The effectiveness of social bubbles as part of a Covid-19 lockdown exit strategy, a modelling study.

Trystan Leng,Adam Kucharski,Joe Hilton,Nicholas G Davies,Stefan Flasche,Lorenzo Pellis,Matt J Keeling,Helena Stage,Connor White

doi:10.12688/wellcomeopenres.16164.2

Abstract

Background: During the coronavirus disease 2019 (COVID-19) lockdown, contact clustering in social bubbles may allow extending contacts beyond the household at minimal additional risk and hence has been considered as part of modified lockdown policy or a gradual lockdown exit strategy. We estimated the impact of such strategies on epidemic and mortality risk using the UK as a case study. Methods: We used an individual based model for a synthetic population similar to the UK, stratified into transmission risks from the community, within the household and from other households in the same social bubble. The base case considers a situation where non-essential shops and schools are closed, the secondary household attack rate is 20% and the initial reproduction number is 0.8. We simulate social bubble strategies (where two households form an exclusive pair) for households including children, for single occupancy households, and for all households. We test the sensitivity of results to a range of alternative model assumptions and parameters. Results: Clustering contacts outside the household into exclusive bubbles is an effective strategy of increasing contacts while limiting the associated increase in epidemic risk. In the base case, social bubbles reduced fatalities by 42% compared to an unclustered increase of contacts. We find that if all households were to form social bubbles the reproduction number would likely increase to above the epidemic threshold of R=1. Strategies allowing households with young children or single occupancy households to form social bubbles increased the reproduction number by less than 11%. The corresponding increase in mortality is proportional to the increase in the epidemic risk but is focussed in older adults irrespective of inclusion in social bubbles. Conclusions: If managed appropriately, social bubbles can be an effective way of extending contacts beyond the household while limiting the increase in epidemic risk.

Highlights

During the coronavirus disease 2019 (COVID-19) lockdown, contact clustering in social bubbles may allow extending contacts beyond the household at minimal additional risk and has been considered as part of modified lockdown policy or a gradual lockdown exit strategy
Impact of social bubble strategies on epidemic risk Assuming an initial reproduction number of 0.8, perfect adherence to the recommended social bubble strategy and that all eligible households pair up, we find that strategies that exclusively target single-person households or households with young children do not increase transmission substantially (R of 0.83 and 0.89 respectively in the base case scenario); their combination is predicted to only marginally increase transmission in the community (R of 0.91) (Figure 2)
We found that contact clustering, or the forming of social bubbles that join two households, can allow increased social contacts beyond the households while limiting additional risk of transmission

Summary

Introduction

During the coronavirus disease 2019 (COVID-19) lockdown, contact clustering in social bubbles may allow extending contacts beyond the household at minimal additional risk and has been considered as part of modified lockdown policy or a gradual lockdown exit strategy. Methods: We used an individual based model for a synthetic population similar to the UK, stratified into transmission risks from the community, within the household and from other households in the same social bubble. We simulate social bubble strategies (where two households form an exclusive pair) for households including children, for single occupancy households, and for all households. Results: Clustering contacts outside the household into exclusive bubbles is an effective strategy of increasing contacts while limiting the associated increase in epidemic risk. We find that if all households were to form social bubbles the reproduction number would likely increase to above the epidemic threshold of R=1. Strategies allowing households with young children or single occupancy households to form social bubbles version 2 (revision)

Methods

Results

Discussion

Conclusion