Dataset Information

How and When to End the COVID-19 Lockdown: An Optimization Approach.

ABSTRACT: Countries around the world are in a state of lockdown to help limit the spread of SARS-CoV-2. However, as the number of new daily confirmed cases begins to decrease, governments must decide how to release their populations from quarantine as efficiently as possible without overwhelming their health services. We applied an optimal control framework to an adapted Susceptible-Exposure-Infection-Recovery (SEIR) model framework to investigate the efficacy of two potential lockdown release strategies, focusing on the UK population as a test case. To limit recurrent spread, we find that ending quarantine for the entire population simultaneously is a high-risk strategy, and that a gradual re-integration approach would be more reliable. Furthermore, to increase the number of people that can be first released, lockdown should not be ended until the number of new daily confirmed cases reaches a sufficiently low threshold. We model a gradual release strategy by allowing different fractions of those in lockdown to re-enter the working non-quarantined population. Mathematical optimization methods, combined with our adapted SEIR model, determine how to maximize those working while preventing the health service from being overwhelmed. The optimal strategy is broadly found to be to release approximately half the population 2-4 weeks from the end of an initial infection peak, then wait another 3-4 months to allow for a second peak before releasing everyone else. We also modeled an "on-off" strategy, of releasing everyone, but re-establishing lockdown if infections become too high. We conclude that the worst-case scenario of a gradual release is more manageable than the worst-case scenario of an on-off strategy, and caution against lockdown-release strategies based on a threshold-dependent on-off mechanism. The two quantities most critical in determining the optimal solution are transmission rate and the recovery rate, where the latter is defined as the fraction of infected people in any given day that then become classed as recovered. We suggest that the accurate identification of these values is of particular importance to the ongoing monitoring of the pandemic.

SUBMITTER: Rawson T

PROVIDER: S-EPMC7298102 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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How and When to End the COVID-19 Lockdown: An Optimization Approach.

Rawson Thomas T Brewer Tom T Veltcheva Dessislava D Huntingford Chris C Bonsall Michael B MB

Frontiers in public health 20200610

Countries around the world are in a state of lockdown to help limit the spread of SARS-CoV-2. However, as the number of new daily confirmed cases begins to decrease, governments must decide how to release their populations from quarantine as efficiently as possible without overwhelming their health services. We applied an optimal control framework to an adapted Susceptible-Exposure-Infection-Recovery (SEIR) model framework to investigate the efficacy of two potential lockdown release strategies, ...[more]

PMID: 32587844

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Project description:The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused the Coronavirus Disease 2019 (COVID-19) worldwide pandemic in 2020. In response, most countries in the world implemented lockdowns, restricting their population's movements, work, education, gatherings, and general activities in attempt to "flatten the curve" of COVID-19 cases. The public health goal of lockdowns was to save the population from COVID-19 cases and deaths, and to prevent overwhelming health care systems with COVID-19 patients. In this narrative review I explain why I changed my mind about supporting lockdowns. The initial modeling predictions induced fear and crowd-effects (i.e., groupthink). Over time, important information emerged relevant to the modeling, including the lower infection fatality rate (median 0.23%), clarification of high-risk groups (specifically, those 70 years of age and older), lower herd immunity thresholds (likely 20-40% population immunity), and the difficult exit strategies. In addition, information emerged on significant collateral damage due to the response to the pandemic, adversely affecting many millions of people with poverty, food insecurity, loneliness, unemployment, school closures, and interrupted healthcare. Raw numbers of COVID-19 cases and deaths were difficult to interpret, and may be tempered by information placing the number of COVID-19 deaths in proper context and perspective relative to background rates. Considering this information, a cost-benefit analysis of the response to COVID-19 finds that lockdowns are far more harmful to public health (at least 5-10 times so in terms of wellbeing years) than COVID-19 can be. Controversies and objections about the main points made are considered and addressed. Progress in the response to COVID-19 depends on considering the trade-offs discussed here that determine the wellbeing of populations. I close with some suggestions for moving forward, including focused protection of those truly at high risk, opening of schools, and building back better with a economy.

Project description:Previous literature on the psychological impact of COVID-19 has shown a direct relationship between family conflicts and psychological distress among parents and their children during the domestic lockdown and social isolation; but there are also opportunities to enhance family bonding, encourage collective problem-solving and improve personal relationships. This study aimed to explore psychological adjustment processes of Spanish adolescents and their parents during the first month of lockdown by analyzing their narratives, perceived outcomes, protection and risk factors. A total of 142 people agreed to participate in this study. Of all participants, 61 were adolescents (M = 13.57; SD = 1.74; 57% women) and 81 were parents (M = 46.09; SD = 4.72; 91% mothers). All were Spanish residents and completed an online survey during the domestic lockdown in March 2020. From a qualitative design, methodology followed a mixed approach to analyze data. The results showed three different types of adaptation to lockdown and social isolation in both adolescents and their parents: 1) positive adjustment, 2) moderate adjustment, and 3) maladjustment. Most participants reported a good adjustment and only a 20% of parents and a 16% of adolescents stated that they had not been able to achieve a positive psychological adjustment. There are few significant quantitative differences between adolescents and their parents. The qualitative analysis of data showed that adolescents reported less psychological distress than their parents. The two most important protective factors were social support and keeping busy during lockdown. The most significant risk factors were loss of mobility and social isolation. The conclusions stressed that regarding psychological maladjustment, parents experienced feelings of uncertainty whereas adolescents experienced a kind of mourning process. These findings can be used to design and implement effective intervention measures for mental health and psychological well-being in such a difficult situation as domestic lockdown.

Dataset Information

How and When to End the COVID-19 Lockdown: An Optimization Approach.

Publications

How and When to End the COVID-19 Lockdown: An Optimization Approach.

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