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Disease control across urban–rural gradients / Konstans Wells, Miguel Lurgi Rivera, Brendan Collins, Biagio Lucini, Rowland R. Kao, Alun L. Lloyd, Simon D. W. Frost, Michael Gravenor

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

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

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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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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&#x2013;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 &#x2018;urban&#x2013;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&#x2013;rural epidemic gradients at high transmission rates. This effect was reversed for strategies targeted at symptomatic individuals only. 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W.</firstname><surname>Frost</surname><order>7</order></author><author><firstname>Michael</firstname><surname>Gravenor</surname><orcid>0000-0003-0710-0947</orcid><order>8</order></author></authors><documents><document><filename>55650__18944__2097c08b1e8a4767b7c8557ffc646ad4.pdf</filename><originalFilename>55650.pdf</originalFilename><uploaded>2020-12-30T14:35:50.8744975</uploaded><type>Output</type><contentLength>1314112</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><action/><documentNotes>&#xA9; 2020 The Authors. Released under the terms of the Creative Commons Attribution License</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling 2021-02-01T14:53:50.3732272 v2 55650 2020-11-12 Disease control across urban–rural gradients d18166c31e89833c55ef0f2cbb551243 0000-0003-0377-2463 Konstans Wells Konstans Wells true false 947df89d116a1ab75515e421089e0443 0000-0001-9891-895X Miguel Lurgi Rivera Miguel Lurgi Rivera true false 7e6fcfe060e07a351090e2a8aba363cf 0000-0001-8974-8266 Biagio Lucini Biagio Lucini true false 70a544476ce62ba78502ce463c2500d6 0000-0003-0710-0947 Michael Gravenor Michael Gravenor true false 2020-11-12 SBI 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. Journal Article Journal of The Royal Society Interface 17 173 20200775 The Royal Society 1742-5662 1742-5662 disease spread, epidemiological metapopulation dynamics, pandemic control, source–sink dynamics 23 12 2020 2020-12-23 10.1098/rsif.2020.0775 COLLEGE NANME Biosciences COLLEGE CODE SBI Swansea University 2021-02-01T14:53:50.3732272 2020-11-12T14:03:07.9161849 College of Science Biosciences Konstans Wells 0000-0003-0377-2463 1 Miguel Lurgi Rivera 0000-0001-9891-895X 2 Brendan Collins 3 Biagio Lucini 0000-0001-8974-8266 4 Rowland R. Kao 5 Alun L. Lloyd 6 Simon D. W. Frost 7 Michael Gravenor 0000-0003-0710-0947 8 55650__18944__2097c08b1e8a4767b7c8557ffc646ad4.pdf 55650.pdf 2020-12-30T14:35:50.8744975 Output 1314112 application/pdf Version of Record true © 2020 The Authors. Released under the terms of the Creative Commons Attribution License true eng
title Disease control across urban–rural gradients
spellingShingle Disease control across urban–rural gradients
Konstans, Wells
Miguel, Lurgi Rivera
Biagio, Lucini
Michael, Gravenor
title_short Disease control across urban–rural gradients
title_full Disease control across urban–rural gradients
title_fullStr Disease control across urban–rural gradients
title_full_unstemmed Disease control across urban–rural gradients
title_sort Disease control across urban–rural gradients
author_id_str_mv d18166c31e89833c55ef0f2cbb551243
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author_id_fullname_str_mv d18166c31e89833c55ef0f2cbb551243_***_Konstans, Wells
947df89d116a1ab75515e421089e0443_***_Miguel, Lurgi Rivera
7e6fcfe060e07a351090e2a8aba363cf_***_Biagio, Lucini
70a544476ce62ba78502ce463c2500d6_***_Michael, Gravenor
author Konstans, Wells
Miguel, Lurgi Rivera
Biagio, Lucini
Michael, Gravenor
author2 Konstans Wells
Miguel Lurgi Rivera
Brendan Collins
Biagio Lucini
Rowland R. Kao
Alun L. Lloyd
Simon D. W. Frost
Michael Gravenor
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description 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.
published_date 2020-12-23T04:21:06Z
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