Homebound by COVID19: the benefits and consequences of non-pharmaceutical intervention strategies

• Type of Material: Article
• Authors: Buse Eylul Oruc, Georgia Institute of Technology; Arden Baxter, Georgia Institute of Technology; Pinar Keskinocak, Emory University; John Asplund, Georgia Institute of Technology; Nicoleta Serban, Georgia Institute of Technology
• Language: English
• Date: 2021-04-06
• Publisher: BMC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s). 2021
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12889-021-10725-9
• Title of Journal or Parent Work: BMC Public Health
• Volume: 21
• Issue: 1
• Start Page: 655
• End Page: 655
• Grant/Funding Information: This research was also supported in part by Cooperative Agreement number NU38OT000297 from The Centers for Disease Control and Prevention (CDC) and CSTE, the National Science Foundation Graduate Research Fellowship awarded to AB (DGE-1650044), an NSF grant to support the high performance computing facilities at Georgia Tech, which were used for the computational runs (MRI 1828187), and research cyber infrastructure resources and services provided by the Partnership for an Advanced Computing Environment (PACE) at Georgia Tech.; This research was supported in part by the William W. George endowment awarded to PK, the Virginia C. and Joseph C. Mello endowments awarded to NS, and the following benefactors at Georgia Tech: Andrea Laliberte, Joseph C. Mello, Richard “Rick” E. & Charlene Zalesky, and Claudia & Paul Raines. This research was also supported in part by the National Science Foundation Graduate Research Fellowship awarded to AB (DGE-1650044), a NSF grant to support the high performance computing facilities at Georgia Tech, which we used for the computational runs (MRI 1828187), and research cyberinfrastructure resources and services provided by the Partnership for an Advanced Computing Environment (PACE) at Georgia Tech. The funders played no role in the study design, data collection, analysis, interpretation, or in writing the manuscript.
• Keywords: Agent-based disease modeling; Life Sciences & Biomedicine; COVID19; Public, Environmental & Occupational Health; Science & Technology; Non-pharmaceutical intervention strategies
• Research Categories: Health Sciences, Public Health; Chemistry, Pharmaceutical; Engineering, System Science; Environmental Sciences

Abstract

Background Recent research has been conducted by various countries and regions on the impact of non-pharmaceutical interventions (NPIs) on reducing the spread of COVID19. This study evaluates the tradeoffs between potential benefits (e.g., reduction in infection spread and deaths) of NPIs for COVID19 and being homebound (i.e., refraining from interactions outside of the household). Methods An agent-based simulation model, which captures the natural history of the disease at the individual level, and the infection spread via a contact network assuming heterogeneous population mixing in households, peer groups (workplaces, schools), and communities, is adapted to project the disease spread and estimate the number of homebound people and person-days under multiple scenarios, including combinations of shelter-in-place, voluntary quarantine, and school closure in Georgia from March 1 to September 1, 2020. Results Compared to no intervention, under voluntary quarantine, voluntary quarantine with school closure, and shelter-in-place with school closure scenarios 4.5, 23.1, and 200+ homebound adult-days were required to prevent one infection, with the maximum number of adults homebound on a given day in the range of 119 K–248 K, 465 K–499 K, 5388 K-5389 K, respectively. Compared to no intervention, school closure only reduced the percentage of the population infected by less than 16% while more than doubling the peak number of adults homebound. Conclusions Voluntary quarantine combined with school closure significantly reduced the number of infections and deaths with a considerably smaller number of homebound person-days compared to shelter-in-place.