The effectiveness of quarantine and isolation determine the trend of the COVID-19 epidemic in the final phase of the current outbreak in China

A conformable fractional finite difference method for modified mathematical modeling of SAR-CoV-2 (COVID-19) disease

In this research, the ongoing COVID-19 disease by considering the vaccination strategies into mathematical models is discussed. A modified and comprehensive mathematical model that captures the complex relationships between various population compartments, including susceptible (Sα), exposed (Eα), infected (Uα), quarantined (Qα), vaccinated (Vα), and recovered (Rα) individuals. Using conformable derivatives, a system of equations that precisely captures the complex interconnections inside the COVID-19 transmission. The basic reproduction number (R0), which is an essential indicator of disease transmission, is the subject of investigation calculating using the next-generation matrix approach. We also compute the R0 sensitivity indices, which offer important information about the relative influence of various factors on the overall dynamics. Local stability and global stability of R0 have been proved at a disease-free equilibrium point. By designing the finite difference approach of the conformable fractional derivative using the Taylor series. The present methodology provides us highly accurate convergence of the obtained solution. Present research fills research addresses the understanding gap between conceptual frameworks and real-world implementations, demonstrating the vaccination therapy's significant possibilities in the struggle against the COVID-19 pandemic.

Compliance with measures among actors and lessons learnt in the management of COVID-19 institutional quarantine in Uganda

Introduction

To support COVID-19 containment measures, several countries implemented quarantine protocols. This study determined the level of compliance to COVID-19 quarantine measures, associated factors, and lessons learnt in institutional quarantine management in Uganda.

Methods

This concurrent mixed methods study involved a cross-sectional survey among individuals who were in institutional quarantine and interviews with key informants, who were reached mostly through phone calls. Univariate, bivariate, and multivariable analysis were conducted to analyse quantitative data while qualitative data were analysed thematically with the aid of Atlas ti 7.

Results

Compliance with quarantine measures at the individual level was moderate at 65.4 %. Factors associated with high compliance with measures were: older age (above 40 years) [APR = 1.30 (95 % CI: 1.04-1.63)], spending 14-15 days in quarantine [APR = 1.39 (95 % CI: 1.00-1.92)] and reporting a high Ministry of Health compliance [APR = 1.33 (CI: 1.11-1.58)]. The positive factors included the availability of guidelines, inspection of facilities and training of personnel. The challenges were related to long turnaround time for results and provision of personal protective equipment (PPE).

Conclusion

Efforts to improve training, supervision and inspection of facilities, and provision of adequate PPE would improve compliance with quarantine measures.

Transmission dynamics informed neural network with application to COVID-19 infections

Since the end of 2019 the COVID-19 repeatedly surges with most countries/territories experiencing multiple waves, and mechanism-based epidemic models played important roles in understanding the transmission mechanism of multiple epidemic waves. However, capturing temporal changes of the transmissibility of COVID-19 during the multiple waves keeps ill-posed problem for traditional mechanism-based epidemic compartment models, because that the transmission rate is usually assumed to be specific piecewise functions and more parameters are added to the model once multiple epidemic waves involved, which poses a huge challenge to parameter estimation. Meanwhile, data-driven deep neural networks fail to discover the driving factors of repeated outbreaks and lack interpretability. In this study, aiming at developing a data-driven method to project time-dependent parameters but also merging the advantage of mechanism-based models, we propose a transmission dynamics informed neural network (TDINN) by encoding the SEIRD compartment model into deep neural networks. We show that the proposed TDINN algorithm performs very well when fitting the COVID-19 epidemic data with multiple waves, where the epidemics in the United States, Italy, South Africa, and Kenya, and several outbreaks the Omicron variant in China are taken as examples. In addition, the numerical simulation shows that the trained TDINN can also perform as a predictive model to capture the future development of COVID-19 epidemic. We find that the transmission rate inferred by the TDINN frequently fluctuates, and a feedback loop between the epidemic shifting and the changes of transmissibility drives the occurrence of multiple waves. We observe a long response delay to the implementation of control interventions in the four countries, while the decline of the transmission rate in the outbreaks in China usually happens once the implementation of control interventions. The further simulation show that 17 days' delay of the response to the implementation of control interventions lead to a roughly four-fold increase in daily reported cases in one epidemic wave in Italy, which suggest that a rapid response to policies that strengthen control interventions can be effective in flattening the epidemic curve or avoiding subsequent epidemic waves. We observe that the transmission rate in the outbreaks in China is already decreasing before enhancing control interventions, providing the evidence that the increasing of the epidemics can drive self-conscious behavioural changes to protect against infections.

Patch model for border reopening and control to prevent new outbreaks of COVID-19

In this paper, we propose a two-patch model with border control to investigate the effect of border control measures and local non-pharmacological interventions (NPIs) on the transmission of COVID-19. The basic reproduction number of the model is calculated, and the existence and stability of the boundary equilibria and the existence of the coexistence equilibrium of the model are obtained. Through numerical simulation, when there are no unquarantined virus carriers in the patch-2, it can be concluded that the reopening of the border with strict border control measures to allow people in patch-1 to move into patch-2 will not lead to disease outbreaks. Also, when there are unquarantined virus carriers in patch-2 (or lax border control causes people carrying the virus to flow into patch-2), the border control is more strict, and the slower the growth of number of new infectious in patch-2, but the strength of border control does not affect the final state of the disease, which is still dependent on local NPIs. Finally, when the border reopens during an outbreak of disease in patch-2, then a second outbreak will happen.

The effect mitigation measures for COVID-19 by a fractional-order SEIHRDP model with individuals migration

In this paper, the generalized SEIHRDP (susceptible-exposed-infective-hospitalized-recovered-death-insusceptible) fractional-order epidemic model is established with individual migration. Firstly, the global properties of the proposed system are studied. Particularly, the sensitivity of parameters to the basic reproduction number are analyzed both theoretically and numerically. Secondly, according to the real data in India and Brazil, it can all be concluded that the bilinear incidence rate has a better description of COVID-19 transmission. Meanwhile, multi-peak situation is considered in China, and it is shown that the proposed system can better predict the next peak. Finally, taking individual migration between Los Angeles and New York as an example, the spread of COVID-19 between cities can be effectively controlled by limiting individual movement, enhancing nucleic acid testing and reducing individual contact.

Timely and effective media coverage's role in the spread of Corona Virus Disease 2019

For all humanity, the sudden outbreak of Corona Virus Disease 2019 has been an important problem. Timely and effective media coverage is considered to be one of the effective approaches to control the spread of epidemic in early stage. In this paper, a Sentiment-enabled Susceptible-Exposed-Infected-Recovered (SEIR) model is established to reveal the relationship between the propagation of the epidemic and media coverage. The authors take the positive and negative media coverage into consideration when implementing the Sentiment-enabled SEIR model. This model is constructed by parameterizing the number of current confirmed cases, cumulative cured cases, cumulative deaths, and media coverage. The numerical simulation and sensitivity analysis are conducted based on the Sentiment-enabled SEIR model. The numerical analysis confirms the rationality of the Sentiment-enabled SEIR model. The sensitivity analysis shows that positive media coverage acts a pivotal part in reducing the figure for confirmed cases. Negative media coverage has an effect on the figure for confirmed cases is not as significant as that of positive media coverage, but it is not negligible.

Assessing Age-Specific Vaccination Strategies and Post-vaccination Reopening Policies for COVID-19 Control Using SEIR Modeling Approach

As the availability of COVID-19 vaccines, it is badly needed to develop vaccination guidelines to prioritize the vaccination delivery in order to effectively stop COVID-19 epidemic and minimize the loss. We evaluated the effect of age-specific vaccination strategies on the number of infections and deaths using an SEIR model, considering the age structure and social contact patterns for different age groups for each of different countries. In general, the vaccination priority should be given to those younger people who are active in social contacts to minimize the number of infections, while the vaccination priority should be given to the elderly to minimize the number of deaths. But this principle may not always apply when the interaction of age structure and age-specific social contact patterns is complicated. Partially reopening schools, workplaces or households, the vaccination priority may need to be adjusted accordingly. Prematurely reopening social contacts could initiate a new outbreak or even a new pandemic out of control if the vaccination rate and the detection rate are not high enough. Our result suggests that it requires at least nine months of vaccination (with a high vaccination rate > 0.1%) for Italy and India before fully reopening social contacts in order to avoid a new pandemic.

Analysis of the Geographic Transmission Differences of COVID-19 in China Caused by Population Movement and Population Density

The coronavirus disease (COVID-19) has led to a global pandemic and caused huge healthy and economic losses. Non-pharmaceutical interventions, especially contact tracing and social distance restrictions, play a vital role in the control of COVID-19. Understanding the spatial impact is essential for designing such a control policy. Based on epidemic data of the confirmed cases after the Wuhan lockdown, we calculate the invasive reproduction numbers of COVID-19 in the different regions of China. Statistical analysis indicates a significant positive correlation between the reproduction numbers and the population input sizes from Wuhan, which indicates that the large-scale population movement contributed a lot to the geographic spread of COVID-19 in China. Moreover, there is a significant positive correlation between reproduction numbers and local population densities, which shows that the higher population density intensifies the spread of disease. Considering that in the early stage, there were sequential imported cases that affected the estimation of reproduction numbers, we classify the imported cases and local cases through the information of epidemiological data and calculate the net invasive reproduction number to quantify the local spread of the epidemic. The results are applied to the design of border control policy on the basis of vaccination coverage.

A quantitative method to project the probability of the end of an epidemic: Application to the COVID-19 outbreak in Wuhan, 2020

The end-of-outbreak declaration is an important part of epidemic control, marking the relaxation or cancellation of prevention and control measures. We propose a probability model to retrospectively quantify the confidence of giving the end-of-outbreak declaration during the COVID-19 epidemic in early 2020 in Wuhan. By using the linear spline, we firstly estimates the time-varying proportion of cases who miss the nonpharmaceutical interventions (NPIs) among all reported cases. Assuming the reproduction numbers being 1.5, 2.0, 3.0, 4.0, 5.0 and 6.0, the respective probability of the end of the COVID-19 outbreak with time after the last reported case can be iteratively computed. Consequently, the varying reproduction numbers produce slightly different increasing patterns of NPI effectiveness, and the end-of-outbreak declarations with 95% confidence are projected consistently earlier than the day when the lockdown was actually lifted. The reason for the timing discrepancy is discussed as well.

The effectiveness of various control strategies: an insight from a comparison modelling study

Several local outbreaks have occurred and been suppressed with the dynamic zero-COVID policy and widely promoted vaccination program implemented in China. The epidemic duration and final size vary significantly in different cities, which may be attributed to different implementation patterns and intensities of non-pharmaceutical interventions (NPIs). It's important to capture the underlying mechanism to explore more efficient implementation patterns of NPIs in order to prevent the future resurgence. In this study, outbreaks caused by Delta variant in Xi'an, Yangzhou and Guangzhou in 2021 are chosen as the examples. A novel model dividing the population into three groups is proposed to describe the heterogeneity of control interventions. The model is calibrated and key parameters related to NPIs are estimated by using multi-source epidemic data. The estimation results show a lower transmission probability but a higher initial reproduction number in Xi'an. Sensitivity analysis are conducted to investigate the impact of various control measures in different epidemic phases. The results identify the vital role of enhancing closed-off management, strengthening tracing and testing intensities, on shortening the epidemic durations and reducing the final size. Further, we find that sufficiently implemented closed-off management would prevent the city from lockdown. Strengthening the tracing other than the testing strategy in the initial stage is more effective on containing the epidemic in a shorter duration with less infections.

A switching dynamic model based on phased COVID-19 data in Chongqing and its evaluation

Objectives

Although COVID-19 has been controlled in China, the risk of invasion of imported cases remains. We aimed to characterize the impact of the number of imported cases and the implementation of first-level emergency response (FLER) policy.

Methods

A SCQIHR switching model was constructed and verified by the complete phased data of COVID-19 in Chongqing in 2020. Then it was used to investigate the impact of the number of imported cases and the timing of FLER. Lastly, it was evaluated by three actual scenarios in Chongqing in 2021.

Results

The proposed model can fit the multidimensional time series well. After the implementation of FLER, the mean effective reproduction number, contact rate and misdetection rate were decreased significantly, but the quarantine rate for close contacts and isolation rate for non-hospitalized infectious cases were increased significantly. The peaks of quarantined close contacts and hospitalized infectious cases increased linearly with the increase of the number of imported cases and the lag of FLER time, which was verified by three actual scenarios in Chongqing in 2021.

Conclusions

These findings can provide guidance for local public health policy-making and allocation of medical resources, reduce the impact of COVID-19 on the local population.

Estimating the Number of COVID-19 Cases and Impact of New COVID-19 Variants and Vaccination on the Population in Kerman, Iran: A Mathematical Modeling Study

COVID-19 is spreading all over Iran, and Kerman is one of the most affected cities. We conducted this study to predict COVID-19-related deaths, hospitalization, and infected cases under different scenarios (scenarios A, B, and C) by 31 December 2021 in Kerman. We also aimed to assess the impact of new COVID-19 variants and vaccination on the total number of COVID-19 cases, deaths, and hospitalizations (scenarios D, E, and F) using the modified susceptible-exposed-infected-removed (SEIR) model. We calibrated the model using deaths reported from the start of the epidemic to August 30, 2021. A Monte Carlo Markov Chain (MCMC) uncertainty analysis was used to estimate 95% uncertainty intervals (UI). We also calculated the time-varying reproductive number (R_t) following time-dependent methods. Under the worst-case scenario (scenario A; contact rate = 10, self‐isolation rate = 30%, and average vaccination shots per day = 5,000), the total number of infections by December 31, 2021, would be 1,625,000 (95% UI: 1,112,000–1,898,000) with 6,700 deaths (95% UI: 5,200–8,700). With the presence of alpha and delta variants without vaccine (scenario D), the total number of infected cases and the death toll were estimated to be 957,000 (95% UI: 208,000–1,463,000) and 4,500 (95% UI: 1,500–7,000), respectively. If 70% of the population were vaccinated when the alpha variant was dominant (scenario E), the total number of infected cases and deaths would be 608,000 (95% UI: 122,000–743,000) and 2,700 (95% UI: 700–4,000), respectively. The R_t was ≥1 almost every day during the epidemic. Our results suggest that policymakers should concentrate on improving vaccination and interventions, such as reducing social contacts, stricter limitations for gathering, public education to promote social distancing, incensing case finding and contact tracing, effective isolation, and quarantine to prevent more COVID-19 cases, hospitalizations, and deaths in Kerman.

Insight into prognostics, diagnostics, and management strategies for SARS CoV-2

The foremost challenge in countering infectious diseases is the shortage of effective therapeutics. The emergence of coronavirus disease (COVID-19) outbreak has posed a great menace to the public health system globally, prompting unprecedented endeavors to contain the virus. Many countries have organized research programs for therapeutics and management development. However, the longstanding process has forced authorities to implement widespread infrastructures for detailed prognostic and diagnostics study of severe acute respiratory syndrome (SARS CoV-2). This review discussed nearly all the globally developed diagnostic methodologies reported for SARS CoV-2 detection. We have highlighted in detail the approaches for evaluating COVID-19 biomarkers along with the most employed nucleic acid- and protein-based detection methodologies and the causes of their severe downfall and rejection. As the variable variants of SARS CoV-2 came into the picture, we captured the breadth of newly integrated digital sensing prototypes comprised of plasmonic and field-effect transistor-based sensors along with commercially available food and drug administration (FDA) approved detection kits. However, more efforts are required to exploit the available resources to manufacture cheap and robust diagnostic methodologies. Likewise, the visualization and characterization tools along with the current challenges associated with waste-water surveillance, food security, contact tracing, and their role during this intense period of the pandemic have also been discussed. We expect that the integrated data will be supportive and aid in the evaluation of sensing technologies not only in current but also future pandemics.

Stability analysis of a nonlocal SIHRDP epidemic model with memory effects

The prediction and control of COVID-19 is critical for ending this pandemic. In this paper, a nonlocal SIHRDP (S-susceptible class, I-infective class (infected but not hospitalized), H-hospitalized class, R-recovered class, D-death class and P-isolated class) epidemic model with long memory is proposed to describe the multi-wave peaks for the spread of COVID-19. Based on the basic reproduction number R 0 , which is completely controlled by fractional order, the stability of the proposed system is studied. Furthermore, the numerical simulation is conducted to gauge the performance of the proposed model. The results on Hunan, China, reveal thatR 0 < 1 suggests that the disease-free equilibrium point is globally asymptotically stable. Likewise, the situation of the multi-peak case in China is presented, and it is clear that the nonlocal epidemic system has a superior fitting effect than the classical model. Finally an adaptive impulsive vaccination is introduced based on the proposed system. Then employing the real data of France, India, the USA and Argentina, parameters identification and short-term forecasts are carried out to verify the effectiveness of the proposed model in describing the case of multiple peaks. Moreover, the implementation of vaccine control is expected once the hospitalized population exceeds 20 % of the total population. Numerical results of France, Indian, the USA and Argentina shed light on the varied effect of vaccine control in different countries. According to the vaccine control imposed on France, no obvious effect is observed even consider reducing human contact. As for India, although there will be a temporary increase in hospitalized admissions after execution of vaccination control, COVID-19 will eventually disappear. Results on the USA have seen most significant effect of vaccine control, the number of hospitalized individuals drops off and the disease is eventually eradicated. In contrast to the USA, vaccine control in Argentina has also been very effective, but COVID-19 cannot be completely eradicated.

Current forecast of COVID-19 in Mexico: A Bayesian and machine learning approaches

The COVID-19 pandemic has been widely spread and affected millions of people and caused hundreds of deaths worldwide, especially in patients with comorbilities and COVID-19. This manuscript aims to present models to predict, firstly, the number of coronavirus cases and secondly, the hospital care demand and mortality based on COVID-19 patients who have been diagnosed with other diseases. For the first part, I present a projection of the spread of coronavirus in Mexico, which is based on a contact tracing model using Bayesian inference. I investigate the health profile of individuals diagnosed with coronavirus to predict their type of patient care (inpatient or outpatient) and survival. Specifically, I analyze the comorbidity associated with coronavirus using Machine Learning. I have implemented two classifiers: I use the first classifier to predict the type of care procedure that a person diagnosed with coronavirus presenting chronic diseases will obtain (i.e. outpatient or hospitalised), in this way I estimate the hospital care demand; I use the second classifier to predict the survival or mortality of the patient (i.e. survived or deceased). I present two techniques to deal with these kinds of unbalanced datasets related to outpatient/hospitalised and survived/deceased cases (which occur in general for these types of coronavirus datasets) to obtain a better performance for the classification.

Activity-based epidemic propagation and contact network scaling in auto-dependent metropolitan areas

We build on recent work to develop a fully mechanistic, activity-based and highly spatio-temporally resolved epidemiological model which leverages person-trajectories obtained from an activity-based model calibrated for two full-scale prototype cities, consisting of representative synthetic populations and mobility networks for two contrasting auto-dependent city typologies. We simulate the propagation of the COVID-19 epidemic in both cities to analyze spreading patterns in urban networks across various activity types. Investigating the impact of the transit network, we find that its removal dampens disease propagation significantly, suggesting that transit restriction is more critical for mitigating post-peak disease spreading in transit dense cities. In the latter stages of disease spread, we find that the greatest share of infections occur at work locations. A statistical analysis of the resulting activity-based contact networks indicates that transit contacts are scale-free, work contacts are Weibull distributed, and shopping or leisure contacts are exponentially distributed. We validate our simulation results against existing case and mortality data across multiple cities in their respective typologies. Our framework demonstrates the potential for tracking epidemic propagation in urban networks, analyzing socio-demographic impacts and assessing activity- and mobility-specific implications of both non-pharmaceutical and pharmaceutical intervention strategies.

Mathematical modeling of the spread of the coronavirus under strict social restrictions

We formulate a simple susceptible-infectious-recovery (SIR) model to describe the spread of the coronavirus under strict social restrictions. The transmission rate in this model is exponentially decreasing with time. We find a formula for basic reproduction function and estimate the maximum number of daily infected individuals. We fit the model to induced death data in Italy, United States, Germany, France, India, Spain, and China over the period from the first reported death to August 7, 2020. We notice that the model has excellent fit to the disease death data in these countries. We estimate the model's parameters in each of these countries with 95% confidence intervals. We order the strength of social restrictions in these countries using the exponential rate. We estimate the time needed to reduce the basic reproduction function to one unit and use it to order the quality of social restrictions in these countries. The social restriction in China was the strictest and the most effective and in India was the weakest and the least effective. Policy-makers may apply the Chinese successful social restriction experiment and avoid the Indian unsuccessful one.

Optimal strategic pandemic control: human mobility and travel restriction

This paper presents a model for finding optimal pandemic control policy considering cross-region human mobility. We extend the baseline susceptible-infectious-recovered (SIR) epidemiology model by including the net human mobility from a severely-impacted region to a mildly-affected region. The strategic optimal mitigation policy combining testing and lockdown in each region is then obtained with the goal of minimizing economic cost under the constraint of limited resources. We parametrize the model using the data of the COVID-19 pandemic and show that the optimal response strategy and mitigation outcome greatly rely on the mitigation duration, available resources, and cross-region human mobility. Furthermore, we discuss the economic impact of travel restriction policies through a quantitative analysis.

The role of proactive behavior on COVID-19 infordemic in the Chinese Sina-Microblog: a modeling study

In order to avoid forming an information cocoon, the information propagation of COVID-19 is usually created through the action of "proactive search", an important behavior other than "reactive follow". This behavior has been largely ignored in modeling information dynamics. Here, we propose to fill in this gap by proposing a proactive-reactive susceptible-discussing-immune (PR-SFI) model to describe the patterns of co-propagation on social networks. This model is based on the forwarding quantity and takes into account both proactive search and reactive follow behaviors. The PR-SFI model is parameterized by data fitting using real data of COVID-19 related topics in the Chinese Sina-Microblog, and the model is calibrated and validated using the prediction accuracy of the accumulated forwarding users. Our sensitivity analysis and numerical experiments provide insights about optimal strategies for public health emergency information dissemination.

Predictability of COVID-19-related morbidity and mortality based on model estimations to establish proactive protocols of countermeasures

The COVID-19 pandemic (SARS-CoV-2) has revealed the need for proactive protocols to react and act, imposing preventive and restrictive countermeasures on time in any society. The extent to which confirmed cases can predict the morbidity and mortality in a society remains an unresolved issue. The research objective is therefore to test a generic model’s predictability through time, based on percentage of confirmed cases on hospitalized patients, ICU patients and deceased. This study reports the explanatory and predictive ability of COVID-19-related healthcare data, such as whether there is a spread of a contagious and virulent virus in a society, and if so, whether the morbidity and mortality can be estimated in advance in the population. The model estimations stress the implementation of a pandemic strategy containing a proactive protocol entailing what, when, where, who and how countermeasures should be in place when a virulent virus (e.g. SARS-CoV-1, SARS-CoV-2 and MERS) or pandemic strikes next time. Several lessons for the future can be learnt from the reported model estimations. One lesson is that COVID-19-related morbidity and mortality in a population is indeed predictable. Another lesson is to have a proactive protocol of countermeasures in place.

Effects of masks on the transmission of infectious diseases

In the present paper, based on the conditions that asymptomatic virus carriers are contagious and all symptomatic infected individuals wear masks, we study the impact of wearing masks in the susceptible and the asymptomatic virus carriers on the spread of infectious diseases by developing a differential equation model. At first, we give the existence, uniqueness, boundedness, and positivity of the solution as well as the basic reproduction number R 0 for the established model. Then, for two cases of wearing masks in the susceptible and the asymptomatic virus carriers where the proportion of wearing masks is fixed and the proportion of wearing masks changes with time, the results of the numerical simulation are shown in a series of pictures, and quantitative description of effects of the proportion of the population wearing masks, the protective effect of masks, and the time when they start wearing masks on the epidemic is given. Our results show that under the situation that the proportion of wearing masks is positively related to the confirmed new cases and new deaths, though the proportion will be close to 1 during the high incidence of patients, the effect on controlling the spread of such infectious diseases is far worse than the case of always maintaining a relatively higher proportion (≥0.66) of wearing masks.

Experiences of persons in COVID-19 institutional quarantine in Uganda: a qualitative study

BACKGROUND

Quarantine has been adopted as a key public health measure to support the control of the Coronavirus disease (COVID-19) pandemic in many countries Uganda adopted institutional quarantine for individuals suspected of exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to be placed in institutions like hotels and/or hostels of institutions for at least 14 days. This study explored experiences of individuals who underwent institutional quarantine in Uganda to inform measures to increase its effectiveness and reduce its associated negative impact.

METHODS

We conducted a qualitative description study using in-depth interviews with 20 purposively selected individuals who had spent time in institutional quarantine facilities. These were mainly phone-based interviews that were audio recorded and transcribed verbatim. Electronic data coding was conducted using Atlas.ti 7 software. Thematic content analysis was used to synthesize the findings with similar codes grouped to form sub-themes and ultimately study themes. The findings are presented thematically with typical participant quotes.

RESULTS

Study participants spent between 14 to 25 days in institutional quarantine. Four themes emerged describing the experiences of study participants during institutional quarantine, which determined whether participants' experiences were positive or negative. These themes were: quarantine environment including facility related factors and compliance with COVID-19 measures; quarantine management factors of entity paying the costs, communication and days spent in quarantine; individual factors comprising attitude towards quarantine, fears during and post-quarantine and coping mechanisms; and linkage to other services such as health care and post-quarantine follow-up.

CONCLUSION

The planning, management and implementation of the quarantine process is a key determinant of the experiences of individuals who undergo the measure. To improve the experience of quarantined individuals and reduce its associated negative impact, the pre-quarantine process should be managed to comply with standards, quarantined persons should be provided as much information as possible, their quarantine duration should kept short and costs of the process ought to be minimised. Furthermore, quarantine facilities should be assessed for suitability and monitored to comply with guidelines while avenues for access to healthcare for the quarantined need to be arranged and any potential stigma associated with quarantine thoroughly addressed.

Impact of Hospital Bed Shortages on the Containment of COVID-19 in Wuhan

The global outbreak of COVID-19 has caused worrying concern amongst the public and health authorities. The first and foremost problem that many countries face during the outbreak is a shortage of medical resources. In order to investigate the impact of a shortage of hospital beds on the COVID-19 outbreak, we formulated a piecewise smooth model for describing the limitation of hospital beds. We parameterized the model while using data on the cumulative numbers of confirmed cases, recovered cases, and deaths in Wuhan city from 10 January to 12 April 2020. The results showed that, even with strong prevention and control measures in Wuhan, slowing down the supply rate, reducing the maximum capacity, and delaying the supply time of hospital beds all aggravated the outbreak severity by magnifying the cumulative numbers of confirmed cases and deaths, lengthening the end time of the pandemic, enlarging the value of the effective reproduction number during the outbreak, and postponing the time when the threshold value was reduced to 1. Our results demonstrated that establishment of the Huoshenshan, Leishenshan, and Fangcang shelter hospitals avoided 22,786 people from being infected and saved 6524 lives. Furthermore, the intervention of supplying hospital beds avoided infections in 362,360 people and saved the lives of 274,591 persons. This confirmed that the quick establishment of the Huoshenshan, Leishenshan Hospitals, and Fangcang shelter hospitals, and the designation of other hospitals for COVID-19 patients played important roles in containing the outbreak in Wuhan.

Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a rapidly emerging disease classified as a pandemic by the World Health Organization (WHO). To support the WHO with their recommendations on quarantine, we conducted a rapid review on the effectiveness of quarantine during severe coronavirus outbreaks.

OBJECTIVES

To assess the effects of quarantine (alone or in combination with other measures) of individuals who had contact with confirmed or suspected cases of COVID-19, who travelled from countries with a declared outbreak, or who live in regions with high disease transmission.

SEARCH METHODS

An information specialist searched the Cochrane COVID-19 Study Register, and updated the search in PubMed, Ovid MEDLINE, WHO Global Index Medicus, Embase, and CINAHL on 23 June 2020.

SELECTION CRITERIA

Cohort studies, case-control studies, time series, interrupted time series, case series, and mathematical modelling studies that assessed the effect of any type of quarantine to control COVID-19. We also included studies on SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome) as indirect evidence for the current coronavirus outbreak.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened abstracts and titles in duplicate. Two review authors then independently screened all potentially relevant full-text publications. One review author extracted data, assessed the risk of bias and assessed the certainty of evidence with GRADE and a second review author checked the assessment. We used three different tools to assess risk of bias, depending on the study design: ROBINS-I for non-randomised studies of interventions, a tool provided by Cochrane Childhood Cancer for non-randomised, non-controlled studies, and recommendations from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) for modelling studies. We rated the certainty of evidence for the four primary outcomes: incidence, onward transmission, mortality, and costs.

MAIN RESULTS

We included 51 studies; 4 observational studies and 28 modelling studies on COVID-19, one observational and one modelling study on MERS, three observational and 11 modelling studies on SARS, and three modelling studies on SARS and other infectious diseases. Because of the diverse methods of measurement and analysis across the outcomes of interest, we could not conduct a meta-analysis and undertook a narrative synthesis. We judged risk of bias to be moderate for 2/3 non-randomized studies of interventions (NRSIs) and serious for 1/3 NRSI. We rated risk of bias moderate for 4/5 non-controlled cohort studies, and serious for 1/5. We rated modelling studies as having no concerns for 13 studies, moderate concerns for 17 studies and major concerns for 13 studies. Quarantine for individuals who were in contact with a confirmed/suspected COVID-19 case in comparison to no quarantine Modelling studies consistently reported a benefit of the simulated quarantine measures, for example, quarantine of people exposed to confirmed or suspected cases may have averted 44% to 96% of incident cases and 31% to 76% of deaths compared to no measures based on different scenarios (incident cases: 6 modelling studies on COVID-19, 1 on SARS; mortality: 2 modelling studies on COVID-19, 1 on SARS, low-certainty evidence). Studies also indicated that there may be a reduction in the basic reproduction number ranging from 37% to 88% due to the implementation of quarantine (5 modelling studies on COVID-19, low-certainty evidence). Very low-certainty evidence suggests that the earlier quarantine measures are implemented, the greater the cost savings may be (2 modelling studies on SARS). Quarantine in combination with other measures to contain COVID-19 in comparison to other measures without quarantine or no measures When the models combined quarantine with other prevention and control measures, such as school closures, travel restrictions and social distancing, the models demonstrated that there may be a larger effect on the reduction of new cases, transmissions and deaths than measures without quarantine or no interventions (incident cases: 9 modelling studies on COVID-19; onward transmission: 5 modelling studies on COVID-19; mortality: 5 modelling studies on COVID-19, low-certainty evidence). Studies on SARS and MERS were consistent with findings from the studies on COVID-19. Quarantine for individuals travelling from a country with a declared COVID-19 outbreak compared to no quarantine Very low-certainty evidence indicated that the effect of quarantine of travellers from a country with a declared outbreak on reducing incidence and deaths may be small for SARS, but might be larger for COVID-19 (2 observational studies on COVID-19 and 2 observational studies on SARS).

AUTHORS' CONCLUSIONS

The current evidence is limited because most studies on COVID-19 are mathematical modelling studies that make different assumptions on important model parameters. Findings consistently indicate that quarantine is important in reducing incidence and mortality during the COVID-19 pandemic, although there is uncertainty over the magnitude of the effect. Early implementation of quarantine and combining quarantine with other public health measures is important to ensure effectiveness. In order to maintain the best possible balance of measures, decision makers must constantly monitor the outbreak and the impact of the measures implemented. This review was originally commissioned by the WHO and supported by Danube-University-Krems. The update was self-initiated by the review authors.

Modeling and analysis of COVID-19 epidemics with treatment in fractional derivatives using real data from Pakistan

Coronaviruses are a large family of viruses that cause different symptoms, from mild cold to severe respiratory distress, and they can be seen in different types of animals such as camels, cattle, cats and bats. Novel coronavirus called COVID-19 is a newly emerged virus that appeared in many countries of the world, but the actual source of the virus is not yet known. The outbreak has caused pandemic with 26,622,706 confirmed infections and 874,708 reported deaths worldwide till August 31, 2020, with 17,717,911 recovered cases. Currently, there exist no vaccines officially approved for the prevention or management of the disease, but alternative drugs meant for HIV, HBV, malaria and some other flus are used to treat this virus. In the present paper, a fractional-order epidemic model with two different operators called the classical Caputo operator and the Atangana-Baleanu-Caputo operator for the transmission of COVID-19 epidemic is proposed and analyzed. The reproduction number R 0 is obtained for the prediction and persistence of the disease. The dynamic behavior of the equilibria is studied by using fractional Routh-Hurwitz stability criterion and fractional La Salle invariant principle. Special attention is given to the global dynamics of the equilibria. Moreover, the fitting of parameters through least squares curve fitting technique is performed, and the average absolute relative error between COVID-19 actual cases and the model's solution for the infectious class is tried to be reduced and the best fitted values of the relevant parameters are achieved. The numerical solution of the proposed COVID-19 fractional-order model under the Caputo operator is obtained by using generalized Adams-Bashforth-Moulton method, whereas for the Atangana-Baleanu-Caputo operator, we have used a new numerical scheme. Also, the treatment compartment is included in the population which determines the impact of alternative drugs applied for treating the infected individuals. Furthermore, numerical simulations of the model and their graphical presentations are performed to visualize the effectiveness of our theoretical results and to monitor the effect of arbitrary-order derivative.