A prospect on the use of antiviral drugs to control local outbreaks of COVID-19
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
Abstract
Background
Current outbreaks of COVID-19 are threatening the health care systems of several countries around the world. Control measures, based on isolation, contact tracing, and quarantine, can decrease and delay the burden of the ongoing epidemic. With respect to the ongoing COVID-19 epidemic, recent modeling work shows that these interventions may be inadequate to control local outbreaks, even when perfect isolation is assumed. The effect of infectiousness prior to symptom onset combined with asymptomatic infectees further complicates the use of contact tracing. We aim to study whether antivirals, which decrease the viral load and reduce infectiousness, could be integrated into control measures in order to augment the feasibility of controlling the epidemic.
Methods
Using a simulation-based model of viral transmission, we tested the efficacy of different intervention measures to control local COVID-19 outbreaks. For individuals that were identified through contact tracing, we evaluate two procedures: monitoring individuals for symptoms onset and testing of individuals. Additionally, we investigate the implementation of an antiviral compound combined with the contact tracing process.
Results
For an infectious disease in which asymptomatic and presymptomatic infections are plausible, an intervention measure based on contact tracing performs better when combined with testing instead of monitoring, provided that the test is able to detect infections during the incubation period. Antiviral drugs, in combination with contact tracing, quarantine, and isolation, result in a significant decrease of the final size and the peak incidence, and increase the probability that the outbreak will fade out.
Conclusion
In all tested scenarios, the model highlights the benefits of control measures based on the testing of traced individuals. In addition, the administration of an antiviral drug, together with quarantine, isolation, and contact tracing, is shown to decrease the spread of the epidemic. This control measure could be an effective strategy to control local and re-emerging outbreaks of COVID-19.
Article activity feed
-
SciScore for 10.1101/2020.03.19.20038182: (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:While this is a limitation of our study, we argue that in the scenarios where we aggressively trace and treat the contacts of individuals, we are more likely to find (and constrain) cases that would otherwise go undetected. To challenge this assumption, we simulate the impact of asymptomatic individuals, defined to be infectives that do …
SciScore for 10.1101/2020.03.19.20038182: (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:While this is a limitation of our study, we argue that in the scenarios where we aggressively trace and treat the contacts of individuals, we are more likely to find (and constrain) cases that would otherwise go undetected. To challenge this assumption, we simulate the impact of asymptomatic individuals, defined to be infectives that do not show symptoms during their infectious periods. Results reported in the sensitivity analysis show that, for the tested scenarios, the use of an antiviral drug increases the control of the outbreak, even when undiagnosed individuals are circulating in the population. In the hospital, we assume perfect isolation, meaning that infected individuals cannot spread the infection. While this assumption is in line with earlier works 1, health care workers are at risk and they could be infected by infected individuals in isolation. In the IBS and IBTBS scenarios we assume that the traced individuals that test positive are isolated in the 16% of cases, even before showing actual severe symptoms. Although this model is informed with data on the control of MERS-CoV viral load using prophylaxis with Remdesivir, it stands to reason that different classes of viral inhibitors control the viral load in different ways. Additionally, despite the sequence similarity of MERS-CoV and SARS-COV-2 it remains to be established whether the impact of Remdesivir (or other antivirals) on the viral load is similar. To this end, longitudinal data of the viral load on COVID...
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.
-
-
-