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Register a new userNon-pharmaceutical interventions during the COVID-19 pandemic: a rapid review
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Nicola Perra
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Infectious diseases and human behavior are intertwined. On one side, our movements and interactions are the engines of transmission. On the other, the unfolding of viruses might induce changes to our daily activities. While intuitive, our understanding of such feedback loop is still limited. Before COVID-19 the literature on the subject was mainly theoretical and largely missed validation. The main issue was the lack of empirical data capturing behavioral change induced by diseases. Things have dramatically changed in 2020. Non-pharmaceutical interventions (NPIs) have been the key weapon against the SARS-CoV-2 virus and affected virtually any societal process. Travels bans, events cancellation, social distancing, curfews, and lockdowns have become unfortunately very familiar. The scale of the emergency, the ease of survey as well as crowdsourcing deployment guaranteed by the latest technology, several Data for Good programs developed by tech giants, major mobile phone providers, and other companies have allowed unprecedented access to data describing behavioral changes induced by the pandemic. Here, I aim to review some of the vast literature written on the subject of NPIs during the COVID-19 pandemic. In doing so, I analyze 347 articles written by more than 2518 of authors in the last $12$ months. While the large majority of the sample was obtained by querying PubMed, it includes also a hand-curated list. Considering the focus, and methodology I have classified the sample into seven main categories: epidemic models, surveys, comments/perspectives, papers aiming to quantify the effects of NPIs, reviews, articles using data proxies to measure NPIs, and publicly available datasets describing NPIs. I summarize the methodology, data used, findings of the articles in each category and provide an outlook highlighting future challenges as well as opportunities
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The impact of the ongoing COVID-19 pandemic is being felt in all spheres of our lives -- cutting across the boundaries of nation, wealth, religions or race. From the time of the first detection of infection among the public, the virus spread though almost all the countries in the world in a short period of time. With humans as the carrier of the virus, the spreading process necessarily depends on the their mobility after being infected. Not only in the primary spreading process, but also in the subsequent spreading of the mutant variants, human mobility plays a central role in the dynamics. Therefore, on one hand travel restrictions of varying degree were imposed and are still being imposed, by various countries both nationally and internationally. On the other hand, these restrictions have severe fall outs in businesses and livelihood in general. Therefore, it is an optimization process, exercised on a global scale, with multiple changing variables. Here we review the techniques and their effects on optimization or proposed optimizations of human mobility in different scales, carried out by data driven, machine learning and model approaches.
We present modeling of the COVID-19 epidemic in Illinois, USA, capturing the implementation of a Stay-at-Home order and scenarios for its eventual release. We use a non-Markovian age-of-infection model that is capable of handling long and variable time delays without changing its model topology. Bayesian estimation of model parameters is carried out using Markov Chain Monte Carlo (MCMC) methods. This framework allows us to treat all available input information, including both the previously published parameters of the epidemic and available local data, in a uniform manner. To accurately model deaths as well as demand on the healthcare system, we calibrate our predictions to total and in-hospital deaths as well as hospital and ICU bed occupancy by COVID-19 patients. We apply this model not only to the state as a whole but also its sub-regions in order to account for the wide disparities in population size and density. Without prior information on non-pharmaceutical interventions (NPIs), the model independently reproduces a mitigation trend closely matching mobility data reported by Google and Unacast. Forward predictions of the model provide robust estimates of the peak position and severity and also enable forecasting the regional-dependent results of releasing Stay-at-Home orders. The resulting highly constrained narrative of the epidemic is able to provide estimates of its unseen progression and inform scenarios for sustainable monitoring and control of the epidemic.
We develop a novel hybrid epidemiological model and a specific methodology for its calibration to distinguish and assess the impact of mobility restrictions (given by Apples mobility trends data) from other complementary non-pharmaceutical interventions (NPIs) used to control the spread of COVID-19. Using the calibrated model, we estimate that mobility restrictions contribute to 47 % (US States) and 47 % (worldwide) of the overall suppression of the disease transmission rate using data up to 13/08/2020. The forecast capacity of our model was evaluated doing four-weeks ahead predictions. Using data up to 30/06/20 for calibration, the mean absolute percentage error (MAPE) of the prediction of cumulative deceased individuals was 5.0 % for the United States (51 states) and 6.7 % worldwide (49 countries). This MAPE was reduced to 3.5% for the US and 3.8% worldwide using data up to 13/08/2020. We find that the MAPE was higher for the total confirmed cases at 11.5% worldwide and 10.2% for the US States using data up to 13/08/2020. Our calibrated model achieves an average R-Squared value for cumulative confirmed and deceased cases of 0.992 using data up to 30/06/20 and 0.98 using data up to 13/08/20.
In March of this year, COVID-19 was declared a pandemic and it continues to threaten public health. This global health crisis imposes limitations on daily movements, which have deteriorated every sector in our society. Understanding public reactions to the virus and the non-pharmaceutical interventions should be of great help to fight COVID-19 in a strategic way. We aim to provide tangible evidence of the human mobility trends by comparing the day-by-day variations across the U.S. Large-scale public mobility at an aggregated level is observed by leveraging mobile device location data and the measures related to social distancing. Our study captures spatial and temporal heterogeneity as well as the sociodemographic variations regarding the pandemic propagation and the non-pharmaceutical interventions. All mobility metrics adapted capture decreased public movements after the national emergency declaration. The population staying home has increased in all states and becomes more stable after the stay-at-home order with a smaller range of fluctuation. There exists overall mobility heterogeneity between the income or population density groups. The public had been taking active responses, voluntarily staying home more, to the in-state confirmed cases while the stay-at-home orders stabilize the variations. The study suggests that the public mobility trends conform with the government message urging to stay home. We anticipate our data-driven analysis offers integrated perspectives and serves as evidence to raise public awareness and, consequently, reinforce the importance of social distancing while assisting policymakers.
In this paper we propose a data-driven model for the spread of SARS-CoV-2 and use it to design optimal control strategies of human-mobility restrictions that both curb the epidemic and minimize the economic costs associated with implementing non-pharmaceutical interventions. We develop an extension of the SEIR epidemic model that captures the effects of changes in human mobility on the spread of the disease. The parameters of our data-driven model are learned using a multitask learning approach that leverages both data on the number of deaths across a set of regions, and cellphone data on individuals mobility patterns specific to each region. We propose an optimal control problem on this data-driven model with a tractable solution provided by geometric programming. The result of this framework is a mobility-based intervention strategy that curbs the spread of the epidemic while obeying a budget on the economic cost incurred. Furthermore, in the absence of a straightforward mapping from human mobility data to economic costs, we propose a practical method by which a budget on economic losses incurred may be chosen to eliminate excess deaths due to over-utilization of hospital resources. Our results are demonstrated with numerical simulations using real data from the Philadelphia metropolitan area.
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