Abstract
For COVID-19, it is vital to understand if quarantines shorter than 14 days can be equally effective with judiciously deployed testing. Here, we develop a mathematical model that quantifies the probability of post-quarantine transmission incorporating testing into travel quarantine, quarantine of traced contacts with an unknown time of infection, and quarantine of cases with a known time of exposure. We find that testing on exit (or entry and exit) can reduce the duration of a 14-day quarantine by 50%, while testing on entry shortens quarantine by at most one day. In a real-world test of our theory applied to offshore oil rig employees, 47 positives were obtained with testing on entry and exit to quarantine, of which 16 had tested negative at entry; preventing an expected nine offshore transmission events that each could have led to outbreaks. We show that appropriately timed testing can make shorter quarantines effective.
Highlights
For COVID-19, it is vital to understand if quarantines shorter than 14 days can be effective with judiciously deployed testing
We derived an infectivity profile based on transmission pairs of COVID-19 infected individuals[17], a basic reproduction number of R0 = 2.5, and an incubation period of 8.29 days[18], and estimated the temporal diagnostic sensitivity of reverse-transcription polymerase chain reaction (RT-PCR) tests[19] (Supplementary Table 1)
For settings where there is no administrative knowledge of the time of exposure such as travel quarantine, we computed the expected post-quarantine transmission (PQT) (Supplementary Fig. 2) and the probability of PQT after a range of quarantine durations without testing (Fig. 1A, Supplementary Fig. 3A)
Summary
For COVID-19, it is vital to understand if quarantines shorter than 14 days can be effective with judiciously deployed testing. 1234567890():,; The COVID-19 pandemic has engendered unprecedented efforts to quell ongoing outbreaks and manage healthcare capacity, including strict travel restrictions and stay-athome orders These efforts have disrupted workplaces, leading to significant and pervasive socioeconomic costs[1,2]. Current strategies to ensure safety often include a 14-day quarantine—either as a consequence of travel or following exposure to an infected person, as recommended by the World Health Organization (WHO)[5] These quarantines are sometimes combined with entry and/or exit testing, in which a positive test prompts isolation until recovery. Symptom-based screening and one-time testing could still entail a significant probability of PQT
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