scholarly journals Optimal COVID-19 quarantine and testing strategies

2020 ◽  
Author(s):  
Chad R. Wells ◽  
Jeffrey P. Townsend ◽  
Abhishek Pandey ◽  
Seyed M. Moghadas ◽  
Gary Krieger ◽  
...  
Keyword(s):  
Public Health ◽  
Contact Tracing ◽  
Successful Outcome ◽  
Entry And Exit ◽  
Prolonged Stay ◽  
Molecular Tests ◽  
Testing Strategies ◽  
Rapid Spread ◽  
Oil Rig ◽  
Offshore Oil

AbstractAs economic woes of the COVID-19 pandemic deepen, strategies are being formulated to avoid the need for prolonged stay-at-home orders, while implementing risk-based quarantine, testing, contact tracing and surveillance protocols. Given limited resources and the significant economic, public health, and operational challenges of the current 14-day quarantine recommendation, it is vital to understand if shorter but equally effective quarantine and testing strategies can be deployed. To quantify the probability of post-quarantine transmission upon isolation of a positive test, we developed a mathematical model in which we varied quarantine duration and the timing of molecular tests for three scenarios of entry into quarantine. Specifically, we consider travel quarantine, quarantine of traced contacts with an unknown time if infection, and quarantine of cases with a known time of exposure. With a one-day delay between test and result, we found that testing on exit (or entry and exit) can reduce the duration of a 14-day quarantine by 50%, while testing on entry shortened quarantine by at most one day. Testing on exit more effectively reduces post-quarantine transmission than testing upon entry. Furthermore, we identified the optimal testing date within quarantines of varying duration, finding that testing on exit was most effective for quarantines lasting up to seven days. As a real-world validation of these principles, we analyzed the results of 4,040 SARS CoV-2 RT-PCR tests administered to offshore oil rig employees. Among the 47 positives obtained with a testing on entry and exit strategy, 16 cases that previously tested negative at entry were identified, with no further cases detected among employees following quarantine exit. Moreover, this strategy successfully prevented an expected nine offshore transmission events stemming from cases who had tested negative on the entry test, each one a serious concern for initiating rapid spread and a disabling outbreak in the close quarters of an offshore rig. This successful outcome highlights that appropriately timed testing can make shorter quarantines more effective, thereby minimizing economic impacts, disruptions to operational integrity, and COVID-related public health risks.

scholarly journals Optimal COVID-19 quarantine and testing strategies

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Chad R. Wells ◽  
Jeffrey P. Townsend ◽  
Abhishek Pandey ◽  
Seyed M. Moghadas ◽  
Gary Krieger ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Real World ◽  
Entry And Exit ◽  
Testing Strategies ◽  
Time Of Infection ◽  
Oil Rig ◽  
Offshore Oil

AbstractFor COVID-19, it is vital to understand if quarantines shorter than 14 days can be equally effective with judiciously deployed testing. Here, we develop a mathematical model that quantifies the probability of post-quarantine transmission incorporating testing into travel quarantine, quarantine of traced contacts with an unknown time of infection, and quarantine of cases with a known time of exposure. We find that testing on exit (or entry and exit) can reduce the duration of a 14-day quarantine by 50%, while testing on entry shortens quarantine by at most one day. In a real-world test of our theory applied to offshore oil rig employees, 47 positives were obtained with testing on entry and exit to quarantine, of which 16 had tested negative at entry; preventing an expected nine offshore transmission events that each could have led to outbreaks. We show that appropriately timed testing can make shorter quarantines effective.

Dealing with COVID-19: lessons learned from the Italian experience

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Silvana Mirella Aliberti ◽  
Francesco De Caro ◽  
Giovanni Boccia ◽  
Rosario Caruso ◽  
Mario Capunzo
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Lessons Learned ◽  
Coherent System ◽  
Effective Response ◽  
Medical Practitioners ◽  
Italian Experience ◽  
Rapid Spread ◽  
Public Health Officials ◽  
Future Plans

: Italy was the first western nation affected by the pandemic and was observed as a pilot case in the management of the new coronavirus epidemic. The outbreak of COVID-19 disease has been very difficult in Italy, on June 25, 2020 there are 239,821 total cases of which 33,592 deaths nationwide. Three lessons emerged from this experience that can serve as a blueprint to improve future plans for the outbreak of viruses. First, early reports on the spread of COVID-19 can help inform public health officials and medical practitioners in effort to combat its progression; second, inadequate risk assessment related to the urgency of the situation and limited reporting to the virus has led the rapid spread of COVID-19; third, an effective response to the virus had to be undertaken with coherent system of actions and simultaneously.

“PHONE-CONNECT” - A Pilot Program Prescribing Phones to Address Digital Health Equity Needs in the COVID-19 Era (Preprint)

2020 ◽  
Author(s):  
Gill Kazevman ◽  
Marck Mercado ◽  
Jennifer Hulme ◽  
Andrea Somers
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Services ◽  
Access To Health Care ◽  
Health Care Services ◽  
Point Of Care ◽  
Digital Health ◽  
Contact Tracing ◽  
Health Care Intervention ◽  
Care Intervention

UNSTRUCTURED Vulnerable populations have been identified as having higher infection rates and poorer COVID-19 related outcomes, likely due to their inability to readily access primary care, follow public health directives and adhere to self-isolation guidelines. As a response to the COVID-19 pandemic, many health care services have adopted new digital solutions, relying on phone and internet connectivity. Yet, persons who are digitally inaccessible, such as those struggling with poverty or homelessness, are often unable to utilize these services. In response to this newly highlighted social disparity known as “digital health inequity”, emergency physicians at the University Health Network, Toronto, initiated a program called “PHONE CONNECT”. This novel approach attempts to improve patients’ access to health care, information and social services, as well as improve their ability to adhere to public health directives (social isolation and contact tracing). While similar programs addressing the same emerging issues have been recently described in the media, this is the first time phones are provided as a health care intervention in an emergency department. This innovative ED point-of-care intervention may have a significant impact on improving the health outcomes for vulnerable people during the COVID-19 pandemic, and even beyond it.

Application of Inherent Risk of Contagion (IRC) framework & modelling to aid local Covid-19 response & mitigation: Viewpoint (Preprint)

2020 ◽  
Author(s):  
Helmi Zakariah ◽  
Fadzilah bt Kamaluddin ◽  
Choo-Yee Ting ◽  
Hui-Jia Yee ◽  
Shereen Allaham ◽  
...  
Keyword(s):  
Public Health ◽  
Public Health Problem ◽  
Analytical Framework ◽  
Vulnerable Population ◽  
Contact Tracing ◽  
Global Public Health ◽  
Inherent Risk ◽  
Transmission Area ◽  
Current Outbreak ◽  
Novel Coronavirus

UNSTRUCTURED The current outbreak of coronavirus disease 2019 (COVID-19) caused by the novel coronavirus named SARS-CoV-2 has been a major global public health problem threatening many countries and territories. Mathematical modelling is one of the non-pharmaceutical public health measures that plays a crucial role for mitigating the risk and impact of the pandemic. A group of researchers and epidemiologists have developed a machine learning-powered inherent risk of contagion (IRC) analytical framework to georeference the COVID-19 with an operational platform to plan response & execute mitigation activities. This framework dataset provides a coherent picture to track and predict the COVID-19 epidemic post lockdown by piecing together preliminary data on publicly available health statistic metrics alongside the area of reported cases, drivers, vulnerable population, and number of premises that are suspected to become a transmission area between drivers and vulnerable population. The main aim of this new analytical framework is to measure the IRC and provide georeferenced data to protect the health system, aid contact tracing, and prioritise the vulnerable.

scholarly journals Fueling the Covid-19 pandemic: summer school holidays and incidence rates in German districts

2021 ◽  
Author(s):  
Thomas Plümper ◽  
Eric Neumayer
Keyword(s):  
Public Health ◽  
Fixed Effects ◽  
Summer School ◽  
Incidence Rates ◽  
Contact Tracing ◽  
Robert Koch Institute ◽  
Cross Sectional ◽  
Holiday Period ◽  
Health Authorities ◽  
Public Health Authorities

AbstractBackgroundThe Robert-Koch-Institute reports that during the summer holiday period a foreign country is stated as the most likely place of infection for an average of 27 and a maximum of 49% of new SARS-CoV-2 infections in Germany.MethodsCross-sectional study on observational data. In Germany, summer school holidays are coordinated between states and spread out over 13 weeks. Employing a dynamic model with district fixed effects, we analyze the association between these holidays and weekly incidence rates across 401 German districts.ResultsWe find effects of the holiday period of around 45% of the average district incidence rates in Germany during their respective final week of holidays and the 2 weeks after holidays end. Western states tend to experience stronger effects than Eastern states. We also find statistically significant interaction effects of school holidays with per capita taxable income and the share of foreign residents in a district’s population.ConclusionsOur results suggest that changed behavior during the holiday season accelerated the pandemic and made it considerably more difficult for public health authorities to contain the spread of the virus by means of contact tracing. Germany’s public health authorities did not prepare adequately for this acceleration.

scholarly journals Assessing testing strategies and duration of quarantine in contact tracing for SARS-CoV-2: a retrospective study of San Francisco’s COVID-19 contact tracing program, June- August, 2020

2021 ◽  
Author(s):  
M J A Reid ◽  
P Prado ◽  
H Brosnan ◽  
A Ernst ◽  
H Spindler ◽  
...  
Keyword(s):  
Retrospective Study ◽  
San Francisco ◽  
Contact Tracing ◽  
Testing Strategies ◽  
Close Contacts

Abstract We sought to assess the proportion of elicited close contacts diagnosed with COVID-19 at the start, and before exiting quarantine, in San Francisco, USA. From June 8th to August 31st, 6946 contacts were identified; 3008 (46.3%) tested, 940 (13.5%) tested positive; 90% tested positive in first 9 days of quarantine.

scholarly journals Harnessing testing strategies and public health measures to avert COVID-19 outbreaks during ocean cruises

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gerardo Chowell ◽  
Sushma Dahal ◽  
Raquel Bono ◽  
Kenji Mizumoto
Keyword(s):  
Public Health ◽  
Cost Effective ◽  
Contact Network ◽  
Social Distancing ◽  
Individual Level ◽  
Health Measures ◽  
Testing Strategies ◽  
Novel Coronavirus ◽  
The Individual ◽  
The Impact

AbstractTo ensure the safe operation of schools, workplaces, nursing homes, and other businesses during COVID-19 pandemic there is an urgent need to develop cost-effective public health strategies. Here we focus on the cruise industry which was hit early by the COVID-19 pandemic, with more than 40 cruise ships reporting COVID-19 infections. We apply mathematical modeling to assess the impact of testing strategies together with social distancing protocols on the spread of the novel coronavirus during ocean cruises using an individual-level stochastic model of the transmission dynamics of COVID-19. We model the contact network, the potential importation of cases arising during shore excursions, the temporal course of infectivity at the individual level, the effects of social distancing strategies, different testing scenarios characterized by the test’s sensitivity profile, and testing frequency. Our findings indicate that PCR testing at embarkation and daily testing of all individuals aboard, together with increased social distancing and other public health measures, should allow for rapid detection and isolation of COVID-19 infections and dramatically reducing the probability of onboard COVID-19 community spread. In contrast, relying only on PCR testing at embarkation would not be sufficient to avert outbreaks, even when implementing substantial levels of social distancing measures.

scholarly journals Moving Faster than the COVID-19 Pandemic: The Rapid, Digital Transformation of a Public Health System

2021 ◽  
Vol 12 (02) ◽  
pp. 229-236
Author(s):  
Clair Sullivan ◽  
Ides Wong ◽  
Emily Adams ◽  
Magid Fahim ◽  
Jon Fraser ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Digital Transformation ◽  
Contact Tracing ◽  
Programming Approach ◽  
Data Governance ◽  
Application Development ◽  
Containment Strategy

Abstract Background Queensland, Australia has been successful in containing the COVID-19 pandemic. Underpinning that response has been a highly effective virus containment strategy which relies on identification, isolation, and contact tracing of cases. The dramatic emergence of the COVID-19 pandemic rendered traditional paper-based systems for managing contact tracing no longer fit for purpose. A rapid digital transformation of the public health contact tracing system occurred to support this effort. Objectives The objectives of the digital transformation were to shift legacy systems (paper or standalone electronic systems) to a digitally enabled public health system, where data are centered around the consumer rather than isolated databases. The objective of this paper is to outline this case study and detail the lessons learnt to inform and give confidence to others contemplating digitization of public health systems in response to the COVID-19 pandemic. Methods This case study is set in Queensland, Australia. Universal health care is available. A multidisciplinary team was established consisting of clinical informaticians, developers, data strategists, and health information managers. An agile “pair-programming” approach was undertaken to application development and extensive change efforts were made to maximize adoption of the new digital workflows. Data governance and flows were changed to support rapid management of the pandemic. Results The digital coronavirus application (DCOVA) is a web-based application that securely captures information about people required to quarantine and creates a multiagency secure database to support a successful containment strategy. Conclusion Most of the literature surrounding digital transformation allows time for significant consultation, which was simply not possible under crisis conditions. Our observation is that staff was willing to adopt new digital systems because the reason for change (the COVID-19 pandemic) was clearly pressing. This case study highlights just how critical a unified purpose, is to successful, rapid digital transformation.

Data-driven inferences of agency-level risk and response communication on COVID-19 through social media-based interactions

2021 ◽  
Vol 19 (7) ◽  
pp. 59-82
Author(s):  
Md Ashraf Ahmed, PhD Candidate ◽  
Arif Mohaimin Sadri, PhD ◽  
M. Hadi Amini, PhD, DEng
Keyword(s):  
Public Health ◽  
Social Media ◽  
Information Dissemination ◽  
Topic Model ◽  
Face Mask ◽  
Community Response ◽  
Machine Learning Algorithms ◽  
Data Driven ◽  
Contact Tracing ◽  
Online Social Media

Risk perception and risk averting behaviors of public agencies in the emergence and spread of COVID-19 can be retrieved through online social media (Twitter), and such interactions can be echoed in other information outlets. This study collected time-sensitive online social media data and analyzed patterns of health risk communication of public health and emergency agencies in the emergence and spread of novel coronavirus using data-driven methods. The major focus is toward understanding how policy-making agencies communicate risk and response information through social media during a pandemic and influence community response—ie, timing of lockdown, timing of reopening, etc.—and disease outbreak indicators—ie, number of confirmed cases and number of deaths. Twitter data of six major public organizations (1,000-4,500 tweets per organization) are collected from February 21, 2020 to June 6, 2020. Several machine learning algorithms, including dynamic topic model and sentiment analysis, are applied over time to identify the topic dynamics over the specific timeline of the pandemic. Organizations emphasized on various topics—eg, importance of wearing face mask, home quarantine, understanding the symptoms, social distancing and contact tracing, emerging community transmission, lack of personal protective equipment, COVID-19 testing and medical supplies, effect of tobacco, pandemic stress management, increasing hospitalization rate, upcoming hurricane season, use of convalescent plasma for COVID-19 treatment, maintaining hygiene, and the role of healthcare podcast in different timeline. The findings can benefit emergency management, policymakers, and public health agencies to identify targeted information dissemination policies for public with diverse needs based on how local, federal, and international agencies reacted to COVID-19.

Leveraging blockchain based decentralized apps for the Tokyo Olympics amid the COVID-19 pandemic

First Monday ◽  
2021 ◽  
Author(s):  
Rishi Sabarigirisan ◽  
Aditi Biswas ◽  
Ridhi Rohatgi ◽  
Shyam KC ◽  
Shekhar Shukla
Keyword(s):  
Public Health ◽  
Health And Safety ◽  
Well Being ◽  
Decision Makers ◽  
Contact Tracing ◽  
Strategic Objectives ◽  
Crowd Management ◽  
Blockchain Technology ◽  
Smooth Contact ◽  
Public Health And Safety

The COVID-19 pandemic has induced a cloud of uncertainty over the mega sports event, the 2021 Tokyo Olympics. Cancelling or re-scheduling the event could have serious repercussions on the economic, social and environmental well-being for the involved stakeholders. Thus, it becomes critical to conduct events of this magnitude by adopting appropriate public health measures. In this research, we primarily focus on two main premises relative to public health and safety, contact tracing and crowd management. We explore and evaluate the usability of blockchain based decentralized apps in crowd management and contact tracing for the Tokyo Olympics using value-focused thinking (VFT). A VFT framework aids in narrowing fundamental and strategic objectives that need to be addressed for smooth contact tracing and crowd management by understanding stakeholder viewpoints. We established an equivalence of the objectives identified through VFT with blockchain technology properties. Further, we also present a conceptual ideation of contact tracing and crowd management through blockchain based decentralized apps for the Tokyo Olympics. This work could potentially assist decision-makers, researchers and stakeholders involved in organizing the Tokyo Olympics in understanding and analysing the utility of blockchain based decentralized apps for crowd management and contact tracing.

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