Mathematical modeling and investigation on the role of demography and contact patterns in social distancing measures effectiveness in COVID-19 dissemination.

Abstract

In this article, we investigate the importance of demography and contact patterns in determining the spread of COVID-19 and to the effectiveness of social distancing policies. We investigate these questions proposing an augmented epidemiological model with an age-structured model, with the population divided into susceptible (S), exposed (E), asymptomatic infectious (A), hospitalized (H), symptomatic infectious (I) and recovered individuals (R), to simulate COVID-19 dissemination. The simulations were carried out using six combinations of four types of isolation policies (work restrictions, isolation of the elderly, community distancing and school closures) and four representative fictitious countries generated over alternative demographic transition stage patterns (aged developed, developed, developing and least developed countries). We concluded that the basic reproduction number depends on the age profile and the contact patterns. The aged developed country had the lowest basic reproduction number ($R0=1.74$) due to the low contact rate among individuals, followed by the least developed country ($R0=2.00$), the developing country ($R0=2.43$) and the developed country ($R0=2.64$). Because of these differences in the basic reproduction numbers, the same intervention policies had higher efficiencies in the aged and least developed countries. Of all intervention policies, the reduction in work contacts and community distancing were the ones that produced the highest decrease in the $R0$ value, prevalence, maximum hospitalization demand and fatality rate. The isolation of the elderly was more effective in the developed and aged developed countries. The school closure was the less effective intervention policy, though its effects were not negligible in the least developed and developing countries.