Synergistic interventions to control COVID-19: Mass testing and isolation mitigates reliance on distancing.

Stay-at-home orders and shutdowns of non-essential businesses are powerful, but socially costly, tools to control the pandemic spread of SARS-CoV-2. Mass testing strategies, which rely on widely administered frequent and rapid diagnostics to identify and isolate infected individuals, could be a pote...

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Autores principales:	Emily Howerton, Matthew J Ferrari, Ottar N Bjørnstad, Tiffany L Bogich, Rebecca K Borchering, Chris P Jewell, James D Nichols, William J M Probert, Michael C Runge, Michael J Tildesley, Cécile Viboud, Katriona Shea
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/8c8bcb4658f749fab07623ccc1261c58
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spelling	oai:doaj.org-article:8c8bcb4658f749fab07623ccc1261c582021-12-02T19:57:27ZSynergistic interventions to control COVID-19: Mass testing and isolation mitigates reliance on distancing.1553-734X1553-735810.1371/journal.pcbi.1009518https://doaj.org/article/8c8bcb4658f749fab07623ccc1261c582021-10-01T00:00:00Zhttps://doi.org/10.1371/journal.pcbi.1009518https://doaj.org/toc/1553-734Xhttps://doaj.org/toc/1553-7358Stay-at-home orders and shutdowns of non-essential businesses are powerful, but socially costly, tools to control the pandemic spread of SARS-CoV-2. Mass testing strategies, which rely on widely administered frequent and rapid diagnostics to identify and isolate infected individuals, could be a potentially less disruptive management strategy, particularly where vaccine access is limited. In this paper, we assess the extent to which mass testing and isolation strategies can reduce reliance on socially costly non-pharmaceutical interventions, such as distancing and shutdowns. We develop a multi-compartmental model of SARS-CoV-2 transmission incorporating both preventative non-pharmaceutical interventions (NPIs) and testing and isolation to evaluate their combined effect on public health outcomes. Our model is designed to be a policy-guiding tool that captures important realities of the testing system, including constraints on test administration and non-random testing allocation. We show how strategic changes in the characteristics of the testing system, including test administration, test delays, and test sensitivity, can reduce reliance on preventative NPIs without compromising public health outcomes in the future. The lowest NPI levels are possible only when many tests are administered and test delays are short, given limited immunity in the population. Reducing reliance on NPIs is highly dependent on the ability of a testing program to identify and isolate unreported, asymptomatic infections. Changes in NPIs, including the intensity of lockdowns and stay at home orders, should be coordinated with increases in testing to ensure epidemic control; otherwise small additional lifting of these NPIs can lead to dramatic increases in infections, hospitalizations and deaths. Importantly, our results can be used to guide ramp-up of testing capacity in outbreak settings, allow for the flexible design of combined interventions based on social context, and inform future cost-benefit analyses to identify efficient pandemic management strategies.Emily HowertonMatthew J FerrariOttar N BjørnstadTiffany L BogichRebecca K BorcheringChris P JewellJames D NicholsWilliam J M ProbertMichael C RungeMichael J TildesleyCécile ViboudKatriona SheaPublic Library of Science (PLoS)articleBiology (General)QH301-705.5ENPLoS Computational Biology, Vol 17, Iss 10, p e1009518 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Biology (General) QH301-705.5
spellingShingle	Biology (General) QH301-705.5 Emily Howerton Matthew J Ferrari Ottar N Bjørnstad Tiffany L Bogich Rebecca K Borchering Chris P Jewell James D Nichols William J M Probert Michael C Runge Michael J Tildesley Cécile Viboud Katriona Shea Synergistic interventions to control COVID-19: Mass testing and isolation mitigates reliance on distancing.
description	Stay-at-home orders and shutdowns of non-essential businesses are powerful, but socially costly, tools to control the pandemic spread of SARS-CoV-2. Mass testing strategies, which rely on widely administered frequent and rapid diagnostics to identify and isolate infected individuals, could be a potentially less disruptive management strategy, particularly where vaccine access is limited. In this paper, we assess the extent to which mass testing and isolation strategies can reduce reliance on socially costly non-pharmaceutical interventions, such as distancing and shutdowns. We develop a multi-compartmental model of SARS-CoV-2 transmission incorporating both preventative non-pharmaceutical interventions (NPIs) and testing and isolation to evaluate their combined effect on public health outcomes. Our model is designed to be a policy-guiding tool that captures important realities of the testing system, including constraints on test administration and non-random testing allocation. We show how strategic changes in the characteristics of the testing system, including test administration, test delays, and test sensitivity, can reduce reliance on preventative NPIs without compromising public health outcomes in the future. The lowest NPI levels are possible only when many tests are administered and test delays are short, given limited immunity in the population. Reducing reliance on NPIs is highly dependent on the ability of a testing program to identify and isolate unreported, asymptomatic infections. Changes in NPIs, including the intensity of lockdowns and stay at home orders, should be coordinated with increases in testing to ensure epidemic control; otherwise small additional lifting of these NPIs can lead to dramatic increases in infections, hospitalizations and deaths. Importantly, our results can be used to guide ramp-up of testing capacity in outbreak settings, allow for the flexible design of combined interventions based on social context, and inform future cost-benefit analyses to identify efficient pandemic management strategies.
format	article
author	Emily Howerton Matthew J Ferrari Ottar N Bjørnstad Tiffany L Bogich Rebecca K Borchering Chris P Jewell James D Nichols William J M Probert Michael C Runge Michael J Tildesley Cécile Viboud Katriona Shea
author_facet	Emily Howerton Matthew J Ferrari Ottar N Bjørnstad Tiffany L Bogich Rebecca K Borchering Chris P Jewell James D Nichols William J M Probert Michael C Runge Michael J Tildesley Cécile Viboud Katriona Shea
author_sort	Emily Howerton
title	Synergistic interventions to control COVID-19: Mass testing and isolation mitigates reliance on distancing.
title_short	Synergistic interventions to control COVID-19: Mass testing and isolation mitigates reliance on distancing.
title_full	Synergistic interventions to control COVID-19: Mass testing and isolation mitigates reliance on distancing.
title_fullStr	Synergistic interventions to control COVID-19: Mass testing and isolation mitigates reliance on distancing.
title_full_unstemmed	Synergistic interventions to control COVID-19: Mass testing and isolation mitigates reliance on distancing.
title_sort	synergistic interventions to control covid-19: mass testing and isolation mitigates reliance on distancing.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/8c8bcb4658f749fab07623ccc1261c58
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Synergistic interventions to control COVID-19: Mass testing and isolation mitigates reliance on distancing.

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