Update: The Boston Marriott Long Wharf, the hotel that hosted a Biogen company gathering linked to a majority of the coronavirus cases in Massachusetts, is closing temporarily. In a letter to guests on Thursday, the hotel said it made the decision with the Boston Public Health Commission.
Among the coronavirus numbers that Massachusetts officials have shared recently, one is particularly striking: Of the state's 95 cases detected as of late Wednesday, they say 77 stemmed from a meeting that the Cambridge biotech company Biogen held in late February.
Perhaps you've heard of Typhoid Mary, the New York cook who spread Typhoid fever in the early 20th century. She used to be seen as an anomaly, because it was thought that everyone was more-or-less equally prone to spread a disease.
But now, it’s known that “superspreaders” or “superspreading events” are common in epidemics, including SARS in 2003 and a measles outbreak in Canada in 2011 that appeared to stem from one patient's stint in the Montreal airport.
Yale professor Nicholas Christakis, a physician and sociologist who studies networks, says the current outbreak in Italy also stemmed from a "superspreader."
"We know from genetic analyses in Italy that the epidemic there was started, we think, by two people, one of whom gave it to 43 other people," he says.
"The question arises," he says, "when we see a superspreading episode like this episode at Biogen appears to be, what's the cause of it? Is it just chance? Or is it something to do with the particular circumstances?"
Though superspreading has been documented in one epidemic after another, it’s not well understood.
"We certainly think biology plays a role," says Dr. Ashish Jha, a professor of health policy at the Harvard Chan School of Public Health. "Some people end up having a very high viral load and then they shed a lot more virus than other people. It may be something with your immune system, something to do with how that immune system is reacting to the virus."
Initial findings suggest the coronavirus could be quite contagious early on, possibly even before symptoms show up or get bad.
Typically it is not possible to know in advance who or under what circumstances we're going to get a superspreading event.Yale's Nicholas Christakis
Christakis from Yale says other factors could cause people to become superspreaders — like even a propensity to cough.
"Maybe they have a lung disease, for example," he says. "And so they're doing more coughing anyway. And so compared to a person who doesn't cough, they transmit it more."
The environment can contribute to spreading, too, he says — poor ventilation, overcrowding. Or — a superspreader may just be more gregarious.
"So there are many types of situations or circumstances that can contribute to the phenomenon of superspreading," says Christakis, author of "Blueprint: The Evolutionary Origins of a Good Society." "And it's not always possible to know — or typically it is not possible to know in advance — who or under what circumstances we're going to get a superspreading event."
So that’s part of why large gatherings are a bad idea right now, Harvard's Ashish Jha says: If you have a superspreader in a crowd, "It can really make things explode. And the name of the game right now for America is a slow and steady rise in infections. We've got to stop explosive growth because that's what's going to cripple our health system and really harm people. And superspreaders can end up being an important part of that problem if we get them into large groups."
In retrospect, Jha says, Biogen probably should have canceled its meeting. "But I understand that decisions are easier to make in retrospect," he says.
This article was originally published on March 12, 2020.
This segment aired on March 12, 2020.