SARS-CoV-2 transmission and control in a hospital setting: an individual-based modelling study

  1. Qimin Huang
  2. Anirban Mondal
  3. Xiaobing Jiang
  4. Mary Ann Horn
  5. Fei Fan
  6. Peng Fu
  7. Xuan Wang
  8. Hongyang Zhao
  9. Martial Ndeffo-Mbah
  10. David Gurarie
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Abstract

Background

Development of strategies for mitigating the severity of COVID-19 is now a top global public health priority. We sought to assess strategies for mitigating the COVID-19 outbreak in a hospital setting via the use of non-pharmaceutical interventions such as social distancing, self-isolation, tracing and quarantine, wearing facial masks/ personal protective equipment.

Methods

We developed an individual-based model for COVID-19 transmission among healthcare workers in a hospital setting. We calibrated the model using data of a COVID-19 outbreak in a hospital unit in Wuhan in a Bayesian framework. The calibrated model was used to simulate different intervention scenarios and estimate the impact of different interventions on outbreak size and workday loss.

Results

We estimated that work-related stress increases susceptibility to COVID-19 infection among healthcare workers by 52% (90% Credible Interval (CrI): 16.4% – 93.0%). The use of high efficacy facial masks was shown to be able to reduce infection cases and workday loss by 80% (90% CrI: 73.1% – 85.7%) and 87% (CrI: 80.0% – 92.5%), respectively. The use of social distancing alone, through reduced contacts between healthcare workers, had a marginal impact on the outbreak. A strict quarantine policy with the isolation of symptomatic cases and a high fraction of pre-symptomatic/ asymptomatic cases (via contact tracing or high test rate), could only prolong outbreak duration with minimal impact on the outbreak size. Our results indicated that a quarantine policy should be coupled with other interventions to achieve its effect. The effectiveness of all these interventions was shown to increase with their early implementation.

Conclusions

Our analysis shows that a COVID-19 outbreak in a hospital’s non-COVID-19 unit can be controlled or mitigated by the use of existing non-pharmaceutical measures.

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