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. 2020 Mar 16:M20-0696. doi: 10.7326/M20-0696

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This article is made available via the PMC Open Access Subset for unrestricted re-use for research, analyses, and text and data mining through PubMed Central. Acknowledgement of the original source shall include a notice similar to the following: “© 2020 American College of Physicians. Some rights reserved. This work permits non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.” These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

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Figure 2. — Estimated outbreak size in Iran required to observe exported cases internationally.

The estimated cumulative number of COVID-19 cases in Iran required to observe 3 cases exported to UAE, LBN, and CAN is shown in green. We also estimated the outbreak size required under alternate scenarios, including no additional exported cases to any other international destinations despite perfect case detection and 1 additional exported case to IRQ, AZE, or SYR (independently or to all 3 countries). Mean and 95% CIs are presented. The rate at which persons become infected while in Iran was assumed to be the same for residents and visitors. The rate of infection among air passengers (λ) was estimated as number of exported cases ÷ person-time at risk while in Iran. Person-time at risk was calculated as number of outbound air passengers × (average length of stay for visitors × proportion of air passengers who are visitors + outbreak duration × proportion of air passengers who are residents of Iran). Outbreak size in Iran was then estimated as λ × population size of Iran × outbreak duration. AZE = Azerbaijan; CAN = Canada; COVID-19 = coronavirus disease 2019; IRQ = Iraq; LBN = Lebanon; SYR = Syria; UAE = United Arab Emirates.