Model-free estimation of COVID-19 transmission dynamics from a complete outbreak
Background New Zealand had 1499 cases of COVID-19 before eliminating transmission of the virus. Extensive contract tracing during the outbreak has resulted in a dataset of epidemiologically linked cases. This data contains useful information about the transmission dynamics of the virus, its dependence on factors such as age, and its response to different control measures. Method We use Monte-Carlo network construction techniques to provide an estimate of the number of secondary cases for every individual infected during the outbreak. We then apply standard statistical techniques to quantify differences between groups of individuals. Findings Children under 10 years old are significantly under-represented in the case data. Children infected fewer people on average and had a lower secondary attack rate in comparison to adults and the elderly. Imported cases infected fewer people on average and had a lower secondary attack rate than domestically acquired cases. Superspreading is a significant contributor to the epidemic dynamics, with 20% of cases among adults responsible for 65-85% of transmission. Asymptomatic cases infected fewer individuals than clinical cases. Serial intervals are approximately normally distributed (μ=5.0 days, σ=5.7 days). Early isolation and quarantine of cases reduced secondary transmission rates. Interpretation Border controls and strong social distancing measures, particularly when targeted at superspreading, play a significant role in reducing the spread of COVID-19. Funding Te Pūnaha Matatini, the New Zealand Centre of Research Excellence in complex systems. New Zealand Ministry of Business, Innovation and Employment.