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Controlling COVID-19 via test-trace-quarantine.

Cliff C Kerr1, Dina Mistry2, Robyn M Stuart3,4

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A test-trace-quarantine strategy can control COVID-19 spread by testing individuals and their contacts, even with increased mobility. Success requires high testing, tracing, compliance, and mask use.

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Area of Science:

  • Epidemiology
  • Public Health Policy
  • Computational Modeling

Background:

  • Initial COVID-19 control in the US relied on mobility restrictions like school/workplace closures, incurring significant societal and economic costs.
  • Alternative strategies are needed to balance public health with economic and social well-being.

Purpose of the Study:

  • To demonstrate the feasibility of a test-trace-quarantine strategy as an alternative to broad mobility restrictions for COVID-19 control.
  • To assess the effectiveness of test-trace-quarantine under various scenarios, including increased mobility and low vaccine coverage.

Main Methods:

  • Utilized Covasim, an open-source agent-based model calibrated with demographic, mobility, and epidemiological data from Seattle (January-June 2020).
  • Simulated routine testing of symptomatic individuals, contact tracing and testing, and quarantine of contacts.
  • Evaluated epidemic control under different levels of mask use, mobility, testing/tracing rates, and quarantine compliance.

Main Results:

  • High but achievable levels of testing and tracing, combined with current mask use and school closures, can maintain epidemic control even with full return to workplace and community mobility.
  • Real-world data from June-September 2020 validated model predictions, showing successful epidemic control with scaled-up testing and tracing programs.
  • The strategy's success is contingent upon high testing/tracing rates, high quarantine compliance, minimal delays, and moderate to high mask usage.

Conclusions:

  • Test-trace-quarantine is a viable strategy for controlling COVID-19 transmission, offering an alternative to widespread mobility restrictions.
  • Effective implementation requires robust performance across all program components: testing, tracing, quarantine compliance, and public health measures like mask-wearing.
  • Achieving epidemic control with increased mobility necessitates strong, coordinated efforts in testing, tracing, and quarantine.