Impact of self-imposed prevention measures and short-term government-imposed social distancing on mitigating and delaying a COVID-19 epidemic: A modelling study

The coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread to nearly every country in the world since it first emerged in China in December 2019. Many countries have implemented social distancing as a measure to "flatten the curve&qu...

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Bibliographic Details
Published in:PLoS medicine 2020-07, Vol.17 (7), p.e1003166-e1003166
Main Authors: Teslya, Alexandra, Pham, Thi Mui, Godijk, Noortje G, Kretzschmar, Mirjam E, Bootsma, Martin C J, Rozhnova, Ganna
Format: Article
Language:English
Subjects:
Analysis
Asymptomatic
Awareness
Betacoronavirus
Communicable Disease Control - methods
Community Participation
Coronaviridae
Coronavirus Infections - epidemiology
Coronavirus Infections - prevention & control
Coronavirus Infections - transmission
Coronaviruses
COVID-19
Demography
Disease prevention
Disease susceptibility
Disease transmission
Engineering and Technology
Epidemics
Epidemics - prevention & control
Epidemiology
Government
Hand Disinfection
Health aspects
Health Education
Health sciences
Humans
Infections
Masks
Medical research
Medicine and Health Sciences
Models, Statistical
Pandemics
Pandemics - prevention & control
Passenger screening
Pneumonia, Viral - epidemiology
Pneumonia, Viral - prevention & control
Pneumonia, Viral - transmission
Population
Prevention
Primary care
Public health
Public Policy
Quarantine
SARS-CoV-2
Severe acute respiratory syndrome
Severe acute respiratory syndrome coronavirus 2
Short term
Social aspects
Social distancing
Social distancing (Public health)
Social Sciences
Stochasticity
Time Factors
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Summary:The coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread to nearly every country in the world since it first emerged in China in December 2019. Many countries have implemented social distancing as a measure to "flatten the curve" of the ongoing epidemics. Evaluation of the impact of government-imposed social distancing and of other measures to control further spread of COVID-19 is urgent, especially because of the large societal and economic impact of the former. The aim of this study was to compare the individual and combined effectiveness of self-imposed prevention measures and of short-term government-imposed social distancing in mitigating, delaying, or preventing a COVID-19 epidemic. We developed a deterministic compartmental transmission model of SARS-CoV-2 in a population stratified by disease status (susceptible, exposed, infectious with mild or severe disease, diagnosed, and recovered) and disease awareness status (aware and unaware) due to the spread of COVID-19. Self-imposed measures were assumed to be taken by disease-aware individuals and included handwashing, mask-wearing, and social distancing. Government-imposed social distancing reduced the contact rate of individuals irrespective of their disease or awareness status. The model was parameterized using current best estimates of key epidemiological parameters from COVID-19 clinical studies. The model outcomes included the peak number of diagnoses, attack rate, and time until the peak number of diagnoses. For fast awareness spread in the population, self-imposed measures can significantly reduce the attack rate and diminish and postpone the peak number of diagnoses. We estimate that a large epidemic can be prevented if the efficacy of these measures exceeds 50%. For slow awareness spread, self-imposed measures reduce the peak number of diagnoses and attack rate but do not affect the timing of the peak. Early implementation of short-term government-imposed social distancing alone is estimated to delay (by at most 7 months for a 3-month intervention) but not to reduce the peak. The delay can be even longer and the height of the peak can be additionally reduced if this intervention is combined with self-imposed measures that are continued after government-imposed social distancing has been lifted. Our analyses are limited in that they do not account for stochasticity, demographics, heterogeneities in contact patterns or mixing, spat
ISSN:1549-1676
1549-1277
1549-1676
DOI:10.1371/journal.pmed.1003166