Assessing the effectiveness of test-trace-isolate interventions using a multi-layered temporal network

IF 8.8 3区 医学 Q1 Medicine
Yunyi Cai , Weiyi Wang , Lanlan Yu , Ruixiao Wang , Gui-Quan Sun , Allisandra G. Kummer , Paulo C. Ventura , Jiancheng Lv , Marco Ajelli , Quan-Hui Liu
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Abstract

In the early stage of an infectious disease outbreak, public health strategies tend to gravitate towards non-pharmaceutical interventions (NPIs) given the time required to develop targeted treatments and vaccines. One of the most common NPIs is Test-Trace-Isolate (TTI). One of the factors determining the effectiveness of TTI is the ability to identify contacts of infected individuals. In this study, we propose a multi-layer temporal contact network to model transmission dynamics and assess the impact of different TTI implementations, using SARS-CoV-2 as a case study. The model was used to evaluate TTI effectiveness both in containing an outbreak and mitigating the impact of an epidemic. We estimated that a TTI strategy based on home isolation and testing of both primary and secondary contacts can contain outbreaks only when the reproduction number is up to 1.3, at which the epidemic prevention potential is 88.2% (95% CI: 87.9%–88.5%). On the other hand, for higher value of the reproduction number, TTI is estimated to noticeably mitigate disease burden but at high social costs (e.g., over a month in isolation/quarantine per person for reproduction numbers of 1.7 or higher). We estimated that strategies considering quarantine of contacts have a larger epidemic prevention potential than strategies that either avoid tracing contacts or require contacts to be tested before isolation. Combining TTI with other social distancing measures can improve the likelihood of successfully containing an outbreak but the estimated epidemic prevention potential remains lower than 50% for reproduction numbers higher than 2.1. In conclusion, our model-based evaluation highlights the challenges of relying on TTIs to contain an outbreak of a novel pathogen with characteristics similar to SARS-CoV-2, and that the estimated effectiveness of TTI depends on the way contact patterns are modeled, supporting the relevance of obtaining comprehensive data on human social interactions to improve preparedness.
使用多层时间网络评估测试-追踪-隔离干预措施的有效性
在传染病爆发的早期阶段,鉴于开发有针对性的治疗方法和疫苗所需的时间,公共卫生战略往往倾向于采取非药物干预措施。最常见的npi之一是测试-跟踪-隔离(TTI)。决定TTI有效性的因素之一是确定受感染个体接触者的能力。在这项研究中,我们提出了一个多层时间接触网络来模拟传播动力学,并评估不同TTI实施的影响,以SARS-CoV-2为例研究。该模型用于评估TTI在遏制疫情爆发和减轻疫情影响方面的有效性。我们估计,基于家庭隔离和检测主要和次要接触者的TTI策略只有在繁殖数达到1.3时才能控制疫情,此时流行病预防潜力为88.2%(95%置信区间:87.9%-88.5%)。另一方面,对于繁殖数较高的值,估计TTI可显著减轻疾病负担,但社会成本较高(例如,繁殖数为1.7或更高时,每人需要隔离/检疫一个多月)。我们估计,考虑隔离接触者的策略比避免追踪接触者或要求在隔离前对接触者进行检测的策略具有更大的流行病预防潜力。将TTI与其他社会距离措施相结合,可以提高成功遏制疫情的可能性,但对于生育数量高于2.1的人,估计的流行病预防潜力仍低于50%。总之,我们基于模型的评估强调了依赖TTI来遏制具有类似SARS-CoV-2特征的新型病原体爆发的挑战,并且TTI的估计有效性取决于接触模式建模的方式,这支持了获取人类社会互动综合数据以改善防范的相关性。
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来源期刊
Infectious Disease Modelling
Infectious Disease Modelling Mathematics-Applied Mathematics
CiteScore
17.00
自引率
3.40%
发文量
73
审稿时长
17 weeks
期刊介绍: Infectious Disease Modelling is an open access journal that undergoes peer-review. Its main objective is to facilitate research that combines mathematical modelling, retrieval and analysis of infection disease data, and public health decision support. The journal actively encourages original research that improves this interface, as well as review articles that highlight innovative methodologies relevant to data collection, informatics, and policy making in the field of public health.
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