Abstract
Under the implementation of non-pharmaceutical interventions such as social distancing and lockdowns, household transmission has been shown to be significant for COVID-19, posing challenges for reducing incidence in settings where people are asked to self-isolate at home and to spend increasing amounts of time at home due to distancing measures. Accordingly, characteristics of households in a region have been shown to relate to transmission heterogeneity of the virus. We introduce a discrete-time stochastic epidemiological model to examine the impact of the household size distribution in a region on the transmission dynamics. We choose parameters to reflect incidence in two health regions of the Greater Vancouver area in British Columbia and simulate the impact of distancing measures on transmission, with household size distribution the only different parameter between simulations for the two regions. Our result suggests that the dissimilarity in household size distribution alone can cause significant differences in incidence of the two regions, and the distributions drive distinct dynamics that match reported cases. Furthermore, our model suggests that offering individuals a place to isolate outside their household can speed the decline in cases, and does so more effectively where there are more larger households.
Highlights
The novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created a global pandemic with over 50 million confirmed cases and more than one million deaths as of November 2020 [1]
The findings indicate that individuals from ethnic minority backgrounds, especially South Asian and black individuals, are of higher risk related to COVID-19 [5,6,7], and household size may be associated with the risk of infection after implementing social distancing or stay-at-home policies [8]
We compare the distributions by Pearson’s χ2 test [26], which rejects the null hypothesis that the household sizes in Fraser Health (FH) and Vancouver Coastal Health (VCH) originate from populations with the same distribution with a p-value 2.2 × 10−16
Summary
The novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created a global pandemic with over 50 million confirmed cases and more than one million deaths as of November 2020 [1]. In the absence of an effective cure and vaccine, various non-pharmaceutical interventions (NPIs), including hand hygiene, face masks, quarantine, isolation, contact tracing and social distancing, have been the primary practices for reducing the spread of the highly transmissible respiratory pathogen. Amid these interventions, stay-at-home policies and quarantine or isolation strategies may alter social interactions and the transmission dynamics of the virus, especially the transmission probabilities within and outside households [2,3]. How different distributions of household size would affect transmission dynamics of the virus and the effectiveness of public health policies remains unknown
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