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      Letter to the Editor: Coronavirus Disease 2019 (COVID-19), Infectivity, and the Incubation Period

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          Abstract

          Dear Editor, We read with great interest the recent publication entitled “A Chinese case of coronavirus disease 2019 (COVID-19) did not show infectivity during the incubation period: based on an epidemiological survey” [1]. Bae concluded that “the epidemiological findings support the claim that the COVID-19 virus does not have infectivity during the incubation period [1].” In fact, a pathogen should not have infectivity during the incubation period or development of disease. However, the exact incubation period of COVID-19 is still unknown. In a recent report by Linton et al. [2], the incubation range was estimated as between 2 days and 14 days with 95% confidence. Exceptional cases might occur with an unusually short or long incubation period. Nevertheless, the reliability of history-taking should also be addressed. How the author was able to confirm the reliability of the patient’s self-reported history is an interesting issue for further discussion. In our country, Thailand, it is not uncommon for patients to disguise their clinical history, which can cause delays in the diagnosis of COVID-19 and exacerbate the local transmission of the disease.

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          Incubation Period and Other Epidemiological Characteristics of 2019 Novel Coronavirus Infections with Right Truncation: A Statistical Analysis of Publicly Available Case Data

          The geographic spread of 2019 novel coronavirus (COVID-19) infections from the epicenter of Wuhan, China, has provided an opportunity to study the natural history of the recently emerged virus. Using publicly available event-date data from the ongoing epidemic, the present study investigated the incubation period and other time intervals that govern the epidemiological dynamics of COVID-19 infections. Our results show that the incubation period falls within the range of 2–14 days with 95% confidence and has a mean of around 5 days when approximated using the best-fit lognormal distribution. The mean time from illness onset to hospital admission (for treatment and/or isolation) was estimated at 3–4 days without truncation and at 5–9 days when right truncated. Based on the 95th percentile estimate of the incubation period, we recommend that the length of quarantine should be at least 14 days. The median time delay of 13 days from illness onset to death (17 days with right truncation) should be considered when estimating the COVID-19 case fatality risk.
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            A Chinese case of novel coronavirus 2019 (COVID-19) did not show infectivity during the incubation period: based on an epidemiological survey

            JM Bae (2020)
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              Author and article information

              Journal
              J Prev Med Public Health
              J Prev Med Public Health
              JPMPH
              Journal of Preventive Medicine and Public Health
              Korean Society for Preventive Medicine
              1975-8375
              2233-4521
              March 2020
              31 March 2020
              : 53
              : 2
              : 70
              Affiliations
              [1 ]Sanitation 1 Medical Academic Center, Bangkok, Thailand
              [2 ]Department of Community Medicine, Dr DY Patil University, Pune, India
              [3 ]Department of Tropical Medicine, Hainan Medical University, Haikou, China
              Author notes
              Corresponding author: Beuy Joob, PhD Sanitation 1 Medical Academic Center, Bangkok 10150, Thailand E-mail: beuyjoob@ 123456hotmail.com
              Author information
              http://orcid.org/0000-0002-5281-0369
              http://orcid.org/0000-0003-1039-3728
              Article
              jpmph-53-2-70
              10.3961/jpmph.20.065
              7142000
              32268458
              3a833570-4567-469d-bb90-6377e1527f7b
              Copyright © 2020 The Korean Society for Preventive Medicine

              This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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              Special Section: COVID-19
              Correspondence

              Public health
              Public health

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