Effectiveness of isolation, testing, contact tracing, and physical distancing on reducing transmission of SARS-CoV-2 in different settings: a mathematical modelling study
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Abstract
BACKGROUND: The isolation of symptomatic cases and tracing of contacts has been used as an early COVID-19 containment measure in many countries, with additional physical distancing measures also introduced as outbreaks have grown. To maintain control of infection while also reducing disruption to populations, there is a need to understand what combination of measures-including novel digital tracing approaches and less intensive physical distancing-might be required to reduce transmission. We aimed to estimate the reduction in transmission under different control measures across settings and how many contacts would be quarantined per day in different strategies for a given level of symptomatic case incidence. METHODS: For this mathematical modelling study, we used a model of individual-level transmission stratified by setting (household, work, school, or other) based on BBC Pandemic data from 40 162 UK participants. We simulated the effect of a range of different testing, isolation, tracing, and physical distancing scenarios. Under optimistic but plausible assumptions, we estimated reduction in the effective reproduction number and the number of contacts that would be newly quarantined each day under different strategies. RESULTS: We estimated that combined isolation and tracing strategies would reduce transmission more than mass testing or self-isolation alone: mean transmission reduction of 2% for mass random testing of 5% of the population each week, 29% for self-isolation alone of symptomatic cases within the household, 35% for self-isolation alone outside the household, 37% for self-isolation plus household quarantine, 64% for self-isolation and household quarantine with the addition of manual contact tracing of all contacts, 57% with the addition of manual tracing of acquaintances only, and 47% with the addition of app-based tracing only. If limits were placed on gatherings outside of home, school, or work, then manual contact tracing of acquaintances alone could have an effect on transmission reduction similar to that of detailed contact tracing. In a scenario where 1000 new symptomatic cases that met the definition to trigger contact tracing occurred per day, we estimated that, in most contact tracing strategies, 15 000-41 000 contacts would be newly quarantined each day. INTERPRETATION: Consistent with previous modelling studies and country-specific COVID-19 responses to date, our analysis estimated that a high proportion of cases would need to self-isolate and a high proportion of their contacts to be successfully traced to ensure an effective reproduction number lower than 1 in the absence of other measures. If combined with moderate physical distancing measures, self-isolation and contact tracing would be more likely to achieve control of severe acute respiratory syndrome coronavirus 2 transmission. FUNDING: Wellcome Trust, UK Engineering and Physical Sciences Research Council, European Commission, Royal Society, Medical Research Council.
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Equitable vaccination coverage requires higher levels of coverage among those most at risk at the intersection of SARS-CoV-2 exposures, severity, and onward transmission.
“Equitable vaccination coverage requires higher levels of coverage among those most at risk at the intersection of SARS-CoV-2 exposures, severity, and onward transmission(44-48).”
From Social inequalities in COVID-19 death by area-level income in 11.2 million people in Ontario, Canada: patterns over time and the mediating role of vaccination. (2026) · cites this paper as [48]
The Discussion (page not available) suggests that people with more contacts may be more likely both to acquire SARS-CoV-2 and to transmit it onward. It does not address equitable vaccination coverage, recommend higher coverage for any group, or assess risk of severe disease. (LLM, conf=0.82)
Experimental — accuracy not yet measuredDue to false negatives in detecting face-to-face contacts, digital contact tracing may not be as effective as its manual counterpart-a study estimated that digital tracing alone can reduce the R number by 44% whereas manual tracing of all contacts can reduce R number by 61%.
“However, due to false negatives in detecting face-to-face contacts, digital contact tracing may not be as effective as its manual counterpart—a study [178] estimated that digital tracing alone can reduce the R number (average number of people infected by a single infectious person) by 44% whereas manual tracing of all contacts can reduce R number by 61%.”
From Human-centred artificial intelligence for mobile health sensing: challenges and opportunities (2023) · cites this paper as [178]
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- Authors
- Kucharski, A. J., Klepac, P., Conlan, A. J. K., Kissler, S. M., Tang, M. L., Fry, H., Gog, J. R., Edmunds, W. J., Emery, J. C., Medley, G., Munday, J. D., Russell, T. W., Leclerc, Q. J., Diamond, C., Procter, S. R., Gimma, A., Sun, F. Y., Gibbs, H. P., Rosello, A., van Zandvoort, K., Hué, S., Meakin, S. R., Deol, A. K., Knight, G., Jombart, T., Foss, A. M., Bosse, N. I., Atkins, K. E., Quilty, B. J., Lowe, R., Prem, K., Flasche, S., Pearson, C. A. B., Houben, R. M. G. J., Nightingale, E. S., Endo, A., Tully, D. C., Liu, Y., Villabona-Arenas, J., O'Reilly, K., Funk, S., Eggo, R. M., Jit, M., Rees, E. M., Hellewell, J., Clifford, S., Jarvis, C. I., Abbott, S., Auzenbergs, M., Davies, N. G., & Simons, D.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- University of Cambridge (GB)
- Harvard University (US)
- University College London (GB)
- Corresponding author
- Kucharski, Adam J
- ORCID
- Kucharski, Adam J
- Klepac, Petra
- Conlan, Andrew J K
- Kissler, Stephen M
- Tang, Maria L
- Fry, Hannah
- Gog, Julia R
- Edmunds, W John
- Emery, Jon C
- Medley, Graham
- Munday, James D
- Russell, Timothy W
- Leclerc, Quentin J
- Diamond, Charlie
- Procter, Simon R
- Gimma, Amy
- Sun, Fiona Yueqian
- Gibbs, Hamish P
- Hué, Stéphane
- Meakin, Sophie R
- Deol, Arminder K
- Jombart, Thibaut
- Foss, Anna M
- Bosse, Nikos I
- Atkins, Katherine E
- Quilty, Billy J
- Lowe, Rachel
- Prem, Kiesha
- Flasche, Stefan
- Pearson, Carl A B
- Houben, Rein M G J
- Nightingale, Emily S
- Endo, Akira
- Tully, Damien C
- Liu, Yang
- Funk, Sebastian
- Eggo, Rosalind M
- Jit, Mark
- Rees, Eleanor M
- Hellewell, Joel
- Clifford, Samuel
- Jarvis, Christopher I
- Abbott, Sam
- Auzenbergs, Megan
- Davies, Nicholas G
- Simons, David
- Venue
- The Lancet Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 20
- Issue
- 10
- Pages
- 1151-1160
- ISSN
- 1473-3099 (ISSN-L)
- OpenAlex
- W3035693076
- Cited by
- 900
- References
- 34
- Citations by year
- 2026: 23 · 2025: 51 · 2024: 68 · 2023: 129 · 2022: 179 · 2021: 317 · 2020: 133
- FWCI
- 30.13
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Lancet Infectious Diseases (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by)
- PubMed (publishedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (publishedVersion, cc-by)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Apollo (cc-by)
- Funders
- Medical Research Council (MC_PC_19065)
- Engineering and Physical Sciences Research Council (0RP\EA\180004, EP/N509620/1)
- Royal Society (206250/Z/17/Z)
- Wellcome Trust
- Topics
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Physical Sciences › Computer Science › Information Systems › COVID-19 Digital Contact Tracing
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mathematical and Theoretical Epidemiology and Ecology Models
- Keywords
- SARS-CoV-2, COVID-19 pandemic, contact tracing, social distancing, large-scale testing, self-isolation, effective reproduction number, transmission reduction, digital contact tracing, pandemic containment measures, household transmission
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Communicable Disease Control, United Kingdom, Humans, Mass Screening, Models, Theoretical, Patient Isolation, Pneumonia, Viral, Quarantine, Incidence, Contact Tracing, Coronavirus Infections, Basic Reproduction Number, Pandemics
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