Quantifying the impact of US state non-pharmaceutical interventions on COVID-19 transmission

Korevaar, Hannah; Becker, Alexander D.; Miller, Ian F.; Grenfell, Bryan T.; Metcalf, C. Jessica E.; Mina, Michael J.

doi:10.1101/2020.06.30.20142877

Cited by 19 publications

(30 citation statements)

References 21 publications

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“…While there is uncertainty in our epidemic projections, our results are consistent with previously published studies [18,[26][27][28] and are intended to serve as guideposts for deliberations regarding the potential relative impact of different school reopening scenarios in the U.S.…”

Section: Discussionsupporting

confidence: 86%

“…The results show that alternating school cohort scenarios can significantly avert the total number of cases by approximately 60M and 28M for the Fewer Open Workplaces and More Open Workplaces, respectively. The results are consistent with previous studies [18,[26][27][28] that have shown that non-pharmaceutical interventions can delay the peak of an outbreak (i.e., flatten the curve) and reduce the total number of cases over the same time frame. Furthermore, the offsite scenario provides the largest benefit by averting the greatest number of cases followed by the 40% scenarios.…”

Section: Cases Deaths and Hospitalizations Avertedsupporting

confidence: 92%

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Using an Agent-Based Model to Assess K-12 School Reopenings Under Different COVID-19 Spread Scenarios – United States, School Year 2020/21

Germann

Smith

Dauelsberg

et al. 2020

Preprint

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School-age children play a key role in the spread of airborne viruses like influenza due to the prolonged and close contacts they have in school settings. As a result, school closures and other non-pharmaceutical interventions were recommended as the first line of defense in response to the novel coronavirus pandemic (COVID-19). Assessing school reopening scenarios is a priority for states, administrators, parents, and children in order to balance educational disparities and negative population impacts of COVID-19. To address this challenge, we used an agent-based model that simulates communities across the United States including daycares, primary, and secondary schools to quantify the relative health outcomes of reopening schools. We explored different reopening scenarios including remote learning, in-person school, and several hybrid options that stratify the student population into cohorts (i.e., split cohort) in order to reduce exposure and disease spread. In addition, we assessed the combined impact of reduced in-person attendance in workplaces (e.g., through differing degrees of reliance on telework and/or temporary workplace closings) and school reopening scenarios to quantify the potential impact of additional transmission pathways contributing to COVID-19 spread. Scenarios where split cohorts of students return to school in non-overlapping formats resulted in significant decreases in the clinical attack rate (i.e., the percentage of symptomatic individuals), potentially by as much as 75% . These split cohort scenarios have impacts which are only modestly lesser than the most impactful 100% distance learning scenario. Split cohort scenarios can also significantly avert the number of cases--approximately 60M and 28M--depending on the scenario, at the national scale over the simulated eight-month period. We found the results of our simulations to be highly dependent on the number of workplaces assumed to be open for in-person business, as well as the initial level of COVID-19 incidence within the simulated community. Our results show that reducing the number of students attending school leads to better health outcomes, and the split cohort option enables part-time in-classroom education while substantially reducing risk. The results of this study can support decisions regarding optimal school reopening strategies that at the population level balance education and the negative health outcomes of COVID-19.

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Section: Discussionsupporting

confidence: 86%

Section: Cases Deaths and Hospitalizations Avertedsupporting

confidence: 92%

Using an Agent-Based Model to Assess K-12 School Reopenings Under Different COVID-19 Spread Scenarios – United States, School Year 2020/21

Germann

Smith

Dauelsberg

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…Two factors that may be of importance for the effect is population density and how widely spread the virus was prior to schools closing. A study of US districts show that transmission of SARS-CoV-2 increases with population density (Korevaar et al, 2020). This suggests that when people live close, each person interact with more people and hence are more likely to transmit the virus.…”

Section: S4 Heterogeneity Analysismentioning

confidence: 99%

School closures and SARS-CoV-2. Evidence from Sweden’s partial school closure

Vlachos

Hertegård

Svaleryd

2020

Preprint

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To reduce the transmission of SARS-CoV-2 most countries closed schools, despite uncertainty if school closures are an effective containment measure. At the onset of the pandemic, Swedish upper secondary schools moved to online instruction while lower secondary school remained open. This allows for a comparison of parents and teachers differently exposed to open and closed schools, but otherwise facing similar conditions. Leveraging rich Swedish register data, we connect all students and teachers in Sweden to their families and study the impact of moving to online instruction on the incidence of SARS-CoV-2 and COVID-19. We find that among parents, exposure to open rather than closed schools resulted in a small increase in PCR-confirmed infections [OR 1.15; CI95 1.03-1.27]. Among lower secondary teachers the infection rate doubled relative to upper secondary teachers [OR 2.01; CI95 1.52-2.67]. This spilled over to the partners of lower secondary teachers who had a higher infection rate than their upper secondary counterparts [OR 1.30; CI95 1.00-1.68]. When analyzing COVID-19 diagnoses from healthcare visits and the incidence of severe health outcomes, results are similar for teachers but somewhat weaker for parents and teachers' partners. The results for parents indicate that keeping lower secondary schools open had minor consequences for the transmission of SARS-CoV-2 in society. The results for teachers suggest that measures to protect teachers could be considered.

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“…To first evaluate variation in the burden emerging from the severity of infection outcome, we consider how demography, comorbidity, and access to care might modulate the age profile of SARS-CoV-2 morbidity and mortality 2 - 4 . Subnational variation in the distribution of high risk age groups indicates considerable variability, with higher burden expected in urban settings in SSA ( Figure 3A ), where density and thus transmission are likely higher 27 .…”

Section: Severity Of Infection Outcomementioning

confidence: 99%

High variation expected in the pace and burden of SARS-CoV-2 outbreaks across sub-Saharan Africa

Rice

Annapragada

Baker

et al. 2020

Preprint

Self Cite

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A surprising feature of the SARS-CoV-2 pandemic to date is the low burdens reported in sub-Saharan Africa (SSA) countries relative to other global regions. Potential explanations (e.g., warmer environments [1], younger populations [2,3,4]) have yet to be framed within a comprehensive analysis accounting for factors that may offset the effects of climate and demography. Here, we synthesize factors hypothesized to shape the pace of this pandemic and its burden as it moves across SSA, encompassing demographic, comorbidity, climatic, healthcare and intervention capacity, and human mobility dimensions of risk. We find large scale diversity in probable drivers, such that outcomes are likely to be highly variable among SSA countries. While simulation shows that extensive climatic variation among SSA population centers has little effect on early outbreak trajectories, heterogeneity in connectivity is likely to play a large role in shaping the pace of viral spread. The prolonged, asynchronous outbreaks expected in weakly connected settings may result in extended stress to health systems. In addition, the observed variability in comorbidities and access to care will likely modulate the severity of infection: We show that even small shifts in the infection fatality ratio towards younger ages, which are likely in high risk settings, can eliminate the protective effect of younger populations. We highlight countries with elevated risk of slow pace, high burden outbreaks. Empirical data on the spatial extent of outbreaks within SSA countries, their patterns in severity over age, and the relationship between epidemic pace and health system disruptions are urgently needed to guide efforts to mitigate the high burden scenarios explored here.

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Quantifying the impact of US state non-pharmaceutical interventions on COVID-19 transmission

Cited by 19 publications

References 21 publications

Using an Agent-Based Model to Assess K-12 School Reopenings Under Different COVID-19 Spread Scenarios – United States, School Year 2020/21

Using an Agent-Based Model to Assess K-12 School Reopenings Under Different COVID-19 Spread Scenarios – United States, School Year 2020/21

School closures and SARS-CoV-2. Evidence from Sweden’s partial school closure

High variation expected in the pace and burden of SARS-CoV-2 outbreaks across sub-Saharan Africa

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