Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the etiological agent of the Coronavirus Disease 2019 (COVID-19) disease, has moved rapidly around the globe, infecting millions and killing hundreds of thousands. The basic reproduction number, which has been widely used—appropriately and less appropriately—to characterize the transmissibility of the virus, hides the fact that transmission is stochastic, often dominated by a small number of individuals, and heavily influenced by superspreading events (SSEs). The distinct transmission features of SARS-CoV-2, e.g., high stochasticity under low prevalence (as compared to other pathogens, such as influenza), and the central role played by SSEs on transmission dynamics cannot be overlooked. Many explosive SSEs have occurred in indoor settings, stoking the pandemic and shaping its spread, such as long-term care facilities, prisons, meat-packing plants, produce processing facilities, fish factories, cruise ships, family gatherings, parties, and nightclubs. These SSEs demonstrate the urgent need to understand routes of transmission, while posing an opportunity to effectively contain outbreaks with targeted interventions to eliminate SSEs. Here, we describe the different types of SSEs, how they influence transmission, empirical evidence for their role in the COVID-19 pandemic, and give recommendations for control of SARS-CoV-2.

严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 是 2019 年冠状病毒病 (COVID-19) 疾病的病原体，已在全球迅速传播，感染了数百万人，导致数十万人死亡。基本传染数已被广泛使用（无论是适当还是不太适当）来描述病毒的传播能力，它掩盖了传播是随机的这一事实，通常由少数人主导，并受到超级传播事件（SSE）的严重影响。SARS-CoV-2 的独特传播特征，例如低流行率下的高随机性（与流感等其他病原体相比），以及 SSE 在传播动态中发挥的核心作用不容忽视。许多爆炸性 SSE 发生在室内环境中，加剧了流行病并影响了其传播，例如长期护理设施、监狱、肉类包装厂、农产品加工设施、鱼类工厂、游轮、家庭聚会、聚会和夜总会。这些 SSE 表明迫切需要了解传播途径，同时为通过有针对性的干预措施消除 SSE 来有效遏制疫情提供了机会。在这里，我们描述了不同类型的 SSE、它们如何影响传播、它们在 COVID-19 大流行中作用的经验证据，并提出了控制 SARS-CoV-2 的建议。