Coronavirus disease 2019 (COVID-19) is an infectious disease of humans caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the first case was identified in China in December 2019 the disease has spread worldwide, leading to an ongoing pandemic. In this article, we present an agent-based model of COVID-19 in Luxembourg, and use it to estimate the impact, on cases and deaths, of interventions including testing, contact tracing, lockdown, curfew and vaccination. Our model is based on collation, with agents performing activities and moving between locations accordingly. The model is highly heterogeneous, featuring spatial clustering, over 2000 behavioural types and a 10 minute time resolution. The model is validated against COVID-19 clinical monitoring data collected in Luxembourg in 2020. Our model predicts far fewer cases and deaths than the equivalent equation-based SEIR model. In particular, with R0 = 2.45, the SEIR model infects 87% of the resident population while our agent-based model infects only around 23% of the resident population. Our simulations suggest that testing and contract tracing reduce cases substantially, but are less effective at reducing deaths. Lockdowns are very effective although costly, while the impact of an 11pm-6am curfew is relatively small. When vaccinating against a future outbreak, our results suggest that herd immunity can be achieved at relatively low coverage, with substantial levels of protection achieved with only 30% of the population fully immune. When vaccinating in the midst of an outbreak, the challenge is more difficult. In this context, we investigate the impact of vaccine efficacy, capacity, hesitancy and strategy. We conclude that, short of a permanent lockdown, vaccination is by far the most effective way to suppress and ultimately control the spread of COVID-19.

Coronavirus disease 2019 (COVID-19) is an infectious disease of humans caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the first case was identified in China in December 2019 the disease has spread worldwide, leading to an ongoing pandemic. In this article, we present a detailed agent-based model of COVID-19 in Luxembourg, and use it to estimate the impact, on cases and deaths, of interventions including testing, contact tracing, lockdown, curfew and vaccination. Our model is based on collation, with agents performing activities and moving between locations accordingly. The model is highly heterogeneous, featuring spatial clustering, over 2000 behavioural types and a 10 minute time resolution. The model is validated against COVID-19 clinical monitoring data collected in Luxembourg in 2020. Our model predicts far fewer cases and deaths than the equivalent equation-based SEIR model. In particular, with $R_0 = 2.45$, the SEIR model infects 87% of the resident population while our agent-based model results, on average, in only around 23% of the resident population infected. Our simulations suggest that testing and contract tracing reduce cases substantially, but are much less effective at reducing deaths. Lockdowns appear very effective although costly, while the impact of an 11pm-6am curfew is relatively small. When vaccinating against a future outbreak, our results suggest that herd immunity can be achieved at relatively low levels, with substantial levels of protection achieved with only 30% of the population immune. When vaccinating in midst of an outbreak, the challenge is more difficult. In this context, we investigate the impact of vaccine efficacy, capacity, hesitancy and strategy. We conclude that, short of a permanent lockdown, vaccination is by far the most effective way to suppress and ultimately control the spread of COVID-19.

Since COVID-19 was first identified in China in 2019, the SARS-CoV-2 virus has mutated and given rise to a large number of variants. A range of non-pharmaceutical interventions have been deployed against the virus in an effort to save lives and reduce pressure on healthcare systems. These interventions may have favoured some variants over others. Despite this possibility, there has thus far been very little work investigating the impact of such interventions on the evolution of the virus. Using mathematical and computational models, we investigate the impact of a lockdown specifically, for the case in which two SARS-CoV-2 variants are circulating simultaneously in a population. We find that under certain conditions, lockdowns disrupt the competition between variants in such a way that highly transmissible variants with long infectious periods are selected for, ultimately leading to more cases overall than would have occurred without the lockdown, due to larger second waves of cases. These are the results of a modelling study and we do not claim to have found evidence of such unfavourable selection effects occurring in reality. On the other hand, our results are consistent with evolutionary theory and suggest that the selective effects of non-pharmaceutical interventions deserve greater scrutiny.