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Commentary on the use of the reproduction number R during the COVID-19 pandemic.

Published version
Peer-reviewed

Change log

Authors

Abbott, Sam 
Ball, Frank 
Brooks-Pollock, Ellen 

Abstract

Since the beginning of the COVID-19 pandemic, the reproduction number [Formula: see text] has become a popular epidemiological metric used to communicate the state of the epidemic. At its most basic, [Formula: see text] is defined as the average number of secondary infections caused by one primary infected individual. [Formula: see text] seems convenient, because the epidemic is expanding if [Formula: see text] and contracting if [Formula: see text]. The magnitude of [Formula: see text] indicates by how much transmission needs to be reduced to control the epidemic. Using [Formula: see text] in a naïve way can cause new problems. The reasons for this are threefold: (1) There is not just one definition of [Formula: see text] but many, and the precise definition of [Formula: see text] affects both its estimated value and how it should be interpreted. (2) Even with a particular clearly defined [Formula: see text], there may be different statistical methods used to estimate its value, and the choice of method will affect the estimate. (3) The availability and type of data used to estimate [Formula: see text] vary, and it is not always clear what data should be included in the estimation. In this review, we discuss when [Formula: see text] is useful, when it may be of use but needs to be interpreted with care, and when it may be an inappropriate indicator of the progress of the epidemic. We also argue that careful definition of [Formula: see text], and the data and methods used to estimate it, can make [Formula: see text] a more useful metric for future management of the epidemic.

Description

Funder: NHS Global Digital Exemplar programme


Funder: James S. McDonnell Foundation; FundRef: https://doi.org/10.13039/100000913


Funder: NIHR Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol


Funder: Wellcome Trust; FundRef: https://doi.org/10.13039/100004440


Funder: Canadian Institutes for Health Research


Funder: Natural Science and Engineering Research Council of Canada

Keywords

COVID-19 pandemic, Reproduction number, Basic Reproduction Number, COVID-19, Forecasting, Humans, Pandemics, Reproduction

Journal Title

Stat Methods Med Res

Conference Name

Journal ISSN

0962-2802
1477-0334

Volume Title

31

Publisher

SAGE Publications
Sponsorship
Engineering and Physical Sciences Research Council (EP/R014604/1)
MRC (via University of Warwick) (MR/V038613/1)