Abstract
A novel coronavirus (SARS-CoV-2) first detected in Wuhan, China, has spread rapidly since December 2019, causing more than 100,000 confirmed infections and 4000 fatalities (as of 10 March 2020). The outbreak has been declared a pandemic by the WHO on Mar 11, 2020. Here, we explore how seasonal variation in transmissibility could modulate a SARS-CoV-2 pandemic. Data from routine diagnostics show a strong and consistent seasonal variation of the four endemic coronaviruses (229E, HKU1, NL63, OC43) and we parameterise our model for SARS-CoV-2 using these data. The model allows for many subpopulations of different size with variable parameters. Simulations of different scenarios show that plausible parameters result in a small peak in early 2020 in temperate regions of the Northern Hemisphere and a larger peak in winter 2020/2021. Variation in transmission and migration rates can result in substantial variation in prevalence between regions. While the uncertainty in parameters is large, the scenarios we explore show that transient reductions in the incidence rate might be due to a combination of seasonal variation and infection control efforts but do not necessarily mean the epidemic is contained. Seasonal forcing on SARS-CoV-2 should thus be taken into account in the further monitoring of the global transmission. The likely aggregated effect of seasonal variation, infection control measures, and transmission rate variation is a prolonged pandemic wave with lower prevalence at any given time, thereby providing a window of opportunity for better preparation of health care systems.
Highlights
A novel coronavirus (SARS-CoV-2) first detected in Wuhan, China, has spread rapidly since December 2019, causing more than 80,000 confirmed infections and 2,700 fatalities
While the uncertainty in parameters is large, the scenarios we explore show that transient reductions in the incidence rate might be due to a combination of seasonal variation and infection control efforts but do not necessarily mean the epidemic is contained
The virus has spread to all provinces of China and small clusters of local spread have been reported from several countries, e.g. Singapore, Germany, and the UK (Rothe et al, 2020; Singapore Ministry of Health, 2020; World Health Organisation (WHO) Emergency Committee, 2020a)
Summary
Data on seasonal variation of HKU1, NL63, OC43 and 229E diagnoses in respiratory samples was obtained from the routine molecular diagnostics at the Karolinska University Hospital, Stockholm, Sweden. The dataset included a total of 52,158 patient samples with 190,257 diagnostic tests, of which 2,084 were positive for any of the coronaviruses (229E = 319; NL63 = 499; OC43 = 604; HKU1 = 355; OC43/HKU1 = 307). From Nov 6, 2017 to Dec 31, 2019, samples were analysed using the commercial kit Allplex Respiratory Panels (Seegene Inc., Seoul (South Korea)). This commercial kit does not distinguish between HKU1 and OC43, and for this reason positive tests for these two viruses were combined for the entire study period. The strength of variation of the transmission rate through the year could be of high relevance to the spread of SARS-CoV-2 in 2020 and following years
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