Optimal Timing and Effectiveness of COVID-19 Outbreak Responses in China: A Modelling Study

50 Pages Posted: 10 Apr 2020 Last revised: 14 Apr 2020

See all articles by Anthony Zhenhuan Zhang

Anthony Zhenhuan Zhang

University of Minnesota - Twin Cities - Department of Industrial and Systems Engineering

Eva Enns

University of Minnesota - Minneapolis

Date Written: March 21, 2020

Abstract

Background: In January 2020, an outbreak of atypical pneumonia caused by a novel coronavirus, SARS-CoV-2, was reported in Wuhan, China. On Jan 23, 2020, the Chinese government instituted mitigation strategies to control spread. Previous modeling studies have focused on projecting epidemiological outcomes throughout the epidemic in China. However, the impact and optimal timing of different mitigation approaches have not been evaluated.

Methods: We developed a mathematical model reflecting SARS-CoV-2 transmission dynamics. The model simulates health and economic outcomes from Dec 1, 2019, through Mar 31, 2020, for Wuhan, Chongqing, Beijing, and Shanghai, China. We considered differences in timing and duration of three mitigation strategies: city-wide quarantine on Wuhan, travel history screening and isolation of travelers from Wuhan to other Chinese cities, and social distancing.

Findings: Our model predicted that implementing all three mitigation strategies one week earlier would have averted 35% of deaths in Wuhan (50% in other cities) at an increased economic loss of 8% (16-18% in other cities). Delaying mitigation strategies by one week was predicted to decrease economic losses by the same amount, but with 50% more deaths in Wuhan and twice as many deaths in the other cities. Of the three mitigation approaches, infections and deaths increased most rapidly if initiation of social distancing was delayed. Furthermore, the duration of social distancing among adults had the greatest impact on infections and deaths compared to prolonged social distancing among adolescents and the elderly.

Interpretation: Optimizing the timing of epidemic mitigation strategies is paramount and involves weighing tradeoffs between preventing infections and deaths and immense economic impacts. The majority of the benefit of China's mitigation strategy was likely due to social distancing measures, which also incurred a much lower daily cost than a city-wide quarantine. In particular, workplace closures were most beneficial in preventing both infections and deaths rather than differential social distancing among younger or older age groups.

Note: Funding: We did not receive any funding support.

Competing Interest Declaration: The authors declare no competing interests.

Keywords: COVID-19, SARS-CoV-2, quarantine, social distancing, travel history screening, optimal strategy

JEL Classification: I10, I15

Suggested Citation

Zhang, Zhenhuan and Enns, Eva, Optimal Timing and Effectiveness of COVID-19 Outbreak Responses in China: A Modelling Study (March 21, 2020). Available at SSRN: https://ssrn.com/abstract=3558339 or http://dx.doi.org/10.2139/ssrn.3558339

Zhenhuan Zhang

University of Minnesota - Twin Cities - Department of Industrial and Systems Engineering ( email )

111 Church St SE
Minneapolis, MN 55455
United States

Eva Enns (Contact Author)

University of Minnesota - Minneapolis ( email )

110 Wulling Hall, 86 Pleasant St, S.E.
308 Harvard Street SE
Minneapolis, MN 55455
United States

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