Role of presymptomatic transmission of COVID-19: evidence from Beijing, China

J Epidemiol Community Health. 2021 Jan;75(1):84-87. doi: 10.1136/jech-2020-214635. Epub 2020 Aug 27.

Abstract

Background: The presymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been documented in limited clusters, and it is predicted through modelling. However, there is a lack of evidence from observations with a large sample size.

Methods: We used data from meticulous contact tracing of people exposed to cases of SARS-CoV-2 to estimate the proportion of cases that result from the presymptomatic transmission of the virus in Beijing during January 2020 and February 2020.

Results: The results showed that presymptomatic transmission occurred in at least 15% of 100 secondary COVID-19 cases. The earliest presymptomatic contact event occurred 5 days prior to the index case's onset of symptoms, and this occurred in two clusters.

Conclusions: The finding suggested that the contact tracing period should be earlier and highlighted the importance of preventing transmission opportunities well before the onset of symptoms.

Keywords: Communicable diseases; control of diseases; public health policy.

MeSH terms

  • Adult
  • Asymptomatic Diseases
  • Asymptomatic Infections / epidemiology*
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology
  • COVID-19 / transmission*
  • COVID-19 Nucleic Acid Testing
  • Carrier State / epidemiology
  • Carrier State / virology*
  • China / epidemiology
  • Contact Tracing
  • Disease Outbreaks*
  • Female
  • Humans
  • Male
  • Middle Aged
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / isolation & purification*