Combining serology with case-detection, to allow the easing of restrictions against SARS-CoV-2: a modelling-based study in India
File(s)
Published version
Author(s)
Mandal, Sandip
Das, Hemanshu
Deo, Sarang
Arinaminpathy, Nimalan
Type
Journal Article
Abstract
India’s lockdown against SARS-CoV-2, if lifted without any other mitigations in place, could risk a second wave of infection. A test-and-isolate strategy, using PCR diagnostic tests, could help to minimise the impact of this second wave. Meanwhile, population-level serological surveillance can provide valuable insights into the level of immunity in the population. Using a mathematical model, consistent with an Indian megacity, we examined how seroprevalence data could guide a test-and-isolate strategy, for lifting a lockdown. For example, if seroprevalence is 20% of the population, we show that a testing strategy needs to identify symptomatic cases within 5 – 8 days of symptom onset, in order to prevent a resurgent wave from overwhelming hospital capacity in the city. This estimate is robust to uncertainty in the effectiveness of the lockdown, as well as in immune protection against reinfection. To set these results in their economic context, we estimate that the weekly cost of such a PCR-based testing programme would be less than 2.1% of the weekly economic loss due to the lockdown. Our results illustrate how PCR-based testing and serological surveillance can be combined to design evidence-based policies, for lifting lockdowns in Indian cities and elsewhere.
Date Issued
2021-01-19
Date Acceptance
2020-12-18
Citation
Scientific Reports, 2021, 11 (1835), pp.1-9
ISSN
2045-2322
Publisher
Nature Publishing Group
Start Page
1
End Page
9
Journal / Book Title
Scientific Reports
Volume
11
Issue
1835
Copyright Statement
© The Author(s) 2021. Tis article is licensed under a Creative Commons Attribution 4.0 International
License, which permits use, sharing, adaptation, distribution and reproduction in any medium or
format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the
Creative Commons licence, and indicate if changes were made. Te images or other third party material in this
article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the
material. If material is not included in the article’s Creative Commons licence and your intended use is not
permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from
the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License, which permits use, sharing, adaptation, distribution and reproduction in any medium or
format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the
Creative Commons licence, and indicate if changes were made. Te images or other third party material in this
article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the
material. If material is not included in the article’s Creative Commons licence and your intended use is not
permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from
the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Sponsor
Medical Research Council (MRC)
Identifier
https://www.nature.com/articles/s41598-021-81405-2
Grant Number
MR/R015600/1
Subjects
COVID-19
COVID-19 Nucleic Acid Testing
Humans
India
Models, Theoretical
Population Surveillance
Prevalence
Quarantine
SARS-CoV-2
Humans
Population Surveillance
Prevalence
Quarantine
Models, Theoretical
India
COVID-19
SARS-CoV-2
COVID-19 Nucleic Acid Testing
Publication Status
Published
Date Publish Online
2021-01-19