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Area of Science:

  • Epidemiology
  • Public Health Policy
  • Health Economics

Background:

  • Physical distancing and regular testing with self-isolation are key epidemic control strategies before vaccines or treatments are available.
  • Testing has been promoted but less utilized than physical distancing for COVID-19 mitigation.
  • Superspreading, where a few individuals cause most infections, is a significant factor in transmission dynamics.

Purpose of the Study:

  • To compare the epidemiological and economic performance of physical distancing versus testing strategies.
  • To evaluate the impact of superspreading on the effectiveness of these control measures.
  • To assess the benefits of combining distancing and testing strategies under various disease parameters.

Main Methods:

  • An integrated epidemiological and economic model was developed.
  • The model incorporated a representation of superseding transmission dynamics.
  • Economic benefits were examined across a range of disease transmissibility and lethality, including COVID-19 variants.

Main Results:

  • An optimized testing strategy demonstrated superior economic performance compared to an optimized distancing strategy.
  • A combined strategy of testing and distancing outperformed individual strategies in over 25% of uncertainty analyses.
  • Superspreading enhanced the relative effectiveness of testing over distancing, particularly when tests detect high viral loads.

Conclusions:

  • Testing with self-isolation presents a more economically advantageous strategy than physical distancing for epidemic control.
  • Combining both strategies offers enhanced performance, especially in the presence of superspreading.
  • Optimal strategy performance was observed at moderate disease transmissibility levels.