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Infectious Diseases

Preparation for Possible Sustained Transmission of 2019 Novel CoronavirusLessons From Previous Epidemics

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To review lessons from previous influenza and coronavirus epidemics to prepare for the possible sustained transmission of 2019-nCoV
1 Credit CME
JAMA
March 24, 2020
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David L. Swerdlow, MD1;
Lyn Finelli, DrPH, MS2
Author Affiliations
  • 1Pfizer Vaccines, Collegeville, Pennsylvania
  • 2Center for Observational and Real-World Evidence, Merck and Co Inc, Kenilworth, New Jersey
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Transmissibility and severity are the 2 most critical factors that determine the effect of an epidemic. Neither the 2009 pandemic influenza A(H1N1) virus ([H1N1]pdm09) pandemic or the severe acute respiratory syndrome coronavirus (SARS-CoV) or the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemics had the combination of both high transmissibility and severity. Control strategies are driven by this combination. R0, the basic reproduction number, is a commonly used measure of transmissibility and is defined as the number of additional persons one case infects over the course of their illness. An R0 of less than 1 indicates the infection will die out “eventually.” An R0 of greater than 1 indicates the infection has the potential for sustained transmission.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

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Global Health Infectious Diseases Influenza Pulmonary Medicine Public Health Coronavirus (COVID-19)
Article Information

Corresponding Author: David L. Swerdlow, MD, Clinical Epidemiology Lead, Medical Development and Scientific/Clinical Affairs, Pfizer Vaccines, 500 Arcola Rd, Collegeville, PA 19426 (david.swerdlow@pfizer.com).

Published Online: February 11, 2020. doi:10.1001/jama.2020.1960

Conflict of Interest Disclosures: Dr Swerdlow reports owning stock and stock options in Pfizer Inc. Dr Swerdlow also reports providing a one-time consultation consisting of an overview of SARS and MERS epidemiology to GLG Consulting and receiving an honorarium. Dr Finelli reports owning stock in Merck and Co.

Funding/Support: Pfizer Inc provided salary support for Dr Swerdlow.

Role of the Funder/Sponsor: Pfizer Inc reviewed the manuscript and approved the decision to submit the manuscript for publication.

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