Assessing the spread of the novel coronavirus in the absence of mass testing

© 2020 John Wiley & Sons Ltd..

BACKGROUND: Assessing why the spread of the COVID-19 virus slowed down in many countries in March through to May of 2020 is of great significance. The relative role of restrictions on behaviour ("lockdowns") and of a natural slowing for other reasons is difficult to assess when mass testing was not widely done. This paper assesses the evolution of the spread of the COVID-19 virus over this period when there was no data on test results for a large, random sample of the population.

METHOD: We estimate a version of the susceptible-infected-recovered model applied to data on the numbers who were tested positive in several countries over the period when the virus spread very fast and then its spread slowed sharply. Up to the end of April 2020, test data came from non-random samples of populations who were overwhelmingly those who displayed symptoms. Using data from a period when the criteria used for testing (which was that people had clear symptoms) was relatively consistent is important in drawing out the message from test results. We use this data to assess two things: how large might be the group of those infected who were not recorded and how effective were lockdown measures in slowing the spread of the infection.

RESULTS: We find that to match data on daily new cases of the virus, the estimated model favours high values for the number of people infected but not recorded.

CONCLUSIONS: Our findings suggest that the infection may have spread far enough in many countries by April 2020 to have been a significant factor behind the fall in measured new cases. Government restrictions on behaviour-lockdowns-were only one factor behind slowing in the spread of the virus.

Media Type:

Electronic Article

Year of Publication:


Contained In:

International journal of clinical practice - Vol. 75, No. 4 (2021), p. e13836




Miles, David Kenneth
Dimdore-Miles, Oscar




Communicable Disease Control
Journal Article


Date Completed 02.04.2021

Date Revised 02.04.2021

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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