SAfE transport: wearing face masks significantly reduces the spread of COVID-19 on trains.

COVID-19 has had a substantial impact globally. It spreads readily, particularly in enclosed and crowded spaces, such as public transport carriages, yet there are limited studies on how this risk can be reduced. We developed a tool for exploring the potential impacts of mitigation strategies on public transport networks, called the Systems Analytics for Epidemiology in Transport (SAfE Transport). SAfE Transport combines an agent-based transit assignment model, a community-wide transmission model, and a transit disease spread model to support strategic and operational decision-making. For this simulated COVID-19 case study, the transit disease spread model incorporates both direct (person-to-person) and fomite (person-to-surface-to-person) transmission modes. We determine the probable impact of wearing face masks on trains over a seven day simulation horizon, showing substantial and statistically significant reductions in new cases when passenger mask wearing proportions are greater than 80%. The higher the level of mask coverage, the greater the reduction in the number of new infections. Also, the higher levels of mask coverage result in an earlier reduction in disease spread risk. These results can be used by decision makers to guide policy on face mask use for public transport networks.

Timely surveillance and temporal calibration of disease response against human infectious diseases.

BACKGROUND: Disease surveillance and response are critical components of epidemic preparedness. The disease response, in most cases, is a set of reactive measures that follow the outcomes of the disease surveillance. Hence, timely surveillance is a prerequisite for an effective response. METHODOLOGY/PRINCIPAL FINDINGS: We apply epidemiological soundness criteria in combination with the Latent Influence Point Process and time-to-event models to construct a disease spread network. The network implicitly quantifies the fertility (whether a case leads to secondary cases) and reproduction (number of secondary cases per infectious case) of the cases as well as the size and generations (of the infection chain) of the outbreaks. We test our approach by applying it to historic dengue case data from Australia. Using the data, we empirically confirm that high morbidity relates positively with delay in disease response. Moreover, we identify what constitutes timely surveillance by applying various thresholds of disease response delay to the network and report their impact on case fertility, reproduction, number of generations and ultimately, outbreak size. We observe that enforcing a response delay threshold of 5 days leads to a large average reduction across all parameters (occurrence 87%, reproduction 83%, outbreak size 80% and outbreak generations 47%), whereas extending the threshold to 10 days, in comparison, significantly limits the effectiveness of the response actions. Lastly, we identify the components of the disease surveillance system that can be calibrated to achieve the identified thresholds. CONCLUSION: We identify practically achievable, timely surveillance thresholds (on temporal scale) that lead to an effective response and identify how they can be satisfied. Our approach can be utilized to provide guidelines on spatially and demographically targeted resource allocation for public awareness campaigns as well as to improve diagnostic abilities and turn-around times for the doctors and laboratories involved.

Should international borders re-open? The impact of travel restrictions on COVID-19 importation risk.

BACKGROUND: Novel coronavirus disease (COVID-19) has spread across the world at an unprecedented pace, reaching over 200 countries and territories in less than three months. In response, many governments denied entry to travellers arriving from various countries affected by the virus. While several industries continue to experience economic losses due to the imposed interventions, it is unclear whether the different travel restrictions were successful in reducing COVID-19 importations. METHODS: Here we develop a comprehensive probabilistic framework to model daily COVID-19 importations, considering different travel bans. We quantify the temporal effects of the restrictions and elucidate the relationship between incidence rates in other countries, travel flows and the expected number of importations into the country under investigation. RESULTS: As a cases study, we evaluate the travel bans enforced by the Australian government. We find that international travel bans in Australia lowered COVID-19 importations by 87.68% (83.39 - 91.35) between January and June 2020. The presented framework can further be used to gain insights into how many importations to expect should borders re-open. CONCLUSIONS: While travel bans lowered the number of COVID-19 importations overall, the effectiveness of bans on individual countries varies widely and directly depends on the change in behaviour in returning residents and citizens. Authorities may consider the presented information when planning a phased re-opening of international borders.

Forecasting the probability of local dengue outbreaks in Queensland, Australia.

The global incidence of dengue is increasing, and many previously unaffected areas have reported local cases of the vector-borne disease in recent years. For the effective containment of local outbreaks health authorities rely on the prompt notification of new cases. However, due to severe under-reporting and misdiagnosis, non-endemic countries face difficulties in containing local outbreaks, and the possibility of dengue becoming endemic. Outbreak control measures in non-endemic countries are largely reactive and health authorities would benefit from a universal early warning system that forecasts the probability of dengue outbreaks for given times and locations. We develop a model that establishes a link between pre- and post-border risk of dengue outbreaks. Specifically, we predict the probability of travellers importing dengue from other countries as well as the probability of those travellers causing local outbreaks. Our model can act as an early warning system, forecasting likely times and places of dengue outbreaks. We run our model for the Australian state of Queensland over a period of twelve years. Our results reveal the airports where dengue infected travellers are most likely to arrive and geographic locations associated with high outbreak probabilities. Our results can be used by health authorities to better utilise prevention and control resources and lead to the development of new prevention measures.

A global model for predicting the arrival of imported dengue infections.

With approximately half of the world's population at risk of contracting dengue, this mosquito-borne disease is of global concern. International travellers significantly contribute to dengue's rapid and large-scale spread by importing the disease from endemic into non-endemic countries. To prevent future outbreaks and dengue from establishing in non-endemic countries, knowledge about the arrival time and location of infected travellers is crucial. We propose a network model that predicts the monthly number of dengue-infected air passengers arriving at any given airport. We consider international air travel volumes to construct weighted networks, representing passenger flows between airports. We further calculate the probability of passengers, who travel through the international air transport network, being infected with dengue. The probability of being infected depends on the destination, duration and timing of travel. Our findings shed light onto dengue importation routes and reveal country-specific reporting rates that have been until now largely unknown. This paper provides important new knowledge about the spreading dynamics of dengue that is highly beneficial for public health authorities to strategically allocate the often limited resources to more efficiently prevent the spread of dengue.