Characterizing key attributes of COVID-19 transmission dynamics in China's original outbreak: Model-based estimations

A novel coronavirus strain, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China. This study aims to characterize key attributes of SARS-CoV-2 epidemiology as the infection emerged in China. An age-stratified mathematical model was constructed to describe transmission dynamics and estimate age-specific differences in biological susceptibility to infection, age-assortativeness in transmission mixing, and transition in rate of infectious contacts (and reproduction number R 0) following introduction of mass interventions. The model estimated the infectious contact rate in early epidemic at 0.59 contacts/day (95% uncertainty interval-UI = 0.48-0.71). Relative to those 60-69 years, susceptibility was 0.06 in those ≤19 years, 0.34 in 20-29 years, 0.57 in 30-39 years, 0.69 in 40-49 years, 0.79 in 50-59 years, 0.94 in 70-79 years, and 0.88 in ≥80 years. Assortativeness in transmission mixing by age was limited at 0.004 (95% UI = 0.002-0.008). R 0 rapidly declined from 2.1 (95% UI = 1.8-2.4) to 0.06 (95% UI = 0.05-0.07) following interventions' onset. Age appears to be a principal factor in explaining the transmission patterns in China. The biological susceptibility to infection seems limited among children but high among those >50 years. There was no evidence for differential contact mixing by age.