PMC:7055038 / 9338-11527
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7055038","sourcedb":"PMC","sourceid":"7055038","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7055038","text":"Discussion and conclusion\nAccording to the cases’ history, the two imported COVID-19 cases described here are not directly linked, yet their genomes are identical. Further, according to information provided by the cases, they have no direct link to the Huanan Seafood Market but their genomes are identical to four sequences from Wuhan collected on 30 December 2019 and sequenced by three different laboratories, indicating potential wider distribution in the city. Although within-outbreak sequence divergence is low for this virus, identical genomes of up to 30 kb are rare and a strong sign of recent transmission linkage, albeit with unknown number of generations within the transmission chain. The missing link to the market, the time of travel and onset of symptoms in the two COVID-19 cases together with the incubation period of mean 6.4 days (range: 5.6–7.7) [16] and the time of closest genome neighbours obtained from sequences in Wuhan, suggest that transmission within Wuhan beyond the Huanan Seafood Market is likely to have occurred in the first week of January or earlier. People travelling out of the city since then may have spread the virus further before travel restrictions were enforced on 23 January [17].\nThailand implemented measures for screening patients travelling from Wuhan since 3 January 2020 at Suvarnabhumi Airport, Don Mueang, Phuket and Chiang Mai airports, and stepped up surveillance at public and private hospitals. The two cases described here who tested positive for SARS-CoV-2 were the first confirmed exported cases from China, suggesting early international spread. Therefore, while one cannot exclude the possibility that asymptomatic cases in their incubation period would be missed and become infectious later, screening of incoming travellers from an affected area proved successful at least in these two instances, when COVID-19 cases were detected, isolated, observed and only discharged once they tested negative for SARS-CoV-2. Rapid response including genome sequencing and sharing via GISAID [18,19] (https://www.gisaid.org/) enabled fast dissemination of results and provided a glimpse of early transmission patterns in this 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