Mathematical model of COVID-19 intervention scenarios for São Paulo-Brazil.

With COVID-19 surging across the world, understanding the effectiveness of intervention strategies on transmission dynamics is of primary global health importance. Here, we develop and analyze an epidemiological compartmental model using multi-objective genetic algorithm design optimization to compare scenarios related to strategy type, the extent of social distancing, time window, and personal protection levels on the transmission dynamics of COVID-19 in São Paulo, Brazil. The results indicate that the optimal strategy for São Paulo is to reduce social distancing over time with a stepping-down reduction in the magnitude of social distancing every 80-days. Our results also indicate that the ability to reduce social distancing depends on a 5-10% increase in the current percentage of people strictly following protective guidelines, highlighting the importance of protective behavior in controlling the pandemic. Our framework can be extended to model transmission dynamics for other countries, regions, states, cities, and organizations.

Modeling the effects of intervention strategies on COVID-19 transmission dynamics.

OBJECTIVES: To model the effects of continuous, intermittent, and stepping-down social distancing (SD) strategies and personal protection measures on COVID-19 transmission dynamics. METHODS: Constant, intermittent, and stepping-down SD strategies were modeled at 4 mean magnitudes (5%, 10 %, 15 % and 20 %), 2 time windows (40-days, 80-days), and 2 levels of personal caution (30 % and 50 %). RESULTS: The stepping-down strategy was the best long-term SD strategy to minimize the peak number of active COVID-19 cases and associated deaths. The stepping-down strategy also resulted in a reduction in total time required to SD over a two-year period by 6.5 % compared to an intermittent or constant SD strategy. An 80-day SD time-window was statistically more effective in maintaining control over the COVID-19 pandemic than a 40-day window. However, the results were dependent upon 50 % of people being cautious (engaging in personal protection measures). CONCLUSION: If people exercise caution while in public by protecting themselves (e.g., wearing a facemask, proper hand hygiene and avoid agglomeration) the magnitude and duration of SD necessary to maintain control over the pandemic can be reduced. Our models suggest that the most effective way to reduce SD over a two-year period is a stepping-down approach every 80 days. According to our model, this method would prevent a second peak and the number of intensive care units needed per day would be within the threshold of those currently available.