Increased Dengue Transmissions in Singapore Attributable to SARS-CoV-2 Social Distancing Measures.

Social distancing (SD) measures aimed at curbing the spread of SARS-CoV-2 remain an important public health intervention. Little is known about the collateral impact of reduced mobility on the risk of other communicable diseases. We used differences in dengue case counts pre- and post implementation of SD measures and exploited heterogeneity in SD treatment effects among different age groups in Singapore to identify the spillover effects of SD measures. SD policy caused an increase of over 37.2% in dengue cases from baseline. Additional measures to preemptively mitigate the risk of other communicable diseases must be considered before the implementation/reimplementation of SARS-CoV-2 SD measures.

Impact of sars-cov-2 interventions on dengue transmission.

An estimated 105 million dengue infections occur per year across 120 countries, where traditional vector control is the primary control strategy to reduce contact between mosquito vectors and people. The ongoing sars-cov-2 pandemic has resulted in dramatic reductions in human mobility due to social distancing measures; the effects on vector-borne illnesses are not known. Here we examine the pre and post differences of dengue case counts in Malaysia, Singapore and Thailand, and estimate the effects of social distancing as a treatment effect whilst adjusting for temporal confounders. We found that social distancing is expected to lead to 4.32 additional cases per 100,000 individuals in Thailand per month, which equates to 170 more cases per month in the Bangkok province (95% CI: 100-242) and 2008 cases in the country as a whole (95% CI: 1170-2846). Social distancing policy estimates for Thailand were also found to be robust to model misspecification, and variable addition and omission. Conversely, no significant impact on dengue transmission was found in Singapore or Malaysia. Across country disparities in social distancing policy effects on reported dengue cases are reasoned to be driven by differences in workplace-residence structure, with an increase in transmission risk of arboviruses from social distancing primarily through heightened exposure to vectors in elevated time spent at residences, demonstrating the need to understand the effects of location on dengue transmission risk under novel population mixing conditions such as those under social distancing policies.

A Mobile Swabbing Booth to Address Singapore GPs’ Concerns About Swabber Protection: Human-Centred Design during the COVID-19 Pandemic (preprint)

BackgroundDuring the COVID-19 pandemic, the Ministry of Health asked Singapore’s private general practitioners (GPs) to perform swab testing in their clinics, but some GPs had concerns about swabber protection. Our aim was to develop a swabbing booth to address these concerns.MethodsWe developed a prototype with potential GP users using a human-centred design approach and piloted it with 10 GP clinics. The pilot was then extended to 170 GP clinics around Singapore. These GPs were then surveyed on user satisfaction.Results93 GPs (54%) responded. The majority (75%) practiced in public residential estates in small practices (mean 1.93 doctors). 86% requested the booth to enhance swabber protection. 74% “would recommend” or “would strongly recommend” the booth to colleagues. 79% continue to use the booth to conduct swab tests. 92% liked that it offered swabber protection. 71% liked that the booth created a separate space for swabbing and 64% liked its ease of disinfection. 47% started swabbing only after receiving the booth and 58% said the booth was “important” or “very important” to their decision to participate in swab testing. However, 34% disliked that it took up too much space and the most frequently critiqued area was the gloves.ConclusionThe human-centred design approach generated a product that had high user satisfaction, addressed GPs’ concerns of swabber protection and increased GPs’ participation in swab testing. The booth may be useful where GPs are concerned about swabber protection and space is limited.

Revealing regional disparities in the transmission potential of SARS-CoV-2 from interventions in Southeast Asia.

SARS-CoV-2 is a new pathogen responsible for the coronavirus disease 2019 (COVID-19) outbreak. Southeast Asia was the first region to be affected outside China, and although COVID-19 cases have been reported in all countries of Southeast Asia, both the policies and epidemic trajectories differ substantially, potentially due to marked differences in social distancing measures that have been implemented by governments in the region. This paper studies the across-country relationships between social distancing and each population's response to policy, the subsequent effects of these responses to the transmissibility and epidemic trajectories of SARS-CoV-2. The analysis couples COVID-19 case counts with real-time mobility data across Southeast Asia to estimate the effects of host population response to social distancing policy and the subsequent effects on the transmissibility and epidemic trajectories of SARS-CoV-2. A novel inference strategy for the time-varying reproduction number is developed to allow explicit inference of the effects of social distancing on the transmissibility of SARS-CoV-2 through a regression structure. This framework replicates the observed epidemic trajectories across most Southeast Asian countries, provides estimates of the effects of social distancing on the transmissibility of disease and can simulate epidemic histories conditional on changes in the degree of intervention scenarios and compliance within Southeast Asia.