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Volume 26, Number 6—June 2020
Perspective

Identifying and Interrupting Superspreading Events—Implications for Control of Severe Acute Respiratory Syndrome Coronavirus 2

Thomas R. Frieden1Comments to Author  and Christopher T. Lee1
Author affiliations: Resolve to Save Lives, New York, New York, USA

Main Article

Table

Factors that increase the risk for superspreading events and implications for prevention and control of COVID-19*

Factor Disease Epidemiologic role Implications for control of COVID-19
Pathogen
 Tuberculosis
 Certain strains of Mycobacterium tuberculosis are more infectious, and patients ill with these strains should be prioritized for examination of a larger circle of contacts (21,22)
 Continued monitoring for genetic change and for changes in the epidemiology of transmission
Host
 Influenza
 Viral shedding and risk for transmission among asymptomatic and presymptomatic persons can result in influenza transmission (23), particularly in closed settings with minimal ventilation (H. Nishiura et al., unpub. data, https://doi.org/10.1101/2020.02.28.20029272)
 Identification of factors associated with increased transmissibility and rapid intervention to prevent transmission from similar patients prospectively; further characterization of risk for asymptomatic transmission
Environment
 SARS
 Airborne transmission of SARS can result in environmental spread of disease in community (24) and healthcare settings (25)
 Assess changes in plumbing and ventilation that may be needed to reduce risk for spread; increase social distancing; reduce mass gatherings in closed environments; ensure effective triage, isolation, and general infection control in healthcare facilities
Behavior
 Ebola
 Inaccurate perceptions of Ebola risk can result in behaviors that increase the probability of transmission (26,27)
 Promote handwashing, cough etiquette, and safer care-seeking behavior, including mask-wearing by persons who are ill, and ensure that timely and accurate messaging about risk and behavioral preventive measures are tailored to and reach affected populations
Response MERS Timely implementation of control measures can reduce outbreak duration and number of transmission events (28) Rapidly identify and isolate cases to reduce transmission; implement large-scale NPIs in affected areas within 1 week

*COVID-19, coronavirus disease; MERS, Middle East respiratory syndrome; NPIs, nonpharmaceutical interventions; SARS, severe acute respiratory syndrome.

Main Article

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1These authors contributed equally to this article.

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