Evaluation of Non-Pharmaceutical Interventions for Reducing Contact Rate in COVID-19 Pandemic: R0 Estimation and Modeling for Istanbul

Abstract

After the declaration of the coronavirus-2019 (COVID-19) pandemic and the detection of the COVID-19 case in Turkey, a series of non-pharmaceutical measures were implemented to reduce the number of contacts at the national level. The aim of this study was to determine the change in the epidemic reproduction rate (R 0) with non-pharmaceutical interventions including curfews starting with the first reported case in Istanbul and to evaluate the effectiveness of interventions by estimating the number of cases and deaths using a dynamic compartmental model. While keeping transmission probability (beta) as 3% and incubation period as seven days, we developed five scenarios that represented non-pharmaceutical interventions The first scenario was if nothing was done and the last scenario was curfew. The contact matrix of 16 age-groups created by Prem et al. was used in the study as the contact matrix of if nothing was done as scenario 1. For all other scenarios (2-5) contact matrices assumptions were created and R-0 values were calculated for the whole of Istanbul according to age groups for all five scenarios. For each scenario, the number of cases and COVID-related deaths for one year from the day the first case was detected were calculated with the mathematical modeling method. In the absence of any intervention, R-0 value was estimated as 2.86 in Istanbul. Among age-groups, the largest R-0 value was observed in ages 15-19, 10-14, 5-9, 20-24 and the values were 5.22, 4.37, 3.32, and 3.33; respectively. Due to school closings and flexible work hours, R 0 values decreased to 2.02, 1.84, 1.63 and 1.85 in the same age-groups. With the addition of a curfew for the population under the age of 20 to the above measures, the R 0 values for all age groups were reduced to less than one. When R-0 values for Istanbul was 2.86 and 1.55 based on our model results, the number of cases and deaths per year were determined as approximately 14 million and 2 million and 2.5 million and 327.000, respectively. School closures were determined as the most effective non-pharmaceutical intervention. Non-pharmaceutical measures with the addition of curfews under the age of 20 and over the age of 65 to the school closings and flexible working hours were identified as effective methods in controlling the COVID-19 epidemic in Istanbul. While the results of this study may not reflect real life data, it has the potential of helping public health policy makers to decide on which non-pharmaceutical interventions are the most effective.