Incubation Period CoronaVirus

Wuhan Novel Coronavirus (2019-nCoV) Incubation Period

The incubation period (time from exposure to the development of symptoms) of the virus is estimated to be between 3 and 29 days based on the following sources:

  • The World Health Organization (WHO) reported an incubation period for 2019-nCoV between 2 and 10 days.
  • China’s National Health Commission (NHC) had initially estimated an incubation period from 10 to 23 days.
  • The United States’ CDC estimates the incubation period for 2019-nCoV to be between 2 and 21 days.
  • DXY.cn, a leading Chinese online community for physicians and health care professionals, is reporting an incubation period of “3 to 14 days, up to 27 days”.

The estimated range will be most likely narrowed down as more data becomes available.

Incubation period of up to 29 days?

The incubation period has been found to be as long as 24 days (range: 0-24 days; median: 3.0 days) in a study published on February 9.

The WHO said in a press conference on February 10 that:

  • a very long incubation period could reflect a double exposure.
  • 24 days represented an outlier observation that must be taken into consideration in the context of the main finding of the study.
  • WHO is not considering changing recommendations regarding incubation periods.

More recently, however, a case with an incubation period of 23 days was observed in a JAMA study published on Feb. 23., and another case with an incubation period of 29 days was reported by Hubei Province on Feb. 25

Incubation period of 7.2 days on average

A Chinese study published in the New England Journal of Medicine on Jan. 30, has found the incubation period to be 7.2 days on average, but it varies greatly among patients. The Chinese team conducting the study said their findings support a 14-day medical observation period for people exposed to the pathogen.

Below is an extract of the study findings:

Among the first 425 patients with confirmed NCIP, the median age was 53 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases.

The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days.

In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9).

Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk.

The importance of knowing the incubation period

Understanding the incubation period is very important for health authorities as it allows them to introduce more effective quarantine systems for people suspected of carrying the virus, as a way of controlling and hopefully preventing the spread of the virus.

Comparison with other viruses

For comparison, the incubation period for the common flu (seasonal influenza) is typically around 2 days. Incubation period for other coronaviruses: SARS 2-7 days; MERS 5 days typically (range 2-14 days).

Summary of findings:

  • 2-14 days represents the current official estimated range for the novel coronavirus COVID-19.
  • However, a case with an incubation period of 29 days has been reported by Hubei Province local government on Feb. 22
  • In addition, a case with an incubation period of 23 days was observed in a JAMA study of 5 cases published on Feb. 21.
  • An outlier of a 24 days incubation period had been for the first time observed in a Feb. 9 study. WHO said at the time that this could actually reflect a second exposure rather than a long incubation period, and that it wasn’t going to change its recommendations.
  • Period can vary greatly among patients.
  • Mean incubation period observed:
    3.0 days
    (0 – 24 days range, study based on 1,324 cases)
    7.2 days (4.1 – 7.0 days range, based on 425 cases).
  • Mean incubation period observed in travelers from Wuhan:
    6.4 days
    (range from 2.1 to 11.1 days).