Impact of layered non-pharmacological interventions on COVID-19 transmission dynamics in Yucatan, Mexico

• Type of Material: Article
• Authors: G. Ayora-Talavera, Universidad Autónoma de Yucatán; P. Granja-Perez, Servicios de Salud de Yucatán; M. Sauri-Vivas, Servicios de Salud de Yucatán; C. I. Hernández-Fuentes, Servicios de Salud de Yucatán; I. P. Hennessee, Rollins School of Public Health; I. López-Martínez, Instituto Nacional de Diagnostico y Referencia Epidemiologicos - InDRE; G. Barrera-Badillo, Instituto Nacional de Diagnostico y Referencia Epidemiologicos - InDRE; A. Che-Mendoza, Universidad Autónoma de Yucatán; P. Manrique-Saide, Universidad Autónoma de Yucatán; Julie Clennon, Emory University; H. Gómez-Dantés, Instituto Nacional de Salud Pública. México; Gonzalo Vazquez Prokopec, Emory University
• Language: English
• Date: 2022-08-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2022 The Authors. Published by Elsevier Inc.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.pmedr.2022.101843
• Title of Journal or Parent Work: Preventive Medicine Reports
• Volume: 28
• Grant/Funding Information: GVP received funding from Emory University through the MP3 Initiative (Vazquez-Prokopec and Collins M, co-PI). PMS received funding from IDRC (Project 109071-002).
• Keywords: Impact; Transmission; Yucatan; Non-pharmaceutical intervention strategies; Dynamics; COVID-19
• Research Categories: Biology, Virology; Health Sciences, Epidemiology; Health Sciences, Public Health; Environmental Sciences

Abstract

Background The pandemic propagation of SARS-CoV-2 led to the adoption of a myriad of non-pharmacological interventions (NPIs, e.g., social distancing, mobility restrictions, gathering restrictions) in the Americas. Using national epidemiological data, here we report the impact of the layered adoption of multiple NPIs aimed at curving SARS-CoV-2 transmission in Yucatan State, Mexico. Methods Data from suspected and laboratory confirmed COVID-19 cases during 2020 were analyzed by age groups and sex, clinical signs, and symptoms as well as outcome. The impact of NPIs was quantified using time-varying reproduction numbers (Rt) estimated as a time-series and by sectors of the city. Findings A total of 69,602 suspected cases were reported, 39.3% were laboratory-confirmed. Men were hospitalized (60.2%), more severely ill (3% vs 1.9%) and more likely to die (62%) than women. Early in the outbreak, all sectors in Merida had Rt estimates above unity. Once all NPÍs were in place, Rt values were dramatically reduced below one, and in the last interval transmission estimates of Rt remained below one in all sectors. Interpretation In the absence of a COVID-19 vaccination program, the combination and wide adherence of NPÍs led to a low and stable trend in SARS-CoV-2 transmission that did not overwhelm the health sector. Our study reflects that a controlled and planned ease of restrictions to balance health, social and economic recovery resulted in a single wave of transmission that prolonged at low and stable levels.