How varying intervention, vaccination, mutation and ethnic conditions affect COVID-19 resurgence

  1. Longbing Cao
  2. Qing Liu

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

After a year of the unprecedented COVID-19 pandemic in 2020, the world has been overwhelmed by COVID-19 resurgences and virus mutations up to today. Here we develop a dynamic intervention, vaccination and mutation-driven epidemiological model with sequential interventions influencing epidemiological compartments and their state transition. We quantify epidemiological differences between waves under fatal viral mutations, the impacts of control or relaxation interventions and fatal virus mutations on resurgence under vaccinated or unvaccinated conditions, and estimate potential trends under varying interventions and mutations. Comprehensive analyses - between waves, with or without vaccinations, across representative countries with distinct ethnic and cultural backgrounds, what-if scenario simulations on second waves, and future 30-day trend - in two COVID-19 waves in Germany, France, Italy, Israel and Japan over 2020 and 2021 obtain quantitative empirical indication of the influence of strong vs. weak interventions, various combinations of control vs. relaxation strategies, and different transmissibility levels of coronavirus mutants on the behaviors and patterns of different waves and resurgences and future infection trends. The analyses quantify that (1) virus mutations, intervention fatigue, early relaxations, and lagging interventions, etc. may be common reasons for the resurgences observed in many countries; (2) timely strong interventions such as full lockdown will contain resurgence; (3) some resurgences relating to fatal mutants could have been better contained by either carrying forward the effective interventions from their early waves or implementing better controls and timing; (4) insufficient evidence is found on distinguishing the infection between unvaccinated and vaccinated countries while substantial vaccinations ensure much low mortality rate and high recovery rate; (5) resurgences with substantial vaccination have a much lower mortality rate and a higher recovery rate than those without vaccination; and (6) in the absence of sufficient vaccination, herd immunity and effective antiviral pharmaceutical treatments and with more infectious mutations, the widespread early or fast relaxation of interventions including public activity restrictions likely result in a COVID-19 resurgence. We also find the severity, number and timing of control and relaxation interventions determines a protection-deconfinement tradeoff, which can be used to evaluate the containment effect and the opportunity of resurgence and reopening under vaccination and fatal mutations.

Article activity feed

  1. Version published to 10.1101/2021.08.31.21262897v2 on medRxiv
  2. ScreenIT

    SciScore for 10.1101/2021.08.31.21262897: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    It is collected from Wikipedia for the COVID-19 pandemic in Germany4, the COVID-19 pandemic in France5, and the COVID-19 pandemic in Italy6.
    Wikipedia
    suggested: (Wikipedia, RRID:SCR_004897)

    Results from OddPub: Thank you for sharing your code and data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    However, our study also has several limitations for further exploration. First, our model assumes an intervention is constant over an entire wave, but it may actually be adjusted over time. For example, the strictness of social distancing, such as restrictions on the number of people participating in indoor events, is often adjusted over the epidemic period according to trends in case development, with harsher restrictions applied in more serious conditions. Second, in reality, multiple interventions are often enforced simultaneously, interacting with each other and jointly affecting an epidemic’s path. In our modeling, we do not disentangle the impact of multiple events if they were undertaken on the same day since such events are explicitly or implicitly coupled with each other in nature. However, further research could infer the impact of each individual event on case movement for characterization and insight about the positive or negative influence of a specific event. Third, the time periods of the second waves in our case study all end on 1 December 2020, which is just before the confirmation and spread of more transmissible virus mutants. The epidemiological attributes of the virus mutants and their transmission patterns may significantly differ from their original version. Hence, expanding the end date may introduce significant uncertainty and inconsistency to the modeling and findings in this work. However, this treatment also leads to the incompleteness of the secon...

    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.
    • No funding statement was detected.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.08.31.21262897v1 on medRxiv