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