Temporal dynamics in viral shedding and transmissibility of COVID-19

  1. Xi He
  2. Eric HY Lau
  3. Peng Wu
  4. Xilong Deng
  5. Jian Wang
  6. Xinxin Hao
  7. Yiu Chung Lau
  8. Jessica Y Wong
  9. Yujuan Guan
  10. Xinghua Tan
  11. Xiaoneng Mo
  12. Yanqing Chen
  13. Baolin Liao
  14. Weilie Chen
  15. Fengyu Hu
  16. Qing Zhang
  17. Mingqiu Zhong
  18. Yanrong Wu
  19. Lingzhai Zhao
  20. Fuchun Zhang
  21. Benjamin J Cowling
  22. Fang Li
  23. Gabriel M Leung
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Abstract

We report temporal patterns of viral shedding in 94 laboratory-confirmed COVID-19 patients and modelled COVID-19 infectiousness profile from a separate sample of 77 infector-infectee transmission pairs. We observed the highest viral load in throat swabs at the time of symptom onset, and inferred that infectiousness peaked on or before symptom onset. We estimated that 44% of transmission could occur before first symptoms of the index. Disease control measures should be adjusted to account for probable substantial pre-symptomatic transmission.

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