A mathematical model of COVID-19 transmission in a tertiary hospital and assessment of the effects of different intervention strategies

Abstract

Novel coronavirus (named SARS-CoV-2) can spread widely in confined settings including hospitals, cruise ships, prisons, and places of worship. In particular, a healthcare-associated outbreak could become the epicenter of coronavirus disease (COVID-19). This study aimed to evaluate the effects of different intervention strategies on the hospital outbreak within a tertiary hospital. A mathematical model was developed for the COVID-19 transmission within a 2500-bed tertiary hospital of South Korea. The SEIR (susceptible-exposed-infectious-recovered) model with a compartment of doctor, nurse, patient, and caregiver was constructed. The effects of different intervention strategies such as front door screening, quarantine unit for newly admitted patients, early testing of suspected infected people, and personal protective equipment for both medical staff and visitors were evaluated. The model suggested that the early testing (within eight hours) of infected cases and monitoring the quarantine ward for newly hospitalized patients are effective measures for decreasing the incidence of COVID-19 within a hospital (81.3% and 70% decrease of number of incident cases, respectively, during 60 days). Front door screening for detecting suspected cases had only 42% effectiveness. Screening for prohibiting the admission of COVID-19 patients was more effective than the measures for patients before emergency room or outpatient clinic. This model suggests that under the assumed conditions, some effective measures have a great influence on the incidence of COVID-19 within a hospital. The implementation of the preventive measures could reduce the size of a hospital outbreak.

Modelling COVID -19 transmission in a hemodialysis centre using simulation generated contacts matrices

“…Table VI summarizes the contact parameter in the normal schedule and without break condition. These contact matrices are symmetric, as expected [4]. As explained above in the methods section, the contact parameters of the same category staff are generally increased when the break is omitted from the workflow.…”

“…The contact rate among the people who are working or receiving treatments in a hospital varies depending on the type of work and hospitalization. Baek, Lee, Cho, Hyun, Kim, Sohn, Kim, Ahn, Jeong, Ku, Yeom, Lee and Choi [4] used the value of contact duration of about 5 hours for the hospital wards and less than 0.5 hours for the outpatient department and emergency room for physicians, nurses, and other caregivers. Patients and caregivers in the hospital wards have the longest contact time.…”

“…Many in-centre dialysis facilities have experienced outbreaks among dialysis patients, physicians, and nursing staff leading to nursing and physician shortages in an already overburdened healthcare system [4]. These outbreaks have downstream effects throughout the healthcare centres in which they are based.…”

Epidemiological analysis of a COVID-19 outbreak associated with an infected surgeon

“…A very interesting study from South Korea has recently offered a mathematical model of in-hospital transmission dynamics of COVID-19, and the authors showed how an ‘early testing strategy’ for newly hospitalised patients is effective to reduce nosocomial outbreaks. Notably, while in a low transmission context, the detection of positive patients before admission seems the most important preventive measure, the widespread use of PPE is crucial to control viral transmissibility in high transmission settings [ 8 ]. The effectiveness of universal masking in the in-hospital setting has been also recently strengthened by studies showing that SARS-CoV-2 positivity rates among HCPs were significantly reduced after its implementation; furthermore, even in large hospitals with nearly 10,000 admitted patients, no clear-cut case of in-hospital acquired SARS-CoV-2 infection was registered [ 1 , 8 ].…”

“…Notably, while in a low transmission context, the detection of positive patients before admission seems the most important preventive measure, the widespread use of PPE is crucial to control viral transmissibility in high transmission settings [ 8 ]. The effectiveness of universal masking in the in-hospital setting has been also recently strengthened by studies showing that SARS-CoV-2 positivity rates among HCPs were significantly reduced after its implementation; furthermore, even in large hospitals with nearly 10,000 admitted patients, no clear-cut case of in-hospital acquired SARS-CoV-2 infection was registered [ 1 , 8 ]. In addition to the triage of suspected cases and PPE use, it was shown that a massive testing strategy, based on nasopharyngeal swabs, to be a third pillar in the control of the pandemic: a group from a highly endemic zone has published its institutional protocol that included molecular testing of all HCPs every 7–10 days, irrespective of their symptoms, and none of the healthcare workers became positive despite being directly in contact with COVID-19 patients [ 9 ].…”