Indirect Virus Transmission via Fomites Can Counteract Lock-Down Effectiveness

HIGHLIGHTS: What are the main findings? Contact tracing (CT) alone can control epidemic spreading. CT efficacy changes under mobility lockdowns (LDs). A small fraction of indirect transmission can impede disease control. What is the implication of the main finding? Detailed knowledge regarding transmission routes is crucial to determine efficient non-pharmaceutical intervention strategies. Reduction of indirect transmission via fomites becomes particular important in the course of mobility LDs. ABSTRACT: The spread of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has raised major health policy questions. Direct transmission via respiratory droplets seems to be the dominant route of its transmission. However, indirect transmission via shared contact of contaminated objects may also occur. The contribution of each transmission route to epidemic spread might change during lock-down scenarios. Here, we simulate viral spread of an abstract epidemic considering both routes of transmission by use of a stochastic, agent-based SEIR model. We show that efficient contact tracing (CT) at a high level of incidence can stabilize daily cases independently of the transmission route long before effects of herd immunity become relevant. CT efficacy depends on the fraction of cases that do not show symptoms. Combining CT with lock-down scenarios that reduce agent mobility lowers the incidence for exclusive direct transmission scenarios and can even eradicate the epidemic. However, even for small fractions of indirect transmission, such lockdowns can impede CT efficacy and increase case numbers. These counterproductive effects can be reduced by applying measures that favor distancing over reduced mobility. In summary, we show that the efficacy of lock-downs depends on the transmission route. Our results point to the particular importance of hygiene measures during mobility lock-downs.