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Impact of the Covid-19 epidemic and related social distancing regulations on social contact and SARS-CoV-2 transmission potential in rural South Africa: analysis of repeated cross-sectional surveys.
McCreesh, Nicky; Dlamini, Vuyiswa; Edwards, Anita; Olivier, Stephen; Dayi, Njabulo; Dikgale, Keabetswe; Nxumalo, Siyabonga; Dreyer, Jaco; Baisley, Kathy; Siedner, Mark J; White, Richard G; Herbst, Kobus; Grant, Alison D; Harling, Guy.
  • McCreesh N; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
  • Dlamini V; Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.
  • Edwards A; Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.
  • Olivier S; Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.
  • Dayi N; Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.
  • Dikgale K; Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.
  • Nxumalo S; Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.
  • Dreyer J; Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.
  • Baisley K; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
  • Siedner MJ; Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.
  • White RG; Harvard Medical School and the Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA.
  • Herbst K; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
  • Grant AD; Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.
  • Harling G; DSI-MRC South African Population Research Infrastructure Network, Durban, South Africa.
BMC Infect Dis ; 21(1): 928, 2021 Sep 08.
Article in English | MEDLINE | ID: covidwho-1403222
ABSTRACT

BACKGROUND:

South Africa implemented rapid and strict physical distancing regulations to minimize SARS-CoV-2 epidemic spread. Evidence on the impact of such measures on interpersonal contact in rural and lower-income settings is limited.

METHODS:

We compared population-representative social contact surveys conducted in the same rural KwaZulu-Natal location once in 2019 and twice in mid-2020. Respondents reported characteristics of physical and conversational ('close interaction') contacts over 24 hours. We built age-mixing matrices and estimated the proportional change in the SARS-CoV-2 reproduction number (R0). Respondents also reported counts of others present at locations visited and transport used, from which we evaluated change in potential exposure to airborne infection due to shared indoor space ('shared air').

RESULTS:

Respondents in March-December 2019 (n = 1704) reported a mean of 7.4 close interaction contacts and 196 shared air person-hours beyond their homes. Respondents in June-July 2020 (n = 216), as the epidemic peaked locally, reported 4.1 close interaction contacts and 21 shared air person-hours outside their home, with significant declines in others' homes and public spaces. Adults aged over 50 had fewer close contacts with others over 50, but little change in contact with 15-29 year olds, reflecting ongoing contact within multigenerational households. We estimate potential R0 fell by 42% (95% plausible range 14-59%) between 2019 and June-July 2020.

CONCLUSIONS:

Extra-household social contact fell substantially following imposition of Covid-19 distancing regulations in rural South Africa. Ongoing contact within intergenerational households highlighted a potential limitation of social distancing measures in protecting older adults.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Epidemics / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Limits: Aged / Humans Country/Region as subject: Africa Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06604-8

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Epidemics / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Limits: Aged / Humans Country/Region as subject: Africa Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: S12879-021-06604-8