Transmission of SARS-CoV-2
Authors: Eric A. Meyerowitz, Aaron Richterman, Rajesh T. Gandhi, Paul E. Sax
Journal: Annals of Internal Medicine (2021)

LettersJuly 2021Transmission of SARS-CoV-2FREEEric A. Meyerowitz, MD, Aaron Richterman, MD, MPH, Rajesh T. Gandhi, MD, Paul E. Sax, MDEric A. Meyerowitz, MDMontefiore Medical Center, Bronx, New York, Aaron Richterman, MD, MPHHospital of the University of Pennsylvania, Philadelphia, Pennsylvania, Rajesh T. Gandhi, MDMassachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, Paul E. Sax, MDHarvard Medical School and Brigham and Women's Hospital, Boston, MassachusettsAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L21-0166 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: We agree wholeheartedly with Dr. Bilbo's comments. As we describe in our review, heterogeneity is perhaps the most important feature of the transmission dynamics of SARS-CoV-2. Among other reasons, this heterogeneity has made it difficult to estimate the reproductive number for this virus. Wide ranges have been reported in different settings, as described in a large systemic review of this topic (1).We agree that Sun and colleagues' article (2) describing the transmission dynamics in the Hunan outbreak is important and illustrative. The major findings of this study have also been replicated in other settings, as we highlighted in our review. These findings include that susceptibility to infection can be based on age (with young children approximately half as susceptible as other persons), proximity is a key determinant of transmission risk, and presymptomatic transmission plays a major role in sustaining outbreaks. We also agree that the relatively long and highly variable incubation period has substantially contributed to the difficulty with controlling the pandemic.References1. Billah MA, Miah MM, Khan MN. Reproductive number of coronavirus: a systematic review and meta-analysis based on global level evidence. PLoS One. 2020;15:e0242128. [PMID: 33175914] doi:10.1371/journal.pone.0242128 CrossrefMedlineGoogle Scholar2. Sun K, Wang W, Gao L, et al. Transmission heterogeneities, kinetics, and controllability of SARS-CoV-2. Science. 2021;371. [PMID: 33234698] doi:10.1126/science.abe2424 CrossrefMedlineGoogle Scholar Comments 0 Comments Sign In to Submit A Comment Author, Article, and Disclosure InformationAuthors: Eric A. Meyerowitz, MD; Aaron Richterman, MD, MPH; Rajesh T. Gandhi, MD; Paul E. Sax, MDAffiliations: Montefiore Medical Center, Bronx, New YorkHospital of the University of Pennsylvania, Philadelphia, PennsylvaniaMassachusetts General Hospital and Harvard Medical School, Boston, MassachusettsHarvard Medical School and Brigham and Women's Hospital, Boston, MassachusettsDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-5008. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTransmission of SARS-CoV-2: A Review of Viral, Host, and Environmental Factors Eric A. Meyerowitz , Aaron Richterman , Rajesh T. Gandhi , and Paul E. 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