Abstract
The interventions and outcomes in the ongoing COVID-19 pandemic are highly varied. The disease and the interventions both impose costs and harm on society. Some interventions with particularly high costs may only be implemented briefly. The design of optimal policy requires consideration of many intervention scenarios. In this paper we investigate the optimal timing of interventions that are not sustainable for a long period. Specifically, we look at at the impact of a single short-term non-repeated intervention (a “one-shot intervention”) on an epidemic and consider the impact of the intervention’s timing. To minimize the total number infected, the intervention should start close to the peak so that there is minimal rebound once the intervention is stopped. To minimise the peak prevalence, it should start earlier, leading to initial reduction and then having a rebound to the same prevalence as the pre-intervention peak rather than one very large peak. To delay infections as much as possible (as might be appropriate if we expect improved interventions or treatments to be developed), earlier interventions have clear benefit. In populations with distinct subgroups, synchronized interventions are less effective than targeting the interventions in each subcommunity separately.
Highlights
The Influenza pandemic of 1918 was one of the deadliest epidemics of infectious disease the world has ever seen
The optimal timing of such an intervention will depend on the ultimate goal
Interventions to delay the epidemic while new treatments or interventions are developed are best implemented as soon as possible
Summary
The Influenza pandemic of 1918 was one of the deadliest epidemics of infectious disease the world has ever seen. There is evidence [1] that some cities which implemented these interventions later had fewer deaths. This seemingly counter-intuitive observation suggests that they were more successful by being slow to respond. When the 2009 influenza pandemic first arrived outside of Mexico, many schools shut after the first observed infection. Once these schools reopened, and received a new introduction, the remaining susceptible population was almost as large as at the outset, so the resulting epidemic was likely to be nearly as large as the original epidemic would have been. Evidence suggests that summer holidays altered the final outcome of the influenza pandemic (at least in the UK), significantly reducing the total number of infections by splitting the epidemic into two smaller peaks [2]
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