Why Do some COVID-19 Patients Infect Many Others, Whereas Most Don’t Spread the Virus at All? | Virus World | Scoop.it

Preventing big clusters of cases would help curb the pandemic, scientists say. When 61 people met for a choir practice in a church in Mount Vernon, Washington, on 10 March, everything seemed normal. For 2.5 hours the chorists sang, snacked on cookies and oranges, and sang some more. But one of them had been suffering for 3 days from what felt like a cold—and turned out to be COVID-19. In the following weeks, 53 choir members got sick, three were hospitalized, and two died, according to a 12 May report by the U.S. Centers for Disease Control and Prevention (CDC) that meticulously reconstructed the tragedy.

 

Many similar “superspreading events” have occurred in the COVID-19 pandemic. A database by Gwenan Knight and colleagues at the London School of Hygiene & Tropical Medicine (LSHTM) lists an outbreak in a dormitory for migrant workers in Singapore linked to almost 800 cases; 80 infections tied to live music venues in Osaka, Japan; and a cluster of 65 cases resulting from Zumba classes in South Korea. Clusters have also occurred aboard ships and at nursing homes, meatpacking plants, ski resorts, churches, restaurants, hospitals, and prisons. Sometimes a single person infects dozens of people, whereas other clusters unfold across several generations of spread, in multiple venues. Other infectious diseases also spread in clusters, and with close to 5 million reported COVID-19 cases worldwide, some big outbreaks were to be expected. But SARS-CoV-2, like two of its cousins, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), seems especially prone to attacking groups of tightly connected people while sparing others. It’s an encouraging finding, scientists say, because it suggests that restricting gatherings where superspreading is likely to occur will have a major impact on transmission, and that other restrictions—on outdoor activity, for example—might be eased....

 

That’s why in addition to R, scientists use a value called the dispersion factor (k), which describes how much a disease clusters. The lower k is, the more transmission comes from a small number of people. In a seminal 2005 Nature paper, Lloyd-Smith and co-authors estimated that SARS—in which superspreading played a major role—had a k of 0.16. The estimated k for MERS, which emerged in 2012, is about 0.25. In the flu pandemic of 1918, in contrast, the value was about one, indicating that clusters played less of a role.