Impact of tiered measures on social contact and mixing patterns in Italy during the second wave of COVID-19 (preprint)

Background: The COVID-19 pandemic has significantly affected social contact patterns worldwide. Particularly during the first epidemic wave, because of the lack of specific treatment or vaccine, most countries around the world enforced non-pharmaceutical interventions. Italy was one of the first countries to be strongly affected by the pandemic, imposing in the first epidemic wave a hard lockdown. During the second wave, the country implemented color-coded, progressively restrictive tiers at the regional level according to weekly epidemiological risk assessments. Methods: We analyze longitudinal surveys of a representative sample of the Italian population by age, gender, and region of residence, collected during the second epidemic wave. After presenting a statistical description of the sample, we compare variations in contact patterns according to a color-coded tier of interventions experienced by the participants. In particular, we use contact matrices to quantify the reduction in the number of contacts by age group and contact settings, focusing on the adult population. We also compare the results with the pre-pandemic baseline assessing the impact of tiered restrictions on contacts. Finally, we compute the reproduction number to evaluate the impact of the restrictions on the spreading of the disease.Results: The comparison with the pre-pandemic baseline, shows a significant decrease in the number of contacts, independently from the age group or contact settings. Moreover, we show that the decrease in the number of contacts significantly depends on the strictness of the non-pharmaceutical interventions. For all levels of strictness considered, the reduction in social mixing results in a reproduction number smaller than one. In particular, the impact of the restriction on the number of contacts decreases with the severity of the interventions. Conclusions: We showed that the progressive restriction tiers implemented in Italy reduced overall the reproduction number, with stricter interventions associated with higher reductions. Readily collected contact data can promptly inform the implementation of mitigation measures at the national level in epidemic emergencies to come.

The influence of risk perceptions on close contact frequency during the SARS-CoV-2 pandemic (preprint)

Human behaviour is known to be crucial in the propagation of infectious diseases through respiratory or close-contact routes like the current SARS-CoV-2 virus. Intervention measures implemented to curb the spread of the virus mainly aim at limiting the number of close contacts, until vaccine roll-out is complete. Our main objective was to assess the relationships between SARS-CoV-2 perceptions and social contact behaviour in Belgium. Understanding these relationships is crucial to maximize interventions' effectiveness, e.g. by tailoring public health communication campaigns. In this study, we surveyed a representative sample of adults in Belgium in two longitudinal surveys (8 waves of survey 1 in April 2020 to August 2020, and 11 waves of survey 2 in November 2020 to April 2021). Generalized linear mixed effects models were used to analyse the two surveys. Participants with low and neutral perceptions on perceived severity made a significantly higher number of social contacts as compared to participants with high levels of perceived severity after controlling for other variables. Furthermore, participants with higher levels of perceived effectiveness of measures and perceived adherence to measures made fewer contacts. However, the differences were small. Our results highlight the key role of perceived severity on social contact behaviour during a pandemic. Nevertheless, additional research is required to investigate the impact of public health communication on severity of COVID-19 in terms of changes in social contact behaviour.