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Modelling lockdown and exit strategies for COVID-19 in Singapore

BACKGROUND: With at least 94 countries undergoing or exiting lockdowns for contact suppression to control the COVID-19 outbreak, sustainable and public health-driven exit strategies are required. Here we explore the impact of lockdown and exit strategies in Singapore for immediate planning. METHODS:...

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Autores principales: Dickens, Borame L., Koo, Joel R., Lim, Jue Tao, Park, Minah, Quaye, Sharon, Sun, Haoyang, Sun, Yinxiaohe, Pung, Rachael, Wilder-Smith, Annelies, Chai, Louis Yi Ann, Lee, Vernon J., Cook, Alex R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395828/
https://www.ncbi.nlm.nih.gov/pubmed/34173590
http://dx.doi.org/10.1016/j.lanwpc.2020.100004
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author Dickens, Borame L.
Koo, Joel R.
Lim, Jue Tao
Park, Minah
Quaye, Sharon
Sun, Haoyang
Sun, Yinxiaohe
Pung, Rachael
Wilder-Smith, Annelies
Chai, Louis Yi Ann
Lee, Vernon J.
Cook, Alex R.
author_facet Dickens, Borame L.
Koo, Joel R.
Lim, Jue Tao
Park, Minah
Quaye, Sharon
Sun, Haoyang
Sun, Yinxiaohe
Pung, Rachael
Wilder-Smith, Annelies
Chai, Louis Yi Ann
Lee, Vernon J.
Cook, Alex R.
author_sort Dickens, Borame L.
collection PubMed
description BACKGROUND: With at least 94 countries undergoing or exiting lockdowns for contact suppression to control the COVID-19 outbreak, sustainable and public health-driven exit strategies are required. Here we explore the impact of lockdown and exit strategies in Singapore for immediate planning. METHODS: We use an agent-based model to examine the impacts of epidemic control over 480 days. A limited control baseline of case isolation and household member quarantining is used. We measure the impact of lockdown duration and start date on final infection attack sizes. We then apply a 3-month gradual exit strategy, immediately re-opening schools and easing workplace distancing measures, and compare this to long-term social distancing measures. FINDINGS: At baseline, we estimated 815 400 total infections (21.6% of the population). Early lockdown at 5 weeks with no exit strategy averted 18 500 (2.27% of baseline averted), 21 300 (2.61%) and 22 400 (2.75%) infections for 6, 8 and 9-week lockdown durations. Using the exit strategy averted a corresponding 114 700, 121 700 and 126 000 total cases, representing 12.07–13.06% of the total epidemic size under baseline. This diminishes to 9 900–11 300 for a late 8-week start time. Long-term social distancing at 6 and 8-week durations are viable but less effective. INTERPRETATION: Gradual release exit strategies are critical to maintain epidemic suppression under a new normal. We present final infection attack sizes assuming the ongoing importation of cases, which require preparation for a potential second epidemic wave due to ongoing epidemics elsewhere. FUNDING: Singapore Ministry of Health, Singapore Population Health Improvement Centre.
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spelling pubmed-73958282020-08-03 Modelling lockdown and exit strategies for COVID-19 in Singapore Dickens, Borame L. Koo, Joel R. Lim, Jue Tao Park, Minah Quaye, Sharon Sun, Haoyang Sun, Yinxiaohe Pung, Rachael Wilder-Smith, Annelies Chai, Louis Yi Ann Lee, Vernon J. Cook, Alex R. Lancet Reg Health West Pac Research Paper BACKGROUND: With at least 94 countries undergoing or exiting lockdowns for contact suppression to control the COVID-19 outbreak, sustainable and public health-driven exit strategies are required. Here we explore the impact of lockdown and exit strategies in Singapore for immediate planning. METHODS: We use an agent-based model to examine the impacts of epidemic control over 480 days. A limited control baseline of case isolation and household member quarantining is used. We measure the impact of lockdown duration and start date on final infection attack sizes. We then apply a 3-month gradual exit strategy, immediately re-opening schools and easing workplace distancing measures, and compare this to long-term social distancing measures. FINDINGS: At baseline, we estimated 815 400 total infections (21.6% of the population). Early lockdown at 5 weeks with no exit strategy averted 18 500 (2.27% of baseline averted), 21 300 (2.61%) and 22 400 (2.75%) infections for 6, 8 and 9-week lockdown durations. Using the exit strategy averted a corresponding 114 700, 121 700 and 126 000 total cases, representing 12.07–13.06% of the total epidemic size under baseline. This diminishes to 9 900–11 300 for a late 8-week start time. Long-term social distancing at 6 and 8-week durations are viable but less effective. INTERPRETATION: Gradual release exit strategies are critical to maintain epidemic suppression under a new normal. We present final infection attack sizes assuming the ongoing importation of cases, which require preparation for a potential second epidemic wave due to ongoing epidemics elsewhere. FUNDING: Singapore Ministry of Health, Singapore Population Health Improvement Centre. Elsevier 2020-08-01 /pmc/articles/PMC7395828/ /pubmed/34173590 http://dx.doi.org/10.1016/j.lanwpc.2020.100004 Text en © 2020 The Author(s). Published by Elsevier Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Research Paper
Dickens, Borame L.
Koo, Joel R.
Lim, Jue Tao
Park, Minah
Quaye, Sharon
Sun, Haoyang
Sun, Yinxiaohe
Pung, Rachael
Wilder-Smith, Annelies
Chai, Louis Yi Ann
Lee, Vernon J.
Cook, Alex R.
Modelling lockdown and exit strategies for COVID-19 in Singapore
title Modelling lockdown and exit strategies for COVID-19 in Singapore
title_full Modelling lockdown and exit strategies for COVID-19 in Singapore
title_fullStr Modelling lockdown and exit strategies for COVID-19 in Singapore
title_full_unstemmed Modelling lockdown and exit strategies for COVID-19 in Singapore
title_short Modelling lockdown and exit strategies for COVID-19 in Singapore
title_sort modelling lockdown and exit strategies for covid-19 in singapore
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395828/
https://www.ncbi.nlm.nih.gov/pubmed/34173590
http://dx.doi.org/10.1016/j.lanwpc.2020.100004
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