Significance There is still considerable scope for advancing our understanding of the epidemiology and ecology of COVID-19. In particular, much is unknown about individual-level transmission heterogeneities such as superspreading and age-specific infectiousness. We statistically synthesize multiple valuable data streams, including surveillance data and mobility data, that are available during the current COVID-19 pandemic. We show that age is an important factor in the transmission of the virus. Superspreading is ubiquitous over space and time, and has particular importance in rural areas and later stages of an outbreak. Our results improve our understanding of the natural history of the virus and have important implications for designing optimal control measures. It is imperative to advance our understanding of heterogeneities in the transmission of SARS-CoV-2 such as age-specific infectiousness and superspreading. To this end, it is important to exploit multiple data streams that are becoming abundantly available during the pandemic. In this paper, we formulate an individual-level spatiotemporal mechanistic framework to integrate individual surveillance data with geolocation data and aggregate mobility data, enabling a more granular understanding of the transmission dynamics of SARS-CoV-2. We analyze reported cases, between March and early May 2020, in five (urban and rural) counties in the state of Georgia. First, our results show that the reproductive number reduced to below one in about 2 wk after the shelter-in-place order. Superspreading appears to be widespread across space and time, and it may have a particularly important role in driving the outbreak in rural areas and an increasing importance toward later stages of outbreaks in both urban and rural settings. Overall, about 2% of cases were directly responsible for 20% of all infections. We estimate that the infected nonelderly cases (<60 y) may be 2.78 [2.10, 4.22] times more infectious than the elderly, and the former tend to be the main driver of superspreading. Our results improve our understanding of the natural history and transmission dynamics of SARS-CoV-2. More importantly, we reveal the roles of age-specific infectiousness and characterize systematic variations and associated risk factors of superspreading. These have important implications for the planning of relaxing social distancing and, more generally, designing optimal control measures.
【저자키워드】 SARS-CoV-2, social distancing, superspreading, Mobility data, age-specific infectiousness, 【초록키워드】 COVID-19, pandemic, Epidemiology, COVID-19 pandemic, Variation, Transmission, risk factor, virus, heterogeneity, infections, Measures, outbreak, Transmission dynamics, age, Stage, surveillance data, aggregate, driving, transmission of SARS-CoV-2, widespread, implication, FIVE, spatiotemporal, IMPROVE, responsible, reported, granular, reduced, appear, imperative, reproductive, statistically, Significance, 【제목키워드】 SARS-CoV-2 transmission, superspreading event, USA,