Incubation period and serial interval of Covid-19 in a chain of infections in Bahia Blanca (Argentina)

Viego, V.; Geri, M.; Castiglia, J.; Jouglard, E.

Objective: To estimate the incubation period and the serial interval of Covid-19 from a sample of symptomatic patients in Bahia Blanca city. Methods: We collected dates of illness onset for primary cases (infectors) and secondary cases (infectees) for the first 18 secondary patients infected with SARS-Cov-2 in Bahia Blanca (Argentina). We ranked the fiability of the data depending upon certainty about the identification of the infector and the date of exposition to infector. The sample has some missing values. In the case of incubation, as 3 patients were infected by other household members, we only have 15 observations with an observed date of exposition. For the estimation of serial interval, one patient became ill from close contact with an asymptomatic infectious. Also, estimations of both the incubation period and the serial interval were carried using the full sample and a subsample with higher certainty about the transmissor and date of exposition. By the time the dataset was prepared all infectors were recovered so estimations do need to take into account right censoring. Results: The mean incubation period for symptomatic patients is 7.9 days (95% CI: 4.6, 11.1) considering the sample of 15 cases patients and 7.5 days (95% CI: 4.1, 10.9) if the sample is restricted to the most certain cases (n=12). The median is 6.1 (95% CI: 4.1, 9.2) and 5.8 (95% CI: 3.6, 9.3) respectively. Moreover, 97.5% of symptomatic cases will develop symptoms after 13.6 days from exposition (95% CI 10.7, 16.5). The point estimation for the mean serial interval is 6.8 days (95% CI: 4.0-9.6). Considering only the most certain pairs, the mean serial interval is estimated at 5.5 days (95% CI: 2.8, 8.1). The estimated median serial intervals were 5.2 (95% CI: 3.0, 8.1) and 4.1 (95% CI: 2.0, 6.9) days respectively. Conclusions: Evidence from Bahia Blanca (Argentina) suggests that the median and mean serial interval of Covid-19 is shorter than the incubation period. This suggests that a pre-symptomatic transmission is not negligible. Comparisons with foreign estimates show that incubation period and serial interval could be longer in Bahia Blanca city than in other regions. That poses a signal of opportunity to attain more timely contact tracing and effective isolation.