Effectiveness of workplace social distancing measures in reducing influenza transmission: a systematic review

Ahmed, Faruque; Zviedrite, Nicole; Uzicanin, Amra

doi:10.1186/s12889-018-5446-1

Cited by 374 publications

(351 citation statements)

References 46 publications

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“…25 This observation is consistent with the conclusions of a review of 15 studies that found a median reduction of 23% (range 12-82) in the cumulative influenza A H1N1 attack rate with workplace distancing alone. 26 The implementation of such a control measure, however, is likely to have an acute societal economic effect on individuals who must work from home or take leave, especially if reimbursement is not possible. Thus, decision making becomes a function of risk as to whether the imported cases have or will infect the local population and cause a local outbreak.…”

Section: Discussionmentioning

confidence: 99%

Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study

Koo

Cook

Park

et al. 2020

The Lancet Infectious Diseases

751

688

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Background Since the coronavirus disease 2019 outbreak began in the Chinese city of Wuhan on Dec 31, 2019, 68 imported cases and 175 locally acquired infections have been reported in Singapore. We aimed to investigate options for early intervention in Singapore should local containment (eg, preventing disease spread through contact tracing efforts) be unsuccessful. MethodsWe adapted an influenza epidemic simulation model to estimate the likelihood of human-to-human transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a simulated Singaporean population. Using this model, we estimated the cumulative number of SARS-CoV-2 infections at 80 days, after detection of 100 cases of community transmission, under three infectivity scenarios (basic reproduction number [R 0 ] of 1•5, 2•0, or 2•5) and assuming 7·5% of infections are asymptomatic. We first ran the model assuming no intervention was in place (baseline scenario), and then assessed the effect of four intervention scenarios compared with a baseline scenario on the size and progression of the outbreak for each R 0 value. These scenarios included isolation measures for infected individuals and quarantining of family members (hereafter referred to as quarantine); quarantine plus school closure; quarantine plus workplace distancing; and quarantine, school closure, and workplace distancing (hereafter referred to as the combined intervention). We also did sensitivity analyses by altering the asymptomatic fraction of infections (22·7%, 30·0%, 40·0%, and 50·0%) to compare outbreak sizes under the same control measures.Findings For the baseline scenario, when R 0 was 1·5, the median cumulative number of infections at day 80 was 279 000 (IQR 245 000-320 000), corresponding to 7•4% (IQR 6·5-8·5) of the resident population of Singapore. The median number of infections increased with higher infectivity: 727 000 cases (670 000-776 000) when R 0 was 2·0, corresponding to 19•3% (17•8-20•6) of the Singaporean population, and 1 207 000 cases (1 164 000-1 249 000) when R 0 was 2·5, corresponding to 32% (30•9-33•1) of the Singaporean population. Compared with the baseline scenario, the combined intervention was the most effective, reducing the estimated median number of infections by 99•3% (IQR 92•6-99•9) when R 0 was 1·5, by 93·0% (81•5-99•7) when R 0 was 2·0, and by 78•2% (59·0 -94•4) when R 0 was 2·5. Assuming increasing asymptomatic fractions up to 50·0%, up to 277 000 infections were estimated to occur at day 80 with the combined intervention relative to 1800 for the baseline at R 0 of 1·5.Interpretation Implementing the combined intervention of quarantining infected individuals and their family members, workplace distancing, and school closure once community transmission has been detected could substantially reduce the number of SARS-CoV-2 infections. We therefore recommend immediate deployment of this strategy if local secondary transmission is confirmed within Singapore. However, quarantine and workplace distancing should be prioritised over school cl...

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Section: Discussionmentioning

confidence: 99%

Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study

Koo

Cook

Park

et al. 2020

The Lancet Infectious Diseases

751

688

View full text Add to dashboard Cite

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“…Not only this, but if a large proportion of the population continues to work while unwell, low compliance will render the various forms of social distancing less effective, as low-income workers are forced to choose between financial and physical health. Indeed, this behaviour has already been observed in the workplace in previous pandemics: workers without access to paid sick leave were more likely to work while unwell than those with paid sick leave (14). A study in China after the H7N9 epidemic found that only 7% of people reported willingness to self-quarantine (15).…”

Section: Discussionmentioning

confidence: 85%

Perceptions and behavioural responses of the general public during the COVID-19 pandemic: A cross-sectional survey of UK Adults

Atchison

Bowman

Vrinten

et al. 2020

Preprint

206

243

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Objective: To examine risk perceptions and behavioural responses of the UK adult population during the early phase of the COVID-19 epidemic in the UK. Design: A cross-sectional surveySetting: Conducted with a nationally representative sample of UK adults within 48 hours of the UK Government advising the public to stop non-essential contact with others and all unnecessary travel.Participants: 2,108 adults living in the UK aged 18 years and over. Data were collected between March 17 and 18 2020. Main outcome measures:Descriptive statistics for all survey questions, including the number of respondents and the weighted percentages. Logistic regression was used to identify sociodemographic variation in: (1) adoption of social-distancing measures, (2) ability to work from home, and (3) willingness and (4) ability to self-isolate. ResultsOverall, 1,992 (94.2%) respondents reported taking at least one preventive measure:85.8% washed their hands with soap more frequently; 56.5% avoided crowded areas and 54.5% avoided social events. Adoption of social-distancing measures was higher in those aged over 70 compared to younger adults aged 18 to 34 years (aOR:1.9; 95% CI:1.1 to 3.4).Those with the lowest household income were six times less likely to be able to work from home (aOR:0.16; 95% CI:0.09 to 0.26) and three times less likely to be able to self-isolate (aOR:0.31; 95% CI:0.16 to 0.58). Ability to self-isolate was also lower in black and minority ethnic groups (aOR:0.47; 95% CI:0.27 to 0.82). Willingness to self-isolate was high across all respondents. ConclusionsThe ability to adopt and comply with certain NPIs is lower in the most economically disadvantaged in society. Governments must implement appropriate social and economic policies to mitigate this. By incorporating these differences in NPIs among socio-economic subpopulations into mathematical models of COVID-19 transmission dynamics, our modelling of epidemic outcomes and response to COVID-19 can be improved.

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“…These measures greatly changed age-specific mixing patterns within the population in previous outbreak response efforts for other respiratory infectious diseases. 5,6 Although travel restrictions undoubtedly had a role in reducing exportations of infections outside Wuhan and delayed the onset of outbreaks in other regions, 7,8 changes in mixing patterns affected the trajectory of the outbreak within Wuhan itself. To estimate the effects of physical distancing measures on the progression of the COVID-19 epidemic, we look at Wuhan, hoping to provide some insights for the rest of the world.…”

Section: Introductionmentioning

confidence: 99%

The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study

Prem¹,

Liu²,

Russell³

et al. 2020

The Lancet Public Health

2,042

2,020

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Background In December, 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, emerged in Wuhan, China. Since then, the city of Wuhan has taken unprecedented measures in response to the outbreak, including extended school and workplace closures. We aimed to estimate the effects of physical distancing measures on the progression of the COVID-19 epidemic, hoping to provide some insights for the rest of the world.Methods To examine how changes in population mixing have affected outbreak progression in Wuhan, we used synthetic location-specific contact patterns in Wuhan and adapted these in the presence of school closures, extended workplace closures, and a reduction in mixing in the general community. Using these matrices and the latest estimates of the epidemiological parameters of the Wuhan outbreak, we simulated the ongoing trajectory of an outbreak in Wuhan using an age-structured susceptible-exposed-infected-removed (SEIR) model for several physical distancing measures. We fitted the latest estimates of epidemic parameters from a transmission model to data on local and internationally exported cases from Wuhan in an age-structured epidemic framework and investigated the age distribution of cases. We also simulated lifting of the control measures by allowing people to return to work in a phased-in way and looked at the effects of returning to work at different stages of the underlying outbreak (at the beginning of March or April).Findings Our projections show that physical distancing measures were most effective if the staggered return to work was at the beginning of April; this reduced the median number of infections by more than 92% (IQR 66-97) and 24% (13-90) in mid-2020 and end-2020, respectively. There are benefits to sustaining these measures until April in terms of delaying and reducing the height of the peak, median epidemic size at end-2020, and affording health-care systems more time to expand and respond. However, the modelled effects of physical distancing measures vary by the duration of infectiousness and the role school children have in the epidemic.Interpretation Restrictions on activities in Wuhan, if maintained until April, would probably help to delay the epidemic peak. Our projections suggest that premature and sudden lifting of interventions could lead to an earlier secondary peak, which could be flattened by relaxing the interventions gradually. However, there are limitations to our analysis, including large uncertainties around estimates of R 0 and the duration of infectiousness.

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Effectiveness of workplace social distancing measures in reducing influenza transmission: a systematic review

Cited by 374 publications

References 46 publications

Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study

Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study

Perceptions and behavioural responses of the general public during the COVID-19 pandemic: A cross-sectional survey of UK Adults

The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study

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