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Epidemiology of Covid-19: Correspondence
Epidemiology of Covid-19: Correspondence
C or r e sp ondence
Epidemiology of Covid-19
To the Editor: With regard to the Perspective No potential conflict of interest relevant to this letter was
reported.
article by Lipsitch et al. (published Feb. 19 at
NEJM.org),1 cases of Covid-19 (the illness caused This letter was published on March 27, 2020, at NEJM.org.
by SARS-CoV-2 infection) with no epidemiologic
1. Lipsitch M, Swerdlow DL, Finelli L. Defining the epidemi-
link to travel to China or known cases outside ology of Covid-19 — studies needed. N Engl J Med 2020;382:
China have caused international concern about 1194-6.
undetected introduction of the virus from sub- 2. Cyranoski D. Did pangolins spread the China coronavirus to
people? Nature 2020:February 20 (Epub ahead of print).
clinical infection. It is also possible that local 3. Lam TT-Y, Shum MH-H, Zhu H-C, et al. Identification of
zoonotic spillover of this coronavirus from an 2019-nCoV related coronaviruses in Malayan pangolins in south-
intermediate animal reservoir or reservoirs into ern China. bioRxiv. February 18, 2020 (https://www.biorxiv.org/
content/10.1101/2020.02.13.945485v1).
human populations might have occurred, par- 4. Yu W-B, Tang G-D, Zhang L, Corlett RT. Decoding evolution
ticularly in Southeast Asia. and transmissions of novel pneumonia coronavirus using the
For example, coronaviruses that are phyloge- whole genomic data. ChinaXiv. February 21, 2020 (http://
chinaxiv.org/abs/202002.00033).
netically close to SARS-CoV-2 have been detected 5. Newly 14 increased cases infected with novel coronavirus in
in pangolins (scaly anteaters),2 especially in Shanghai (in Chinese). January 29, 2020 (https://news.163.com/
Malayan pangolins (also known as Sunda pan- 20/0129/09/F424CO6A0001899O.html).
tions are out there, going undetected? And what Since publication of their article, the authors report no fur-
ther potential conflict of interest.
level of population-wide immunity is being at-
tained? The answers to those questions have This letter was published on March 27, 2020, at NEJM.org.
worldwide implications. 1. Guan W, Ni Z, Hu Y, et al. Clinical characteristics of coro-
navirus disease 2019 in China. N Engl J Med. DOI:10.1056/
David L. Swerdlow, M.D. NEJMoa2002032.
2. Alraddadi BM, Watson JT, Almarashi A, et al. Risk factors for
Pfizer Vaccines
Collegeville, PA primary Middle East respiratory syndrome coronavirus illness in
humans, Saudi Arabia, 2014. Emerg Infect Dis 2016;22:49-55.
3. Cauchemez S, Epperson S, Biggerstaff M, Swerdlow D, Fi-
Lyn Finelli, Dr.P.H.
nelli L, Ferguson NM. Using routine surveillance data to esti-
Merck mate the epidemic potential of emerging zoonoses: application
Kenilworth, NJ to the emergence of US swine origin influenza A H3N2v virus.
PLoS Med 2013;10:e1001399.
Marc Lipsitch, D.Phil. 4. The COVID-19 Investigation Team. First 12 patients with
Harvard T.H. Chan School of Public Health coronavirus disease 2019 (COVID-19) in the United States.
Boston, MA medRxiv preprint. DOI:10.1101/2020.03.09.20032896.
mlipsitc@hsph.harvard.edu DOI: 10.1056/NEJMc2005157
Correspondence Copyright © 2020 Massachusetts Medical Society.