Prevention of household transmission crucial to stop the catastrophic spread of COVID-19 in cities
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Abstract
After weeks under lockdown, metropolitan areas fighting the spread of COVID-19 aim to balance public health goals with social and economic standards for well-being. Mathematical models of disease transmission seeking to evaluate mitigation strategies must assess the possible impacts of social distancing, economic lockdowns and other measures. However, obscure relations between model parameters and real-world phenomena complicate such analyses. Here, we use a high-resolution metapopulation model of Guadalajara (GDL, Western Mexico) to represent daily mobility patterns driven by economic activities and their relation to epidemic growth. Given the prominence of essential activities in the city’s economy, we find that strategies aiming to mitigate the risk of out-of-home interactions are insufficient to stop the catastrophic spread of COVID-19. Using baseline reproduction numbers R 0 = [2.5, 3.0] in the absence of interventions, our simulations suggest that household transmission alone can make R t ∼ 1, and is estimated to drive 70 ± 15% of current epidemic growth. This sets an upper bound for the impact of mobility-based interventions, which are unlikely to lower R t below 1.3 and must be complemented with aggressive campaigns for early case detection and isolation. As laboratory testing and health services become insufficient to meet demand in GDL and most other cities, we propose that cities facilitate guidelines and equipment to help people curb spreading within their own homes. Postponing these actions will increase their economic cost and decrease their potential returns.
Author summary
Public health strategies to mitigate the spread of COVID-19 in metropolitan areas have focused on preventing transmission in schools, work sites and other public spaces. Here, we use a demographically- and spatially-explicit model of Guadalajara (GDL, Western Mexico) to represent economic lockdowns and their impact on disease spread. Our findings suggest that viral exposure within households accounts for 70 ± 15% of the epidemic’s current growth rate. This highlights the importance of early case detection and isolation as necessary measures to prevent the spread of COVID-19 between strangers and close contacts alike.
Article activity feed
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SciScore for 10.1101/2020.06.05.20123711: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar …
SciScore for 10.1101/2020.06.05.20123711: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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