Testing-isolation interventions will likely be insufficient to contain future novel disease outbreaks

Area of Science:

• Epidemiology
• Mathematical Modeling
• Public Health

Background:

• Rapid diagnostic testing and isolation are crucial for controlling novel pathogen outbreaks.
• The COVID-19 pandemic highlighted challenges in meeting testing demands, potentially hindering epidemic containment.
• Understanding how disease characteristics influence the effectiveness of testing-isolation strategies under resource constraints is critical for future pandemic preparedness.

Purpose of the Study:

• To investigate the generalizability of testing-isolation strategy failures across various novel human pathogens.
• To identify key disease characteristics that determine epidemic controllability under realistic testing capacity limitations.
• To provide guidelines for managing expectations and optimizing control strategies for future disease invasions.

Main Methods:

• Development and application of a generalized mathematical model.
• Parameterization of the model using data from seven distinct human diseases and their variants.
• Analysis of disease controllability based on factors including basic reproduction number, latent period, and non-symptomatic transmission.

Main Results:

• Testing-isolation strategies are generally insufficient to contain epidemic outbreaks at achievable testing capacities.
• The basic reproduction number, mean latent period, and non-symptomatic transmission index were identified as key determinants of controllability.
• Disease characteristics significantly influence the effectiveness of testing-isolation and the need for additional measures.

Conclusions:

• Epidemic control via testing-isolation alone is often infeasible for novel pathogens with high transmission potential or significant asymptomatic spread.
• Diseases with specific trait combinations require supplementary transmission-reduction measures, such as social distancing, for effective containment.
• This research offers a framework for anticipating and managing controllability challenges posed by future novel disease outbreaks.