Modeling the effect of exposure notification and non-pharmaceutical interventions on COVID-19 transmission in Washington state.
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ABSTRACT:
SUBMITTER: Abueg M
PROVIDER: S-EPMC7955120 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Graphical abstract Background As Covid-19 spread rapidly, many countries implemented a strict shelter-in-place to “flatten the curve” and build capacity to treat in the absence of effective preventative therapies or treatments. Policymakers and public health officials must balance the positive health effects of lockdowns with economic, social, and psychological costs. This study examined the economic impacts of state and county level restrictions during the 2020 Covid-19 pandemic for two regions of Georgia. Methods Taking unemployment data from the Opportunity Insights Economic Tracker with mandate information from various sites, we examined trends before and after a mandate's implementation and relaxation using joinpoint regression. Results We found mandates with the largest impact on unemployment claims rates were the shelters-in-place (SIPs) and closures of non-essential businesses. Specific to our study, mandates had an effect where first implemented, i.e., if the state implemented an SIP after the county, the state-wide SIP had no additional measurable effect on claims rates. School closures had a consistent impact on increasing unemployment claims rates, but to a lesser degree than SIPs or business closures. While closing businesses did have a deleterious effect, implementing social distancing for businesses and restricting gatherings did not. Notably, the Coastal region was less affected than the Metro Area. Additionally, our findings indicate that race ethnicity may be a larger predictor of adverse economic effects than education, poverty level, or geographic area. Conclusions Our findings coincided with other studies in some areas but showed differences in what indicators may best predict adverse effects and that coastal communities may not always be as impacted as other regions in a state. Ultimately, the most restrictive measures consistently had the largest negative economic impacts. Social distancing and mask mandates can be effective for containment while mitigating the economic impacts of strict SIPs and business closures.
| S-EPMC10116346 | biostudies-literature
Project description:BackgroundAggressive non-pharmaceutical interventions (NPIs) may reduce transmission of SARS-CoV-2. The extent to which these interventions are successful in stopping the spread have not been characterized in countries with distinct socioeconomic groups. We compared the effects of a partial lockdown on disease transmission among Kuwaitis (P1) and non-Kuwaitis (P2) living in Kuwait.MethodsWe fit a modified metapopulation SEIR transmission model to reported cases stratified by two groups to estimate the impact of a partial lockdown on the effective reproduction number ([Formula: see text]). We estimated the basic reproduction number ([Formula: see text]) for the transmission in each group and simulated the potential trajectories of an outbreak from the first recorded case of community transmission until 12 days after the partial lockdown. We estimated [Formula: see text] values of both groups before and after the partial curfew, simulated the effect of these values on the epidemic curves and explored a range of cross-transmission scenarios.ResultsWe estimate [Formula: see text] at 1·08 (95% CI: 1·00-1·26) for P1 and 2·36 (2·03-2·71) for P2. On March 22nd, [Formula: see text] for P1 and P2 are estimated at 1·19 (1·04-1·34) and 1·75 (1·26-2·11) respectively. After the partial curfew had taken effect, [Formula: see text] for P1 dropped modestly to 1·05 (0·82-1·26) but almost doubled for P2 to 2·89 (2·30-3·70). Our simulated epidemic trajectories show that the partial curfew measure greatly reduced and delayed the height of the peak in P1, yet significantly elevated and hastened the peak in P2. Modest cross-transmission between P1 and P2 greatly elevated the height of the peak in P1 and brought it forward in time closer to the peak of P2.ConclusionOur results indicate and quantify how the same lockdown intervention can accentuate disease transmission in some subpopulations while potentially controlling it in others. Any such control may further become compromised in the presence of cross-transmission between subpopulations. Future interventions and policies need to be sensitive to socioeconomic and health disparities.
| S-EPMC8152192 | biostudies-literature
Project description:This paper describes a data-driven simulation study that explores the relative impact of several low-cost and practical non-pharmaceutical interventions on the spread of COVID-19 in an outpatient hospital dialysis unit. The interventions considered include: (i) voluntary self-isolation of healthcare personnel (HCPs) with symptoms; (ii) a program of active syndromic surveillance and compulsory isolation of HCPs; (iii) the use of masks or respirators by patients and HCPs; (iv) improved social distancing among HCPs; (v) increased physical separation of dialysis stations; and (vi) patient isolation combined with preemptive isolation of exposed HCPs. Our simulations show that under conditions that existed prior to the COVID-19 outbreak, extremely high rates of COVID-19 infection can result in a dialysis unit. In simulations under worst-case modeling assumptions, a combination of relatively inexpensive interventions such as requiring surgical masks for everyone, encouraging social distancing between healthcare professionals (HCPs), slightly increasing the physical distance between dialysis stations, and-once the first symptomatic patient is detected-isolating that patient, replacing the HCP having had the most exposure to that patient, and relatively short-term use of N95 respirators by other HCPs can lead to a substantial reduction in both the attack rate and the likelihood of any spread beyond patient zero. For example, in a scenario with R0 = 3.0, 60% presymptomatic viral shedding, and a dialysis patient being the infection source, the attack rate falls from 87.8% at baseline to 34.6% with this intervention bundle. Furthermore, the likelihood of having no additional infections increases from 6.2% at baseline to 32.4% with this intervention bundle.
| S-EPMC8291695 | biostudies-literature
Project description:Since the re-emergence of Ebola in West Africa in 2014, comprehensive and stringent interventions have been implemented to decelerate the spread of the disease. The effectiveness of interventions still remains unclear. In this paper, we develop an epidemiological model that includes various controlling measures to systematically evaluate their effects on the disease transmission dynamics. By fitting the model to reported cumulative cases and deaths in Guinea, Sierra Leone and Liberia until March 22, 2015, we estimate the basic reproduction number in these countries as 1.2552, 1.6093 and 1.7994, respectively. Model analysis shows that there exists a threshold of the effectiveness of isolation, below which increasing the fraction of latent individuals diagnosed prior to symptoms onset or shortening the duration between symptoms onset and isolation may lead to more Ebola infection. This challenges an existing view. Media coverage plays a substantial role in reducing the final epidemic size. The response to reported cumulative infected cases and deaths may have a different effect on the epidemic spread in different countries. Among all the interventions, we find that shortening the duration between death and burial and improving the effectiveness of isolation are two effective interventions for controlling the outbreak of Ebola virus infection.
| S-EPMC4626779 | biostudies-other
Project description:We conduct a large (N = 6567) online experiment to measure the features of non-pharmaceutical interventions (NPIs) that citizens of six European countries perceive to lower the risk of transmission of SARS-Cov-2 the most. We collected data in Bulgaria (n = 1069), France (n = 1108), Poland (n = 1104), Italy (n = 1087), Spain (n = 1102) and Sweden (n = 1097). Based on the features of the most widely adopted public health guidelines to reduce SARS-Cov-2 transmission (mask wearing vs not, outdoor vs indoor contact, short vs 90 min meetings, few vs many people present, and physical distancing of 1 or 2 m), we conducted a discrete choice experiment (DCE) to estimate the public's perceived risk of SARS-CoV-2 transmission in scenarios that presented mutually exclusive constellations of these features. Our findings indicate that participants' perception of transmission risk was most influenced by the NPI attributes of mask-wearing and outdoor meetings and the least by NPI attributes that focus on physical distancing, meeting duration, and meeting size. Differentiating by country, gender, age, cognitive style (reflective or intuitive), and perceived freight of COVID-19 moreover allowed us to identify important differences between subgroups. Our findings highlight the importance of improving health policy communication and citizens' health literacy about the design of NPIs and the transmission risk of SARS-Cov-2 and potentially future viruses.
| S-EPMC10902314 | biostudies-literature
Project description:Non-pharmaceutical interventions (NPIs) play a central role in infectious disease outbreak response and control. Their usefulness cannot be overstated, especially during the early phases of a new epidemic when vaccines and effective treatments are not available yet. These interventions can be very effective in curtailing the spread of infectious diseases when adequately implemented and sufficiently adopted by the public. However, NPIs can be very disruptive, and the socioeconomic and cultural hardships that come with their implementation interfere with both the ability and willingness of affected populations to adopt such interventions. This can lead to reduced and unsteady adherence to NPIs, making disease control more challenging to achieve. Deciphering this complex interaction between disease dynamics, NPI stringency, and NPI adoption would play a critical role in informing disease control strategies. In this work, we formulate a general-purpose model that integrates government-imposed control measures and public adherence into a deterministic compartmental epidemic model and study its properties. By combining imitation dynamics and the health belief model to encode the unsteady nature of NPI adherence, we investigate how temporal variations in NPI adherence levels affect the dynamics and control of infectious diseases. Among the results, we note the occurrence of multiple epidemic waves as a result of temporal variations in NPI adherence and a trade-off between the stringency of control measures and adherence. Additionally, our results suggest that interventions that aim at increasing public adherence to NPIs are more beneficial than implementing more stringent measures. Our findings highlight the necessity of taking the socioeconomic and cultural realities of affected populations into account when devising public health interventions.
| S-EPMC9807866 | biostudies-literature
Project description:Background and objectivesSocial and behavioral non-pharmaceutical interventions (NPIs), such as mask-wearing, social distancing and travel restrictions, as well as diagnostic tests, have been broadly implemented in response to the COVID-19 pandemic. Epidemiological models and data analysis affirm that wide adoption of NPIs helps to control the pandemic. However, SARS-CoV-2 has extensively demonstrated its ability to evolve. Therefore, it is crucial to examine how NPIs may affect the evolution of the virus. Such evolution could have important effects on the spread and impact of the pandemic.MethodologyWe used evo-epidemiological models to examine the effect of NPIs and testing on two evolutionary trajectories for SARS-CoV-2: attenuation and test evasion.ResultsOur results show that when stronger measures are taken, selection may act to reduce disease severity. Additionally, the timely application of NPIs could significantly affect the competition between viral strains, favoring the milder strain. Furthermore, a higher testing rate can select for a test-evasive viral strain, even if that strain is less infectious than the detectable competing strain. Importantly, if a less detectable strain evolves, epidemiological metrics such as confirmed daily cases may distort our assessment of the pandemic.Conclusions and implicationsOur results highlight the important implications NPIs can have on the evolution of SARS-CoV-2.Lay summaryWe used evo-epidemiological models to examine the effect of non-pharmaceutical interventions and testing on two evolutionary trajectories for SARS-CoV-2: attenuation and test evasion. Our results show that when stronger measures are taken, selection may act to reduce disease severity.
| S-EPMC9046092 | biostudies-literature
Project description:Governments around the globe use non-pharmaceutical interventions (NPIs) to curb the spread of coronavirus disease 2019 (COVID-19) cases. Making decisions under uncertainty, they all face the same temporal paradox: estimating the impact of NPIs before they have been implemented. Due to the limited variance of empirical cases, researchers could so far not disentangle effects of individual NPIs or their impact on different demographic groups. In this paper, we utilize large-scale agent-based simulations in combination with Susceptible-Exposed-Infectious-Recovered (SEIR) models to investigate the spread of COVID-19 for some of the most affected federal states in Germany. In contrast to other studies, we sample agents from a representative survey. Including more realistic demographic attributes that influence agents' behavior yields accurate predictions of COVID-19 transmissions and allows us to investigate counterfactual what-if scenarios. Results show that quarantining infected people and exploiting industry-specific home office capacities are the most effective NPIs. Disentangling education-related NPIs reveals that each considered institution (kindergarten, school, university) has rather small effects on its own, yet, that combined openings would result in large increases in COVID-19 cases. Representative survey-characteristics of agents also allow us to estimate NPIs' effects on different age groups. For instance, re-opening schools would cause comparatively few infections among the risk-group of people older than 60 years.
| S-EPMC8553158 | biostudies-literature
Project description:On 11 March 2020, the World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) a pandemic1. The strategies based on non-pharmaceutical interventions that were used to contain the outbreak in China appear to be effective2, but quantitative research is still needed to assess the efficacy of non-pharmaceutical interventions and their timings3. Here, using epidemiological data on COVID-19 and anonymized data on human movement4,5, we develop a modelling framework that uses daily travel networks to simulate different outbreak and intervention scenarios across China. We estimate that there were a total of 114,325 cases of COVID-19 (interquartile range 76,776-164,576) in mainland China as of 29 February 2020. Without non-pharmaceutical interventions, we predict that the number of cases would have been 67-fold higher (interquartile range 44-94-fold) by 29 February 2020, and we find that the effectiveness of different interventions varied. We estimate that early detection and isolation of cases prevented more infections than did travel restrictions and contact reductions, but that a combination of non-pharmaceutical interventions achieved the strongest and most rapid effect. According to our model, the lifting of travel restrictions from 17 February 2020 does not lead to an increase in cases across China if social distancing interventions can be maintained, even at a limited level of an on average 25% reduction in contact between individuals that continues until late April. These findings improve our understanding of the effects of non-pharmaceutical interventions on COVID-19, and will inform response efforts across the world.
| S-EPMC7116778 | biostudies-literature
Project description:Following its emergence in Wuhan, China, in late November or early December 2019, the SARS-CoV-2 virus has rapidly spread throughout the world. On March 11, 2020, the World Health Organization declared Coronavirus Disease 2019 (COVID-19) a pandemic. Genome sequencing of SARS-CoV-2 strains allows for the reconstruction of transmission history connecting these infections. Here, we analyze 346 SARS-CoV-2 genomes from samples collected between 20 February and 15 March 2020 from infected patients in Washington State, USA. We found that the large majority of SARS-CoV-2 infections sampled during this time frame appeared to have derived from a single introduction event into the state in late January or early February 2020 and subsequent local spread, strongly suggesting cryptic spread of COVID-19 during the months of January and February 2020, before active community surveillance was implemented. We estimate a common ancestor of this outbreak clade as occurring between 18 January and 9 February 2020. From genomic data, we estimate an exponential doubling between 2.4 and 5.1 days. These results highlight the need for large-scale community surveillance for SARS-CoV-2 introductions and spread and the power of pathogen genomics to inform epidemiological understanding.
| S-EPMC7276023 | biostudies-literature