.49-4.09) respectively for serial intervals of 5 and 6 days; and when quarantine started, with the reported asymptomatic ratio 0.505, R0 rose to 4.18 (95%CI, 3.86-4.52) and 4.73 (95%CI, 4.37-5.12) respectively for passengers who might be exposed to the virus due to pre/asymptomatic crew. Results confirm that the higher the asymptomatic ratio is, the more infectious contacts would happen. We find evidence to support a US CDC report that "a high proportion of asymptomatic infections could partially explain the high attack rate among cruise ship passengers and crew."Our study suggests that if the asymptomatic ratio is high, the conventional quarantine procedure may not be effective to stop the spread of virus.
AB - The COVID-19 outbreak on the Diamond Princess (DP) cruise ship has provided empirical data to study the transmission potential of COVID-19 with the presence of pre/asymptomatic cases. We studied the changes in R0 on DP from January 21 to February 19, 2020 based on chain binomial models under two scenarios: no quarantine assuming a random mixing condition, and quarantine of passengers in cabins - passengers may get infected either by an infectious case in a shared cabin or by pre/asymptomatic crew who continued to work. Estimates of R0 at the beginning of the epidemic were 3.27 (95% CI, 3.02-3.54) and 3.78 (95% CI, 3.49-4.09) respectively for serial intervals of 5 and 6 days; and when quarantine started, with the reported asymptomatic ratio 0.505, R0 rose to 4.18 (95%CI, 3.86-4.52) and 4.73 (95%CI, 4.37-5.12) respectively for passengers who might be exposed to the virus due to pre/asymptomatic crew. Results confirm that the higher the asymptomatic ratio is, the more infectious contacts would happen. We find evidence to support a US CDC report that "a high proportion of asymptomatic infections could partially explain the high attack rate among cruise ship passengers and crew."Our study suggests that if the asymptomatic ratio is high, the conventional quarantine procedure may not be effective to stop the spread of virus.
UR - http://www.scopus.com/inward/record.url?scp=85102766158&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0248273
DO - 10.1371/journal.pone.0248273
M3 - Article
C2 - 33725000
AN - SCOPUS:85102766158
SN - 1932-6203
VL - 16
JO - PLoS ONE
JF - PLoS ONE
IS - 3 March
M1 - e0248273
ER -