Evaluating the contributions of strategies to prevent SARS-CoV-2 transmission in the healthcare setting: a modelling study.
TLDR
In this article, the authors quantified and compared the impacts of personal protection equipment (PPE) use, patient and healthcare workers surveillance testing and sub-cohorting strategies to prevent the COVID-19 pandemic.Abstract:
Introduction Since its onset, the COVID-19 pandemic has caused significant morbidity and mortality worldwide, with particularly severe outcomes in healthcare institutions and congregate settings. To mitigate spread, healthcare systems have been cohorting patients to limit contacts between uninfected patients and potentially infected patients or healthcare workers (HCWs). A major challenge in managing the pandemic is the presence of currently asymptomatic/presymptomatic individuals capable of transmitting the virus, who could introduce COVID-19 into uninfected cohorts. The optimal combination of personal protective equipment (PPE), testing and other approaches to prevent these events is unclear, especially in light of ongoing limited resources. Methods Using stochastic simulations with a susceptible-exposed-infected-recovered dynamic model, we quantified and compared the impacts of PPE use, patient and HCWs surveillance testing and subcohorting strategies. Results In the base case without testing or PPE, the healthcare system was rapidly overwhelmed, and became a net contributor to the force of infection. We found that effective use of PPE by both HCWs and patients could prevent this scenario, while random testing of apparently asymptomatic/presymptomatic individuals on a weekly basis was less effective. We also found that even imperfect use of PPE could provide substantial protection by decreasing the force of infection. Importantly, we found that creating smaller patient/HCW-interaction subcohorts can provide additional resilience to outbreak development with limited resources. Conclusion These findings reinforce the importance of ensuring adequate PPE supplies even in the absence of testing and provide support for strict subcohorting regimens to reduce outbreak potential in healthcare institutions.read more
Citations
More filters
Journal ArticleDOI
COVID-19 Prevention and Control Measures in Workplace Settings: A Rapid Review and Meta-Analysis.
Carolyn Ingram,Vicky Downey,Mark Roe,Yanbing Chen,Mary Archibald,Kadri-Ann Kallas,Jaspal Kumar,Peter Naughton,Cyril Onwuelaza Uteh,Alejandro Rojas-Chaves,Shibu Shrestha,Shiraz Syed,Fionn Büttner,Conor J. Buggy,Carla Perrotta +14 more
TL;DR: A rapid review and meta-analysis was conducted to synthesize evidence assessing the effectiveness of COVID-19 IPC measures implemented in global workplace settings through April 2021 as discussed by the authors, where 60 studies from healthcare, nursing home, meatpacking, manufacturing, and office settings were included, accounting for ~280,000 employees based in Europe, Asia, and North America.
Journal ArticleDOI
Interventions to control nosocomial transmission of SARS-CoV-2: a modelling study.
Thi Mui Pham,Hannan Tahir,Janneke van de Wijgert,Janneke van de Wijgert,Bastiaan van der Roest,Pauline M. Ellerbroek,Marc J.M. Bonten,Martin C. J. Bootsma,Mirjam Kretzschmar +8 more
TL;DR: In this article, the authors developed an agent-based model and compared the impact of personal protective equipment (PPE), screening of healthcare workers (HCWs), contact tracing of symptomatic HCWs and restricting HCWs from working in multiple units (HCW cohorting) on nosocomial SARS-CoV-2 transmission.
Journal ArticleDOI
SARS-CoV-2 transmission and control in a hospital setting: an individual-based modelling study
Qimin Huang,Anirban Mondal,Xiaobing Jiang,Mary Ann Horn,Fei Fan,Peng Fu,Xuan Wang,Hongyang Zhao,Martial L. Ndeffo-Mbah,David Gurarie +9 more
TL;DR: In this article, the authors developed an individual-based model for COVID-19 transmission in a hospital setting and calibrated the model using data of a COVID19 outbreak in a unit in Wuhan.
Posted ContentDOI
SARS-CoV-2 transmission and control in a hospital setting: an individual-based modelling study
Qimin Huang,Anirban Mondal,Xiaobing Jiang,Mary Ann Horn,Fei Fan,Peng Fu,Xuan Wang,Hongyang Zhao,Martial L. Ndeffo-Mbah,David Gurarie +9 more
TL;DR: An individual-based model for COVID-19 transmission among healthcare workers in a hospital setting indicates that a quarantine policy should be coupled with other interventions to achieve its effect, and shows that a CO VID-19 outbreak in a Hospital Unit can be controlled or mitigated by the use of existing non-pharmaceutical measures.
Journal ArticleDOI
Control of airborne infectious disease in buildings: Evidence and research priorities.
P. Jacob Bueno de Mesquita,William W. Delp,Wanyu R. Chan,William P. Bahnfleth,Brett C. Singer +4 more
TL;DR: In this article, the authors identify an overarching need for investment to implement building controls and evaluate their effectiveness on infection in well-characterized and real-world settings, supported by specific, methodological advances.
References
More filters
Journal ArticleDOI
Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia.
Qun Li,Xuhua Guan,Peng Wu,Xiaoye Wang,Lei Zhou,Yeqing Tong,Ruiqi Ren,Kathy Leung,Eric H. Y. Lau,Jessica Y. Wong,Xuesen Xing,Nijuan Xiang,Yang Wu,Chao Li,Chen Qi,Dan Li,Tian Liu,Jing Zhao,Man Liu,Wenxiao Tu,Chuding Chen,Lianmei Jin,Rui Yang,Qi Wang,Suhua Zhou,Rui Wang,Hui Liu,Yingbo Luo,Yuan Liu,Ge Shao,Huan Li,Zhongfa Tao,Yang Yang,Yang Yang,Zhiqiang Deng,Boxi Liu,Zhitao Ma,Yanping Zhang,Guoqing Shi,Tommy Tsan-Yuk Lam,Joseph T. Wu,George F. Gao,George F. Gao,Benjamin J. Cowling,Bo Yang,Gabriel M. Leung,Zijian Feng +46 more
TL;DR: There is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019 and considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere.
Journal ArticleDOI
Temporal dynamics in viral shedding and transmissibility of COVID-19.
Xi He,Eric H. Y. Lau,Peng Wu,Xilong Deng,Jian Wang,Xinxin Hao,Yiu Chung Lau,Jessica Y. Wong,Yujuan Guan,Xinghua Tan,Xiaoneng Mo,Yanqing Chen,Baolin Liao,Weilie Chen,Fengyu Hu,Qing Zhang,Mingqiu Zhong,Yanrong Wu,Lingzhai Zhao,Fuchun Zhang,Benjamin J. Cowling,Fang Li,Gabriel M. Leung +22 more
TL;DR: It is estimated that 44% (95% confidence interval, 25–69%) of secondary cases were infected during the index cases’ presymptomatic stage, in settings with substantial household clustering, active case finding and quarantine outside the home.
Journal ArticleDOI
Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study.
TL;DR: It is inferred that epidemics are already growing exponentially in multiple major cities of China with a lag time behind the Wuhan outbreak of about 1–2 weeks, and that other major Chinese cities are probably sustaining localised outbreaks.
Journal ArticleDOI
Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing.
Luca Ferretti,Chris Wymant,Michelle Kendall,Lele Zhao,Anel Nurtay,Lucie Abeler-Dörner,Michael Parker,David Bonsall,Christophe Fraser +8 more
TL;DR: A mathematical model for infectiousness was developed to estimate the basic reproductive number R0 and to quantify the contribution of different transmission routes and the requirements for successful contact tracing, and the combination of two key parameters needed to reduce R0 to less than 1 was determined.
Journal ArticleDOI
Superspreading and the effect of individual variation on disease emergence
TL;DR: It is shown that contact tracing data from eight directly transmitted diseases shows that the distribution of individual infectiousness around R0 is often highly skewed, and implications for outbreak control are explored, showing that individual-specific control measures outperform population-wide measures.
Related Papers (5)
Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study.
Long H. Nguyen,David A. Drew,Mark S. Graham,Amit Joshi,Chuan Guo Guo,Chuan Guo Guo,Wenjie Ma,Raaj S. Mehta,Erica T. Warner,Daniel Sikavi,Chun-Han Lo,Sohee Kwon,Mingyang Song,Lorelei A. Mucci,Meir J. Stampfer,Walter C. Willett,A. Heather Eliassen,Jaime E. Hart,Jorge E. Chavarro,Janet W. Rich-Edwards,Richard Davies,Joan Capdevila,Karla A. Lee,Mary Ni Lochlainn,Thomas Varsavsky,Carole H. Sudre,M. Jorge Cardoso,Jonathan Wolf,Tim D. Spector,Sebastien Ourselin,Claire J. Steves,Andrew T. Chan,Christine M. Albert,Gabriella Andreotti,Bijal Bala,Bijal A. Balasubramanian,Laura Beane-Freeman,John S. Brownstein,Fiona Bruinsma,Joe Coresh,Rui Costa,Annie Cowan,Anusila Deka,Sandra Deming-Halverson,Maria Elena Martinez,Michael E. Ernst,Jane C. Figueiredo,Pedro Fortuna,Paul W. Franks,Laura E. Beane Freeman,Christopher D. Gardner,Irene M. Ghobrial,Christopher A. Haiman,Janet E. Hall,Jae H. Kang,Brenda Kirpach,Karestan C. Koenen,Laura D. Kubzansky,James V. Lacey,Loic Le Marchand,Xihong Lin,Pamela L. Lutsey,Catherine R. Marinac,Roger L. Milne,Anne M. Murray,Denis Nash,Julie R. Palmer,Alpa V. Patel,Eric Pierce,McKaylee Robertson,Lynn Rosenberg,Dale P. Sandler,Shepherd H. Schurman,Kara Sewalk,Shreela V. Sharma,Chris Sidey-Gibbons,Liz Slevin,Jordan W. Smoller,Maarit Tiirikainen,Scott T. Weiss,Lynne R. Wilkens,Feng Zhang +81 more