Dataset Information

Transmission dynamics of COVID-19 in household and community settings in the United Kingdom, January to March 2020.

ABSTRACT: BackgroundHouseholds appear to be the highest risk setting for COVID-19 transmission. Large household transmission studies in the early stages of the pandemic in Asia reported secondary attack rates ranging from 5 to 30%.AimWe aimed to investigate the transmission dynamics of COVID-19 in household and community settings in the UK.MethodsA prospective case-ascertained study design based on the World Health Organization FFX protocol was undertaken in the UK following the detection of the first case in late January 2020. Household contacts of cases were followed using enhanced surveillance forms to establish whether they developed symptoms of COVID-19, became confirmed cases and their outcomes. We estimated household secondary attack rates (SAR), serial intervals and individual and household basic reproduction numbers. The incubation period was estimated using known point source exposures that resulted in secondary cases.ResultsWe included 233 households with two or more people with 472 contacts. The overall household SAR was 37% (95% CI: 31-43%) with a mean serial interval of 4.67 days, an R₀ of 1.85 and a household reproduction number of 2.33. SAR were lower in larger households and highest when the primary case was younger than 18 years. We estimated a mean incubation period of around 4.5 days.ConclusionsRates of COVID-19 household transmission were high in the UK for ages above and under 18 years, emphasising the need for preventative measures in this setting. This study highlights the importance of the FFX protocol in providing early insights on transmission dynamics.

SUBMITTER: Lopez Bernal J

PROVIDER: S-EPMC9012093 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Transmission dynamics of COVID-19 in household and community settings in the United Kingdom, January to March 2020.

Lopez Bernal Jamie J Panagiotopoulos Nikolaos N Byers Chloe C Garcia Vilaplana Tatiana T Boddington Nicki N Zhang Xu-Sheng XS Charlett Andre A Elgohari Suzanne S Coughlan Laura L Whillock Rosie R Logan Sophie S Bolt Hikaru H Sinnathamby Mary M Letley Louise L MacDonald Pauline P Vivancos Roberto R Edeghere Obaghe O Anderson Charlotte C Paranthaman Karthik K Cottrell Simon S McMenamin Jim J Zambon Maria M Dabrera Gavin G Ramsay Mary M Saliba Vanessa V

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 20220401 15

BackgroundHouseholds appear to be the highest risk setting for COVID-19 transmission. Large household transmission studies in the early stages of the pandemic in Asia reported secondary attack rates ranging from 5 to 30%.AimWe aimed to investigate the transmission dynamics of COVID-19 in household and community settings in the UK.MethodsA prospective case-ascertained study design based on the World Health Organization FFX protocol was undertaken in the UK following the detection of the first cas ...[more]

PMID: 35426357

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Project description:ObjectivesTo determine whether the previously described trend of improving mortality in people with coronavirus disease 2019 in critical care during the first wave was maintained, plateaued, or reversed during the second wave in United Kingdom, when B117 became the dominant strain.DesignNational retrospective cohort study.SettingAll English hospital trusts (i.e., groups of hospitals functioning as single operational units), reporting critical care admissions (high dependency unit and ICU) to the Coronavirus Disease 2019 Hospitalization in England Surveillance System.PatientsA total of 49,862 (34,336 high dependency unit and 15,526 ICU) patients admitted between March 1, 2020, and January 31, 2021 (inclusive).InterventionsNot applicable.Measurements and main resultsThe primary outcome was inhospital 28-day mortality by calendar month of admission, from March 2020 to January 2021. Unadjusted mortality was estimated, and Cox proportional hazard models were used to estimate adjusted mortality, controlling for age, sex, ethnicity, major comorbidities, social deprivation, geographic location, and operational strain (using bed occupancy as a proxy). Mortality fell to trough levels in June 2020 (ICU: 22.5% [95% CI, 18.2-27.4], high dependency unit: 8.0% [95% CI, 6.4-9.6]) but then subsequently increased up to January 2021: (ICU: 30.6% [95% CI, 29.0-32.2] and high dependency unit, 16.2% [95% CI, 15.3-17.1]). Comparing patients admitted during June-September 2020 with those admitted during December 2020-January 2021, the adjusted mortality was 59% (CI range, 39-82) higher in high dependency unit and 88% (CI range, 62-118) higher in ICU for the later period. This increased mortality was seen in all subgroups including those under 65.ConclusionsThere was a marked deterioration in outcomes for patients admitted to critical care at the peak of the second wave of coronavirus disease 2019 in United Kingdom (December 2020-January 2021), compared with the post-first-wave period (June 2020-September 2020). The deterioration was independent of recorded patient characteristics and occupancy levels. Further research is required to determine to what extent this deterioration reflects the impact of the B117 variant of concern.

Project description:ObjectiveTo analyse the transmission dynamics of the monkeypox outbreak in the UK, declared a Public Health Emergency of International Concern in July 2022.DesignContact tracing study, linking data on case-contact pairs and on probable exposure dates.SettingCase questionnaires from the UK Health Security Agency (UKHSA), United Kingdom.Participants2746 people with polymerase chain reaction confirmed monkeypox virus in the UK between 6 May and 1 August 2022.Main outcome measuresThe incubation period and serial interval of a monkeypox infection using two bayesian time delay models-one corrected for interval censoring (ICC-interval censoring corrected) and one corrected for interval censoring, right truncation, and epidemic phase bias (ICRTC-interval censoring right truncation corrected). Growth rates of cases by reporting date, when monkeypox virus was confirmed and reported to UKHSA, were estimated using generalised additive models.ResultsThe mean age of participants was 37.8 years and 95% reported being gay, bisexual, and other men who have sex with men (1160 out of 1213 reporting). The mean incubation period was estimated to be 7.6 days (95% credible interval 6.5 to 9.9) using the ICC model and 7.8 days (6.6 to 9.2) using the ICRTC model. The estimated mean serial interval was 8.0 days (95% credible interval 6.5 to 9.8) using the ICC model and 9.5 days (7.4 to 12.3) using the ICRTC model. Although the mean serial interval was longer than the incubation period for both models, short serial intervals were more common than short incubation periods, with the 25th centile and the median of the serial interval shorter than the incubation period. For the ICC and ICRTC models, the corresponding estimates ranged from 1.8 days (95% credible interval 1.5 to 1.8) to 1.6 days (1.4 to 1.6) shorter at the 25th centile and 1.6 days (1.5 to 1.7) to 0.8 days (0.3 to 1.2) shorter at the median. 10 out of 13 linked patients had documented pre-symptomatic transmission. Doubling times of cases declined from 9.07 days (95% confidence interval 12.63 to 7.08) on the 6 May, when the first case of monkeypox was reported in the UK, to a halving time of 29 days (95% confidence interval 38.02 to 23.44) on 1 August.ConclusionsAnalysis of the instantaneous growth rate of monkeypox incidence indicates that the epidemic peaked in the UK as of 9 July and then started to decline. Short serial intervals were more common than short incubation periods suggesting considerable pre-symptomatic transmission, which was validated through linked patient level records. For patients who could be linked through personally identifiable data, four days was the maximum time that transmission was detected before symptoms manifested. An isolation period of 16 to 23 days would be required to detect 95% of people with a potential infection. The 95th centile of the serial interval was between 23 and 41 days, suggesting long infectious periods.

Dataset Information

Transmission dynamics of COVID-19 in household and community settings in the United Kingdom, January to March 2020.

Publications

Transmission dynamics of COVID-19 in household and community settings in the United Kingdom, January to March 2020.

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