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2022 Winter Simulation Conference, WSC 2022 ; 2022-December:605-616, 2022.
Article in English | Scopus | ID: covidwho-2280546


Global travel and trade have been hit hard by the COVID-19 pandemic. Border closures have impacted both leisure and business travel. The socioeconomic costs of border closure are particularly severe for individuals living and working across state lines, for which previously unhindered passage has been curtailed, and daily commute across borders is now virtually impossible. Here, we examine how the periodic screening of daily cross-border commuters across territories with relatively low COVID-19 incidence will impact the transmission of SARS-CoV-2 across borders using agent-based simulation. We find that periodic testing at practical frequencies of once every 7, 14 or 21 days would reduce the number of infected individuals crossing the border. The unique transmission characteristics of SARS-CoV-2 suggest that periodic testing of populations with low incidence is of limited use in reducing cross-border transmission and is not as cost-effective as other mitigation measures for preventing transmission. © 2022 IEEE.

Annals of the Academy of Medicine, Singapore ; 50(8):619-628, 2021.
Article in English | MEDLINE | ID: covidwho-1391356


INTRODUCTION: The COVID-19 pandemic has affected the world for more than a year, with multiple waves of infections resulting in morbidity, mortality and disruption to the economy and society. Response measures employed to control it have generally been effective but are unlikely to be sustainable over the long term. METHODS: We examined the evidence for a vaccine-driven COVID-19 exit strategy including academic papers, governmental reports and epidemiological data, and discuss the shift from the current pandemic footing to an endemic approach similar to influenza and other respiratory infectious diseases. RESULTS: A desired endemic state is characterised by a baseline prevalence of infections with a generally mild disease profile that can be sustainably managed by the healthcare system, together with the resumption of near normalcy in human activities. Such an endemic state is attainable for COVID-19 given the promising data around vaccine efficacy, although uncertainty remains around vaccine immunity escape in emergent variants of concern. Maintenance of non-pharmaceutical interventions remains crucial until high vaccination coverage is attained to avoid runaway outbreaks. It may also be worthwhile to de-escalate measures in phases, before standing down most measures for an endemic state. If a variant that substantially evades immunity emerges, it will need to be managed akin to a new disease threat, with pandemic preparedness and response plans. CONCLUSION: An endemic state for COVID-19, characterised by sustainable disease control measures, is likely attainable through vaccination.

Annals of the Academy of Medicine, Singapore ; 50(8):649-651, 2021.
Article in English | MEDLINE | ID: covidwho-1391098
Int J Tuberc Lung Dis ; 25(6): 421-423, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1248354