Scientific article
OA Policy
English

Maximizing and evaluating the impact of test-trace-isolate programs : A modeling study

Published inPLoS medicine, vol. 18, no. 4, e1003585
Publication date2021-04
First online date2021-04-30
Abstract

Background: Test-trace-isolate programs are an essential part of coronavirus disease 2019 (COVID-19) control that offer a more targeted approach than many other nonpharmaceutical interventions. Effective use of such programs requires methods to estimate their current and anticipated impact.

Methods and findings: We present a mathematical modeling framework to evaluate the expected reductions in the reproductive number, R, from test-trace-isolate programs. This framework is implemented in a publicly available R package and an online application. We evaluated the effects of completeness in case detection and contact tracing and speed of isolation and quarantine using parameters consistent with COVID-19 transmission (R0: 2.5, generation time: 6.5 days). We show that R is most sensitive to changes in the proportion of cases detected in almost all scenarios, and other metrics have a reduced impact when case detection levels are low (<30%). Although test-trace-isolate programs can contribute substantially to reducing R, exceptional performance across all metrics is needed to bring R below one through test-trace-isolate alone, highlighting the need for comprehensive control strategies. Results from this model also indicate that metrics used to evaluate performance of test-trace-isolate, such as the proportion of identified infections among traced contacts, may be misleading. While estimates of the impact of test-trace-isolate are sensitive to assumptions about COVID-19 natural history and adherence to isolation and quarantine, our qualitative findings are robust across numerous sensitivity analyses.

Conclusions: Effective test-trace-isolate programs first need to be strong in the "test" component, as case detection underlies all other program activities. Even moderately effective test-trace-isolate programs are an important tool for controlling the COVID-19 pandemic and can alleviate the need for more restrictive social distancing measures.

Keywords
  • COVID-19 / diagnosis
  • COVID-19 / prevention & control
  • Contact Tracing / methods
  • Disease Outbreaks / prevention & control
  • Humans
  • Models, Theoretical
  • Quarantine
  • SARS-CoV-2 / pathogenicity
Affiliation entities Not a UNIGE publication
Funding
  • State of California Institute of Technology [19-13081]
Citation (ISO format)
GRANTZ, Kyra H et al. Maximizing and evaluating the impact of test-trace-isolate programs : A modeling study. In: PLoS medicine, 2021, vol. 18, n° 4, p. e1003585. doi: 10.1371/journal.pmed.1003585
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Article (Published version)
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Identifiers
Journal ISSN1549-1277
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