Establishment, contagiousness, and initial spread of SARS-CoV-2 in Canada

This study empirically quantifies dynamics of SARS-CoV-2 establishment and early spread in Canada. We developed a transmission model that was simulation tested and fitted in a Bayesian framework to timeseries of new cases per day prior to physical distancing interventions. A hierarchical version was fitted to all provinces simultaneously to obtain average estimates for Canada. Across scenarios of a latent period of 2–4 d and an infectious period of 5–9 d, the R 0 estimate for Canada ranges from a minimum of 3.0 (95% CI: 2.3–3.9) to a maximum of 5.3 (95% CI: 3.9–7.1). Among provinces, the estimated commencement of community transmission ranged from 3 d before to 50 d after the first reported case and from 2 to 25 d before the first reports of community transmission. Among parameter scenarios and provinces, the median reduction in transmission needed to obtain R 0 < 1 ranged from 46% (95% CI: 43%–48%) to 89% (95% CI: 88%–90%). Our results indicate that local epidemics of SARS-CoV-2 in Canada entail high levels of stochasticity, contagiousness, and observation delay, which facilitates rapid undetected spread and requires comprehensive testing and contact tracing for its containment.