The effectiveness of quarantine and isolation determine the trend of the COVID-19 epidemics in the final phase of the current outbreak in China

Tang, Biao; Xia, Fan; Tang, Sanyi; Bragazzi, Nicola Luigi; Li, Qian; Sun, Xiaodan; Liang, Juhua; Xiao, Yanni; Wu, Jianhong

doi:10.1016/j.ijid.2020.03.018

Cited by 251 publications

(238 citation statements)

References 14 publications

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“…It should be noted, however, that testing, contact tracing and isolation of known contacts is only useful as part of a deliberate containment strategy that keeps an epidemic manageably small, and may be particularly useful for extinguishing the remaining embers of an effectivley-contained epidemic. 41 While testing is always useful for clinical management of severe cases, once 1% or more of the population has been infected even this important subset of cases alone overwhelms testing capacity ( Figure 2B, D, E and F) and the fraction of non-severe cases confirmed plummets to negligible levels. In any case, population-wide testing of mildly symptomatic cases becomes unhelpful as a guide to targeting containment measures: How does one selectively target those at immediate risk when that means everyone?…”

Section: Contact Tracing As An Epidemiological Surveillance Platformmentioning

confidence: 99%

Why lockdown? Simplified arithmetic tools for decision-makers, health professionals, journalists and the general public to explore containment options for the novel coronavirus

Killeen

Kiware

2020

Preprint

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Half the world's population is already under lock-down and the remainder will have to follow if the ongoing novel coronavirus 2019 virus pandemic is to be contained. Faced with such brutally difficult decisions, it is essential that as many people as possible understand (1) why lockdown interventions represent the only realistic way for individual countries to contain their nationallevel epidemics before they turn into public health catastrophes, (2) why these need to be implemented so early, so aggressively and for such extended periods, and (3) why international cooperation to conditionally re-open trade and travel between countries that have successfully eliminated local transmission represents the only way to contain the pandemic at global level. Here we present simplified arithmetic models of COVID-19 transmission, control and elimination in userfriendly Shiny and Excel formats that allow non-specialists to explore, query, critique and understand the containment decisions facing their country and the world at large. Based on parameter values representative of the United Republic of Tanzania, which is still early enough in its epidemic cycle and response to avert a national catastrophe, national containment and elimination with less than 10 deaths is predicted for highly rigorous lock down within 5 weeks of the first confirmed cases and maintained for 15 weeks. However, elimination may only be sustained if case importation from outside the country is comprehensively contained by isolating for three weeks all incoming travellers, except those from countries certified as COVID-free in the future. Any substantive relaxation of these assumptions, specifically shortening the lock-down period, less rigorous lockdown or imperfect importation containment, may facilitate epidemic re-initiation, resulting in over half a million deaths unless rigorously contained a second time. Removing contact tracing and isolation has minimal impact on successful containment trajectories because high incidence of similar mild symptoms caused by other common pathogens attenuates detection success of COVID-19 testing. Nevertheless, contact tracing is recommended as an invaluable epidemiological surveillance platform for monitoring and characterizing the epidemic, and for understanding the influence of interventions on transmission dynamics.

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Section: Contact Tracing As An Epidemiological Surveillance Platformmentioning

confidence: 99%

Why lockdown? Simplified arithmetic tools for decision-makers, health professionals, journalists and the general public to explore containment options for the novel coronavirus

Killeen

Kiware

2020

Preprint

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“…In the absence of effective treatments for, or vaccines against, COVID-19, the early 58 adoption of strict prevention and control measures will undoubtedly play a very 59 important role in limiting the spread of the virus and the growth of the epidemic (1)(2)(3)(4)(5)(6)(7)(8). 60…”

Section: Main Text: 57mentioning

confidence: 99%

“…In order to accurately describe the gradual strengthening of control strategies in this model, we 442 assume that with increasing intensity of a control strategy the contact rate c(t) is a decreasing 443 function with respect to time t, given by (1,2) 444 where q 0 is the initial quarantined rate of exposed individuals with q(0) = q 0 for China, South 453 Korea, Italy, Spain and Iran, is the maximum quarantined rate under the current control strategies 454 with lim t→∞ q(t) = and > q 0 , and 2 represents how an exponential increase in the quarantined 455 rate is achieved. The critical times for each country are the same as those in function H c (t).…”

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confidence: 99%

Effects of medical resource capacities and intensities of public mitigation measures on outcomes of COVID-19 outbreaks

Wang

Sun

et al. 2020

Preprint

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One sentence summary: Multiple data sources and cross validation of a COVID-19 3 epidemic model, coupled with a medical resource logistic model, reveal that the key 4 factors that affect epidemic progressions and their outbreak patterns in different 5 countries are the type of emergency medical response to avoid runs on medical 6 resources, especially improved detection rates, the ability to promote public health 7 measures, and the synergistic effects of combinations of multiple prevention and 8 control strategies. 9

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“…Quarantine has been proven necessary when a site reaches a certain level of COVID-19 contamination, and it has been decisive in positive outcomes, especially when implemented early. 17 Due to its transmission characteristics, COVID-19 requires both respiratory and contact isolation. 18 Schizophrenia patients appear to have greater difficulty following adequate hygiene practices than the general population.…”

mentioning

confidence: 99%

Schizophrenia and COVID-19: risks and recommendations

Fonseca

Diniz

Mendonça

et al. 2020

Braz. J. Psychiatry

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The effectiveness of quarantine and isolation determine the trend of the COVID-19 epidemics in the final phase of the current outbreak in China

Cited by 251 publications

References 14 publications

Why lockdown? Simplified arithmetic tools for decision-makers, health professionals, journalists and the general public to explore containment options for the novel coronavirus

Why lockdown? Simplified arithmetic tools for decision-makers, health professionals, journalists and the general public to explore containment options for the novel coronavirus

Effects of medical resource capacities and intensities of public mitigation measures on outcomes of COVID-19 outbreaks

Schizophrenia and COVID-19: risks and recommendations

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