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Int J Epidemiol . Impact of age-selective vs non-selective physical-distancing measures against coronavirus disease 2019: a mathematical modelling s

tetano

Editor, Senior Moderator
Int J Epidemiol


. 2021 Mar 12;dyab043.
doi: 10.1093/ije/dyab043. Online ahead of print.
Impact of age-selective vs non-selective physical-distancing measures against coronavirus disease 2019: a mathematical modelling study


Daniel Ortega-Quijano[SUP] 1 [/SUP], Noe Ortega-Quijano[SUP] 2 [/SUP]



Affiliations

Abstract

Background: There is a real possibility of successive COVID-19-epidemic waves with devastating consequences. In this context, it has become mandatory to design age-selective measures aimed at achieving an optimal balance between protecting public health and maintaining a viable economic activity.
Methods: We programmed a Susceptible, Exposed, Infected, Removed (SEIR) model in order to introduce epidemiologically relevant age classes into the outbreak-dynamics analysis. The model was fitted to the official death toll and calculated age distribution of deaths in Wuhan using a constrained linear least-squares algorithm. Subsequently, we used synthetic location-specific and age-structured contact matrices to quantify the effect of age-selective interventions both on mortality and on economic activity in Wuhan. For this purpose, we simulated four different scenarios ranging from an absence of measures to age-selective interventions with stronger physical-distancing measures for older individuals.
Results: An age-selective strategy could reduce the death toll by >30% compared with the non-selective measures applied during Wuhan's lockdown for the same workforce. Moreover, an alternative age-selective strategy could allow a 5-fold increase in the population working on site without a detrimental impact on the death toll compared with the Wuhan scenario.
Conclusion: Our results suggest that age-selective-distancing measures focused on the older population could have achieved a better balance between COVID-19 mortality and economic activity during the first COVID-19 outbreak in Wuhan. However, the implications of this need to be interpreted along with considerations of the practical feasibility and potential wider benefits and drawbacks of such a strategy.

Keywords: Covid-19; SEIR; age-selective; mathematical model; physical distancing; shielding.
 
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