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Disease control across urban–rural gradients

Konstans Wells Orcid Logo, Miguel Lurgi Rivera Orcid Logo, Brendan Collins, Biagio Lucini Orcid Logo, Rowland R. Kao, Alun L. Lloyd, Simon D. W. Frost, Michael Gravenor Orcid Logo

Journal of The Royal Society Interface, Volume: 17, Issue: 173, Start page: 20200775

Swansea University Authors: Konstans Wells Orcid Logo, Miguel Lurgi Rivera Orcid Logo, Biagio Lucini Orcid Logo, Michael Gravenor Orcid Logo

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DOI (Published version): 10.1098/rsif.2020.0775

Abstract

Controlling the regional re-emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after its initial spread in ever-changing personal contact networks and disease landscapes is a challenging task. In a landscape context, contact opportunities within and between populations are cha...

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Published in: Journal of The Royal Society Interface
ISSN: 1742-5662 1742-5662
Published: The Royal Society 2020
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URI: https://cronfa.swan.ac.uk/Record/cronfa55650
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Abstract: Controlling the regional re-emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after its initial spread in ever-changing personal contact networks and disease landscapes is a challenging task. In a landscape context, contact opportunities within and between populations are changing rapidly as lockdown measures are relaxed and a number of social activities re-activated. Using an individual-based metapopulation model, we explored the efficacy of different control strategies across an urban–rural gradient in Wales, UK. Our model shows that isolation of symptomatic cases or regional lockdowns in response to local outbreaks have limited efficacy unless the overall transmission rate is kept persistently low. Additional isolation of non-symptomatic infected individuals, who may be detected by effective test-and-trace strategies, is pivotal to reducing the overall epidemic size over a wider range of transmission scenarios. We define an ‘urban–rural gradient in epidemic size' as a correlation between regional epidemic size and connectivity within the region, with more highly connected urban populations experiencing relatively larger outbreaks. For interventions focused on regional lockdowns, the strength of such gradients in epidemic size increased with higher travel frequencies, indicating a reduced efficacy of the control measure in the urban regions under these conditions. When both non-symptomatic and symptomatic individuals are isolated or regional lockdown strategies are enforced, we further found the strongest urban–rural epidemic gradients at high transmission rates. This effect was reversed for strategies targeted at symptomatic individuals only. Our results emphasize the importance of test-and-trace strategies and maintaining low transmission rates for efficiently controlling SARS-CoV-2 spread, both at landscape scale and in urban areas.
Keywords: disease spread, epidemiological metapopulation dynamics, pandemic control, source–sink dynamics
College: Faculty of Science and Engineering
Issue: 173
Start Page: 20200775