Curbing the COVID-19 pandemic with facility-based isolation of mild cases: a mathematical modeling study

Abstract

Background 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 aim to examine the impact of facility-based isolation compared to self-isolation at home on the continuing epidemic in the United States. Methods We developed a compartment model to simulate the dynamic transmission of COVID-19 and calibrated it to key epidemic measures in the United States from March to September. We simulated facility-based isolation strategies with various capacities and starting times under different diagnosis rates. The primary model outcomes included the reduction of new infections and deaths over two months from October onwards. We further explored different effects of facility-based isolation under different epidemic burdens by major US Census Regions, and performed sensitivity analyses by varying key model assumptions and parameters. Results We projected 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 two months compared with home-based isolation, 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 would achieve greater reduction of 76% (62–84%) in new infections and 52% (37–64%) in deaths when supported by the expanded testing with a 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. Conclusion Timely facility-based isolation for mild COVID-19 cases could substantially reduce the number of new infections and effectively curb the continuing epidemic compared to home-based isolation. The local epidemic burden should determine the effective scale of facility-based isolation strategies.

Climate and the spread of COVID-19

“…However, our results do not imply that the disease will vanish during summer. Rather, the higher temperatures and more intense UV radiation in summer are likely to support public health measures to contain SARS-CoV-2 29,30 . WHO's warning that the virus spreads in all climates must still be taken seriously.…”

Prevalence of depression in China during the early stage of the COVID-19 pandemic: a cross-sectional study in an online survey sample

“…During the initial phase of the COVID-19 outbreak in China, the Chinese government enforced a rigid social distancing policy through social media and strongly promoted hand washing, surface disinfection and the use of protective masks 47. In Wuhan, the most affected city, people with mild and asymptomatic infection received care in Fangcang shelter hospitals, which are designed for facility-based isolation, treatment and monitoring,47and have been proven to be an effective method to control the epidemic 48 49. Fangcang shelter hospitals also provided mental health counselling services and social support to help patients recover during isolation,50 which may also reduce the incidence of depression in hard-hit areas.…”

Knowledge About COVID-19 Among Adults in China: Cross-sectional Online Survey

“…For example, over a third of survey participants selected at least one of the following options when asked whether they are effective prevention measures: using a hand dryer, rinsing your nose with saline, taking antibiotics, or gargling with mouthwash. Reasons for these false beliefs are unclear but could be different for populations in East Asian countries like China or Singapore, which were affected by the severe acute respiratory syndrome outbreak in 2002-2004. Assessing the population's perceptions and knowledge of COVID-19 is not only essential to understanding and comparing different behaviors and policy decisions retrospectively but also vital for informing postlockdown policies since it will be crucial that people follow infection prevention methods as they start to interact more [10,11]. As of November 2020, China appears to have been successful in containing the spread of COVID-19 and has reported low case numbers [12].…”