Quantifying the impact of quarantine duration on COVID-19 transmission

  1. Peter Ashcroft  Is a corresponding author
  2. Sonja Lehtinen
  3. Daniel C Angst
  4. Nicola Low
  5. Sebastian Bonhoeffer  Is a corresponding author
  1. ETH Zurich, Switzerland
  2. University of Bern, Switzerland

Abstract

The large number of individuals placed into quarantine because of possible SARS CoV-2 exposure has high societal and economic costs. There is ongoing debate about the appropriate duration of quarantine, particularly since the fraction of individuals who eventually test positive is perceived as being low. We use empirically determined distributions of incubation period, infectivity, and generation time to quantify how the duration of quarantine affects onward transmission from traced contacts of confirmed SARS-CoV-2 cases and from returning travellers. We also consider the roles of testing followed by release if negative (test-and-release), reinforced hygiene, adherence, and symptoms in calculating quarantine efficacy. We show that there are quarantine strategies based on a test-and-release protocol that, from an epidemiological viewpoint, perform almost as well as a 10 day quarantine, but with fewer person days spent in quarantine. The findings apply to both travellers and contacts, but the specifics depend on the context.

Data availability

All data generated or analysed during this study are included in the manuscript and supporting files. These files are available on github (https://github.com/ashcroftp/quarantine2020/) and archived at https://doi.org/10.5281/zenodo.4498169.

Article and author information

Author details

  1. Peter Ashcroft

    Institute of Integrative Biology, ETH Zurich, Zurich, Switzerland
    For correspondence
    peter.ashcroft@env.ethz.ch
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-4067-7692
  2. Sonja Lehtinen

    Department of Environmental Systems Science, ETH Zurich, Zurich, Switzerland
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-4236-828X
  3. Daniel C Angst

    Institute of Integrative Biology, ETH Zurich, Zurich, Switzerland
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-6512-4595
  4. Nicola Low

    University of Bern, Bern, Switzerland
    Competing interests
    The authors declare that no competing interests exist.
  5. Sebastian Bonhoeffer

    Institute of Integrative Biology, ETH Zurich, Zurich, Switzerland
    For correspondence
    seb@env.ethz.ch
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-8052-3925

Funding

H2020 European Research Council (EpiPose,101003688)

  • Nicola Low

Swiss National Science Foundation (176233)

  • Nicola Low

Swiss National Science Foundation (176401)

  • Sebastian Bonhoeffer

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Copyright

© 2021, Ashcroft et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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  1. Peter Ashcroft
  2. Sonja Lehtinen
  3. Daniel C Angst
  4. Nicola Low
  5. Sebastian Bonhoeffer
(2021)
Quantifying the impact of quarantine duration on COVID-19 transmission
eLife 10:e63704.
https://doi.org/10.7554/eLife.63704

Share this article

https://doi.org/10.7554/eLife.63704

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    Background:

    Biological aging exhibits heterogeneity across multi-organ systems. However, it remains unclear how is lifestyle associated with overall and organ-specific aging and which factors contribute most in Southwest China.

    Methods:

    This study involved 8396 participants who completed two surveys from the China Multi-Ethnic Cohort (CMEC) study. The healthy lifestyle index (HLI) was developed using five lifestyle factors: smoking, alcohol, diet, exercise, and sleep. The comprehensive and organ-specific biological ages (BAs) were calculated using the Klemera–Doubal method based on longitudinal clinical laboratory measurements, and validation were conducted to select BA reflecting related diseases. Fixed effects model was used to examine the associations between HLI or its components and the acceleration of validated BAs. We further evaluated the relative contribution of lifestyle components to comprehension and organ systems BAs using quantile G-computation.

    Results:

    About two-thirds of participants changed HLI scores between surveys. After validation, three organ-specific BAs (the cardiopulmonary, metabolic, and liver BAs) were identified as reflective of specific diseases and included in further analyses with the comprehensive BA. The health alterations in HLI showed a protective association with the acceleration of all BAs, with a mean shift of –0.19 (95% CI −0.34, –0.03) in the comprehensive BA acceleration. Diet and smoking were the major contributors to overall negative associations of five lifestyle factors, with the comprehensive BA and metabolic BA accounting for 24% and 55% respectively.

    Conclusions:

    Healthy lifestyle changes were inversely related to comprehensive and organ-specific biological aging in Southwest China, with diet and smoking contributing most to comprehensive and metabolic BA separately. Our findings highlight the potential of lifestyle interventions to decelerate aging and identify intervention targets to limit organ-specific aging in less-developed regions.

    Funding:

    This work was primarily supported by the National Natural Science Foundation of China (Grant No. 82273740) and Sichuan Science and Technology Program (Natural Science Foundation of Sichuan Province, Grant No. 2024NSFSC0552). The CMEC study was funded by the National Key Research and Development Program of China (Grant No. 2017YFC0907305, 2017YFC0907300). The sponsors had no role in the design, analysis, interpretation, or writing of this article.