The effectiveness of social bubbles as part of a Covid-19 lockdown exit strategy, a modelling study
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Abstract
Background: During the coronavirus disease 2019 (COVID-19) lockdown, contact clustering in social bubbles may allow extending contacts beyond the household at minimal additional risk and hence has been considered as part of modified lockdown policy or a gradual lockdown exit strategy. We estimated the impact of such strategies on epidemic and mortality risk using the UK as a case study.
Methods: We used an individual based model for a synthetic population similar to the UK, stratified into transmission risks from the community, within the household and from other households in the same social bubble. The base case considers a situation where non-essential shops and schools are closed, the secondary household attack rate is 20% and the initial reproduction number is 0.8. We simulate social bubble strategies (where two households form an exclusive pair) for households including children, for single occupancy households, and for all households. We test the sensitivity of results to a range of alternative model assumptions and parameters.
Results: Clustering contacts outside the household into exclusive bubbles is an effective strategy of increasing contacts while limiting the associated increase in epidemic risk. In the base case, social bubbles reduced fatalities by 42% compared to an unclustered increase of contacts. We find that if all households were to form social bubbles the reproduction number would likely increase to above the epidemic threshold of R=1. Strategies allowing households with young children or single occupancy households to form social bubbles increased the reproduction number by less than 11%. The corresponding increase in mortality is proportional to the increase in the epidemic risk but is focussed in older adults irrespective of inclusion in social bubbles.
Conclusions: If managed appropriately, social bubbles can be an effective way of extending contacts beyond the household while limiting the increase in epidemic risk.
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SciScore for 10.1101/2020.06.05.20123448: (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:Our analyses have a number of limitations. Firstly, we only assessed the risk of extending social bubbles but not the benefits. As of June 2020 in England, social contact beyond the immediate household is restricted to virtual contact or contact in open spaces with up to 5 individuals while keeping 2 meters apart. In other words, one can have a conversation. While conversations are a large part of the social contacts of adults they have little …
SciScore for 10.1101/2020.06.05.20123448: (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:Our analyses have a number of limitations. Firstly, we only assessed the risk of extending social bubbles but not the benefits. As of June 2020 in England, social contact beyond the immediate household is restricted to virtual contact or contact in open spaces with up to 5 individuals while keeping 2 meters apart. In other words, one can have a conversation. While conversations are a large part of the social contacts of adults they have little role in the social interactions of young children. Hence the benefit of extending bubbles for children is likely disproportionately higher. Furthermore, clustering contacts into social bubbles is likely to ease contact tracing which is an integral part of both containment and lockdown exit strategies. We considered social bubbles against the background of a lockdown, particularly where schools are closed. As lockdown measures are eased and schools are gradually re-opened forming social bubbles that largely overlap with societal one (for example forming social clusters with families that have children going to the same class) is likely further reducing the additional epidemic risk from social bubbles. We also did not include the possibility to form bigger social bubbles that would cluster together 3 or more households. While this has been implemented in other countries, the complexity of creating an exclusive cluster of three or more households could lead to a loss of adherence. We did not consider further heterogeneity of the society. T...
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.
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- No protocol registration statement was detected.
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