Reducing COVID-19 quarantine with SARS-CoV-2 testing: a simulation study
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Abstract
To evaluate the effectiveness of SARS-CoV-2 testing on shortening the duration of quarantines for COVID-19 and to identify the most effective choices of testing schedules.
Design
We performed extensive simulations to evaluate the performance of quarantine strategies when one or more SARS-CoV-2 tests were administered during the quarantine. Simulations were based on statistical models for the transmissibility and viral loads of SARS-CoV-2 infections and the sensitivities of available testing methods. Sensitivity analyses were performed to evaluate the impact of perturbations in model assumptions on the outcomes of optimal strategies.
Results
We found that SARS-CoV-2 testing can effectively reduce the length of a quarantine without compromising safety. A single reverse transcription-PCR (RT-PCR) test performed before the end of quarantine can reduce quarantine duration to 10 days. Two tests can reduce the duration to 8 days, and three highly sensitive RT-PCR tests can justify a 6-day quarantine. More strategic testing schedules and longer quarantines are needed if tests are administered with less-sensitive RT-PCR tests or antigen tests. Shorter quarantines can be used for applications that tolerate a residual postquarantine transmission risk comparable to a 10-day quarantine.
Conclusions
Testing could substantially reduce the length of isolation, reducing the physical and mental stress caused by lengthy quarantines. With increasing capacity and lowered costs of SARS-CoV-2 tests, test-assisted quarantines could be safer and more cost-effective than 14-day quarantines and warrant more widespread use.
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SciScore for 10.1101/2020.11.06.20222398: (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: Thank you for sharing your code.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:A potential limitation of our modeling technique is our use of probabilistic modeling. We simulated the occurrence of infection and recovery events at random based off measured parameter probabilities of COVID-19 spread within a network or between networks. This limits the contribution of geographical constraints or non-random social interaction. Further, we found lengthened incubation periods diminishes the efficacy of quarantine strategies. …
SciScore for 10.1101/2020.11.06.20222398: (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: Thank you for sharing your code.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:A potential limitation of our modeling technique is our use of probabilistic modeling. We simulated the occurrence of infection and recovery events at random based off measured parameter probabilities of COVID-19 spread within a network or between networks. This limits the contribution of geographical constraints or non-random social interaction. Further, we found lengthened incubation periods diminishes the efficacy of quarantine strategies. Therefore, it is critically important to understand variations in incubation period, especially for test-assisted quarantine strategies with shorter quarantine durations. Since individuals with shorter incubation periods are more likely to show symptoms during quarantine (Figure 4b), individuals at the tail of the distribution of incubation period contribute to the majority of cases who show symptoms and infect others after quarantine, and to the PQTR of our presented quarantine strategies. The literature on foreshortened and test-assisted quarantine strategies is sparse. Only two investigations similar to ours have been conducted, and currently, neither have been peer reviewed. The first study extrapolated epidemiological parameters of COVID-19 from a real-world dataset from COVID-19 testing of offshore oil rig employees (51). The second used a model to capture transmission associated with air travel and develop quality strategies to mitigate the entry of COVID-19 into new regions (52). Both studies had limitations similar to ours. They...
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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