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Preventing a cluster from becoming a new wave in settings with zero community COVID-19 cases.
Abeysuriya, Romesh G; Delport, Dominic; Stuart, Robyn M; Sacks-Davis, Rachel; Kerr, Cliff C; Mistry, Dina; Klein, Daniel J; Hellard, Margaret; Scott, Nick.
  • Abeysuriya RG; Burnet Institute, Melbourne, VIC, Australia. romesh.abeysuriya@burnet.edu.au.
  • Delport D; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. romesh.abeysuriya@burnet.edu.au.
  • Stuart RM; Burnet Institute, Melbourne, VIC, Australia.
  • Sacks-Davis R; Burnet Institute, Melbourne, VIC, Australia.
  • Kerr CC; Department of Mathematical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Mistry D; Burnet Institute, Melbourne, VIC, Australia.
  • Klein DJ; Institute for Disease Modeling at the Bill & Melinda Gates Foundation, Seattle, USA.
  • Hellard M; School of Physics, University of Sydney, Sydney, NSW, Australia.
  • Scott N; Institute for Disease Modeling at the Bill & Melinda Gates Foundation, Seattle, USA.
BMC Infect Dis ; 22(1): 232, 2022 Mar 07.
Article in English | MEDLINE | ID: covidwho-1731519
ABSTRACT

BACKGROUND:

In settings with zero community transmission, any new SARS-CoV-2 outbreaks are likely to be the result of random incursions. The level of restrictions in place at the time of the incursion is likely to considerably affect possible outbreak trajectories, but the probability that a large outbreak eventuates is not known.

METHODS:

We used an agent-based model to investigate the relationship between ongoing restrictions and behavioural factors, and the probability of an incursion causing an outbreak and the resulting growth rate. We applied our model to the state of Victoria, Australia, which has reached zero community transmission as of November 2020.

RESULTS:

We found that a future incursion has a 45% probability of causing an outbreak (defined as a 7-day average of > 5 new cases per day within 60 days) if no restrictions were in place, decreasing to 23% with a mandatory masks policy, density restrictions on venues such as restaurants, and if employees worked from home where possible. A drop in community symptomatic testing rates was associated with up to a 10-percentage point increase in outbreak probability, highlighting the importance of maintaining high testing rates as part of a suppression strategy.

CONCLUSIONS:

Because the chance of an incursion occurring is closely related to border controls, outbreak risk management strategies require an integrated approaching spanning border controls, ongoing restrictions, and plans for response. Each individual restriction or control strategy reduces the risk of an outbreak. They can be traded off against each other, but if too many are removed there is a danger of accumulating an unsafe level of risk. The outbreak probabilities estimated in this study are of particular relevance in assessing the downstream risks associated with increased international travel.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Oceania Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: S12879-022-07180-1

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Oceania Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: S12879-022-07180-1