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https://doi.org/10.1093/jtm/taab113
Title: | Risk scorecard to minimize impact of COVID-19 when reopening | Authors: | Lim, Shin B. Pung, Rachael Tan, Kellie Lang, Jocelyn H. S. Yong, Dominique Z. X. Teh, Shi-Hua Quah, Elizabeth Sun, Yinxiaohe Ma, Stefan Lee, Vernon J. M. |
Keywords: | contact tracing imported cases infectious diseases quarantine SARS-CoV-2 social distancing traveller testing |
Issue Date: | 23-Jul-2021 | Publisher: | NLM (Medline) | Citation: | Lim, Shin B., Pung, Rachael, Tan, Kellie, Lang, Jocelyn H. S., Yong, Dominique Z. X., Teh, Shi-Hua, Quah, Elizabeth, Sun, Yinxiaohe, Ma, Stefan, Lee, Vernon J. M. (2021-07-23). Risk scorecard to minimize impact of COVID-19 when reopening. Journal of travel medicine 28 (7). ScholarBank@NUS Repository. https://doi.org/10.1093/jtm/taab113 | Rights: | Attribution 4.0 International | Abstract: | BACKGROUND: We present a novel approach for exiting coronavirus disease 2019 (COVID-19) lockdowns using a 'risk scorecard' to prioritize activities to resume whilst allowing safe reopening. METHODS: We modelled cases generated in the community/week, incorporating parameters for social distancing, contact tracing and imported cases. We set thresholds for cases and analysed the effect of varying parameters. An online tool to facilitate country-specific use including the modification of parameters (https://sshsphdemos.shinyapps.io/covid_riskbudget/) enables visualization of effects of parameter changes and trade-offs. Local outbreak investigation data from Singapore illustrate this. RESULTS: Setting a threshold of 0.9 mean number of secondary cases arising from a case to keep R?1, we showed that opening all activities excluding high-risk ones (e.g. nightclubs) allows cases to remain within threshold; while opening high-risk activities would exceed the threshold and result in escalating cases. An 80% reduction in imported cases per week (141 to 29) reduced steady-state cases by 30% (295 to 205). One-off surges in cases (due to superspreading) had no effect on the steady state if the R remains <1. Increasing the effectiveness of contact tracing (probability of a community case being isolated when infectious) by 33% (0.6 to 0.8) reduced cases by 22% (295 to 231). Cases grew exponentially if the product of the mean number of secondary cases arising from a case and (1-probability of case being isolated) was >1. CONCLUSIONS: Countries can utilize a 'risk scorecard' to balance relaxations for travel and domestic activity depending on factors that reduce disease impact, including hospital/ICU capacity, contact tracing, quarantine and vaccination. The tool enabled visualization of the combinations of imported cases and activity levels on the case numbers and the trade-offs required. For vaccination, a reduction factor should be applied both for likelihood of an infected case being present and a close contact getting infected. © International Society of Travel Medicine 2021. Published by Oxford University Press. | Source Title: | Journal of travel medicine | URI: | https://scholarbank.nus.edu.sg/handle/10635/232900 | ISSN: | 1708-8305 | DOI: | 10.1093/jtm/taab113 | Rights: | Attribution 4.0 International |
Appears in Collections: | Elements Staff Publications |
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