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Modelling the transmission of infectious diseases inside hospital bays: implications for COVID-19

  • Received: 28 August 2020 Accepted: 15 October 2020 Published: 12 November 2020
  • Healthcare associated transmission of viral infections is a major problem that has significant economic costs and can lead to loss of life. Infections with the highly contagious SARS-CoV-2 virus have been shown to have a high prevalence in hospitals around the world. The spread of this virus might be impacted by the density of patients inside hospital bays. To investigate this aspect, in this study we consider a mathematical modelling and computational approach to describe the spread of SARS-CoV-2 among hospitalised patients. We focus on 4-bed bays and 6-bed bays, which are commonly used to accommodate various non-COVID-19 patients in many hospitals across the United Kingdom (UK). We investigate the spread of SARS-CoV-2 infections among patients in non-COVID bays, in the context of various scenarios: placing the initially-exposed individual in different beds, varying the recovery and incubation periods, having symptomatic vs. asymptomatic patients, removing infected individuals from these hospital bays once they are known to be infected, and the role of periodic testing of hospitalised patients. Our results show that 4-bed bays reduce the spread of SARS-CoV-2 compared to 6-bed bays. Moreover, we show that the position of a new (not infected) patient in specific beds in a 6-bed bay might also slow the spread of the disease. Finally, we propose that regular SARS-CoV-2 testing of hospitalised patients would allow appropriate placement of infected patients in specific (COVID-only) hospital bays.

    Citation: David Moreno Martos, Benjamin J. Parcell, Raluca Eftimie. Modelling the transmission of infectious diseases inside hospital bays: implications for COVID-19[J]. Mathematical Biosciences and Engineering, 2020, 17(6): 8084-8104. doi: 10.3934/mbe.2020410

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  • Healthcare associated transmission of viral infections is a major problem that has significant economic costs and can lead to loss of life. Infections with the highly contagious SARS-CoV-2 virus have been shown to have a high prevalence in hospitals around the world. The spread of this virus might be impacted by the density of patients inside hospital bays. To investigate this aspect, in this study we consider a mathematical modelling and computational approach to describe the spread of SARS-CoV-2 among hospitalised patients. We focus on 4-bed bays and 6-bed bays, which are commonly used to accommodate various non-COVID-19 patients in many hospitals across the United Kingdom (UK). We investigate the spread of SARS-CoV-2 infections among patients in non-COVID bays, in the context of various scenarios: placing the initially-exposed individual in different beds, varying the recovery and incubation periods, having symptomatic vs. asymptomatic patients, removing infected individuals from these hospital bays once they are known to be infected, and the role of periodic testing of hospitalised patients. Our results show that 4-bed bays reduce the spread of SARS-CoV-2 compared to 6-bed bays. Moreover, we show that the position of a new (not infected) patient in specific beds in a 6-bed bay might also slow the spread of the disease. Finally, we propose that regular SARS-CoV-2 testing of hospitalised patients would allow appropriate placement of infected patients in specific (COVID-only) hospital bays.


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    [1] B. Carter, J. T. Collins, F. Barlow-Pay, F. Rickard, E. Bruce, et al., Nosocomial COVID-19 infection: examining the risk of mortality. The COPE-Nosocomial study (COVID in Older PEople), J. Hosp. Infect., 106 (2020), 376-384. doi: 10.1016/j.jhin.2020.07.013
    [2] H. M. Rickman, T. Rampling, K. Shaw, G. Martinez-Garcia, L. Hail, P. Coen, et al., Nosocomial transmission of COVID-19: a retrospective study of 66 hospital-acquired cases in a London teaching hospital, Clin. Infect. Dis., (2020), ciaa816.
    [3] Q. Zhou, Y. Gao, X. Wang, R. Liu, P. Du, X. Wang, et al., Nosocomial infections among patients with COVID-19, SARS and MERS: a rapid review and meta-analysis, Ann. Transl. Med., 8 (2020), 629. doi: 10.21037/atm-20-3324
    [4] K. Mizumoto, K. Kagaya, A. Zarebski, G. Chowell, Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020, Euro. Surveil., 25 (2020), pii = 2000180. https://doi.org/10.2807/1560-7917.ES.2020.25.10.2000180.
    [5] H. Nishiura, T. Miyama, A. Suzuki, S.M. Jung, K. Hayashi, R. Kinoshita, et al., Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19), Int. J. Infect. Dis., 94 (2020), 154-155. doi: 10.1016/j.ijid.2020.03.020
    [6] M. Day, COVID-19: identifying and isolating asymptomatic people helped eliminate virus in Italian village, BMJ, 368 (2020), m1165.
    [7] A. J. Ing, C. Cocks, J. P. Green, COVID-19: in the footsteps of Ernest Shackleton, Thorax, 75 (2020), 693-694. doi: 10.1136/thoraxjnl-2020-215091
    [8] S. Tian, N. Hu, J. Lou, K. Chen, X. Kang, Z. Xiang, et al., Characteristics of COVID-19 infection in Beijing, J. Infect., 80 (2020), 401-406. doi: 10.1016/j.jinf.2020.02.018
    [9] J. Maben, P. Griffiths, C. Penfold, M. Simon, E. Pizzo, J. Anderson, et al., Evaluating a major innovation in hospital design: workforce implications and impact on patient and staff experiences of all single room hospital accommodation, Health. Serv. Deliv. Res., 3 (2015), 1-342.
    [10] X. Wang, Q. Zhou, Y. He, L. Liu, X. Ma, X. Wei, et al., Nosocomial outbreak of COVID-2019 pneumonia in Wuhan, China, Eur. Respir. J., 55 (2020), 2000544. doi: 10.1183/13993003.00544-2020
    [11] Y. Fang, Y. Nie, M. Penny, Transmission dynamics of the COVID-19 outbreak and effectiveness of government interventions: A data-driven analysis, J. Med. Virol., 92 (2020), 645-659. doi: 10.1002/jmv.25750
    [12] A. Grant, Dynamics of COVID-19 epidemics: SEIR models underestimate peak infection rates and overestimate epidemic duration, medRxiv, (2020), https://doi.org/10.1101/2020.04.02.20050674.
    [13] A. J. Kucharski, T. W. Russell, C. Diamond, Y. Liu, J. Edmunds, S. Funk, et al., Early dynamics of transmission and control of COVID-19: a mathematical modelling study, Lancet Infect. Dis., 20 (2020), P553-558.
    [14] L. R. Lopez, X. Rodo, A modified SEIR model to predict the COVID-19 outbreak in Spain and Italy: simulating control scenarios and multi-scale epidemics, available at SSRN 3576802, (2020), http://dx.doi.org/10.2139/ssrn.3576802.
    [15] J. M. Read, J. R. E. Bridgen, D. A. T. Cummings, A. Jo, C. P. Jewell, Novel coronavirus 2019-nCoV: early estimation of epidemiological parameters and epidemic predictions, medRxiv, (2020), https://doi.org/10.1101/2020.01.23.20018549.
    [16] J. Arino, A simple model for COVID-19, Infect. Disease Model., 5 (2020), 309-315.
    [17] D. He, S. Zhao, Q. Lin, Z. Zhuang, P. Gao, M. H. Wang, et al., The relative transmissibility of asymptomatic COVID-19 infections among close contacts, Int. J. Infect. Dis., 94 (2020), 145-147. doi: 10.1016/j.ijid.2020.04.034
    [18] J. Pan, Y. Zhao, Z. Liu, M. Li, Y. Wang, W. Dong, et al., Effectiveness of control strategies for Coronavirus Disease 2019: a SEIR dynamic modelling study, Bull World Health Organ, E-pub, (2020), http://dx.doi.org/10.2471/BLT.20.253807.
    [19] D. W. Berger, K. F. Herkenhoff, S. Mongey, An SEIR infectious disease model with testing and conditional quarantine, Natl. Bur. Econ. Res., (2020), https://doi.org/10.3386/w26901.
    [20] L. Peng, W. Yang, D. Zhang, C. Zhuge, L. Hong, Epidemic analysis of COVID-19 in China by dynamical modelling, medRxiv, (2020), https://doi.org/10.1101/2020.02.16.20023465.
    [21] Y. Liu, Z. Gu, S. Xia, B. Shi, X.-N. Zhou, Y. Shi, et al., What are the underlying transmission patterns of COVID-19 outbreak? An age-specific social contact characterisation, Lancet EClin. Med., 22 (2020), 100354.
    [22] K. Prem, Y. Liu, T. W. Russell, A. J. Kucharski, R. M. Eggo, N. Davies, et al., The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study, Lancet Public Health, 5 (2020), E261-E270.
    [23] A. Teslya, T. M. Pham, N. G. Godijk, M. E. Kretzschmar, M. C. J. Bootsma, G. Rozhnova, Impact of self-imposed prevention measures and short-term government-imposed social distancing on mitigating and delaying a COVID-19 epidemic: A modelling study, PLoS Med., 17, (2020), e1003166.
    [24] Z. Yang, Z. Xheng, K. Wang, S-S. Wong, W. Liang, M. Zanin, et al., Modified SEIR and AI prediction of the epidemics trend of COVID-19 in China under public health interventions, J. Thorac. Dis., 12 (2020), 165-174. doi: 10.21037/jtd.2020.02.64
    [25] A. J. Kucharski, P. Klepac, A. J. K. Conlan, S. M. Kissler, M. L. Tang, H. Fry, et al., Effectiveness of isolation, testing, contact tracing, and physical distancing on reducing transmission of SARSCoV-2 in different settings: a mathematical modelling study, Lancet Infect. Disease., 20 (2020), P1151-1160.
    [26] S. Evans, E. Agnew, E. Vynnycky, J. V. Robotham, The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals, medRxiv, (2020), https://doi.org/10.1101/2020.05.12.20095562.
    [27] E. G. Nepomuceno, R. H. C. Takahashi, L. A. Aguirre, Individual-based model (IBM): an alternative framework for epidemiological compartment models, Rev. Bras. Biom., 34 (2016), 133-162.
    [28] S. Romano-Bertrand, L.-S. Aho-Glele, B. Grandbastien, J.-F. Gehanno, D. Lepelletier, Sustainability of SARS-CoV-2 in aerosols: should we worry about airborne transmission? J. Hosp. Infect., 105 (2020), 601-603.
    [29] M. Klompas, M. A. Baker, C. Rhee, Airborne transmission of SARS-CoV-2. Theoretical considerations and available evidence, JAMA, 324 (2020), 441-442. doi: 10.1001/jama.2020.12458
    [30] Public Health England, Reducing the risk of transmission of COVID-19 in the hospital setting, 2020. Available from: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/reducing-the-risk-of-transmission-of-covid-19-in-the-hospital-setting.
    [31] D. Moreno-Martos, Modelling COVID-19 transmission in hospital bays. MSc Thesis. University of Dundee, UK (2020).
    [32] T. Chen, J. Rui, Q.-P. Wang, Z.-Y. Zhao, J.-A. Cui, L. Yin, A mathematical model for simulating the phase-based transmissibility of a novel coronavirus, Infect. Dis. Poverty, 9 (2020), 24. doi: 10.1186/s40249-020-00640-3
    [33] F. B. Hamzah, C. Lau, H. Nazri, D. V. Ligot, G. Lee, C. L. Tan, et al., CoronaTracker: World-wide COVID-19 outbreak data analysis and prediction, Bull World Health Organ, 1 (2020), 32.
    [34] COVID-19 Coronavirus Pandemic, (2020). Available from: https://www.worldometers.info/coronavirus.
    [35] L. Danon, E. Brooks-Pollock, M. Bailey, M. J. Keeling, A spatial model of COVID-19 transmission in England and Wales: early spread and peak timing, medRxiv, (2020), https://doi.org/10.1101/2020.02.12.20022566.
    [36] B. Tang, X. Wang, Q. Li, N. L. Bragazzi, S. Tang, Y. Xiao, et al., Estimation of the transmission risk of the 2019-nCoV and its implication for public health interventions, J. Clin. Med., 9 (2020), 462. doi: 10.3390/jcm9020462
    [37] H. Wang, Z. Wang, Y. Dong, R. Chang, C. Xu, X. Yu, et al., Phase-adjusted estimation of the number of Coronavirus Disease 2019 cases in Wuhan, China, Cell Discov., 6 (2020), 10.
    [38] S. A. Lauer, K. H. Grantz, Q. Bi, F. K. Jones, Q. Zheng, H. R. Meredith, et al., The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application, Ann. Intern. Med., 172 (2020), 577-582. doi: 10.7326/M20-0504
    [39] F. Ndaïrou, I. Area, J. J. Nieto, D. F. M. Torres, Mathematical modelling of COVID-19 transmission dynamics with a case study of Wuhan, Chaos Solitons Fractals, 135 (2020), 109846. doi: 10.1016/j.chaos.2020.109846
    [40] R. F. Reis, B. M. Quintela, J. O. Campos, J. M. Gomes, B. M. Rocha, M. Lobosco, et al., Characterisation of the COVID-19 pandemic and the impact of uncertainties, mitigation strategies, and underreporting of cases in South Korea, Italy, and Brazil, Chaos Solitons Fractals, 136, (2020), 109888.
    [41] C. Savvides, R. Siegel, Asymptomatic and presymptomatic transmission of SARS-CoV-2: A systematic review, medRxiv, (2020), doi: 10.1101/2020.06.11.20129072.
    [42] Z.-D. Tong, A. Tang, K.-F. Li, P. Li, H.-L. Wang, J.-P. Yi, et al., Potential presymptomatic transmission of SARS-CoV-2, Zhejiang Province, China, 2020, Emerg. Infect. Dis., 26(5) (2020), 1052-1054.
    [43] P. Yu, J. Zhu, Z. Zhang, Y. Han, A familial cluster of infection associated with the 2019 novel coronavirus indicating possible person-to-person transmission during the incubation period, J. Infect. Dis., 221, (2020), 1757-1761.
    [44] R. S. Sikkema, S. D. Pas, D. F. Nieuwenhuijse, A. O'Toole, J. J. Verweij, A. van der Linden, et al., COVID-19 in health-care workers in three hospitals in the south of the Netherlands: a crosssectional study, Lancet Infect. Dis., 20 (2020), 1273-1280. doi: 10.1016/S1473-3099(20)30527-2
    [45] N. van Doremalen, T. Bushmaker, D. H. Morris, M. G. Holbrook, A. Gamble, B. N. Williamson, et al., Aerosol and surface stability of SARS-CoV-2 as compared with SARS-Cov-1, N. Engl. J. Med., 382 (2020), 1564-1567. doi: 10.1056/NEJMc2004973
    [46] M. E. Halloran, Secondary attack rate, In Encyclopedia of Biostatistics (eds. P. Armitage and T. Colton), American Cancer Society, (2005).
    [47] R. M. Burke, C. M. Midgley, A. Dratch, M. Fenstersheib, T. Haupt, M. Holshue, et al., Active monitoring of persons exposed to patients with confirmed COVID-19 - United States, JanuaryFebruary 2020, MMWR Morb. Mortal. Wkly Rep., 69 (2020), 245-246. doi: 10.15585/mmwr.mm6909e1
    [48] Y. Liu, R. M. Eggo, A. J. Kucharski, Secondary attack rate and superspreading events for SARSCoV-2, Lancet, 395 (2020), e47.
    [49] W. W. Sun, F. Ling, J. R. Pan, J. Cai, Z. P. Miao, S. L. Liu, et al., Epidemiological characteristics of COVID-19 family clustering in Zhejiang Province, Zhonghua Yu Fang Yi Xue Za Zhi, 54 (2020), 625-629.
    [50] Y.-T. Huang, Y.-K. Tu, P.-C. Lai, Estimation of the secondary attack rate of COVID-19 using proportional meta-analysis of nationwide contact tracing data in Taiwan, J. Microbiol. Immun. Infect., (2020), S1684-1182(20)30143-2.
    [51] D. K. Chu, E. A. Akl, S. Duda, K. Solo, S. Yaacoub, H. J. Schünemann, et al., Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis, Lancet, 395 (2020), P1973-1987.
    [52] C. R. McIntyre, Q. Wang, Physical distancing, face masks, and eye protection for prevention of COVID-19, Lancet, 395 (2020), P1950-1951.
    [53] Q. X. Long, X.-J. Tang, Q.-L. Shi, Q. Lin, H.-J. Deng, J. Yuan, et al., Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections, Nat. Med., 26 (2020), 1200-1204. doi: 10.1038/s41591-020-0965-6
    [54] M. Day, COVID-19: four fifths of cases are asymptomatic, China figures indicate, BMJ, 369 (2020), m1375.
    [55] G. Giordano, F. Blanchini, R. Bruno, P. Colaneri, A. Di Filippo, A. Di Matteo, et al., Modelling the COVID-19 epidemic and implementation of population-wide interventions in Italy, Nat. Med., 26 (2020), 855-860. doi: 10.1038/s41591-020-0883-7
    [56] Health Protection Scotland, Novel coronavirus (COVID-19) guidance for secondary care, (2020). Available from: https://www.hps.scot.nhs.uk/web-resources-container/covid-19-guidance-for-secondary-care/.
    [57] Interim Guidance for Use of Pooling Procedures in SARS-CoV-2 Diagnostic, Screening, and Surveillance Testing, (2020). Available from: https://www.cdc.gov/coronavirus/2019-ncov/lab/pooling-procedures.html.
    [58] T. Roques, R. Board, Guidance on SARS-CoV-2 antigen testing for asymptomatic healthcare workers (HCW) and patients in non-surgical oncology in the UK, (2020). Available from https://www.rcr.ac.uk/sites/default/files/guidance-covid19-testing-asymptomatic-hcw-patients-oncology.pdf.
    [59] C. Aitken, D. J. Jeffries, Nosocomial spread of viral disease, Clin. Microbiol. Rev., 14 (2001), 528-546. doi: 10.1128/CMR.14.3.528-546.2001
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