Transmission Dynamics of the COVID-19 Epidemic at the District Level in India: Prospective Observational Study (Preprint)

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Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). We aimed to estimate the serial interval and basic reproduction number (R0) for Jodhpur, India and to use it for epidemic projection for next one month. Contact tracing of SARS-CoV-2 infected individuals was done to obtain the serial intervals. Aggregate and instantaneous R0 values were derived and epidemic projection was done using R software v4.0.0. Median and 95 percentile values of serial interval were 5.23 days (95%CI 4.72 – 5.79) and 13.20 days (95%CI 10.90 – 18.18), respectively. R0 during the first 30 days of outbreak was 1.62 (95%CI 1.07 – 2.17) which subsequently decreased to 1.15 (95%CI 1.09 – 1.21). Instantaneous R0 ranged from a peak of 3.43 (95%CI 1.71 – 5.74) to 1.12 (95%CI 1.03 – 1.21) as on 6 July 2020. Epidemic projection over next one month was 2131 individuals (95%CI 1799 – 2462). Reduction of transmission by 25% and 50% could lead to 58.7% and 84.0% reduction in epidemic size, respectively. Aggressive control measures reduced R0 indicating prevention of COVID-19 transmission. Further strengthening of control measures could lead to substantial reduction of COVID-19 epidemic size. A data-driven approach at local level was found useful in guiding the public health strategy and surge capacity planning.