The Effectiveness of Contact Tracing in Emerging Epidemics

Klinkenberg, Don; Fraser, Christophe; Heesterbeek, Hans

In the fourth panel (2C), with variable detection time and long infectious period, effective contact tracing requires a proportion of contacts smaller than 121/R 0 pre to be traced, if the latent period is large enough (like SARS). This can be explained as follows. If the detection time is variable and the latent and infectious periods are large, many infecteds will be detected before becoming infectious. If many infecteds are not infectious before being detected, the few that are should be very infectious (''superspreaders'') to attain a given R 0 pre (the average number of secondary infections before detection). Because many of the infectees of these superspreaders will be detected early (variable detection time), the superspreaders will be quarantined after backwards tracing, which adds to the effect of forwards tracing preventing infectees to reach their infectious period. Effectiveness may be very sensitive to the latent period, especially if there is little variation in the detection time. This is most apparent in the sharp transition in panel 2B, where tracing is only effective if all infectors are detected (at t = 12t lat ) before the infectious period (at t = t lat ), so t lat .0.5. The high sensitivity can be a problem for assessing the tracing effectiveness for a specific infection: the conclusion may largely depend on how correct the available estimates for the latent and incubation periods are, the incubation period determining the time to detection. Figure 2 indicates that this might be a problem for FMD.