How much leeway is there to relax COVID-19 control measures?

Following successful non-pharmaceutical interventions (NPI) aiming to control COVID-19, many jurisdictions reopened their economies and borders. As little immunity had developed in most populations, re-establishing higher contact carried substantial risks, and therefore many locations began to see r...

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Veröffentlicht in:Epidemics 2021-06, Vol.35, p.100453-100453, Article 100453
Hauptverfasser: Anderson, Sean C., Mulberry, Nicola, Edwards, Andrew M., Stockdale, Jessica E., Iyaniwura, Sarafa A., Falcao, Rebeca C., Otterstatter, Michael C., Janjua, Naveed Z., Coombs, Daniel, Colijn, Caroline
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container_end_page 100453
container_issue
container_start_page 100453
container_title Epidemics
container_volume 35
creator Anderson, Sean C.
Mulberry, Nicola
Edwards, Andrew M.
Stockdale, Jessica E.
Iyaniwura, Sarafa A.
Falcao, Rebeca C.
Otterstatter, Michael C.
Janjua, Naveed Z.
Coombs, Daniel
Colijn, Caroline
description Following successful non-pharmaceutical interventions (NPI) aiming to control COVID-19, many jurisdictions reopened their economies and borders. As little immunity had developed in most populations, re-establishing higher contact carried substantial risks, and therefore many locations began to see resurgence in COVID-19 cases. We present a Bayesian method to estimate the leeway to reopen, or alternatively the strength of change required to re-establish COVID-19 control, in a range of jurisdictions experiencing different COVID-19 epidemics. We estimated the timing and strength of initial control measures such as widespread distancing and compared the leeway jurisdictions had to reopen immediately after NPI measures to later estimates of leeway. Finally, we quantified risks associated with reopening and the likely burden of new cases due to introductions from other jurisdictions. We found widely varying leeway to reopen. After initial NPI measures took effect, some jurisdictions had substantial leeway (e.g., Japan, New Zealand, Germany) with > 0.99 probability that contact rates were below 80% of the threshold for epidemic growth. Others had little leeway (e.g., the United Kingdom, Washington State) and some had none (e.g., Sweden, California). For most such regions, increases in contact rate of 1.5–2 fold would have had high (> 0.7) probability of exceeding past peak sizes. Most jurisdictions experienced June–August trajectories consistent with our projections of contact rate increases of 1–2-fold. Under such relaxation scenarios for some regions, we projected up to ∼100 additional cases if just one case were imported per week over six weeks, even between jurisdictions with comparable COVID-19 risk. We provide an R package covidseir to enable jurisdictions to estimate leeway and forecast cases under different future contact patterns. Estimates of leeway can establish a quantitative basis for decisions about reopening. We recommend a cautious approach to reopening economies and borders, coupled with strong monitoring for changes in transmission. •COVID-19 was controlled largely by non-pharmaceutical interventions for months.•It was necessary to reopen economies in the absence of large-scale immunity.•We developed a Bayesian method and R package covidseir to estimate reopening leeway.•Leeway varied widely and was consistent with subsequent COVID-19 trajectories.•Even between places with comparable leeway, introductions can cause many new cases.
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As little immunity had developed in most populations, re-establishing higher contact carried substantial risks, and therefore many locations began to see resurgence in COVID-19 cases. We present a Bayesian method to estimate the leeway to reopen, or alternatively the strength of change required to re-establish COVID-19 control, in a range of jurisdictions experiencing different COVID-19 epidemics. We estimated the timing and strength of initial control measures such as widespread distancing and compared the leeway jurisdictions had to reopen immediately after NPI measures to later estimates of leeway. Finally, we quantified risks associated with reopening and the likely burden of new cases due to introductions from other jurisdictions. We found widely varying leeway to reopen. After initial NPI measures took effect, some jurisdictions had substantial leeway (e.g., Japan, New Zealand, Germany) with &gt; 0.99 probability that contact rates were below 80% of the threshold for epidemic growth. Others had little leeway (e.g., the United Kingdom, Washington State) and some had none (e.g., Sweden, California). For most such regions, increases in contact rate of 1.5–2 fold would have had high (&gt; 0.7) probability of exceeding past peak sizes. Most jurisdictions experienced June–August trajectories consistent with our projections of contact rate increases of 1–2-fold. Under such relaxation scenarios for some regions, we projected up to ∼100 additional cases if just one case were imported per week over six weeks, even between jurisdictions with comparable COVID-19 risk. We provide an R package covidseir to enable jurisdictions to estimate leeway and forecast cases under different future contact patterns. 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As little immunity had developed in most populations, re-establishing higher contact carried substantial risks, and therefore many locations began to see resurgence in COVID-19 cases. We present a Bayesian method to estimate the leeway to reopen, or alternatively the strength of change required to re-establish COVID-19 control, in a range of jurisdictions experiencing different COVID-19 epidemics. We estimated the timing and strength of initial control measures such as widespread distancing and compared the leeway jurisdictions had to reopen immediately after NPI measures to later estimates of leeway. Finally, we quantified risks associated with reopening and the likely burden of new cases due to introductions from other jurisdictions. We found widely varying leeway to reopen. After initial NPI measures took effect, some jurisdictions had substantial leeway (e.g., Japan, New Zealand, Germany) with &gt; 0.99 probability that contact rates were below 80% of the threshold for epidemic growth. Others had little leeway (e.g., the United Kingdom, Washington State) and some had none (e.g., Sweden, California). For most such regions, increases in contact rate of 1.5–2 fold would have had high (&gt; 0.7) probability of exceeding past peak sizes. Most jurisdictions experienced June–August trajectories consistent with our projections of contact rate increases of 1–2-fold. Under such relaxation scenarios for some regions, we projected up to ∼100 additional cases if just one case were imported per week over six weeks, even between jurisdictions with comparable COVID-19 risk. We provide an R package covidseir to enable jurisdictions to estimate leeway and forecast cases under different future contact patterns. Estimates of leeway can establish a quantitative basis for decisions about reopening. 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As little immunity had developed in most populations, re-establishing higher contact carried substantial risks, and therefore many locations began to see resurgence in COVID-19 cases. We present a Bayesian method to estimate the leeway to reopen, or alternatively the strength of change required to re-establish COVID-19 control, in a range of jurisdictions experiencing different COVID-19 epidemics. We estimated the timing and strength of initial control measures such as widespread distancing and compared the leeway jurisdictions had to reopen immediately after NPI measures to later estimates of leeway. Finally, we quantified risks associated with reopening and the likely burden of new cases due to introductions from other jurisdictions. We found widely varying leeway to reopen. 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Estimates of leeway can establish a quantitative basis for decisions about reopening. 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subjects Bayes Theorem
Bayesian
Communicable Disease Control
COVID-19
COVID-19 - epidemiology
COVID-19 - prevention & control
COVID-19 - transmission
Forecasting
Humans
Infectious Diseases
Life Sciences & Biomedicine
Non-pharmaceutical interventions
Risk
SARS-CoV-2
Science & Technology
SEIR
title How much leeway is there to relax COVID-19 control measures?
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