Dependence of COVID-19 Policies on End-of-Year Holiday Contacts in Mexico City Metropolitan Area: A Modeling Study
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Abstract
Background. Mexico City Metropolitan Area (MCMA) has the largest number of COVID-19 (coronavirus disease 2019) cases in Mexico and is at risk of exceeding its hospital capacity in early 2021. Methods. We used the Stanford-CIDE Coronavirus Simulation Model (SC-COSMO), a dynamic transmission model of COVID-19, to evaluate the effect of policies considering increased contacts during the end-of-year holidays, intensification of physical distancing, and school reopening on projected confirmed cases and deaths, hospital demand, and hospital capacity exceedance. Model parameters were derived from primary data, literature, and calibrated. Results. Following high levels of holiday contacts even with no in-person schooling, MCMA will have 0.9 million (95% prediction interval 0.3–1.6) additional COVID-19 cases between December 7, 2020, and March 7, 2021, and hospitalizations will peak at 26,000 (8,300–54,500) on January 25, 2021, with a 97% chance of exceeding COVID-19-specific capacity (9,667 beds). If MCMA were to control holiday contacts, the city could reopen in-person schools, provided they increase physical distancing with 0.5 million (0.2–0.9) additional cases and hospitalizations peaking at 12,000 (3,700–27,000) on January 19, 2021 (60% chance of exceedance). Conclusion. MCMA must increase COVID-19 hospital capacity under all scenarios considered. MCMA’s ability to reopen schools in early 2021 depends on sustaining physical distancing and on controlling contacts during the end-of-year holiday.
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SciScore for 10.1101/2020.12.21.20248597: (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 analysis has several limitations. First, while our model is stratified by age to account for differential mixing, it does not include differential transmission by younger people.24 Some studies find that younger children may transmit less than teens and adults.22,24 If children are differentially less likely to transmit then, at …
SciScore for 10.1101/2020.12.21.20248597: (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 analysis has several limitations. First, while our model is stratified by age to account for differential mixing, it does not include differential transmission by younger people.24 Some studies find that younger children may transmit less than teens and adults.22,24 If children are differentially less likely to transmit then, at least for primary schools, our results may understate the possibility of resuming in-person schooling with social distancing without exacerbating the epidemic and could be viewed as conservative. Second, our analysis does not account for vaccination. However, the time periods we focus on precede plausible mass vaccination, given current expectations regarding vaccine roll-out in Mexico.25 Third, we purposefully focus on the health and health systems impacts of policy alternatives needed in the short-term and do not conduct a cost-effectiveness analysis (CEA) over a lifetime horizon. Hence, we do not quantify the full costs and health outcomes associated with missing school26 or work.27 Findings from our analysis will be useful inputs for a wider economic evaluation of policy alternatives in future research. Our study has several strengths. First, we use the SC-COSMO model, which is a dynamic transmission model that accounts for realistic contact patterns based on adjusted population density28 and both community and household transmission.10 The SC-COSMO framework enables quantification and propagation of uncertainty to generate probabilistic proje...
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: Please consider improving the rainbow (“jet”) colormap(s) used on page 21. At least one figure is not accessible to readers with colorblindness and/or is not true to the data, i.e. not perceptually uniform.
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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