Evaluate the timing of resumption of business for the states of New York, New Jersey and California via a pre-symptomatic and asymptomatic transmission model of COVID-19 (preprint)

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.