Abstract
Background The United States has the highest numbers of confirmed cases of COVID-19, where they took up nearly half in the hot spot states of New York, New Jersey, Connecticut, and California. The workforce in these states was required to work from home except for essential services. It is necessary to evaluate an appropriate date for resumption of business since premature reopening of economy will lead to broader spread of COVID-19, while the opposite situation would cause greater loss of economy.
Methods To consider pre-symptomatic and asymptomatic transmission of COIVD-19, it is crucial to evaluate the unobserved numbers of unidentified infectious individuals but not the observed number of confirmed cases, which reflect the real-time risks of different stage of infectious disease. We proposed an epidemic model in considering the pre-symptomatic transmission and asymptomatic transmission of COVID-19 to evaluate the real-time risk of epidemic for the states of New York, New Jersey and Connecticut, and compared with California state (where it effectively phased reopened on May 8) for assessments of the appropriate Monday for resumption of business.
Results The predicted numbers of unidentified infectious individuals per 100,000 for states of New York, New Jersey and Connecticut which are close to those in California state are 12.23 with 95% CI (10.68, 13.57) on June 1, 25.65 with 95% CI (20.04, 30.43) on June 15, 28.49 with 95% CI (19.10, 38.65) on June 22, respectively, which may cause 11.23%, 15.64% and 17.32% higher than the estimated number of cumulative confirmed cases on July 11, if the second wave of the infection would happen after people return to work.
Conclusions It may be feasible for states of New York, New Jersey and Connecticut to reopen business on June 1 (or even May 18), June 15 and June 22. For the period after resumption of work, if the number of unidentified infectious individuals is still non-zero, the risks for the second wave of the infection would never vanish.
Competing Interest Statement
The authors have declared no competing interest.
Funding Statement
No funding was received for this article.
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
Not applicable.
All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.
Yes
Data Availability
To emphasize the effectiveness of our model for evaluating the real-time risk of epidemic before the second wave of the infection, we focused on the data during the period before the protest in United States. We collected the epidemic data from March 13, 2020 when the national emergency concerning COVID-19 was proclaimed to May 24, 2020 in four states of New York, New Jersey, Connecticut, and California. The data are available on the New York Times.
https://www.mndaily.com/article/2020/06/pf-the-george-floyd-protests-a-visual-timeline
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html