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Visualizing the Network Structure of COVID-19 in Singapore.

ABSTRACT: Many infectious diseases such as coronavirus disease 2019 spread through preexisting social networks. Although network models consider the implications of micro-level interaction patterns for disease transmission, epidemiologists and social scientists know little about the meso-structure of disease transmission. Meso-structure refers to the pattern of disease spread at a higher level of aggregation, that is, among infection clusters corresponding to organizations, locales, and events. The authors visualizes this meso-structure using publicly available contact tracing data from Singapore. Visualization shows that one highly central infection cluster appears to have generated on the order of seven or eight infection chains, amounting to 60 percent of nonimported cases during the period considered. However, no other cluster generated more than two infection chains. This heterogeneity suggests that network meso-structure is highly consequential for epidemic dynamics.

SUBMITTER: Van Gunten T

PROVIDER: S-EPMC7944021 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundCoronavirus disease 2019 (COVID-19) has impacted the provision of health services in all specialties. We aim to study the impact of COVID-19 on the utilization of pediatric hospital services including emergency department (ED) attendances, hospitalizations, diagnostic categories and resource utilization in Singapore.MethodsWe performed a retrospective review of ED attendances and hospital admissions among children < 18 years old from January 1st to August 8th 2020 in a major pediatric hospital in Singapore. Data were analyzed in the following time periods: Pre-lockdown (divided by the change in Disease Outbreak Response System Condition (DORSCON) level), during-lockdown and post-lockdown. We presented the data using proportions and percentage change in mean counts per day with the corresponding 95% confidence intervals (CIs).ResultsWe attended to 58,367 children with a mean age of 5.1 years (standard deviation, SD 4.6). The mean ED attendance decreased by 331 children/day during lockdown compared to baseline (p < 0.001), attributed largely to a drop in respiratory (% change - 87.9, 95% CI - 89.3 to - 86.3, p < 0.001) and gastrointestinal infections (% change - 72.4, 95%CI - 75.9 to - 68.4, p < 0.001). Trauma-related diagnoses decreased at a slower rate across the same periods (% change - 40.0, 95%CI - 44.3 to - 35.3, p < 0.001). We saw 226 children with child abuse, with a greater proportion of total attendance seen post-lockdown (79, 0.6%) compared to baseline (36, 0.2%) (p < 0.001). In terms of ED resource utilization, there was a decrease in the overall mean number of procedures performed per day during the lockdown compared to baseline, driven largely by a reduction in blood investigations (% change - 73.9, 95%CI - 75.9 to - 71.7, p < 0.001).ConclusionsWe highlighted a significant decrease in infection-related presentations likely attributed to the lockdown and showed that the relative proportion of trauma-related attendances increased. By describing the impact of COVID-19 on health services, we report important trends that may provide guidance when planning resources for future pandemics.

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Visualizing the Network Structure of COVID-19 in Singapore.

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