Curbing the COVID-19 pandemic with facility-based isolation of mild cases: a mathematical modeling study
In many countries, patients with mild coronavirus disease 2019 (COVID-19) are told to self-isolate at home, but imperfect compliance and shared living space with uninfected people limit the effectiveness of home-based isolation. We examine the impact of facility-based isolation compared to self-isol...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2021
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| In: |
Journal of travel medicine
Year: 2021, Volume: 28, Issue: 2, Pages: 1-11 |
| ISSN: | 1708-8305 |
| DOI: | 10.1093/jtm/taaa226 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1093/jtm/taaa226
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| Author Notes: | Simiao Chen, ScD, Qiushi Chen, PhD, Juntao Yang, PhD, Lin Lin, PhD, Linye Li, MS, Lirui Jiao, BA, Pascal Geldsetzer, MD, Chen Wang, MD, Annelies Wilder-Smith, MD and Till Bärnighausen, MD |
| Summary: | In many countries, patients with mild coronavirus disease 2019 (COVID-19) are told to self-isolate at home, but imperfect compliance and shared living space with uninfected people limit the effectiveness of home-based isolation. We examine the impact of facility-based isolation compared to self-isolation at home on the continuing epidemic in the USA.We developed a compartment model to simulate the dynamic transmission of COVID-19 and calibrated it to key epidemic measures in the USA from March to September 2020. We simulated facility-based isolation strategies with various capacities and starting times under different diagnosis rates. Our primary model outcomes are new infections and deaths over 2 months from October 2020 onwards. In addition to national-level estimations, we explored the effects of facility-based isolation under different epidemic burdens in major US Census Regions. We performed sensitivity analyses by varying key model assumptions and parameters.We find that facility-based isolation with moderate capacity of 5 beds per 10 000 total population could avert 4.17 (95% credible interval 1.65-7.11) million new infections and 16 000 (8000-23 000) deaths in 2 months compared with home-based isolation. These results are equivalent to relative reductions of 57% (44-61%) in new infections and 37% (27-40%) in deaths. Facility-based isolation with high capacity of 10 beds per 10 000 population could achieve reductions of 76% (62-84%) in new infections and 52% (37-64%) in deaths when supported by expanded testing with an additional 20% daily diagnosis rate. Delays in implementation would substantially reduce the impact of facility-based isolation. The effective capacity and the impact of facility-based isolation varied by epidemic stage across regions.Timely facility-based isolation for mild COVID-19 cases could substantially reduce the number of new infections and effectively curb the continuing epidemic in the USA. Local epidemic burdens should determine the scale of facility-based isolation strategies. |
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| Item Description: | Published: 03 December 2020 Gesehen am 18.05.2021 |
| Physical Description: | Online Resource |
| ISSN: | 1708-8305 |
| DOI: | 10.1093/jtm/taaa226 |