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Ben Cowling Profile picture
@bencowling88
Sep 17, 2020 • 5 tweets • 3 min read • Read on X
Our work on superspreading has just been published nature.com/articles/s4159…, the preprint was posted a few months ago.
Work done with @DillonCAdam @gmleunghku @Jessica_Y_Wong @TimTsang1 @SCauchemez
Key finding - between 23 January and 28 April 2020 in Hong Kong, we analysed contact tracing data and estimated that 19% of cases seeded 80% of all local transmission. For those interested in the dispersion parameter k it was 0.33 (95% CI: 0.14–0.98). nature.com/articles/s4159…
Placing close contacts of cases in mandatory government quarantine was very effective at terminating chains of transmission. nature.com/articles/s4159…
The same work was also earlier described in an article in New York Times with @DillonCAdam nytimes.com/2020/06/02/opi…

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More from @bencowling88

Ben Cowling Profile picture
Feb 22, 2023
New preprint on Omicron severity just out. Key findings – intrinsic severity of Omicron is similar to ancestral Wuhan strain, but effective (observed) severity of Omicron is reduced in people who have been vaccinated and/or previously infected (1/16)
medrxiv.org/content/10.110…
In South Africa, Omicron caused a large number of infections in late 2021 but relatively low rates of severe disease, likely because of high population immunity from prior waves of infections. Omicron was mild, but would it always be mild elsewhere? (2/16)
thelancet.com/journals/langl…
In Hong Kong in early 2022, millions of people were infected with Omicron BA.2, and there were more than 9000 deaths by the end of the wave, mostly in unvaccinated older adults (3/16)
Read 16 tweets
Ben Cowling Profile picture
Feb 2, 2023
New in @sciencemagazine #SciencePerspective “Managing sources of error during pandemics”. We discuss the emerging challenges we and others have faced in monitoring #COVID19 epidemiology now that the most acute phase of the pandemic is over (1/14)
science.org/doi/10.1126/sc…
We discuss challenges in monitoring incidence of infections, the changing severity of infections, and the burden of infections including the number of hospitalisations and deaths. All of this information is valuable for risk assessment and consequent decision-making (2/14)
Now that laboratory testing has scaled back, and case reporting practices have changed, surveillance will perhaps move towards an approach similar to that for seasonal influenza. The tools used to track #COVID19 will have to be adapted accordingly (3/14)
Read 14 tweets
Ben Cowling Profile picture
Dec 13, 2022
Brief thread on containment vs mitigation. Summary point - I hope there's a plan for intense mitigation measures in China in the next 1-2 months, as part of the transition to living-with-COVID
(1/9)
In pandemic preparedness plans, this type of figure is often used to illustrate some key concepts. I have labelled the relevant periods. A is pre-pandemic preparation. B is containment, some countries will skip this if containment ...
(2/9)
(source: nyas.org/ebriefings/202…)
...is judged to be infeasible. In the COVID pandemic, the best known term for containment is "Zero Covid". China has spent almost 3 years in period B in the figure above, and it worked well in preventing infections until recently, although at a high cost
(3/9)
Read 9 tweets
Ben Cowling Profile picture
Oct 14, 2022
We have a new preprint (not yet peer-reviewed) on residential clustering of COVID-19 in Hong Kong, and the efficiency of residential Compulsory Testing Notices and Restriction Testing Declarations ("ambush lockdowns") led by @BenYoun11984381
medrxiv.org/content/10.110…
(1/15)
(2/15) Residential clustering was a major feature of SARS in 2003 ... almost 20% of the 1755 SARS cases in Hong Kong resulted from one large super-spreading event in the Amoy Gardens housing estate in Kowloon
edition.cnn.com/2013/02/21/wor…
(3/15) In contrast, we find that there is not much residential clustering of COVID-19 cases. One notable exception was the cluster of hundreds of Omicron BA.2 cases found in residents of three blocks in the Kwai Chung Estate at the start of our fifth wave
academic.oup.com/cid/article/75…
Read 15 tweets
Ben Cowling Profile picture
Oct 11, 2022
It's not at all surprising that the detection of cases in arriving travelers has increased, because (1) there's no more pre-departure PCR and (2) there's no more 3-day hotel quarantine but testing still goes out to day 6 ... (1/5)
In the previous 3+4 system, with tests on 0/2/4/6, positivity with low Ct value on d4 was very unlikely (would have had to be a long incubation period or a within-hotel transmission), and d6 positives were mostly ppl who were infected on d3-4 with a short incubation period (2/5)
In the new 0+3 system, almost all cases identified on days 4 and 6 will have been infected /after/ arrival (there's a far far greater risk of infection in the community than in a quarantine hotel) and these post-arrival infections may be misclassified as "imported" cases (3/5)
Read 5 tweets
Ben Cowling Profile picture
Oct 5, 2022
A few brief suggestions of how to proceed. Public health measures, such as masks and avoiding crowds and larger gatherings, could be recommended (but not mandated) for people to reduce their risk of respiratory virus infection (including COVID and influenza) ... (1/6)
Healthcare settings and elderly homes should implement measures to minimise the frequency and impact of outbreaks of respiratory virus infections (including COVID and influenza), which could include staff masking and regular use of RATs by staff and patients/residents ... (2/6)
Schools and workplaces may decide to bring back some preventive measures if community activity rises again, but I think there's currently limited justification for control measures given the low level of community incidence and the low severity of infections that do occur (3/6)
Read 6 tweets

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