Challenges in control of Covid-19: short doubling time and long delay to effect of interventions
Pellis L., Scarabel F., Stage HB., Overton CE., Chappell LHK., Lythgoe KA., Fearon E., Bennett E., Curran-Sebastian J., Das R., Fyles M., Lewkowicz H., Pang X., Vekaria B., Webb L., House TA., Hall I.
<jats:p>The unconstrained growth rate of COVID-19 is crucial for measuring the impact of interventions, assessing worst-case scenarios, and calibrating mathematical models for policy planning. However, robust estimates are limited, with scientific focus on the time-insensitive basic reproduction number <jats:italic>R</jats:italic><jats:sub>0</jats:sub>. Using multiple countries, data streams and methods, we consistently estimate that European COVID-19 cases doubled every three days when unconstrained, with the impact of physical distancing interventions typically seen about nine days after implementation, during which time cases grew eight-fold. The combination of fast growth and long detection delays explains the struggle in countries' response better than large values of <jats:italic>R</jats:italic><jats:sub>0</jats:sub> alone, and warns against relaxing physical distancing measures too quickly. Testing and tracing are fundamental in shortening such delays, thus preventing cases from escalating unnoticed.</jats:p>