Systems dynamics and the uncertainties of diagnostics, testing and contact tracing for COVID-19

Abstract

The current COVID-19 pandemic contains an unprecedented amount of uncertainty and variability and thus, there is a critical need for understanding of the variation documented in the biological, policy, sociological, and infrastructure responses during an epidemic to support decisions at all levels. With the significant asymptomatic spread of the virus and without an immediate vaccine and pharmaceuticals available, the best feasible strategies for testing and diagnostics, contact tracing, and quarantine need to be optimized. With potentially high false negative test results, infected people would not be enrolled in contact-trace programs and thus, may not be quarantined. Similarly, without broad testing, asymptomatic people are not identified and quarantined. Interconnected system dynamics models can be used to optimize strategies for mitigations for decision support during a pandemic. We use a systems dynamics epidemiology model along with other interconnected system models within public health including hospitals, intensive care units, masks, contact tracing, social distancing, and a newly developed testing and diagnostics model to investigate the uncertainties with testing and to optimize strategies for detecting and diagnosing infected people. Using an orthogonal array Latin Hypercube experimental design, we ran 54 simulations each for two scenarios of 10% and 30% asymptomatic people, varying important inputs for testing and social distancing. Systems dynamics modeling, coupled with computer experimental design and statistical analysis can provide rapid and quantitative results for decision support. Our results show that widespread testing, contacting tracing and quarantine can curtail the pandemic through identifying asymptomatic people in the population.

Factors associated with SARS-CoV-2 infection amongst healthcare workers in a COVID-19 designated hospital

“…This emphasizes the importance of infection prevention and control in avoiding nosocomial SARS-CoV-2 outbreaks and disruptions to essential services [ 7 , 8 ]. However, there are several challenges facing infection control departments within hospitals that include protective personal equipment shortages [ 7 ], lack of clarity regarding SARS-CoV-2 transmission patterns [ 9 ] and the difficulty of implementing guidelines issued by international governing bodies that are continuously changing [ 10 , 11 ].…”

Challenges to manage pandemic of coronavirus disease (COVID-19) in Iran with a special situation: a qualitative multi-method study

“…Contact tracing is an essential control measure to break the chains of COVID-19 transmission [41]. Because COVID-19 is highly variable and is asymptomatic in many nonspecific individuals, there is a need to advance the contact tracing to prevent further transmission [42]. Action based on a coherent protocol and guideline that includes all stages of screening, contact tracing, patient follow-up, treatment, and rehabilitation of patients is a fundamental principle in the comprehensive control and management of the pandemic.…”

Emergency Supply Control from the Perspectives of Peacetime and Wartime: A System Dynamics Simulation

“…The advantages of system dynamics have enabled scholars to apply it to medical treatments [9,10] , architecture [11] , agriculture [12] , and other fields. It is also used to solve different problems, such as water resources management [13,14] , power resources management [15] , battery solid recovery [16] and energy emissions [17] , population and housing issues [18] , urban development [19] , research on the influencing factors of strategic materials [20] , and research on the influencing factors of transportation [21] . Some scholars have also combined the advantages of system dynamics to solve complex systems with other methods to solve problems.…”