Superspreaders, asymptomatics and COVID‐19 elimination

To the Editor: We read with interest article by Kault,1 who carried out an analysis on superspreaders, asymptomatic cases, and coronavirus disease 2019 (COVID-19) elimination. Although all efforts made for preventing or containing COVID-19 pandemic are certainly welcome, we raise doubts some basic aspects used constructing prediction model which do not seem to be evidence-based. In risk of re-emergence after release restrictive measures (eg, lockdowns), Kault erroneous assumptions, including fact that subjects may as infectious symptomatic patients COVID-19.1 This hypothesis seems contradicted several lines evidence. First, a meta-analysis published in 2020 concluded rate transmission severe acute respiratory syndrome 2 (SARS-CoV-2) infection is 35% lower compared illness.2 has also been clearly explained seminal study showing viral load highest concomitance symptoms onset, so infectiousness pre-symptomatic individuals probably low.3 Notably, impact SARS-CoV-2 rather limited, whereby secondary attack was found account only 15% cases.4 A second aspect needs highlighted presuming 50% SARS-CoV-2-positive formally incorrect. Beside varies greatly depending many genetic, demographic (ie, age, sex ethnic origin) even clinical time course disease, comorbidities) variables, official database Italian National Institute Health reveals, example, approximates 70%.5 Combined infectiousness, high prevalence bearing practices lifting lockdowns) would persuade us conclude possible superspreaders low perhaps insufficient influence guide future policies aimed at restricting individual freedom. No relevant disclosures.