Projected effects of nonpharmaceutical public health interventions to prevent resurgence of SARS-CoV-2 transmission in Canada

Ng, Victoria; Fazil, Aamir; Waddell, Lisa A.; Bancej, Christina; Turgeon, Patricia; Otten, Ainsley; Atchessi, Nicole; Ogden, Nicholas H.

Projected effects of nonpharmaceutical public health interventions to prevent resurgence of SARS-CoV-2 transmission in Canada

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creativework.keywords - en: Adolescent; Adult; Aged; Aged, 80 and over; Asymptomatic Infections / epidemiology; Betacoronavirus; COVID-19; COVID-19 Testing; Canada / epidemiology; Child; Clinical Laboratory Techniques; Communicable Disease Control; Computer Simulation; Contact Tracing*; Coronavirus Infections / diagnosis; Coronavirus Infections / epidemiology; Coronavirus Infections / prevention & control*; Coronavirus Infections / transmission; Humans; Middle Aged; Pandemics / prevention & control*; Patient Isolation*; Pneumonia, Viral / diagnosis; Pneumonia, Viral / epidemiology; Pneumonia, Viral / prevention & control*; Pneumonia, Viral / transmission; Public Health*; Quarantine*; SARS-CoV-2; Young Adult
dc.contributor.author: Ng, Victoria; Fazil, Aamir; Waddell, Lisa A.; Bancej, Christina; Turgeon, Patricia; Otten, Ainsley; Atchessi, Nicole; Ogden, Nicholas H.
dc.date.accessioned: 2024-07-05T19:11:19Z
dc.date.available: 2024-07-05T19:11:19Z
dc.date.issued: 2020-09-14
dc.description.abstract - en: BACKGROUND: Continual efforts to eliminate community transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) will be needed to prevent additional waves of infection. We explored the impact of nonpharmaceutical interventions on projected SARS-CoV-2 transmission in Canada. METHODS: We developed an age-structured agent-based model of the Canadian population simulating the impact of current and projected levels of public health interventions on SARS-CoV-2 transmission. Interventions included case detection and isolation, contact tracing and quarantine, physical distancing and community closures, evaluated alone and in combination. RESULTS: Without any interventions, 64.6% (95% credible interval [CrI] 63.9%–65.0%) of Canadians will be infected with SARS-CoV-2 (total attack rate) and 3.6% (95% CrI 2.4%–3.8%) of those infected and symptomatic will die. If case detection and contact tracing continued at baseline levels without maintained physical distancing and reimplementation of restrictive measures, this combination brought the total attack rate to 56.1% (95% CrI 0.05%–57.1%), but it dropped to 0.4% (95% CrI 0.03%–23.5%) with enhanced case detection and contact tracing. Combining the latter scenario with maintained physical distancing reduced the total attack rate to 0.2% (95% CrI 0.03%–1.7%) and was the only scenario that consistently kept hospital and intensive care unit bed use under capacity, prevented nearly all deaths and eliminated the epidemic. Extending school closures had minimal effects but did reduce transmission in schools; however, extending closures of workplaces and mixed-age venues markedly reduced attack rates and usually or always eliminated the epidemic under any scenario. INTERPRETATION: Controlling SARS-CoV-2 transmission will depend on enhancing and maintaining interventions at both the community and individual levels. Without such interventions, a resurgent epidemic will occur, with the risk of overwhelming our health care systems.
dc.identifier.citation: Ng V, Fazil A, Waddell LA, et al. Projected effects of nonpharmaceutical public health interventions to prevent resurgence of SARS-CoV-2 transmission in Canada. CMAJ. 2020;192(37):E1053-E1064. doi:https://doi.org/10.1503/cmaj.200990
dc.identifier.doi: 10.1503/cmaj.200990
dc.identifier.uri: https://open-science.canada.ca/handle/123456789/2661
dc.language.iso: en
dc.publisher: CMAJ Group
dc.rights - en: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
dc.rights - fr: Creative Commons Attribution - Pas d'utilisation commerciale - Pas de modification 4.0 International (CC BY-NC-ND 4.0)
dc.rights.openaccesslevel - en: Gold
dc.rights.openaccesslevel - fr: Or
dc.rights.uri - en: https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.uri - fr: https://creativecommons.org/licenses/by-nc-nd/4.0/deed.fr
dc.subject - en: Health
dc.subject - fr: Santé
dc.subject.en - en: Health
dc.subject.fr - fr: Santé
dc.title - en: Projected effects of nonpharmaceutical public health interventions to prevent resurgence of SARS-CoV-2 transmission in Canada
dc.type - en: Article
dc.type - fr: Article
local.article.journalissue: 37
local.article.journaltitle: Canadian Medical Association Journal (CMAJ)
local.article.journalvolume: 192
local.peerreview - en: Yes
local.peerreview - fr: Oui