This article is a Preprint
Preprints are preliminary research reports that have not been certified by peer review. They should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Preprints posted online allow authors to receive rapid feedback and the entire scientific community can appraise the work for themselves and respond appropriately. Those comments are posted alongside the preprints for anyone to read them and serve as a post publication assessment.
Prevention of household transmission crucial to stop the catastrophic spread of COVID-19 in cities
Preprint
in English
| medRxiv
| ID: ppmedrxiv-20123711
ABSTRACT
After weeks under lockdown, metropolitan areas fighting the spread of COVID-19 aim to balance public health goals with social and economic standards for well-being. Mathematical models of disease transmission seeking to evaluate mitigation strategies must assess the possible impacts of social distancing, economic lockdowns and other measures. However, obscure relations between model parameters and real-world phenomena complicate such analyses. Here, we use a high-resolution metapopulation model of Guadalajara (GDL, Western Mexico) to represent daily mobility patterns driven by economic activities and their relation to epidemic growth. Given the prominence of essential activities in the citys economy, we find that strategies aiming to mitigate the risk of out-of-home interactions are insufficient to stop the catastrophic spread of COVID-19. Using baseline reproduction numbers R0 = [2.5, 3.0] in the absence of interventions, our simulations suggest that household transmission alone can make Rt [~] 1, and is estimated to drive 70 {+/-}15% of current epidemic growth. This sets an upper bound for the impact of mobility-based interventions, which are unlikely to lower Rt below 1.3 and must be complemented with aggressive campaigns for early case detection and isolation. As laboratory testing and health services become insufficient to meet demand in GDL and most other cities, we propose that cities facilitate guidelines and equipment to help people curb spreading within their own homes. Postponing these actions will increase their economic cost and decrease their potential returns. Author summaryPublic health strategies to mitigate the spread of COVID-19 in metropolitan areas have focused on preventing transmission in schools, work sites and other public spaces. Here, we use a demographically- and spatially-explicit model of Guadalajara (GDL, Western Mexico) to represent economic lockdowns and their impact on disease spread. Our findings suggest that viral exposure within households accounts for 70{+/-}15% of the epidemics current growth rate. This highlights the importance of early case detection and isolation as necessary measures to prevent the spread of COVID-19 between strangers and close contacts alike.
cc_by_nc
Full text:
Available
Collection:
Preprints
Database:
medRxiv
Type of study:
Experimental_studies
/
Prognostic study
Language:
English
Year:
2020
Document type:
Preprint