Abstract
BackgroundCyprus addressed the first wave of SARS CoV-2 (COVID-19) by implementing non-pharmaceutical interventions (NPIs). The aims of this study were: a) to estimate epidemiological parameters of this wave including infection attack ratio, infection fatality ratio, and case ascertainment ratio, b) to assess the impact of public health interventions and examine what would have happened if those interventions had not been implemented.MethodsA dynamic, stochastic, individual-based Susceptible-Exposed-Infected-Recovered (SEIR) model was developed to simulate COVID-19 transmission and progression in the population of the Republic of Cyprus. The model was fitted to the observed trends in COVID-19 deaths and intensive care unit (ICU) bed use.ResultsBy May 8th, 2020, the infection attack ratio was 0.31% (95% Credible Interval [CrI]: 0.15, 0.54%), the infection fatality ratio was 0.71% (95% CrI: 0.44, 1.61%), and the case ascertainment ratio was 33.2% (95% CrI: 19.7, 68.7%). If Cyprus had not implemented any public health measure, the healthcare system would have been overwhelmed by April 14th. The interventions averted 715 (95% CrI: 339, 1235) deaths. If Cyprus had only increased ICU beds, without any social distancing measure, the healthcare system would have been overwhelmed by April 19th.ConclusionsThe decision of the Cypriot authorities to launch early NPIs limited the burden of the first wave of COVID-19. The findings of these analyses could help address the next waves of COVID-19 in Cyprus and other similar settings.
Highlights
On January 30th 2020, the World Health Organization declared the outbreak of 2019 Coronavirus disease (COVID-19) a Public Health Emergency of International Concern [1], and on March 11th, 2020 a pandemic
We report the results of a dynamic COVID-19 modeling approach
Model’s status quo scenario accurately captures the observed trends in hospitalized cases, intensive care unit (ICU) bed use, and COVID-19-related deaths (Supplementary, page 6, Fig. S3-S5)
Summary
On January 30th 2020, the World Health Organization declared the outbreak of 2019 Coronavirus disease (COVID-19) a Public Health Emergency of International Concern [1], and on March 11th, 2020 a pandemic. The first COVID-19 cases in the Republic of Cyprus (~ 876,000 residents in the government-controlled area) were detected on March 9th, 2020, followed by a surge in diagnoses that peaked in late March to early April 2020. During the first epidemic wave (by May 8th 2020), the testing rate in the Republic of Cyprus was 8932 per 100,000 population, which was significantly higher than in other European countries The aims of this study were: a) to estimate epidemiological parameters of this wave including infection attack ratio, infection fatality ratio, and case ascertainment ratio, b) to assess the impact of public health interventions and examine what would have happened if those interventions had not been implemented
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