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Suggested Citation:"Rapid Expert Consultation." National Academies of Sciences, Engineering, and Medicine. 2020. Rapid Expert Consultation on SARS-CoV-2 Surface Stability and Incubation for the COVID-19 Pandemic (March 15, 2020). Washington, DC: The National Academies Press. doi: 10.17226/25751.
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Rapid Expert Consultation on SARS-CoV-2 Surface Stability and Incubation for the COVID-19 Pandemic (March 15, 2020)

March 15, 2020

Kelvin Droegemeier, Ph.D.

Office of Science and Technology Policy

Executive Office of the President

Eisenhower Executive Office Building

1650 Pennsylvania Avenue, NW

Washington, DC 20504

Dear Dr. Droegemeier:

You requested immediate feedback on two crucial questions. The following expert members of the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats were involved in preparing this document: Kent Kester, David Relman, David Walt, and me. Ellen Wright Clayton, Vanderbilt University, reviewed this document.

Question 1: Survival of virus on surfaces.

One of the most thorough and informative studies is just now under consideration for publication and has not undergone full peer review. The investigators are a highly reputable group, and we can expect that their study was carefully conducted. They tested both the current coronavirus (SARS-CoV-2) and the original SARS virus (SARS-CoV-1). Results were similar for both viruses. They tested the viability (survival) of both viruses after controlled aerosolization and on a variety of surfaces. The aerosol (particles smaller than 5 microns that can float in the air) showed viral detection up to 3 hours post aerosolization. Following surface contamination, SARS-CoV-2 could be detected up to 4 hours on copper, up to 24 hours on cardboard and up to 2-3 days on plastic and on stainless steel. These results are consistent with the plausibility of both aerosol and surface (fomite) transmission of SARS-CoV2. The difference in survival on copper (4 hours) and on stainless steel (2-3 days) is noteworthy. Note that this study excludes what is probably the most common route of spread, direct droplet transmission by cough or sneeze, or even exhalation by an infected person. Additionally, the members of the standing committee identified above note that the National Biodefense Analysis and Countermeasures Center (NBACC) is conducting environmental survival studies of SARSCoV-2 and their results should be taken into account.

Question 2: Incubation period (time between exposure and onset of symptoms).

Note that it is possible for viral shedding to begin prior to the onset of symptoms. Also, we are not considering here the question of how long viral shedding can continue in someone who has been infected.

Suggested Citation:"Rapid Expert Consultation." National Academies of Sciences, Engineering, and Medicine. 2020. Rapid Expert Consultation on SARS-CoV-2 Surface Stability and Incubation for the COVID-19 Pandemic (March 15, 2020). Washington, DC: The National Academies Press. doi: 10.17226/25751.
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Rather, as we understand it, the question here pertains to the appropriate period of quarantine for an exposed individual. One of the more informative reports on incubation period studied 181 patients in China who had identifiable dates of exposure and of symptom onset.1 In this study, the mean incubation period was estimated to be 5.1 days (95% confidence interval 4.5 to 5.8 days) and 97.5% of those who develop symptoms will do so within 11.5 days (95% confidence interval 8.2 to 15.6 days) of exposure. These estimates imply that only about 1% of cases (101/10,000) will develop symptoms following 14 days after exposure. Shortening quarantine to fewer than 14 days would increase the fraction who were still to develop symptoms. Note that Lauer et al. acknowledged that publicly reported cases may overrepresent severe cases, the incubation period for which may differ from that of mild cases.

Respectfully,

Harvey V. Fineberg, M.D., Ph.D.

Chair

Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats

__________________

1 Lauer et al. 2020. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: Estimation and application free. Annals of Internal Medicine. DOI: 10.7326/M20-0504.

Suggested Citation:"Rapid Expert Consultation." National Academies of Sciences, Engineering, and Medicine. 2020. Rapid Expert Consultation on SARS-CoV-2 Surface Stability and Incubation for the COVID-19 Pandemic (March 15, 2020). Washington, DC: The National Academies Press. doi: 10.17226/25751.
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Suggested Citation:"Rapid Expert Consultation." National Academies of Sciences, Engineering, and Medicine. 2020. Rapid Expert Consultation on SARS-CoV-2 Surface Stability and Incubation for the COVID-19 Pandemic (March 15, 2020). Washington, DC: The National Academies Press. doi: 10.17226/25751.
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Rapid Expert Consultation on SARS-CoV-2 Surface Stability and Incubation for the COVID-19 Pandemic (March 15, 2020) Get This Book
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This rapid expert consultation responds to a request from the Office of Science and Technology Policy (OSTP) concerning the survival of the SARS-CoV-2 virus on surfaces and the incubation period between exposure and onset of symptoms.

The National Academies of Sciences, Engineering, and Medicine convened a standing committee of experts to help inform OSTP on critical science and policy issues related to emerging infectious diseases and other public health threats. The standing committee includes members with expertise in emerging infectious diseases, public health, public health preparedness and response, biological sciences, clinical care and crisis standards of care, risk communication, and regulatory issues.

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