Household Transmission of #SARSCoV2: A Systematic Review and Meta-analysis

Interesting paper - a few highlights (taken directly from paper) - worth a read 👇

jamanetwork.com/journals/jaman…
Meta-analysis of 54 studies with 77 ,758 participants, the estimated mean secondary attack rate (SAR) for household contacts was 16.4% (95% CI, 13.4%-19.6%) & family contacts was 17.4% (95% CI, 12.7%-22.5%)
Household and family SARs were >3 times higher than for close contacts (4.8%; 95% CI, 3.4%-6.5%; P < .001)
Estimated mean household SAR from symptomatic index cases (18.0%; 95% CI, 14.2%-22.1%) was significantly higher than from asymptomatic or presymptomatic index cases (0.7%; 95% CI, 0%-4.9%; P < .001), although there were few studies in the latter group.
The estimated mean household SAR was significantly higher to adult contacts (28.3%; 95% CI, 20.2%-37.1%) than to child contacts (16.8%; 95% CI, 12.3%-21.7%; P < .001).
So much more in the paper... have a read for yourself.
Similar findings on household SAR ⬇️

Household SAR (pooled estimate) 21.1% 95%CI 17.4-24.8%, compared to social gatherings with family and friends SAR 5.9% 95%CI 3.8%-8.1%

SAR for symptomatic cases about 3 times higher than asymptomatic cases

imperial.ac.uk/mrc-global-inf…
Oops, sorry. SAR from sympt/asymptomatic comes from @nicolamlow and colleague’s paper.

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More from @mvankerkhove

14 Nov
1/ Re-sharing this thorough systematic review & meta-analysis of % asymptomatic infection & asymptomatic /presymptomatic/ symptomatic transmission of #SARSCOV2 - @nicolamlow & co

journals.plos.org/plosmedicine/a…
2/ (Preprint of this has been available for some time, & peer-review paper available in Sept) but re-sharing to make a few points still critical today.

We have a long way to go, but we can #ControlCOVID

hear me out 👇
3/ Review addressed 3 questions:

1️⃣what proportion of cases never experience symptoms at all during their infection?

Findings: Estimate 20% (95%CI 17–25)
Read 13 tweets
11 Nov
1/ Wonderful news: 2021 is the International Year of International Year of Health & Care Workers

Let’s take a min and talk health & care workers...
2/ Health & care workers carry out amazing work all over the 🌎

They are dedicated, strong, smart, compassionate, hard working people selflessly caring for others

We owe it to them to do everything we can to support their work
3/ & protect them from infection from #COVID19

Infection can be prevented and even 1️⃣ case is 1️⃣ case too many

From day 1, @WHO has worked to protect health workers with IPC guidance first issued in early January, <2 weeks after @WHO learned about the cluster in Wuhan, 🇨🇳
Read 6 tweets
18 Oct
1/All are so impt but we cannot stress enough the importance of:

1) isolation of all cases, preferably in medical facility for care. But can be done at home w/ right precautions

2) quarantine of contacts, preferably outside of the home. If not, can be with precautions at home
2/ without isolation of cases AND quarantine of contacts, the virus will spread.

➡️😷alone cannot prevent spread
➡️Testing alone cannot spread
➡️👋hygiene alone cannot prevent spread
➡️Good ventilation alone cannot prevent spread
➡️physical distancing alone cannot prevent spread
3/ We cannot & should not become over reliant on any one measure.

It will not work.

All countries have tools right now and they must be used.

All countries have highly motivated people who want to protect themselves & others.

We can do this together.

We must.

We will.
Read 4 tweets
10 Oct
1/
Even if local areas can only focus on identifying symptomatic cases & isolate & care for them; trace & quarantine close contacts; you can eventually catch up on finding mild & asymptomatic cases because they will already be in quarantine.

This is how #ContactTracing works...
2/ This will break chains of transmission.

I described this at the @WHO Live Q&A this past Wednesday - see around min 57

twitter.com/i/events/13112…
3/ Remember cases have highest viral loads (appear to be most infectious) -2 days before & up to 5-7 days after symptom onset for mild/moderate patients.

Severe/critical patients (who should be cared for in hospital) can be infectious for up to three weeks & possibly longer.
Read 5 tweets
25 Sep
1/ Interesting published paper in @Lancet y'day
thelancet.com/journals/lance…

Highlighting the importance of:
➡️Knowledge of infection status
➡️Community engagement
➡️Adequate public health capacity
➡️Adequate health system capacity
➡️Border controls

Nice work by @devisridhar et al
2/ This is in line w/@WHO's guidance pub Apr 2020

@WHO's criteria to consider before adjusting Public Health & Social Measures

👉COVID-19 transmission is controlled

👉Sufficient public health workforce & health system capacities are in place
...
3/ 👉Outbreak risks in high-vulnerability settings are
minimized

👉Preventive measures are established in workplaces

👉Manage the risk of exporting and importing cases from communities w/ high risks of transmission

👉Communities are fully engaged

@WHO has previously issued...
Read 4 tweets
19 Sep
1/"This virus is controllable" in the US - @CNN

#COVID19 in the 🇺🇸 can be “overturned," Dr @mvankerkhove, technical lead for the @WHO's coronavirus response, told @CNN’s @drsanjaygupta on Friday.

cnn.com/world/live-new…
2/“I think it's important that we express concern when there's concern, but I do think it's also important to express some hope, because with this particular pandemic and this virus – this virus is controllable,” Van Kerkhove said.
3/ ...
Van Kerkhove said she knows there is frustration about how long it takes to defeat the virus, and that some places aren’t seeing case numbers go down – but that it is important to keep perspective that it can change.
Read 6 tweets

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