Combining serology with case-detection, to allow the easing of restrictions against SARS-CoV-2: a modelling-based study in India

Abstract India’s lockdown and subsequent restrictions against SARS-CoV-2, if lifted without any other mitigations in place, could risk a second wave of infection. A test-and-isolate strategy, using PCR diagnostic tests, could help to minimise the impact of this second wave. Meanwhile, population-lev...

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Autores principales:	Sandip Mandal, Hemanshu Das, Sarang Deo, Nimalan Arinaminpathy
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/11267fafebd340dd96d66521fc4387be
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spelling	oai:doaj.org-article:11267fafebd340dd96d66521fc4387be2021-12-02T10:49:16ZCombining serology with case-detection, to allow the easing of restrictions against SARS-CoV-2: a modelling-based study in India10.1038/s41598-021-81405-22045-2322https://doaj.org/article/11267fafebd340dd96d66521fc4387be2021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81405-2https://doaj.org/toc/2045-2322Abstract India’s lockdown and subsequent restrictions against SARS-CoV-2, if lifted without any other mitigations in place, could risk a second wave of infection. A test-and-isolate strategy, using PCR diagnostic tests, could help to minimise the impact of this second wave. Meanwhile, population-level serological surveillance can provide valuable insights into the level of immunity in the population. Using a mathematical model, consistent with an Indian megacity, we examined how seroprevalence data could guide a test-and-isolate strategy, for fully lifting restrictions. For example, if seroprevalence is 20% of the population, we show that a testing strategy needs to identify symptomatic cases within 5–8 days of symptom onset, in order to prevent a resurgent wave from overwhelming hospital capacity in the city. This estimate is robust to uncertainty in the effectiveness of the lockdown, as well as in immune protection against reinfection. To set these results in their economic context, we estimate that the weekly cost of such a PCR-based testing programme would be less than 2.1% of the weekly economic loss due to the lockdown. Our results illustrate how PCR-based testing and serological surveillance can be combined to design evidence-based policies, for lifting lockdowns in Indian cities and elsewhere.Sandip MandalHemanshu DasSarang DeoNimalan ArinaminpathyNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sandip Mandal Hemanshu Das Sarang Deo Nimalan Arinaminpathy Combining serology with case-detection, to allow the easing of restrictions against SARS-CoV-2: a modelling-based study in India
description	Abstract India’s lockdown and subsequent restrictions against SARS-CoV-2, if lifted without any other mitigations in place, could risk a second wave of infection. A test-and-isolate strategy, using PCR diagnostic tests, could help to minimise the impact of this second wave. Meanwhile, population-level serological surveillance can provide valuable insights into the level of immunity in the population. Using a mathematical model, consistent with an Indian megacity, we examined how seroprevalence data could guide a test-and-isolate strategy, for fully lifting restrictions. For example, if seroprevalence is 20% of the population, we show that a testing strategy needs to identify symptomatic cases within 5–8 days of symptom onset, in order to prevent a resurgent wave from overwhelming hospital capacity in the city. This estimate is robust to uncertainty in the effectiveness of the lockdown, as well as in immune protection against reinfection. To set these results in their economic context, we estimate that the weekly cost of such a PCR-based testing programme would be less than 2.1% of the weekly economic loss due to the lockdown. Our results illustrate how PCR-based testing and serological surveillance can be combined to design evidence-based policies, for lifting lockdowns in Indian cities and elsewhere.
format	article
author	Sandip Mandal Hemanshu Das Sarang Deo Nimalan Arinaminpathy
author_facet	Sandip Mandal Hemanshu Das Sarang Deo Nimalan Arinaminpathy
author_sort	Sandip Mandal
title	Combining serology with case-detection, to allow the easing of restrictions against SARS-CoV-2: a modelling-based study in India
title_short	Combining serology with case-detection, to allow the easing of restrictions against SARS-CoV-2: a modelling-based study in India
title_full	Combining serology with case-detection, to allow the easing of restrictions against SARS-CoV-2: a modelling-based study in India
title_fullStr	Combining serology with case-detection, to allow the easing of restrictions against SARS-CoV-2: a modelling-based study in India
title_full_unstemmed	Combining serology with case-detection, to allow the easing of restrictions against SARS-CoV-2: a modelling-based study in India
title_sort	combining serology with case-detection, to allow the easing of restrictions against sars-cov-2: a modelling-based study in india
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/11267fafebd340dd96d66521fc4387be
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Combining serology with case-detection, to allow the easing of restrictions against SARS-CoV-2: a modelling-based study in India

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