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Event-specific interventions to minimize COVID-19 transmission.

ABSTRACT: COVID-19 is a global pandemic with over 25 million cases worldwide. Currently, treatments are limited, and there is no approved vaccine. Interventions such as handwashing, masks, social distancing, and "social bubbles" are used to limit community transmission, but it is challenging to choose the best interventions for a given activity. Here, we provide a quantitative framework to determine which interventions are likely to have the most impact in which settings. We introduce the concept of "event R," the expected number of new infections due to the presence of a single infectious individual at an event. We obtain a fundamental relationship between event R and four parameters: transmission intensity, duration of exposure, the proximity of individuals, and the degree of mixing. We use reports of small outbreaks to establish event R and transmission intensity in a range of settings. We identify principles that guide whether physical distancing, masks and other barriers to transmission, or social bubbles will be most effective. We outline how this information can be obtained and used to reopen economies with principled measures to reduce COVID-19 transmission.

SUBMITTER: Tupper P

PROVIDER: S-EPMC7749284 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Event-specific interventions to minimize COVID-19 transmission.

Tupper Paul P Boury Himani H Yerlanov Madi M Colijn Caroline C

Proceedings of the National Academy of Sciences of the United States of America 20201119 50

COVID-19 is a global pandemic with over 25 million cases worldwide. Currently, treatments are limited, and there is no approved vaccine. Interventions such as handwashing, masks, social distancing, and "social bubbles" are used to limit community transmission, but it is challenging to choose the best interventions for a given activity. Here, we provide a quantitative framework to determine which interventions are likely to have the most impact in which settings. We introduce the concept of "even ...[more]

PMID: 33214148

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Project description:As the outbreak of novel coronavirus disease (COVID-19) continues to spread throughout the world, steps are being taken to limit the impact on public health. In the realm of infectious diseases like COVID-19, social distancing is one of the effective measures to avoid exposure to the virus and reduce its spread. Traveling on public transport can meaningfully facilitate the propagation of the transmission of infectious diseases. Accordingly, responsive actions taken by public transit agencies against risk factors can effectively limit the risk and make transit systems safe. Among the multitude of risk factors that can affect infection spread on public transport, the likelihood of exposure is a major factor that depends on the number of people riding the public transport and can be reduced by socially distanced settings. Considering that many individuals may not act in the socially optimal manner, the necessity of public transit agencies to implement measures and restrictions is vital. In this study, we present a novel web-based application, T-Ridership, based on a hybrid optimized dynamic programming inspired by neural networks algorithm to optimize public transit for safety with respect to COVID-19. Two main steps are taken in the analysis through Metropolitan Transportation Authority (MTA): detecting high-density stations by input data normalization, and then, using these results, the T-Ridership tool automatically determines optimal station order to avoid overcrowded transit vehicles. Effectively our proposed web tool helps public transit to be safe to ride under risk of infections by reducing the density of riders on public transit vehicles as well as trip duration. These results can be used in expanding on and improving policy in public transit, to better plan the scheduled time of trains and buses in a way that prevents high-volume human contact, increases social distance, and reduces the possibility of disease transmission (available at:http://t-ridership.com and GitHub at: https://github.com/Imani-Saba/TRidership).

Project description:We present a novel approach for exiting coronavirus disease 2019 (COVID-19) lockdowns using a 'risk scorecard' to prioritize activities to resume whilst allowing safe reopening. We modelled cases generated in the community/week, incorporating parameters for social distancing, contact tracing and imported cases. We set thresholds for cases and analysed the effect of varying parameters. An online tool to facilitate country-specific use including the modification of parameters (https://sshsphdemos.shinyapps.io/covid_riskbudget/) enables visualization of effects of parameter changes and trade-offs. Local outbreak investigation data from Singapore illustrate this. Setting a threshold of 0.9 mean number of secondary cases arising from a case to keep R < 1, we showed that opening all activities excluding high-risk ones (e.g. nightclubs) allows cases to remain within threshold; while opening high-risk activities would exceed the threshold and result in escalating cases. An 80% reduction in imported cases per week (141 to 29) reduced steady-state cases by 30% (295 to 205). One-off surges in cases (due to superspreading) had no effect on the steady state if the R remains <1. Increasing the effectiveness of contact tracing (probability of a community case being isolated when infectious) by 33% (0.6 to 0.8) reduced cases by 22% (295 to 231). Cases grew exponentially if the product of the mean number of secondary cases arising from a case and (1-probability of case being isolated) was >1. Countries can utilize a 'risk scorecard' to balance relaxations for travel and domestic activity depending on factors that reduce disease impact, including hospital/ICU capacity, contact tracing, quarantine and vaccination. The tool enabled visualization of the combinations of imported cases and activity levels on the case numbers and the trade-offs required. For vaccination, a reduction factor should be applied both for likelihood of an infected case being present and a close contact getting infected.

Project description:Background. The novel coronavirus SARS-CoV-2 spread across the world causing many waves of COVID-19. Children were at high risk of being exposed to the disease because they were not eligible for vaccination during the first 20 mo of the pandemic in the United States. While children 5 y and older are now eligible to receive a COVID-19 vaccine in the United States, vaccination rates remain low despite most schools returning to in-person instruction. Nonpharmaceutical interventions (NPIs) are important for controlling the spread of COVID-19 in K-12 schools. US school districts used varied and layered mitigation strategies during the pandemic. The goal of this article is to analyze the impact of different NPIs on COVID-19 transmission within K-12 schools. Methods. We developed a deterministic stratified SEIR model that captures the role of social contacts between cohorts in disease transmission to estimate COVID-19 incidence under different NPIs including masks, random screening, contact reduction, school closures, and test-to-stay. We designed contact matrices to simulate the contact patterns between students and teachers within schools. We estimated the proportion of susceptible infected associated with each intervention over 1 semester under the Omicron variant. Results. We find that masks and reducing contacts can greatly reduce new infections among students. Weekly screening tests also have a positive impact on disease mitigation. While self-quarantining symptomatic infections and school closures are effective measures for decreasing semester-end infections, they increase absenteeism. Conclusion. The model provides a useful tool for evaluating the impact of a variety of NPIs on disease transmission in K-12 schools. While the model is tested under Omicron variant parameters in US K-12 schools, it can be adapted to study other populations under different disease settings.HighlightsA stratified SEIR model was developed that captures the role of social contacts in K-12 schools to estimate COVID-19 transmission under different nonpharmaceutical interventions.While masks, random screening, contact reduction, school closures, and test-to-stay are all beneficial interventions, masks and contact reduction resulted in the greatest reduction in new infections among students from the tested scenarios.Layered interventions provide more benefits than implementing interventions independently.

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Event-specific interventions to minimize COVID-19 transmission.

Publications

Event-specific interventions to minimize COVID-19 transmission.

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