Dataset Information

Investigation of the Efficiency of Mask Wearing, Contact Tracing, and Case Isolation during the COVID-19 Outbreak.

ABSTRACT: Case isolation and contact tracing are two essential parts of control measures to prevent the spread of COVID-19, however, additional interventions, such as mask wearing, are required. Taiwan successfully contained local COVID-19 transmission after the initial imported cases in the country in early 2020 after applying the above-mentioned interventions. In order to explain the containment of the disease spread in Taiwan and understand the efficiency of different non-pharmaceutical interventions, a mathematical model has been developed. A stochastic model was implemented in order to estimate the effectiveness of mask wearing together with case isolation and contact tracing. We investigated different approaches towards mask usage, estimated the effect of the interventions on the basic reproduction number (R₀), and simulated the possibility of controlling the outbreak. With the assumption that non-medical and medical masks have 20% and 50% efficiency, respectively, case isolation works on 100%, 70% of all people wear medical masks, and R₀ = 2.5, there is almost 80% probability of outbreak control with 60% contact tracing, whereas for non-medical masks the highest probability is only about 20%. With a large proportion of infectiousness before the onset of symptoms (40%) and the presence of asymptomatic cases, the investigated interventions (isolation of cases, contact tracing, and mask wearing by all people), implemented on a high level, can help to control the disease spread. Superspreading events have also been included in our model in order to estimate their impact on the outbreak and to understand how restrictions on gathering and social distancing can help to control the outbreak. The obtained quantitative results are in agreement with the empirical COVID-19 data in Taiwan.

SUBMITTER: Filonets T

PROVIDER: S-EPMC8269102 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ImportanceContact tracing is a multistep process to limit SARS-CoV-2 transmission. Gaps in the process result in missed opportunities to prevent COVID-19.ObjectiveTo quantify proportions of cases and their contacts reached by public health authorities and the amount of time needed to reach them and to compare the risk of a positive COVID-19 test result between contacts and the general public during 4-week assessment periods.Design, setting, and participantsThis cross-sectional study took place at 13 health departments and 1 Indian Health Service Unit in 11 states and 1 tribal nation. Participants included all individuals with laboratory-confirmed COVID-19 and their named contacts. Local COVID-19 surveillance data were used to determine the numbers of persons reported to have laboratory-confirmed COVID-19 who were interviewed and named contacts between June and October 2020.Main outcomes and measuresFor contacts, the numbers who were identified, notified of their exposure, and agreed to monitoring were calculated. The median time from index case specimen collection to contact notification was calculated, as were numbers of named contacts subsequently notified of their exposure and monitored. The prevalence of a positive SARS-CoV-2 test among named and tested contacts was compared with that jurisdiction's general population during the same 4 weeks.ResultsThe total number of cases reported was 74 185. Of these, 43 931 (59%) were interviewed, and 24 705 (33%) named any contacts. Among the 74 839 named contacts, 53 314 (71%) were notified of their exposure, and 34 345 (46%) agreed to monitoring. A mean of 0.7 contacts were reached by telephone by public health authorities, and only 0.5 contacts per case were monitored. In general, health departments reporting large case counts during the assessment (≥5000) conducted smaller proportions of case interviews and contact notifications. In 9 locations, the median time from specimen collection to contact notification was 6 days or less. In 6 of 8 locations with population comparison data, positive test prevalence was higher among named contacts than the general population.Conclusions and relevanceIn this cross-sectional study of US local COVID-19 surveillance data, testing named contacts was a high-yield activity for case finding. However, this assessment suggests that contact tracing had suboptimal impact on SARS-CoV-2 transmission, largely because 2 of 3 cases were either not reached for interview or named no contacts when interviewed. These findings are relevant to decisions regarding the allocation of public health resources among the various prevention strategies and for the prioritization of case investigations and contact tracing efforts.

Project description:Simultaneously controlling COVID-19 epidemics and limiting economic and societal impacts presents a difficult challenge, especially with limited public health budgets. Testing, contact tracing, and isolating/quarantining is a key strategy that has been used to reduce transmission of SARS-CoV-2, the virus that causes COVID-19 and other pathogens. However, manual contact tracing is a time-consuming process and as case numbers increase a smaller fraction of cases' contacts can be traced, leading to additional virus spread. Delays between symptom onset and being tested (and receiving results), and a low fraction of symptomatic cases being tested and traced can also reduce the impact of contact tracing on transmission. We examined the relationship between increasing cases and delays and the pathogen reproductive number Rt, and the implications for infection dynamics using deterministic and stochastic compartmental models of SARS-CoV-2. We found that Rt increased sigmoidally with the number of cases due to decreasing contact tracing efficacy. This relationship results in accelerating epidemics because Rt initially increases, rather than declines, as infections increase. Shifting contact tracers from locations with high and low case burdens relative to capacity to locations with intermediate case burdens maximizes their impact in reducing Rt (but minimizing total infections may be more complicated). Contact tracing efficacy decreased sharply with increasing delays between symptom onset and tracing and with lower fraction of symptomatic infections being tested. Finally, testing and tracing reductions in Rt can sometimes greatly delay epidemics due to the highly heterogeneous transmission dynamics of SARS-CoV-2. These results demonstrate the importance of having an expandable or mobile team of contact tracers that can be used to control surges in cases. They also highlight the synergistic value of high capacity, easy access testing and rapid turn-around of testing results, and outreach efforts to encourage symptomatic cases to be tested immediately after symptom onset.

Dataset Information

Investigation of the Efficiency of Mask Wearing, Contact Tracing, and Case Isolation during the COVID-19 Outbreak.

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