Age- and vaccination status-dependent isolation guidelines based on simulation of SARS-CoV-2 Delta cases in Singapore.

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Tác giả: Marco Ajelli, Po Ying Chia, Hoong Kai Chua, Keisuke Ejima, Shingo Iwami, Yong Dam Jeong, David Chien Lye, Norio Ohmagari, Sean W X Ong, Luis Ponce, Kenji Shibuya, Ananya Singh, Kelvin Bryan Tan, Kiyosu Taniguchi, Yuqian Wang, Barnaby E Young

Ngôn ngữ: eng

Ký hiệu phân loại:

Thông tin xuất bản: England : Communications medicine , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 711791

BACKGROUND: In the absence of effective pharmaceutical interventions early in an infectious disease outbreak, non-pharmaceutical measures, especially isolating infected individuals, critically limit its impact. The ongoing COVID-19 pandemic has sparked debates on optimal isolation guidelines. This study proposes a variable isolation period approach (variable-period approach), tailoring isolation durations for distinct population groups with varied viral load dynamics. METHODS: To compare our variable-period approach with a fixed-period strategy, we developed a simulation model generating synthetic longitudinal SARS-CoV-2 viral load data. The data was generated from the viral dynamics model parameterized using SARS-CoV-2 Delta patient data in Singapore, accounting for age and vaccination status. RESULTS: Findings show that age and vaccination status significantly influence viral dynamics, with younger age and vaccination linked to shorter viral shedding durations. The variable-period framework suggests longer isolation lengths for older and unvaccinated individuals. By setting the leaking risk (risk of remaining infectious at the end of isolation) below 10%, the optimal fixed-period isolation is 14 days, with an average excess isolation burden of 7.4 unnecessary days. In contrast, the variable-period guideline reduces the excess isolation burden to 6.0 days, with the optimal isolation periods ranging from 9 to 16 days, depending on the population group. We confirmed similar results when we used the effective reproduction number as an alternative to the leaking risk. CONCLUSIONS: In this case, study using the SARS-CoV-2 Delta variant, our analysis demonstrates that unnecessary time spent in isolation can be reduced by adopting variable-period guidelines based on patient characteristics.
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