Engagement and adherence trade-offs for SARS-CoV-2 contact tracing

Philos Trans R Soc Lond B Biol Sci. 2021 Jul 19;376(1829):20200270. doi: 10.1098/rstb.2020.0270. Epub 2021 May 31.

Abstract

Contact tracing is an important tool for allowing countries to ease lockdown policies introduced to combat SARS-CoV-2. For contact tracing to be effective, those with symptoms must self-report themselves while their contacts must self-isolate when asked. However, policies such as legal enforcement of self-isolation can create trade-offs by dissuading individuals from self-reporting. We use an existing branching process model to examine which aspects of contact tracing adherence should be prioritized. We consider an inverse relationship between self-isolation adherence and self-reporting engagement, assuming that increasingly strict self-isolation policies will result in fewer individuals self-reporting to the programme. We find that policies which increase the average duration of self-isolation, or that increase the probability that people self-isolate at all, at the expense of reduced self-reporting rate, will not decrease the risk of a large outbreak and may increase the risk, depending on the strength of the trade-off. These results suggest that policies to increase self-isolation adherence should be implemented carefully. Policies that increase self-isolation adherence at the cost of self-reporting rates should be avoided. This article is part of the theme issue 'Modelling that shaped the early COVID-19 pandemic response in the UK'.

Keywords: COVID-19; SARS-CoV-2; adherence; case isolation; contact tracing; quarantine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Basic Reproduction Number / statistics & numerical data
  • COVID-19 / epidemiology*
  • COVID-19 / transmission
  • COVID-19 / virology
  • Communicable Disease Control / statistics & numerical data
  • Contact Tracing / statistics & numerical data*
  • Disease Outbreaks
  • Humans
  • Models, Theoretical*
  • Pandemics*
  • SARS-CoV-2 / pathogenicity