Reducing societal impacts of SARS-CoV-2 interventions through subnational implementation

  1. Mark M Dekker
  2. Luc E Coffeng
  3. Frank P Pijpers
  4. Debabrata Panja  Is a corresponding author
  5. Sake J de Vlas
  1. Utrecht University, Netherlands
  2. Erasmus MC, Netherlands
  3. University of Amsterdam, Netherlands

Abstract

To curb the initial spread of SARS-CoV-2, many countries relied on nation-wide implementation of non-pharmaceutical intervention measures, resulting in substantial socio-economic impacts. Potentially, subnational implementations might have had less of a societal impact, but comparable epidemiological impact. Here, using the first COVID-19 wave in the Netherlands as a case in point, we address this issue by developing a high-resolution analysis framework that uses a demographically-stratified population and a spatially-explicit, dynamic, individual contact-pattern based epidemiology, calibrated to hospital admissions data and mobility trends extracted from mobile phone signals and Google. We demonstrate how a subnational approach could achieve similar level of epidemiological control in terms of hospital admissions, while some parts of the country could stay open for a longer period. Our framework is exportable to other countries and settings, and may be used to develop policies on subnational approach as a better strategic choice for controlling future epidemics.

Data availability

Data associated with mobility and mixing reductions (Google mobility and PIENTER) [17, 34], age-stratified mixing matrices used in the analysis (POLYMOD) [9], and hospital admission data (NICE) publicly available as described in SI A.5, have been made available at the Data Repository https://osf.io/muj4q/. All analysis codes have been made available at https://github.com/MarkMDekker/covid_intervention_evaluation. Our analysis also uses mobility information as input. This dataset is owned by a commercial party (Mezuro) and can therefore not be made public. For the purpose of enabling readers to run our codes and obtaining comparable results, we have made synthetic mobility data available, also at the Data Repository https://osf.io/muj4q/. This synthetic data has been generated using a gravity model. For frequent travels, this is entirely standard, for infrequent visits square root of the distance is used in the numerator. The prefactor G in the standard gravity model is chosen as 0.5 to account for the double counting due to return journeys. For infrequent visits, mostly weekend trips, we have used G = 1/7. Request for the actual mobility data can be sent to info@mezuro.com as a proposal. Access to the data may require payment, and will certainly be subject to vetting related to privacy issues by GDPR (General Data Protection Regulation).

Article and author information

Author details

  1. Mark M Dekker

    Department of Information and Computing Sciences, Utrecht University, Utrecht, Netherlands
    Competing interests
    The authors declare that no competing interests exist.
  2. Luc E Coffeng

    Department of Public Health, Erasmus MC, Rotterdam, Netherlands
    Competing interests
    The authors declare that no competing interests exist.
  3. Frank P Pijpers

    Korteweg-de Vries Institute for Mathematics, University of Amsterdam, Amsterdam, Netherlands
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-7572-9435
  4. Debabrata Panja

    Department of Information and Computing Sciences, Utrecht University, Utrecht, Netherlands
    For correspondence
    d.panja@uu.nl
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-2141-9735
  5. Sake J de Vlas

    Department of Public Health, Erasmus MC, Rotterdam, Netherlands
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-1830-5668

Funding

ZonMw (10430022010001)

  • Sake J de Vlas

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

Copyright

© 2023, Dekker 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.

Metrics

  • 1,222
    views
  • 173
    downloads
  • 4
    citations

Views, downloads and citations are aggregated across all versions of this paper published by eLife.

Download links

A two-part list of links to download the article, or parts of the article, in various formats.

Downloads (link to download the article as PDF)

Open citations (links to open the citations from this article in various online reference manager services)

Cite this article (links to download the citations from this article in formats compatible with various reference manager tools)

  1. Mark M Dekker
  2. Luc E Coffeng
  3. Frank P Pijpers
  4. Debabrata Panja
  5. Sake J de Vlas
(2023)
Reducing societal impacts of SARS-CoV-2 interventions through subnational implementation
eLife 12:e80819.
https://doi.org/10.7554/eLife.80819

Share this article

https://doi.org/10.7554/eLife.80819

Further reading

    1. Epidemiology and Global Health
    2. Genetics and Genomics
    Tianyu Zhao, Hui Li ... Li Chen
    Research Article

    Alzheimer’s disease (AD) is a complex degenerative disease of the central nervous system, and elucidating its pathogenesis remains challenging. In this study, we used the inverse-variance weighted (IVW) model as the major analysis method to perform hypothesis-free Mendelian randomization (MR) analysis on the data from MRC IEU OpenGWAS (18,097 exposure traits and 16 AD outcome traits), and conducted sensitivity analysis with six models, to assess the robustness of the IVW results, to identify various classes of risk or protective factors for AD, early-onset AD, and late-onset AD. We generated 400,274 data entries in total, among which the major analysis method of the IVW model consists of 73,129 records with 4840 exposure traits, which fall into 10 categories: Disease, Medical laboratory science, Imaging, Anthropometric, Treatment, Molecular trait, Gut microbiota, Past history, Family history, and Lifestyle trait. More importantly, a freely accessed online platform called MRAD (https://gwasmrad.com/mrad/) has been developed using the Shiny package with MR analysis results. Additionally, novel potential AD therapeutic targets (CD33, TBCA, VPS29, GNAI3, PSME1) are identified, among which CD33 was positively associated with the main outcome traits of AD, as well as with both EOAD and LOAD. TBCA and VPS29 were negatively associated with the main outcome traits of AD, as well as with both EOAD and LOAD. GNAI3 and PSME1 were negatively associated with the main outcome traits of AD, as well as with LOAD, but had no significant causal association with EOAD. The findings of our research advance our understanding of the etiology of AD.

    1. Epidemiology and Global Health
    Xiaoning Wang, Jinxiang Zhao ... Dong Liu
    Research Article

    Artificially sweetened beverages containing noncaloric monosaccharides were suggested as healthier alternatives to sugar-sweetened beverages. Nevertheless, the potential detrimental effects of these noncaloric monosaccharides on blood vessel function remain inadequately understood. We have established a zebrafish model that exhibits significant excessive angiogenesis induced by high glucose, resembling the hyperangiogenic characteristics observed in proliferative diabetic retinopathy (PDR). Utilizing this model, we observed that glucose and noncaloric monosaccharides could induce excessive formation of blood vessels, especially intersegmental vessels (ISVs). The excessively branched vessels were observed to be formed by ectopic activation of quiescent endothelial cells (ECs) into tip cells. Single-cell transcriptomic sequencing analysis of the ECs in the embryos exposed to high glucose revealed an augmented ratio of capillary ECs, proliferating ECs, and a series of upregulated proangiogenic genes. Further analysis and experiments validated that reduced foxo1a mediated the excessive angiogenesis induced by monosaccharides via upregulating the expression of marcksl1a. This study has provided new evidence showing the negative effects of noncaloric monosaccharides on the vascular system and the underlying mechanisms.