Epidemiology and transmission dynamics of COVID-19 in two Indian states
Open accessPublished version of a preprint
Abstract
Epidemiology in southern India: By August 2020, India had reported several million cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with cases tending to show a younger age distribution than has been reported in higher-income countries. Laxminarayan et al. analyzed data from the Indian states of Tamil Nadu and Andhra Pradesh, which have developed rigorous contact tracing and testing systems (see the Perspective by John and Kang). Superspreading predominated, with 5% of infected individuals accounting for 80% of cases. Enhanced transmission risk was apparent among children and young adults, who accounted for one-third of cases. Deaths were concentrated in 50- to 64-year-olds. Incidence did not change in older age groups, possibly because of effective stay-at-home orders and social welfare programs or socioeconomic status. As in other settings, however, mortality rates were associated with older age, comorbidities, and being male. Science , this issue p. 691 ; see also p. 663
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This finding, together with prior evidence of the effectiveness of India's nationwide lockdown in delaying widespread SARS-CoV-2 transmission, presents a reassuring contrast to expectations in early 2020 that lockdowns could cause greater harm than public health benefit.
“This finding, together with prior evidence of the effectiveness of India’s nationwide lockdown in delaying widespread SARS-CoV-2 transmission14, presents a reassuring contrast to expectations in early 2020 that lockdowns could cause greater harm than public health benefit, although measures of impact besides mortality remain important to consider.”
From Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city (2023) · cites this paper as [14]
Mounting evidence suggests that such differences have also manifested in the context of the COVID-19 pandemic.
“Mounting evidence suggests that such differences have also manifested in the context of the COVID-19 pandemic (26, 27).”
From Socioeconomic status determines COVID-19 incidence and related mortality in Santiago, Chile (2021) · cites this paper as [27]
Children can be a source of transmission of SARS-CoV-2 to each other and to adult family members.
“children can be a source of transmission of SARS-CoV-2 to each other and to adult family members.9”
From SARS-CoV-2 vaccine testing and trials in the pediatric population: biologic, ethical, research, and implementation challenges (2021) · cites this paper as [9]
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- Authors
- Laxminarayan, R., Wahl, B., Dudala, S. R., Gopal, K., Mohan B, C., Neelima, S., Jawahar Reddy, K. S., Radhakrishnan, J., & Lewnard, J. A.
- Affiliations
- Johns Hopkins University (US)
- Department of Community Medicine, Government Medical College, Kadapa, Andhra Pradesh, India.
- Government of Tamil Nadu (IN)
- Backward Classes, Most Backward Classes, and Minorities Welfare Department, Government of Tamil Nadu, Chennai, Tamil Nadu, India.
- Guntur Medical College (IN)
- Department of Health, Family Welfare, and Medical Education, Government of Andhra Pradesh, Amaravati, Andhra Pradesh, India.
- University of California, Berkeley (US)
- Corresponding author
- Lewnard, Joseph A.
- ORCID
- Venue
- Science
- Published
- 2020-11-06
- Volume
- 370
- Issue
- 6517
- Pages
- 691-697
- ISSN
- 0036-8075 (ISSN-L)
- 1095-9203
- PMC
- PMC7857399
- OpenAlex
- W3090786066
- Cited by
- 485
- References
- 53
- Citations by year
- 2026: 6 · 2025: 18 · 2024: 33 · 2023: 59 · 2022: 104 · 2021: 206 · 2020: 58
- FWCI
- 16.97
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Science (publishedVersion, cc-by)
- medRxiv (acceptedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- National Science Foundation (CCF-1918628)
- Centers for Disease Control and Prevention (16IPA16092427)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2CHD073964)
- Topics
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- COVID-19 pandemic, SARS-CoV-2 transmission, transmission dynamics, case fatality rate, age-specific mortality, resource-limited settings, Tamil Nadu, Andhra Pradesh, India, epidemic control measures
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, India, Infant, Infant, Newborn, Male, Middle Aged, Pneumonia, Viral, Incidence, Contact Tracing, Age Distribution, Coronavirus Infections, Young Adult, Pandemics
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