Highlights • Reported cases may not reflect true epidemic growth due to limited testing capacity. • Numbers of hospitalized and severe cases may be less biased. • Case series by date of symptoms onset can eliminate the bias from testing capacity. Since the novel coronavirus disease (COVID-19) emerged in December 2019 in China, it has rapidly spread around the world, leading to one of the most significant pandemic events of recent history. Deriving reliable estimates of the COVID-19 epidemic growth rate is quite important to guide the timing and intensity of intervention strategies. Indeed, many studies have quantified the epidemic growth rate using time-series of reported cases during the early phase of the outbreak to estimate the basic reproduction number, R 0 . Using daily time series of COVID-19 incidence, we illustrate how epidemic curves of reported cases may not always reflect the true epidemic growth rate due to changes in testing rates, which could be influenced by limited diagnostic testing capacity during the early epidemic phase.
【저자키워드】 COVID-19, basic reproduction number, models, growth rate, statistical,