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# Health Sciences# Infectious Diseases (except HIV/AIDS)

The Impact of Separation on Disease Spread

Examining how contact rates differ between vaccinated and unvaccinated populations.

― 5 min read


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Models help us look at how diseases spread and how health policies can affect this spread. There are benefits to using simple models that still reflect reality well. Sometimes, overly simple models can't provide the details needed for specific situations. Researchers have built on basic models to better represent real diseases, including factors like births, deaths, and immunity from vaccines or past infections.

Recently, models have been created to look at the interactions between two groups in society: those who are Vaccinated and those who are not. These models help us see how the pandemic affects each group and whether Unvaccinated individuals put vaccinated people at greater risk, especially using information related to COVID-19. However, previous models assumed that both groups mixed equally, which doesn't reflect real-life situations where unvaccinated people may have less contact with the vaccinated population.

In our work, we look at how Contact Rates differ between vaccinated and unvaccinated people. This is important because in real-life situations, unvaccinated individuals often have limited access to public spaces and services. For example, they might be restricted from places like restaurants or public transport. As a result, their contact frequency can decrease when separated, or it might increase if they gather closely together. By including this feature in our model, we can see more complex patterns in Infection Rates among both vaccinated and unvaccinated populations.

The Model Framework

We use a standard framework that divides the population into two groups based on vaccination status. In this model, a person who is susceptible can become infected after coming into contact with an infectious person. Eventually, those who are infectious will recover and develop permanent immunity.

In our model, vaccination is treated as an all-or-nothing approach. A certain percentage of the vaccinated group will be immune from the start based on vaccine effectiveness. Additionally, a small percentage of the unvaccinated population may also be immune due to past infections.

A key aspect of our model is the parameter that measures how separated the two groups are. When there is no Separation, both groups mix freely. But when they are completely separated, vaccinated individuals only interact with other vaccinated individuals, while unvaccinated individuals only interact with others who are unvaccinated.

Our approach recognizes that the way people interact is not fixed. We explored how contact rates change as the degree of separation increases. For instance, if unvaccinated people face increasing restrictions, their contact frequency decreases. Conversely, if they are isolated together (for example, quarantined), their contact frequency could actually increase.

Key Findings from the Model

Our model shows that the way separation affects infection rates among the vaccinated population is quite nuanced. As the level of separation grows, the infection rates among vaccinated people can either increase or decrease, depending on how separation alters their contact frequency.

When unvaccinated individuals are isolated, the number of infections in the vaccinated group can drop. However, if the unvaccinated individuals are grouped closely together, the vaccinated group could see their infection rates rise.

This means that the impact of separation on disease spread is not straightforward. For some viruses that spread easily, isolating unvaccinated individuals may lower infection rates in the vaccinated population. But for viruses that are less contagious, both isolating and compiling separation could lead to higher infection rates among vaccinated individuals.

Additionally, the share of infections among vaccinated individuals that come from contact with unvaccinated people also changes with the degree of separation. As separation increases, this share may rise, fall, or show more complex behavior, revealing how intertwined these two populations actually are.

Impacts of Separation on Health Outcomes

Our model helps illustrate the potential negative impacts of societal separation policies. While such policies might aim to protect vaccinated individuals, they can inadvertently lead to greater infection rates among both groups.

In situations where unvaccinated individuals can gather, the overall rate of infections can rise due to increased contact among unvaccinated people. This creates a feedback loop where the interaction of unvaccinated populations leads to higher rates of infection. The vaccinated group, while somewhat shielded from these rising numbers, could still see infection rates increase due to the indirect effects of unvaccinated interactions.

It is essential to note that our model does not consider other factors, such as hospitalizations or deaths, which could also be influenced by these dynamics. We focus on the overall rates of infection, which can help inform policies and public health decisions.

Limitations of the Model

While our model offers valuable insights, it also has limitations. We only focus on two groups and do not account for variations based on other factors like gender, age, or underlying health conditions. Also, our model considers constant contact rates, which may not reflect real-life situations where contact patterns can change based on cultural or environmental factors.

Additionally, we assume that vaccination is entirely effective without any diminishing immunity over time. This simplification can impact our results, especially in cases where breakthrough infections might occur.

The nature of respiratory diseases adds another layer of complexity. These diseases can spread rapidly and in unpredictable patterns, which our model, based on pairwise contacts, may not fully capture.

Conclusion

In summary, our model highlights the importance of considering contact rates and degrees of separation when analyzing disease spread among vaccinated and unvaccinated populations. The findings emphasize that separation measures need to be carefully evaluated, as they can have unintended consequences on infection rates across different groups.

Real-life scenarios and health policies should always consider the nuances of how populations interact to inform effective strategies for managing infectious diseases. Understanding these dynamics can help us make better choices about public health interventions and improve outcomes during health crises.

Original Source

Title: Viral respiratory epidemic modelling of societal segregation based on vaccination status

Abstract: BackgroundSocietal segregation of unvaccinated people from public spaces has been a novel and controversial COVID-era public health practice in many countries. Models exploring potential consequences of vaccination-status-based segregation have not considered how segregation influences the contact frequencies in the segregated groups. We systematically investigate implementing effects of segregation on population-specific contact frequencies and show this critically determines the predicted epidemiological outcomes, focusing on the attack rates in the vaccinated and unvaccinated populations and the share of infections among vaccinated people that were due to contacts with infectious unvaccinated people. MethodsWe describe a susceptible-infectious-recovered (SIR) two-population model for vaccinated and unvaccinated groups of individuals that transmit an infectious disease by person-to-person contact. The degree of segregation of the two groups, ranging from zero to complete segregation, is implemented using the like-to-like mixing approach developed for sexually-transmitted diseases, adapted for presumed SARS-CoV-2 transmission. We allow the contact frequencies for individuals in the two groups to be different and depend, with variable strength, on the degree of segregation. ResultsSegregation can either increase or decrease the attack rate among the vaccinated, depending on the type of segregation (isolating or compounding), and the contagiousness of the disease. For diseases with low contagiousness, segregation can cause an attack rate in the vaccinated, which does not occur without segregation. InterpretationThere is no predicted blanket epidemiological advantage to segregation, either for the vaccinated or the unvaccinated. Negative epidemiological consequences can occur for both groups.

Authors: Joseph Hickey, D. G. Rancourt

Last Update: 2023-10-31 00:00:00

Language: English

Source URL: https://www.medrxiv.org/content/10.1101/2022.08.21.22279035

Source PDF: https://www.medrxiv.org/content/10.1101/2022.08.21.22279035.full.pdf

Licence: https://creativecommons.org/licenses/by/4.0/

Changes: This summary was created with assistance from AI and may have inaccuracies. For accurate information, please refer to the original source documents linked here.

Thank you to medrxiv for use of its open access interoperability.

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