Modelling the health and economic impacts of different testing and tracing strategies for COVID-19 in the UK

Tim Colbourn*, William Waites, David Manheim, Derek Foster, Simone Sturniolo, Mark Sculpher, Cliff C. Kerr, Greg Colbourn, Cam Bowie, Keith M. Godfrey, Julian Peto, Rochelle A. Burgess, David McCoy, Nisreen A. Alwan, Guiqing Yao, Kang Ouyang, Paul J. Roderick, Elena Pizzo, Tony Hill, Nuala McGrathMiriam Orcutt, Owain Evans, Nathan J. Cheetham, Chris Bonell, Manuel Gomes, Jasmina Panovska-Griffiths, Rosalind Raine

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Coronavirus disease 2019 (COVID-19) is resurgent in the UK and health and economic costs of the epidemic continue to rise. There is a need to understand the health and economic costs of different courses of action. Methods: We combine modelling, economic analysis and a user-friendly interface to contrast the impact and costs of different testing strategies: two levels of testing within the current test-trace-isolate (TTI) strategy (testing symptomatic people, tracing and isolating everyone) and a strategy where TTI is combined with universal testing (UT; i.e. additional population testing to identify asymptomatic cases). We also model effective coverage of face masks. Results: Increased testing is necessary to suppress the virus after lockdown. Partial reopening accompanied by scaled-up TTI (at 50% test and trace levels), full isolation and moderately effective coverage of masks (30% reduction in overall transmission) can reduce the current resurgence of the virus and protect the economy in the UK. Additional UT from December 2020 reduces the epidemic dramatically by Jan 2021 when combined with enhanced TTI (70% test-trace levels) and full isolation. UT could then be stopped; continued TTI would prevent rapid recurrence. This TTI+UT combination can suppress the virus further to save ~20,000 more lives and avoid ~£90bn economic losses, though costs ~£8bn more to deliver. We assume that all traced and lab-confirmed cases are isolated. The flexible interface we have developed allows exploration of additional scenarios, including different levels of reopening of society after the second lockdown in England as well as different levels of effective mask coverage. Conclusions: Our findings suggest that increased TTI is necessary to suppress the virus and protect the economy after the second lockdown in England. Additional UT from December 2020 reduces the epidemic dramatically by Jan 2021 and could then be stopped, as continued TTI would prevent rapid recurrence.

Original languageEnglish
Article number1454
Number of pages32
JournalF1000research
Volume9
DOIs
Publication statusPublished - 14 Dec 2020

Bibliographical note

© 2020 Colbourn T et al.


Funding Information:
WW acknowledges support from the Chief Scientist Office (COV/EDI/20/12). RR, JPG, and EP are supported by the National Institute for Health Research ARC North Thames. NMcG is a recipient of an NIHR Global Health Research Professorship award (Ref: RP-2017-08-ST2-008). NAA receives research support from NIHR Applied Research Collaboration Wessex and NIHR Southampton Biomedical Research Centre. The views expressed in this independent research are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) and NIHR Southampton Biomedical Research Centre (IS-BRC-1215-20004)), British Heart Foundation (RG/15/17/3174), and the US National Institute On Aging of the National Institutes of Health (Award No. U24AG047867). GY acknowledges her research partially supported from the Newton Fund through a UK-China ARM Partnership Hub award (No:MR/S013717/1). DF is supported by Rethink Priorities (www.rethink priorities.org). All other authors declare that no specific grants were involved in supporting their time on this work.

Keywords

  • COVID-19
  • Economic
  • Health
  • Impacts
  • Isolate
  • Mathematical Model
  • Test
  • Trace
  • UK

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