scholarly journals A data-driven metapopulation model for the Belgian COVID-19 epidemic: assessing the impact of lockdown and exit strategies

Author(s):  
Pietro Coletti ◽  
Pieter Libin ◽  
Oana Petrof ◽  
Lander Willem ◽  
Abrams Steven ◽  
...  

In response to the ongoing COVID-19 pandemic, several countries adopted measures of social distancing to a different degree. For many countries, after successfully curbing the initial wave, lockdown measures were gradually lifted. In Belgium, such relief started on May 4th with phase 1, followed by several subsequent phases over the next few weeks. We analysed the expected impact of relaxing stringent lockdown measures taken according to the phased Belgian exit strategy. We developed a stochastic, data-informed, meta-population model that accounts for mixing and mobility of the age-structured population of Belgium. The model is calibrated to daily hospitalization data and serological data and is able to reproduce the outbreak at the national level. We consider different scenarios for relieving the lockdown, quantified in terms of relative reductions in pre-pandemic social mixing and mobility. We validate our assumptions by making comparisons with social contact data collected during and after the lockdown. Our model is able to successfully describe the initial wave of COVID-19 in Belgium and identifies interactions during leisure/other activities as pivotal in the exit strategy. Indeed, we find a smaller impact of school re-openings as compared to restarting leisure activities and re-openings of work places. We also assess the impact of case isolation of new (suspected) infections, and find that it allows re-establishing relatively more social interactions while still ensuring epidemic control. Scenarios predicting a second wave of hospitalizations were not observed, suggesting that the per-contact probability of infection has changed with respect to the pre-lockdown period. Community contacts are found to be most influential, followed by professional contacts and school contacts, respectively, for an impending second wave of COVID-19. Regular re-assessment is crucial to adjust to evolving behavioral changes that can affect epidemic diffusion. In addition to social distancing, sufficient capacity for extensive testing and contact tracing is essential for successful mitigation.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pietro Coletti ◽  
Pieter Libin ◽  
Oana Petrof ◽  
Lander Willem ◽  
Steven Abrams ◽  
...  

Abstract Background In response to the ongoing COVID-19 pandemic, several countries adopted measures of social distancing to a different degree. For many countries, after successfully curbing the initial wave, lockdown measures were gradually lifted. In Belgium, such relief started on May 4th with phase 1, followed by several subsequent phases over the next few weeks. Methods We analysed the expected impact of relaxing stringent lockdown measures taken according to the phased Belgian exit strategy. We developed a stochastic, data-informed, meta-population model that accounts for mixing and mobility of the age-structured population of Belgium. The model is calibrated to daily hospitalization data and is able to reproduce the outbreak at the national level. We consider different scenarios for relieving the lockdown, quantified in terms of relative reductions in pre-pandemic social mixing and mobility. We validate our assumptions by making comparisons with social contact data collected during and after the lockdown. Results Our model is able to successfully describe the initial wave of COVID-19 in Belgium and identifies interactions during leisure/other activities as pivotal in the exit strategy. Indeed, we find a smaller impact of school re-openings as compared to restarting leisure activities and re-openings of work places. We also assess the impact of case isolation of new (suspected) infections, and find that it allows re-establishing relatively more social interactions while still ensuring epidemic control. Scenarios predicting a second wave of hospitalizations were not observed, suggesting that the per-contact probability of infection has changed with respect to the pre-lockdown period. Conclusions Contacts during leisure activities are found to be most influential, followed by professional contacts and school contacts, respectively, for an impending second wave of COVID-19. Regular re-assessment of social contacts in the population is therefore crucial to adjust to evolving behavioral changes that can affect epidemic diffusion.


Author(s):  
Alberto Aleta ◽  
David Martin-Corral ◽  
Ana Pastore y Piontti ◽  
Marco Ajelli ◽  
Maria Litvinova ◽  
...  

The new coronavirus disease 2019 (COVID-19) has required the implementation of severe mobility restrictions and social distancing measures worldwide. While these measures have been proven effective in abating the epidemic in several countries, it is important to estimate the effectiveness of testing and tracing strategies to avoid a potential second wave of the COVID-19 epidemic. We integrate highly detailed (anonymized, privacy-enhanced) mobility data from mobile devices, with census and demographic data to build a detailed agent-based model to describe the transmission dynamics of SARS-CoV-2 in the Boston metropolitan area. We find that enforcing strict social distancing followed by a policy based on a robust level of testing, contact-tracing and household quarantine, could keep the disease at a level that does not exceed the capacity of the health care system. Assuming the identification of 50% of the symptomatic infections, and the tracing of 40% of their contacts and households, which corresponds to about 9% of individuals quarantined, the ensuing reduction in transmission allows the reopening of economic activities while attaining a manageable impact on the health care system. Our results show that a response system based on enhanced testing and contact tracing can play a major role in relaxing social distancing interventions in the absence of herd immunity against SARS-CoV-2.


2021 ◽  
Vol 376 (1829) ◽  
pp. 20200276
Author(s):  
Ellen Brooks-Pollock ◽  
Jonathan M. Read ◽  
Angela R. McLean ◽  
Matt J. Keeling ◽  
Leon Danon

In the absence of a vaccine, severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) transmission has been controlled by preventing person-to-person interactions via social distancing measures. In order to re-open parts of society, policy-makers need to consider how combinations of measures will affect transmission and understand the trade-offs between them. We use age-specific social contact data, together with epidemiological data, to quantify the components of the COVID-19 reproduction number. We estimate the impact of social distancing policies on the reproduction number by turning contacts on and off based on context and age. We focus on the impact of re-opening schools against a background of wider social distancing measures. We demonstrate that pre-collected social contact data can be used to provide a time-varying estimate of the reproduction number ( R ). We find that following lockdown (when R = 0.7, 95% CI 0.6, 0.8), opening primary schools has a modest impact on transmission ( R = 0.89, 95% CI 0.82−0.97) as long as other social interactions are not increased. Opening secondary and primary schools is predicted to have a larger impact ( R = 1.22, 95% CI 1.02−1.53). Contact tracing and COVID security can be used to mitigate the impact of increased social mixing to some extent; however, social distancing measures are still required to control transmission. Our approach has been widely used by policy-makers to project the impact of social distancing measures and assess the trade-offs between them. Effective social distancing, contact tracing and COVID security are required if all age groups are to return to school while controlling transmission. This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK’.


2020 ◽  
Author(s):  
Benn Sartorius ◽  
Andrew Lawson ◽  
Rachel L. Pullan

Abstract Background: COVID-19 caseloads in England appear have passed through a first peak, with evidence of an emerging second wave. To ensure continued response to the epidemic is most effective, it is imperative to better understand both retrospectively and prospectively the geographical evolution of COVID-19 caseloads and deaths, identify localised areas in space-time at significantly higher risk, quantify the impact of changes in localised population mobility (or movement) on caseloads, identify localised risk factors for increased mortality and project the likely course of the epidemic at small-area resolution in coming weeks.Methods: We applied a Bayesian space–time SEIR model to assess the spatiotemporal variability of COVID-19 caseloads (transmission) and deaths at small-area scale in England (Middle Layer Super Output Area [MSOA], 6791 units) and by week (using observed data from week 5 to 34), including key determinants, the modelled transmission dynamics and spatial-temporal random effects. We also estimate the number of cases and deaths at small-area resolution with uncertainty projected forward in time by MSOA (up to week 51 of 2020), the impact mobility reductions (and subsequent easing) have had on COVID-19 caseloads and quantify the impact of key socio-demographic risk factors on COVID-19 related mortality risk by MSOA.Results: Reductions in population mobility due the course of the first lockdown had a significant impact on the reduction of COVID-19 caseloads across England, however local authorities have had a varied rate of reduction in population movement which our model suggest has substantially impacted the geographic heterogeneity in caseloads at small-area scale. The steady gain in population mobility, observed from late April, appears to have contributed to a slowdown in caseload reductions towards late June and subsequent steady increase signalling the start of the second wave. MSOA with higher proportions of elderly (70+ years of age) and elderly living in deprivation, both with very distinct geographic distributions, have a significantly elevated COVID-19 mortality rates.Conclusions: While non-pharmaceutical interventions (that is, reductions in population mobility and social distancing) had a profound impact on the trajectory of the first wave of the COVID-19 outbreak in England, increased population mobility appears to have contributed to the current increase signalling the start of the second wave. A number of contiguous small-areas appear to be at a significant elevated risk of high COVID-19 transmission, many of which are also at increased risk for higher mortality rates. A geographically staggered re-introduction of intensified social distancing measures is advised and limited cross MSOA movement if the magnitude and geographic extent of the second wave is to be reduced.


Science ◽  
2020 ◽  
Vol 368 (6498) ◽  
pp. 1481-1486 ◽  
Author(s):  
Juanjuan Zhang ◽  
Maria Litvinova ◽  
Yuxia Liang ◽  
Yan Wang ◽  
Wei Wang ◽  
...  

Intense nonpharmaceutical interventions were put in place in China to stop transmission of the novel coronavirus disease 2019 (COVID-19). As transmission intensifies in other countries, the interplay between age, contact patterns, social distancing, susceptibility to infection, and COVID-19 dynamics remains unclear. To answer these questions, we analyze contact survey data for Wuhan and Shanghai before and during the outbreak and contact-tracing information from Hunan province. Daily contacts were reduced seven- to eightfold during the COVID-19 social distancing period, with most interactions restricted to the household. We find that children 0 to 14 years of age are less susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection than adults 15 to 64 years of age (odds ratio 0.34, 95% confidence interval 0.24 to 0.49), whereas individuals more than 65 years of age are more susceptible to infection (odds ratio 1.47, 95% confidence interval 1.12 to 1.92). Based on these data, we built a transmission model to study the impact of social distancing and school closure on transmission. We find that social distancing alone, as implemented in China during the outbreak, is sufficient to control COVID-19. Although proactive school closures cannot interrupt transmission on their own, they can reduce peak incidence by 40 to 60% and delay the epidemic.


2020 ◽  
Vol 1 (1) ◽  
pp. 15-25
Author(s):  
Amod K. Pokhrel ◽  
Yadav P. Joshi ◽  
Sopnil Bhattarai

There is limited information on the epidemiology and the effects of mitigation measures on the spread of COVID-19 in Nepal. Using publicly available databases, we analyzed the epidemiological trend, the people's movement trends at different intervals across different categories of places and evaluated implications of social mobility on COVID-19. We also estimated the epidemic peak. As of June 9, 2020, Provinces 2 and 5 have most of the cases. People between 15 and 54 years are vulnerable to becoming infected, and more males than females are affected. The cases are growing exponentially. The growth rate of 0.13 and >1 reproduction numbers (R0) over time (median: 1.48; minimum: 0.58, and maximum: 3.71) confirms this trend. The case doubling time is five days. Google's community mobility data suggest that people strictly followed social distancing measures for one month after the lockdown. By around the 4th week of April, the individual's movement started rising, and social contacts increased. The number of cases peaked on May 12, with 83 confirmed cases in one day. The Susceptible-Exposed-Infectious-Removed (SEIR) model suggests that the epidemic will peak approximately on day 41 (July 21, 2020), and start to plateau after day 80. To contain the spread of the virus, people should maintain social distancing. The Government needs to continue active surveillance, more PCR-based testing, case detection, contact tracing, isolation, and quarantine. The Government should also provide financial support and safety-nets to the citizen to limit the impact of COVID-19.


2020 ◽  
pp. 000313482097335
Author(s):  
Brad Boserup ◽  
Mark McKenney ◽  
Adel Elkbuli

Background Health disparities are prevalent in many areas of medicine. We aimed to investigate the impact of the COVID-19 pandemic on racial/ethnic groups in the United States (US) and to assess the effects of social distancing, social vulnerability metrics, and medical disparities. Methods A cross-sectional study was conducted utilizing data from the COVID-19 Tracking Project and the Centers for Disease Control and Prevention (CDC). Demographic data were obtained from the US Census Bureau, social vulnerability data were obtained from the CDC, social distancing data were obtained from Unacast, and medical disparities data from the Center for Medicare and Medicaid Services. A comparison of proportions by Fisher’s exact test was used to evaluate differences between death rates stratified by age. Negative binomial regression analysis was used to predict COVID-19 deaths based on social distancing scores, social vulnerability metrics, and medical disparities. Results COVID-19 cumulative infection and death rates were higher among minority racial/ethnic groups than whites across many states. Older age was also associated with increased cumulative death rates across all racial/ethnic groups on a national level, and many minority racial/ethnic groups experienced significantly greater cumulative death rates than whites within age groups ≥ 35 years. All studied racial/ethnic groups experienced higher hospitalization rates than whites. Older persons (≥ 65 years) also experienced more COVID-19 deaths associated with comorbidities than younger individuals. Social distancing factors, several measures of social vulnerability, and select medical disparities were identified as being predictive of county-level COVID-19 deaths. Conclusion COVID-19 has disproportionately impacted many racial/ethnic minority communities across the country, warranting further research and intervention.


2020 ◽  
Vol 5 (9) ◽  
pp. e003055
Author(s):  
Amir Siraj ◽  
Alemayehu Worku ◽  
Kiros Berhane ◽  
Maru Aregawi ◽  
Munir Eshetu ◽  
...  

IntroductionSince its emergence in late December 2019, COVID-19 has rapidly developed into a pandemic in mid of March with many countries suffering heavy human loss and declaring emergency conditions to contain its spread. The impact of the disease, while it has been relatively low in the sub-Saharan Africa (SSA) as of May 2020, is feared to be potentially devastating given the less developed and fragmented healthcare system in the continent. In addition, most emergency measures practised may not be effective due to their limited affordability as well as the communal way people in SSA live in relative isolation in clusters of large as well as smaller population centres.MethodsTo address the acute need for estimates of the potential impacts of the disease once it sweeps through the African region, we developed a process-based model with key parameters obtained from recent studies, taking local context into consideration. We further used the model to estimate the number of infections within a year of sustained local transmissions under scenarios that cover different population sizes, urban status, effectiveness and coverage of social distancing, contact tracing and usage of cloth face mask.ResultsWe showed that when implemented early, 50% coverage of contact tracing and face mask, with 33% effective social distancing policies can bringing the epidemic to a manageable level for all population sizes and settings we assessed. Relaxing of social distancing in urban settings from 33% to 25% could be matched by introduction and maintenance of face mask use at 43%.ConclusionsIn SSA countries with limited healthcare workforce, hospital resources and intensive care units, a robust system of social distancing, contact tracing and face mask use could yield in outcomes that prevent several millions of infections and thousands of deaths across the continent.


2021 ◽  
pp. 136787792199745
Author(s):  
Mark Andrejevic ◽  
Hugh Davies ◽  
Ruth DeSouza ◽  
Larissa Hjorth ◽  
Ingrid Richardson

In this article we explore preliminary findings from the study COVIDSafe and Beyond: Perceptions and Practices conducted in Australia in 2020. The study involved a survey followed by interviews, and aimed to capture the dynamic ways in which members of the Australian public perceive the impact of Covid practices – especially public health measures like the introduction of physical and social distancing, compulsory mask wearing, and contact tracing. In the rescripting of public space, different notions of formal and informal surveillance, along with different textures of mediated and social care, appeared. In this article, we explore perceptions around divergent forms of surveillance across social, technological, governmental modes, and the relationship of surveillance to care in our media and cultural practices. What does it mean to care for self and others during a pandemic? How does care get enacted in, and through, media interfaces and public interaction?


2020 ◽  
Author(s):  
Qimin Huang ◽  
Anirban Mondal ◽  
Xiaobing Jiang ◽  
Mary Ann Horn ◽  
Fei Fan ◽  
...  

Background: Development of strategies for mitigating the severity of COVID-19 is now a top global public health priority. We sought to assess strategies for mitigating the COVID-19 outbreak in a hospital setting via the use of non-pharmaceutical interventions such as social distancing, self-isolation, tracing and quarantine, wearing facial masks/ personal protective equipment. Methods: We developed an individual-based model for COVID-19 transmission among healthcare workers in a hospital setting. We calibrated the model using data of a COVID-19 outbreak in a hospital unit in Wuhan in a Bayesian framework. The calibrated model was used to simulate different intervention scenarios and estimate the impact of different interventions on outbreak size and workday loss. Results: We estimated that work-related stress increases susceptibility to COVID-19 infection among healthcare workers by 52% (90% Credible Interval (CrI): 16.4% - 93.0%). The use of high efficacy facial masks was shown to be able to reduce infection cases and workday loss by 80% (90% CrI: 73.1% - 85.7%) and 87% (CrI: 80.0% - 92.5%), respectively. The use of social distancing alone, through reduced contacts between healthcare workers, had a marginal impact on the outbreak. A strict quarantine policy with the isolation of symptomatic cases and a high fraction of pre-symptomatic/ asymptomatic cases (via contact tracing or high test rate), could only prolong outbreak duration with minimal impact on the outbreak size. Our results indicated that a quarantine policy should be coupled with other interventions to achieve its effect. The effectiveness of all these interventions was shown to increase with their early implementation. Conclusions: Our analysis shows that a COVID-19 outbreak in a hospital's non-COVID-19 unit can be controlled or mitigated by the use of existing non-pharmaceutical measures.


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