Thread by @celinegounder

THREAD: When you don't have #drugs or #vaccines, you've got to rely on containment strategies. But how well do they work? pnas.org/content/114/15… #nCoV19 #coronavirus #CoronavirusOutbreak

Contact tracing: Who are all the people who may have been in contact with someone with the disease? These are "contacts." pnas.org/content/114/15… #nCoV19 #coronavirus #CoronavirusOutbreak

Active symptom monitoring: Check on contacts 1-2x/d. Isolate them if symptoms develop. pnas.org/content/114/15… #nCoV19 #coronavirus #CoronavirusOutbreak

Quarantine: Isolate all potential contacts even if healthy. pnas.org/content/114/15… #nCoV19 #coronavirus #CoronavirusOutbreak Costs: enforcement, human rights restrictions, stigma, interruptions to travel/trade, economic impact.

Quarantine makes sense IF:
- fast progression from infection to symptoms of disease
pnas.org/content/114/15… #nCoV19 #coronavirus #CoronavirusOutbreak

Symptom monitoring makes sense IF:
- can trace most contacts
- slow progression from infection to symptoms of disease pnas.org/content/114/15… #nCoV19 #coronavirus #CoronavirusOutbreak

Quarantine also makes sense IF:
- highly infectious pathogen
- asymptomatic transmission
- cannot identify contacts
- cannot identify symptomatic persons
pnas.org/content/114/15… #nCoV19 #coronavirus #CoronavirusOutbreak

"quarantine was inefficient for a respiratory disease like #SARS" pnas.org/content/114/15… #nCoV19 #coronavirus #CoronavirusOutbreak

"for SARS, our analysis indicates that effective isolation of symptomatic patients is sufficient to control an outbreak"
pnas.org/content/101/16… #nCoV19 #coronavirus #CoronavirusOutbreak

"Influenza...predicted to be very difficult to control even with 90% quarantining & contact tracing b/c of high level of presymptomatic transmission." pnas.org/content/101/16… #nCoV19 #coronavirus #CoronavirusOutbreak

"quarantining and contact tracing for influenza would probably be unfeasible because of the very short incubation (2 days) and infectious (3–4 days) periods of that disease." pnas.org/content/101/16… #nCoV19 #coronavirus #CoronavirusOutbreak

So is #coronavirus more like #SARS or #influenza when it comes to controlling it?
Incubation periods:
- flu 1-4 days
- SARS 2-7 days
- #nCoV19 ~5 days
#CoronavirusOutbreak

When infectious?
- #Influenza: 1 day before symptoms develop & up to 7 days after getting sick
- #SARS: only with symptoms
- #nCoV19: before symptoms develop (unclear how significant), unclear for how long after symptoms develop
#coronavirus #CoronavirusOutbreak