Abstract
As the spread of COVID19 in the US continues to grow, local and state officials face difficult decisions about when and how to transition to a “new normal.” The goal of this study is to project the number of COVID19 infections and resulting severe outcomes, and the need for hospital capacity under social distancing, particularly, shelter-in-place and voluntary quarantine for the State of Georgia. We developed an agent-based simulation model to project the infection spread. The model utilizes COVID19-specific parameters and data from Georgia on population interactions and demographics. The simulation study covered a seven and a half-month period, testing different social distancing scenarios, including baselines (no-intervention or school closure only) and combinations of shelter-in-place and voluntary quarantine with different timelines and compliance levels. The following outcomes are compared at the state and community levels: the number and percentage of cumulative and daily new symptomatic and asymptomatic infections, hospitalizations, and deaths; COVID19-related demand for hospital beds, ICU beds, and ventilators. The results suggest that shelter-in-place followed by voluntary quarantine reduced peak infections from approximately 180K under no intervention and 113K under school closure, respectively, to below 53K, and delayed the peak from April to July or later. Increasing shelter-in-place duration from four to five weeks yielded 2–9% and 3–11% decrease in cumulative infection and deaths, respectively. Regardless of the shelter-in-place duration, increasing voluntary quarantine compliance decreased daily new infections from almost 53K to 25K, and decreased cumulative infections by about 50%. The cumulative number of deaths ranged from 6,660 to 19,430 under different scenarios. Peak infection date varied across scenarios and counties; on average, increasing shelter-in-place duration delayed the peak day by 6 days. Overall, shelter-in-place followed by voluntary quarantine substantially reduced COVID19 infections, healthcare resource needs, and severe outcomes.
Highlights
The novel coronavirus SARS-CoV-2 causes a rapidly spreading respiratory illness, Coronavirus Disease 2019 (COVID19), which has become a pandemic [1]
In Georgia, schools closed on March 16, 2020 [56], shelter-in-place orders were issued on April 3, 2020, transitioning out of shelterin-place started on April 24, 2020 [57], and shelter-in-place officially ended on April 30, 2020
We analyzed the impact of shelter-in-place duration and social distancing compliance levels, voluntary quarantine, using data from Georgia
Summary
The novel coronavirus SARS-CoV-2 causes a rapidly spreading respiratory illness, Coronavirus Disease 2019 (COVID19), which has become a pandemic [1]. During the early stages of a pandemic, medical interventions, such as vaccines or antiviral treatments, are either non-existent or extremely limited [2]. Local, national, and global governments and public officials wrestle with the difficult decisions of how, when, and where to implement non-medical interventions [3]. We developed an agent-based simulation model to predict the spread of COVID19 geographically and over time. The model captures both the natural history of the disease and interactions in households, workplaces, schools, and communities [5,6,7,8,9]. The model’s outputs include new daily infections (symptomatic and asymptomatic by age group), hospitalizations, and deaths at the census tract level
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