COVID-19: Does the Infectious Inoculum Dose-Response Relationship Contribute to Understanding Heterogeneity in Disease Severity and Transmission Dynamics?

21 Pages Posted: 17 Jul 2020 Last revised: 3 Aug 2020

See all articles by Wim Van Damme

Wim Van Damme

Institute of Tropical Medicine

Ritwik Dahake

Independent Researcher

Remco van de Pas

Institute of Tropical Medicine

Guido Vanham

University of Antwerp - Department of Biomedical Sciences

Yibeltal Assefa

University of Queensland - School of Public Health

Date Written: July 13, 2020

Abstract

The variation in the speed and intensity of SARS-CoV-2 transmission and severity of the resulting COVID-19 disease are still imperfectly understood. We postulate a dose-response relationship in COVID-19, and that “the dose of virus in the initial inoculum” is an important missing link in understanding several incompletely explained observations in COVID-19 as a factor in transmission dynamics and severity of disease. We hypothesize that:

(1) Viral dose in inoculum is related to severity of disease,

(2) Severity of disease is related to transmission potential, and

(3) In certain contexts, chains of severe cases can build up to severe local outbreaks, and large-scale intensive epidemics.

Considerable evidence from other infectious diseases substantiates this hypothesis and recent evidence from COVID-19 points in the same direction. If proven, our hypothesis could explain several of these lacunae in understanding the ongoing COVID-19 pandemic and strengthen the scientific basis for deciding priority containment measures in various contexts.

Keywords: SARS-CoV-2, COVID-19, Dose of the Initial Inoculum

Suggested Citation

Van Damme, Wim and Dahake, Ritwik and van de Pas, Remco and Vanham, Guido and Assefa, Yibeltal, COVID-19: Does the Infectious Inoculum Dose-Response Relationship Contribute to Understanding Heterogeneity in Disease Severity and Transmission Dynamics? (July 13, 2020). Available at SSRN: https://ssrn.com/abstract=3649975 or http://dx.doi.org/10.2139/ssrn.3649975

Wim Van Damme (Contact Author)

Institute of Tropical Medicine ( email )

B-2000 Antwerp
Belgium

Ritwik Dahake

Independent Researcher ( email )

Bengaluru
India

Remco Van de Pas

Institute of Tropical Medicine ( email )

B-2000 Antwerp
Belgium

Guido Vanham

University of Antwerp - Department of Biomedical Sciences ( email )

Prinsstraat 13
Antwerp, Antwerp 2000
Belgium

Yibeltal Assefa

University of Queensland - School of Public Health ( email )

St Lucia
Brisbane
Australia

Here is the Coronavirus
related research on SSRN

Paper statistics

Downloads
193
Abstract Views
1,030
rank
174,176
PlumX Metrics