Abstract
In most countries, during the initial months of the COVID-19 outbreak resources were directed to mitigation measures that prevented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission from symptomatic individuals. The coverage of the pre-symptomatic and asymptomatic individuals’ testing required intensive clinical sampling along with rigorous symptom-based screening. Based on the SARS-CoV-2 transmission, the disease outbreak across nations was divided into four distinct stages: (i) epidemic, (ii) community transmission, (iii) local transmission, and (iv) imported cases. Here we discuss the COVID-19 community transmission stage for the top ten COVID-19 affected nations. Epidemic dynamics and policies implemented to contain the spread of SARS-CoV-2 infection varied globally. Further, the mitigation strategies and related health policies for dealing with the pandemic were based on the stages of transmission of the disease. We suggest that correctly identifying the transmission stage during a pandemic ensures the implementation of mitigation strategies. Thus prompt analysis of the status of COVID-19 transmission stage(s) in any nation seems crucial to direct health policies accordingly.
Highlights
COVID-19 outbreak first appeared in China (Wuhan) in December 2019, and community transmission developed within three months.[4]
The SARS-CoV-2 genetic sequences were analyzed via: (i) retroactive testing of stored samples of influenza, (ii) review of the COVID-19 cases reported early from the emergency rooms, (iii) discovery of two people in California that succumbed to COVID-19 in January 2020, and (iv) an infected patient from San Francisco who died on February 2020
The agent is transmitted to people who may not have been in contact with anyone with a travel history to affected countries and where cases cannot be linked to specific clusters
Summary
COVID-19 outbreak first appeared in China (Wuhan) in December 2019, and community transmission developed within three months.[4]. The first instance of SARSCoV-2 infection in the United States was reported on January 15, 2020, from Washington.[7] The CDC team collected multiple samples from four distinct regions and on February 26, 2020 reported the first confirmed case of SARSCoV-2 community transmission from California.[8] The concerned authorities in California reported SARS-CoV-2 infection in a patient with no travel history (international) or via contact with someone with a travel history or COVID-19 infection.[8] The SARS-CoV-2 genetic sequences were analyzed via: (i) retroactive testing of stored samples of influenza, (ii) review of the COVID-19 cases reported early from the emergency rooms, (iii) discovery of two people in California that succumbed to COVID-19 in January 2020, and (iv) an infected patient from San Francisco who died on February 2020 Based on these data, CDC concluded that community transmission began in the USA in late January or early February 2020.9 Brazil reported its first SARSCoV-2 positive case on 25 February 2020 in São Paulo, and subsequently on 13 March 2020 community transmission was reported in São Paulo and Rio de Janeiro states.[10] France reported its first case on 24 January 2020, and community transmission was reported by 4 April 2020. Turkey reported its first case on 10 March 2020 and within 30 days, Turkey appeared in the list of countries with community transmission.[11,12] By the end of April 2020, other countries like Germany, Spain, and eastern European countries had confirmed community transmission as well.[13,14]
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