Digital measurement of SARS-CoV-2 transmission risk from 7 million contacts.
Ferretti L., Wymant C., Petrie J., Tsallis D., Kendall M., Ledda A., Di Lauro F., Fowler A., Di Francia A., Panovska-Griffiths J., Abeler-Dörner L., Charalambides M., Briers M., Fraser C.
How likely is it to become infected by SARS-CoV-2 after being exposed? Virtually everyone has wondered about this question during the COVID-19 pandemic. Contact tracing apps1,2 recorded measurements of proximity3 and duration between nearby smartphones. Contacts - individuals exposed to confirmed cases - were notified according to public health policies such as the 2-metre 15-minute guideline4,5, despite limited evidence supporting this threshold. Here we analysed 7 million contacts notified by the NHS COVID-19 app6,7 in England and Wales to infer how app measurements translated to actual transmissions. Empirical metrics and statistical modelling showed a strong relation between app-computed risk scores and actual transmission probability. Longer exposures at greater distances had similar risk to shorter exposures at closer distances. The probability of transmission confirmed by a reported positive test increased initially linearly with duration of exposure (1.1% per hour) and continued increasing over several days. While most exposures were short (median 0.7 hours, IQR 0.4-1.6), transmissions typically resulted from exposures lasting one hour to several days (median 6 hours, IQR 1.4-28). Households accounted for about 6% of contacts but 40% of transmissions. With sufficient preparation, privacy-preserving yet precise analyses of risk that would inform public health measures, based on digital contact tracing, could be performed within weeks of a new pathogen emerging.