key: cord-0994951-o4n27q3l
authors: Jackson, Michael L.
title: Low-impact social distancing interventions to mitigate local epidemics of SARS-CoV-2
date: 2020-09-22
journal: Microbes Infect
DOI: 10.1016/j.micinf.2020.09.006
sha: 54b9215859fa20894df20e85a0c9e2b5601dc856
doc_id: 994951
cord_uid: o4n27q3l

Many jurisdictions implemented intensive social distancing to suppress SARS-CoV-2 transmission. The challenge now is to mitigate the ongoing COVID-19 epidemic without overburdening economic and social activities. An agent-based model simulated the population of King County, Washington. SARS-CoV-2 transmission probabilities were estimated by fitting simulated to observed hospital admissions. Interventions considered included encouraging telecommuting, reducing contacts to high-risk persons, and reductions to contacts outside of the home, among others. Removing all existing interventions would result in nearly 42,000 COVID-19 hospitalizations between June 2020 and January 2021, with peak hospital occupancy exceeding available beds 6-fold. Combining interventions is predicted to reduce total hospitalizations by 48% (95% CI, 47-49%), with peak COVID-19 hospital occupancy of 70% of total beds. Targeted school closures can further reduce the peak occupancy. Combining low-impact interventions may mitigate the course of the COVID-19 epidemic, keeping hospital burden within the capacity of the healthcare system.

In the absence of an effective and widely available vaccine against SARS-CoV-2, social 37 distancing measures are the primary interventions available for mitigating the severity of the 38 COVID-19 pandemic. During the initial pandemic wave, many jurisdictions around the world 39 implemented intensive social distancing regulations, such as forbidding large gatherings, closing 40 schools and businesses, or issuing shelter-in-place orders. [1, 2] These measures have, for the 41 most part, successfully suppressed transmission of SARS-CoV-2 by lowering the effective 42 reproductive number of the virus. [2] [3] [4] 43 While effective at reducing SARS-CoV-2 transmission, these social distancing measures 44 have incurred high economic costs [5] and are now being relaxed in many jurisdictions. The 45 challenge is to identify economically and socially sustainable interventions that can keep 46 COVID-19 incidence low enough to be managed with existing hospital capacity. This report presents findings from an agent-based model of SARS-CoV-2 transmission that can help guide latent period is between 3 and 5 days, [12, 13] and the incubation period is assumed to be 1-3 107 days longer than the latent period, so that individuals become infectious before becoming To this end, the number of hospital beds occupied by COVID-19 patients over time is predicted 171 using each of the strategies tested, assuming that the interventions start on June 22 nd 2020. These 

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