Preprints with The Lancet is a collaboration between The Lancet Group of journals and SSRN to facilitate the open sharing of preprints for early engagement, community comment, and collaboration. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early-stage research papers that have not been peer-reviewed. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. The findings should not be used for clinical or public health decision-making or presented without highlighting these facts. For more information, please see the FAQs.
The Effectiveness of Public Health Interventions Against COVID-19: Lessons from the Singapore Experience
15 Pages Posted: 28 Apr 2020
More...Abstract
Background: This study conducts a counterfactual analysis, using the case of Singapore, a country fairly successful in suppressing community spread of COVID-19, to explore what the trajectory of COVID-19 infection might have been in Singapore had the government intervention not focused on containment, but rather on mitigation or uninhibited spread.
Methods: We developed an SEIR model to estimate the number of COVID-19 infection cases in Singapore and deaths, under different public health intervention compared to the containment interventions implemented in Singapore.
Finding: Under the Singapore containment interventions, we would expect a peak in infected cases to occur 3 months from January 23, 2020 [100% confidence range (CR), 2·2 to 4]. The infected cases of COVID-19 over 8·6 months is projected to be 2,488 [1,814 to 4,510]; representing 0·044% of the total population [0·032 to 0·081]. Deaths is estimated to be 25 [9 to 57]. In comparison, a mitigation intervention with 20% quarantine rate, would delay the time to peak infection by an estimated 5·2 months, prolong duration of the infection by 12·4 months, cumulative infected cases 1,388-fold, and deaths 1,371-fold. Likewise, a mitigation intervention with 40% quarantine rate, compared to the Singapore containment intervention could delay the time to peak infection by 7 months, extend the infection surge by 21 months, and increase cumulative infected cases and deaths 727-fold. Finally, a strategy of uninhibited spread would increase the time to peak infection by 2·9 months, duration of infection by 8 months, increase cumulative infected cases 1,863-fold and deaths 1,840-fold.
Interpretation: Early public health measures in the context of targeted, aggressive containment — such as swift and effective contact tracing and quarantine – was likely responsible for suppressing the number of COVID-19 infections in Singapore.
Funding Statement: The project was funded by the Singapore Ministry of Health’s National Medical Research Council.
Declaration of Interests: There is no conflict of interests.
Keywords: COVID-19; Public Health Interventions; Simulation Modelling; Singapore
Suggested Citation: Suggested Citation