Early estimates of COVID-19 infections in small, medium and large population clusters
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Abstract
Since its emergence in late December 2019, COVID-19 has rapidly developed into a pandemic in mid of March with many countries suffering heavy human loss and declaring emergency conditions to contain its spread. The impact of the disease, while it has been relatively low in the sub-Saharan Africa (SSA) as of May 2020, is feared to be potentially devastating given the less developed and fragmented healthcare system in the continent. In addition, most emergency measures practised may not be effective due to their limited affordability as well as the communal way people in SSA live in relative isolation in clusters of large as well as smaller population centres.
Methods
To address the acute need for estimates of the potential impacts of the disease once it sweeps through the African region, we developed a process-based model with key parameters obtained from recent studies, taking local context into consideration. We further used the model to estimate the number of infections within a year of sustained local transmissions under scenarios that cover different population sizes, urban status, effectiveness and coverage of social distancing, contact tracing and usage of cloth face mask.
Results
We showed that when implemented early, 50% coverage of contact tracing and face mask, with 33% effective social distancing policies can bringing the epidemic to a manageable level for all population sizes and settings we assessed. Relaxing of social distancing in urban settings from 33% to 25% could be matched by introduction and maintenance of face mask use at 43%.
Conclusions
In SSA countries with limited healthcare workforce, hospital resources and intensive care units, a robust system of social distancing, contact tracing and face mask use could yield in outcomes that prevent several millions of infections and thousands of deaths across the continent.
Article activity feed
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SciScore for 10.1101/2020.04.07.20053421: (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
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: We detected the following sentences addressing limitations in the study:Our model is not without limitations. We have not considered symptomatic and asymptomatic infections separately, which may have overestimated the force of infection due to the lower shedding probability among non-symptomatic COVID-19 cases [12]. We also accounted for contract tracing by considering a fraction of the incubation period, …
SciScore for 10.1101/2020.04.07.20053421: (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
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: We detected the following sentences addressing limitations in the study:Our model is not without limitations. We have not considered symptomatic and asymptomatic infections separately, which may have overestimated the force of infection due to the lower shedding probability among non-symptomatic COVID-19 cases [12]. We also accounted for contract tracing by considering a fraction of the incubation period, unlike others who have used more realistic distribution-based time to isolation [8]. We have assumed that contact tracing will be completely effective with no onward transmission from those individuals suspected of the disease, which may not be realistic given the less optimal process in identifying suspects, and putting them in safe isolated location in many African settings. The estimates that we provided for mortality should also be taken only as rough initial attempts, as not much is known about the case fatality rate in SSA and also potentially higher levels of mortality due to lower levels of immunity in the populations (even if young) and impacts of underlying health conditions. Finally, the fact that our model does not have age structure has limited our capacity to make more realistic estimates of age specific mortality.
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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