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Transmission roles of symptomatic and asymptomatic COVID-19 cases: a modeling study

By Jianbin Tan, Yang Ge, Leonardo Martinez, Zhiping Chen, Changwei Li, Adrianna Westbrook, Enfu Chen, Jinren Pan, Yang Li, Feng Ling, Jimin Sun, Hui Huang, Ye Shen

Posted 14 May 2021
medRxiv DOI: 10.1101/2021.05.11.21257060

Objective Age-dependent asymptomatic and symptomatic transmission dynamics of COVID-19 have not been well quantified due to limited data. Methods Through a population-based surveillance network, we collected data on 1342 confirmed cases with a 90-days follow-up for all asymptomatic cases. Results The difference in transmissibility of a symptomatic and asymptomatic case depended on age and was most distinct for the middle-age groups. The asymptomatic cases had a 66.72% lower transmissibility rate than symptomatic cases, and 74.10% (95%CI: 65.85% - 80.72%) of all asymptomatic cases were missed in detection. The average proportion of asymptomatic cases was 28.22% (95%CI: 22.97% - 34.56%). Simulation showed that the burden of asymptomatic transmission increased as the epidemic continued and could potentially dominate the spreading. Conclusion Asymptomatic COVID-19 cases play a significant role in transmission. Vaccine Strategies prioritizing the population between 30-60 years old are likely to have the most population-level benefits.

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