USA TODAY US Edition

A visual look at how the virus spreads.

- BY JANIE HASEMAN, VERONICA BRAVO, MITCHELL THORSON AND SHAWN SULLIVAN/USA TODAY

Not long after the novel coronaviru­s — which causes the disease COVID-19 — was first discovered in China, scientists and doctors warned that the virus could spread around the world. It has now spread to at least 115 countries, with thousands of people in the United States now reported to have COVID-19. But how is the virus spreading so quickly? It all comes down to the basic reproducti­ve number, or how many new people contract the virus from one infected person. This is how it's calculated — and how we can reduce it.

How contagious is coronaviru­s?

A key factor in studying the spread of disease is determinin­g the average number of new people who will be infected by each person with the virus. This is called R0, or the basic reproducti­ve number. There are many, many variables that can go into calculatin­g R , but at 0 the most basic level it involves 3 numbers.

First, the number of people each infected person has contact with is estimated. In this hypothetic­al example, let’s say each infected person comes into contact with 3 people susceptibl­e to the virus.

The number of contacts is then multiplied by the percent chance that 1 of those contacts has been infected. In this hypothetic­al, let’s say the chance was 33%.

That number is then multiplied by the length of time individual­s are able to contract the disease from the infected person.

So if someone with this hypothetic­al virus had contact with 3 people per day, and there was a 1 in 3 chance of infection for each contact, and the infected person was contagious for three days, the R0 would be 3. About 3 new people would contract the illness from each person infected.

Again, there are a lot of other variables that epidemiolo­gists can add into this equation — those are only the basics.

The R0 of coronaviru­s is usually estimated to be somewhere between 2 and 3. This means that if one person contracts the virus, the next wave of infection — assuming there was no interventi­on — would be 2 to 3 times as large. It’s why the number of people affected increases rapidly after the first case in an area.

Researcher­s don’t know exactly what the R0 is for certain because no one has complete data on who has been infected.

Most of the coronaviru­s charts and maps you’ve probably been seeing, including the charts above, show the number of reported COVID-19 cases. But many people who have COVID-19 — and no one knows how many — are not being counted by medical authoritie­s. COVID-19 can have mild symptoms or even no symptoms at all, and some people are unaware they even have the disease.

This means that in order to calculate R0 and other variables, researcher­s need to make assumption­s about the number of people infected and other missing data. As a result, statistica­l estimates from different studies can vary. This is why while we know that the basic reproducti­ve number of coronaviru­s is probably between 1 and 3, the exact number is still uncertain.

Because we don’t know for sure how many people have the virus, an area with 10 reported cases could easily have 100 cases in reality. And because of the exponentia­l growth of the number of people with the coronaviru­s, those 100 cases could become 1,000 within a week.

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Last updated: 3/18/20
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3 contacts per day X 1/3 chance of infection on contact X 3-day infectious period = R0 of 3
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3 contacts per day X 1/3 chance of infection on contact
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3 contacts per day

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