Modeling strict age-targeted mitigation strategies for COVID-19

Chikina, Maria; Pegden, Wesley

doi:10.1371/journal.pone.0236237

Cited by 44 publications

(44 citation statements)

References 17 publications

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“…Our results cast a pessimistic shadow on so-called targeted policies that selectively relax restrictions on lower-risk, younger persons while seeking to protect more vulnerable older persons (Chikina and Pegden 2020, Acemoglu et al 2020, Iverson, Karp, and Peri 2020, Gollier 2020. Such a policy might be feasible in settings where older persons are sequestered in retirement communities or assisted living facilities, but the data here show that this is not the reality of Los Angeles County.…”

Section: Discussionmentioning

confidence: 89%

Los Angeles County SARS-CoV-2 Epidemic: Critical Role of Multi-generational Intra-household Transmission

Harris

2020

Preprint

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We tracked the course of the COVID-19 epidemic among the approximately 300 communities comprising Los Angeles County. The epidemic, we found, had three distinct phases. During Phase I, from early March through about April 4, initial seeding of infection in relatively affluent areas was followed by radial geographic extension to adjoining communities. During Phase II, which continued to about July 11, COVID-19 cases continued to rise at a slower rate, and became increasingly concentrated in four geographic foci of infection across the county. This phase saw changes in two indicators of social mobility: the proportion of location-tracked smartphones staying at home, and the number of smartphones visiting a gym. For both indicators, those communities with a larger reduction in social mobility during April reported fewer new COVID-19 cases in May. During Phase III, COVID-19 incidence only gradually declined, remaining as high as the incidence seen at the end of Phase I. Across communities, the prevalence of households at high risk for intergenerational transmission was strongly correlated with the persistence of continued COVID-19 propagation. This association was even stronger in those communities with a higher rate of gym attendance in Phase II. The map of the prevalence of at-risk households in Los Angeles County coincided strikingly with the map of cumulative COVID-19 incidence. These findings, taken together, support the critical role of household structure in the persistent propagation of COVID-19 infections in Los Angeles County. Public health policy needs to be reoriented from a focus on protecting the individual to a focus on protecting the household.

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Section: Discussionmentioning

confidence: 89%

Los Angeles County SARS-CoV-2 Epidemic: Critical Role of Multi-generational Intra-household Transmission

Harris

2020

Preprint

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“…Therefore, even if herd immunity possibly develops under intermittent suppression without a protection measure for high-risk individuals 24 , the duration of such a control strategy becomes by far longer than that with protection, thereby placing a substantial burden on the economy and also resulting in high mortality. Using more complex age-structured epidemic models, several previous researches explore effectiveness of age-targeted measures in reducing adverse effects in the population 14 , 25 , 26 ; instead, by focusing on a simple model without age structure, our framework can provide estimates that depend on small number of basic parameters. Reliable estimates for the number of infected individuals in the population are crucial for implementing an adaptive control scheme as the proposed one and assessing how close it is to herd immunity.…”

Section: Discussionmentioning

confidence: 99%

“…Reduction of the required number of infections to achieve herd immunity can also contribute to minimizing the possible social burden of prolonged isolation of high-risk individuals. For asking further important questions, e.g., how long does it take for the population to acquire herd immunity, we would need age-structured epidemic dynamics models 14 , 25 , 26 that take into account individual heterogeneity in susceptibility.…”

Section: Discussionmentioning

confidence: 99%

Model-based analysis on social acceptability and feasibility of a focused protection strategy against the COVID-19 pandemic

Akamatsu

Nagae

Osawa

et al. 2021

Sci Rep

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This paper studies the social acceptability and feasibility of a focused protection strategy against coronavirus disease 2019 (COVID-19). We propose a control scheme to develop herd immunity while satisfying the following two basic requirements for a viable policy option. The first requirement is social acceptability: the overall deaths should be minimized for social acceptance. The second is feasibility: the healthcare system should not be overwhelmed to avoid various adverse effects. To exploit the fact that the disease severity increases considerably with age and comorbidities, we assume that some focused protection measures for those high-risk individuals are implemented and the disease does not spread within the high-risk population. Because the protected population has higher severity ratios than the unprotected population by definition, the protective measure can substantially reduce mortality in the whole population and also avoid the collapse of the healthcare system. Based on a simple susceptible-infected-recovered model, social acceptability and feasibility of the proposed strategy are summarized into two easily computable conditions. The proposed framework can be applied to various populations for studying the viability of herd immunity strategies against COVID-19. For Japan, herd immunity may be developed by the proposed scheme if $${\mathcal {R}}_0 \le 2.0$$ R 0 ≤ 2.0 and the severity rates of the disease are 1/10 times smaller than the previously reported value, although as high mortality as seasonal influenza is expected.

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“…Several recent studies have used homogeneous compartmental models [3,36,17,29,42,48,45,49] or age-stratified versions of such models [1,15,16,34,44,52] to analyse the dynamics and impact of the COVID-19 epidemic in various countries. Our framework, while compatible with such homogeneous models at aggregate level, accounts for demographic and spatial heterogeneity in a more detailed manner, leading to regional outcomes which may substantially deviate from such models, as discussed in Section 5.2.…”

Section: Overviewmentioning

confidence: 99%

“…Homogeneous SIR models [3,36,17,29,42,48,45,49] or age-stratified versions of such models [1,15,16,44,52] have been used in many recent studies on COVID-19 in the UK and other countries.…”

Section: Impact Of Demographic and Spatial Heterogeneitymentioning

confidence: 99%

Modelling COVID-19 Contagion: Risk Assessment and Targeted Mitigation Policies

Cont

Kotlicki

2020

SSRN Journal

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We use a spatial epidemic model with demographic and geographic heterogeneity to study the regional dynamics of COVID-19 across 133 regions in England. Our model emphasises the role of variability of regional outcomes and heterogeneity across age groups and geographic locations, and provides a framework for assessing the impact of policies targeted towards sub-populations or regions. We define a concept of efficiency for comparative analysis of epidemic control policies and show targeted mitigation policies based on local monitoring to be more efficient than country-level or non-targeted measures. In particular, our results emphasise the importance of shielding vulnerable sub-populations and show that targeted policies based on local monitoring can considerably lower fatality forecasts and, in many cases, prevent the emergence of second waves which may occur under centralised policies.

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Modeling strict age-targeted mitigation strategies for COVID-19

Cited by 44 publications

References 17 publications

Los Angeles County SARS-CoV-2 Epidemic: Critical Role of Multi-generational Intra-household Transmission

Los Angeles County SARS-CoV-2 Epidemic: Critical Role of Multi-generational Intra-household Transmission

Model-based analysis on social acceptability and feasibility of a focused protection strategy against the COVID-19 pandemic

Modelling COVID-19 Contagion: Risk Assessment and Targeted Mitigation Policies

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