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Key questions for modelling COVID-19 exit strategies.

ABSTRACT: Combinations of intense non-pharmaceutical interventions (lockdowns) were introduced worldwide to reduce SARS-CoV-2 transmission. Many governments have begun to implement exit strategies that relax restrictions while attempting to control the risk of a surge in cases. Mathematical modelling has played a central role in guiding interventions, but the challenge of designing optimal exit strategies in the face of ongoing transmission is unprecedented. Here, we report discussions from the Isaac Newton Institute 'Models for an exit strategy' workshop (11-15 May 2020). A diverse community of modellers who are providing evidence to governments worldwide were asked to identify the main questions that, if answered, would allow for more accurate predictions of the effects of different exit strategies. Based on these questions, we propose a roadmap to facilitate the development of reliable models to guide exit strategies. This roadmap requires a global collaborative effort from the scientific community and policymakers, and has three parts: (i) improve estimation of key epidemiological parameters; (ii) understand sources of heterogeneity in populations; and (iii) focus on requirements for data collection, particularly in low-to-middle-income countries. This will provide important information for planning exit strategies that balance socio-economic benefits with public health.

SUBMITTER: Thompson RN

PROVIDER: S-EPMC7575516 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Key questions for modelling COVID-19 exit strategies.

Thompson Robin N RN Hollingsworth T Déirdre TD Isham Valerie V Arribas-Bel Daniel D Ashby Ben B Britton Tom T Challenor Peter P Chappell Lauren H K LHK Clapham Hannah H Cunniffe Nik J NJ Dawid A Philip AP Donnelly Christl A CA Eggo Rosalind M RM Funk Sebastian S Gilbert Nigel N Glendinning Paul P Gog Julia R JR Hart William S WS Heesterbeek Hans H House Thomas T Keeling Matt M Kiss István Z IZ Kretzschmar Mirjam E ME Lloyd Alun L AL McBryde Emma S ES McCaw James M JM McKinley Trevelyan J TJ Miller Joel C JC Morris Martina M O'Neill Philip D PD Parag Kris V KV Pearson Carl A B CAB Pellis Lorenzo L Pulliam Juliet R C JRC Ross Joshua V JV Tomba Gianpaolo Scalia GS Silverman Bernard W BW Struchiner Claudio J CJ Tildesley Michael J MJ Trapman Pieter P Webb Cerian R CR Mollison Denis D Restif Olivier O

Proceedings. Biological sciences 20200812 1932

Combinations of intense non-pharmaceutical interventions (lockdowns) were introduced worldwide to reduce SARS-CoV-2 transmission. Many governments have begun to implement exit strategies that relax restrictions while attempting to control the risk of a surge in cases. Mathematical modelling has played a central role in guiding interventions, but the challenge of designing optimal exit strategies in the face of ongoing transmission is unprecedented. Here, we report discussions from the Isaac Newt ...[more]

PMID: 32781946

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Project description:BackgroundMore than half of the global population is under strict forms of social distancing. Estimating the expected impact of lockdown and exit strategies is critical to inform decision makers on the management of the COVID-19 health crisis.MethodsWe use a stochastic age-structured transmission model integrating data on age profile and social contacts in Île-de-France to (i) assess the epidemic in the region, (ii) evaluate the impact of lockdown, and (iii) propose possible exit strategies and estimate their effectiveness. The model is calibrated to hospital admission data before lockdown. Interventions are modeled by reconstructing the associated changes in the contact matrices and informed by mobility reductions during lockdown evaluated from mobile phone data. Different types and durations of social distancing are simulated, including progressive and targeted strategies, with large-scale testing.ResultsWe estimate the reproductive number at 3.18 [3.09, 3.24] (95% confidence interval) prior to lockdown and at 0.68 [0.66, 0.69] during lockdown, thanks to an 81% reduction of the average number of contacts. Model predictions capture the disease dynamics during lockdown, showing the epidemic curve reaching ICU system capacity, largely strengthened during the emergency, and slowly decreasing. Results suggest that physical contacts outside households were largely avoided during lockdown. Lifting the lockdown with no exit strategy would lead to a second wave overwhelming the healthcare system, if conditions return to normal. Extensive case finding and isolation are required for social distancing strategies to gradually relax lockdown constraints.ConclusionsAs France experiences the first wave of COVID-19 pandemic in lockdown, intensive forms of social distancing are required in the upcoming months due to the currently low population immunity. Extensive case finding and isolation would allow the partial release of the socio-economic pressure caused by extreme measures, while avoiding healthcare demand exceeding capacity. Response planning needs to urgently prioritize the logistics and capacity for these interventions.

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Key questions for modelling COVID-19 exit strategies.

Publications

Key questions for modelling COVID-19 exit strategies.

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