Background Aggressive non-pharmaceutical interventions (NPIs) may reduce transmission of SARS-CoV-2. The extent to which these interventions are successful in stopping the spread have not been characterized in countries with distinct socioeconomic groups. We compared the effects of a partial lockdown on disease transmission among Kuwaitis (P 1 ) and non-Kuwaitis (P 2 ) living in Kuwait. Methods We fit a modified metapopulation SEIR transmission model to reported cases stratified by two groups to estimate the impact of a partial lockdown on the effective reproduction number ( \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\mathcal{R_e $$\end{document} R e ). We estimated the basic reproduction number ( \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\mathcal{R_0 $$\end{document} R 0 ) for the transmission in each group and simulated the potential trajectories of an outbreak from the first recorded case of community transmission until 12 days after the partial lockdown. We estimated \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\mathcal{R_e $$\end{document} R e values of both groups before and after the partial curfew, simulated the effect of these values on the epidemic curves and explored a range of cross-transmission scenarios. Results We estimate \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\mathcal{R_e $$\end{document} R e at 1·08 (95% CI: 1·00–1·26) for P 1 and 2·36 (2·03–2·71) for P 2 . On March 22nd, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\mathcal{R_e $$\end{document} R e for P 1 and P 2 are estimated at 1·19 (1·04–1·34) and 1·75 (1·26–2·11) respectively. After the partial curfew had taken effect, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\mathcal{R_e $$\end{document} R e for P 1 dropped modestly to 1·05 (0·82–1·26) but almost doubled for P 2 to 2·89 (2·30–3·70). Our simulated epidemic trajectories show that the partial curfew measure greatly reduced and delayed the height of the peak in P 1 , yet significantly elevated and hastened the peak in P 2 . Modest cross-transmission between P 1 and P 2 greatly elevated the height of the peak in P 1 and brought it forward in time closer to the peak of P 2 . Conclusion Our results indicate and quantify how the same lockdown intervention can accentuate disease transmission in some subpopulations while potentially controlling it in others. Any such control may further become compromised in the presence of cross-transmission between subpopulations. Future interventions and policies need to be sensitive to socioeconomic and health disparities. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10984-6.
【저자키워드】 COVID-19, mathematical modeling, Non-pharmaceutical interventions, Socioeconomic disparities, 【초록키워드】 lockdown, Intervention, Transmission, Spread, Epidemic, Health, outbreak, Reproduction number, NPIs, Kuwait, basic reproduction number, trajectory, community transmission, Transmission model, disease transmission, supplementary material, subpopulations, subpopulation, transmission of SARS-CoV-2, partial lockdown, SEIR, Future, Effect, country, effective, the epidemic, Result, significantly, reported, elevated, reduced, characterized, reduce, two group, groups, recorded, stratified, Aggressive, both group, dropped, 【제목키워드】 Intervention, Population, SARS-CoV-2 transmission, Effect,