Temporal contact patterns and the implications for predicting superspreaders and planning of targeted outbreak control.

Directly transmitted infectious diseases spread through social contacts that change over time, but outbreak models typically make simplifying assumptions about network structure and dynamics. To assess how common assumptions relate to real-world interactions, we analysed 11 networks from five settings and developed metrics, capturing crucial epidemiological features of these networks. We developed a novel metric, the 'retention index', to characterize the distribution of retained contacts over consecutive time steps relative to fully static and dynamic networks. In workplaces and schools, contacts in the same department formed most of the retained contacts. In contrast, no clear contact type dominated the retained contacts in hospitals, thus reducing overall risk of disease introduction would be more effective than control targeted at departments. We estimated the contacts repetition over multiple days and showed that simple resource planning models overestimate the number of unique contacts by 20%-70%. We distinguished the difference between 'superspreader' and infectious individuals driving 'superspreading events' by measuring how often the individual represents the top 80% of contacts in the time steps over the study duration. We showed an inherent difficulty in identifying 'superspreaders' reliably: less than 20% of the individuals in most settings were highly connected for multiple time steps.