Journal
SCIENCE
Volume 370, Issue 6517, Pages 691-+Publisher
AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/science.abd7672
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Funding
- Berkeley Population Center (National Institute of Child Health and Human Development) [P2CHD073964]
- NSF [CCF-1918628]
- U.S. Centers for Disease Control and Prevention [16IPA16092427]
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Although most cases of coronavirus disease 2019 (COVID-19) have occurred in low-resource countries, little is known about the epidemiology of the disease in such contexts. Data fromthe Indian states of Tamil Nadu and Andhra Pradesh provide a detailed view into severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission pathways and mortality in a high-incidence setting. Reported cases and deaths have been concentrated in younger cohorts than would be expected from observations in higher-income countries, even after accounting for demographic differences across settings. Among 575,071 individuals exposed to 84,965 confirmed cases, infection probabilities ranged from 4.7 to 10.7% for low-risk and high-risk contact types, respectively. Same-age contacts were associated with the greatest infection risk. Case fatality ratios spanned 0.05% at ages of 5 to 17 years to 16.6% at ages of 85 years or more. Primary data from low-resource countries are urgently needed to guide control measures.
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