Preprint Article Version 5 Preserved in Portico This version is not peer-reviewed

Partial Unlock for COVID-19-Like Epidemics Can Save 1-3 Million Lives Worldwide

Version 1 : Received: 13 April 2020 / Approved: 15 April 2020 / Online: 15 April 2020 (10:02:51 CEST)
Version 2 : Received: 16 April 2020 / Approved: 17 April 2020 / Online: 17 April 2020 (08:48:55 CEST)
Version 3 : Received: 9 May 2020 / Approved: 10 May 2020 / Online: 10 May 2020 (15:14:11 CEST)
Version 4 : Received: 15 May 2020 / Approved: 16 May 2020 / Online: 16 May 2020 (16:13:16 CEST)
Version 5 : Received: 20 May 2020 / Approved: 21 May 2020 / Online: 21 May 2020 (04:13:13 CEST)
Version 6 : Received: 14 July 2020 / Approved: 15 July 2020 / Online: 15 July 2020 (03:14:33 CEST)

How to cite: Shuler, R.L.; Koukouvitis, T.; Suematsu, D. Partial Unlock for COVID-19-Like Epidemics Can Save 1-3 Million Lives Worldwide. Preprints 2020, 2020040239. https://doi.org/10.20944/preprints202004.0239.v5 Shuler, R.L.; Koukouvitis, T.; Suematsu, D. Partial Unlock for COVID-19-Like Epidemics Can Save 1-3 Million Lives Worldwide. Preprints 2020, 2020040239. https://doi.org/10.20944/preprints202004.0239.v5

Abstract

Objectives: We study partial unlock or reopening interaction with seasonal effects in a managed epidemic to quantify overshoot effects on small and large unlock steps and discover robust strategies for reducing overshoot. Methods: We simulate partial unlock of social distancing for epidemics over a range of replication factor, immunity duration and seasonality factor for strategies targeting immunity thresholds using overshoot optimization. Results: Seasonality change must be taken into account as one of the steps in an easing sequence, and a two step unlock, including seasonal effects, minimizes overshoot and deaths. It may cause undershoot, which causes rebounds and assists survival of the pathogen. Conclusions: Partial easing levels, even low levels for economic relief while waiting on a vaccine, have population immunity thresholds based on the reduced replication rates and may experience overshoot as well. We further find a two step strategy remains highly sensitive to variations in case ratio, replication factor, seasonality and timing. We demonstrate a three or more step strategy is more robust, and conclude that the best possible approach minimizes deaths under a range of likely actual conditions which include public response.

Keywords

epidemic; caseload management; partial unlock; social distancing; overshoot; COVID-19; coronavirus; eco-nomic impact; ventilator utilization; SARS-CoV-2

Subject

Biology and Life Sciences, Virology

Comments (1)

Comment 1
Received: 21 May 2020
Commenter: Robert Shuler
Commenter's Conflict of Interests: Author
Comment: More focused presentation reduces word count to 6000, eliminate intermittent daily unlock.  Emphasize 3-step method for robust overshoot avoidance.
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