Increased Detection coupled with Social Distancing and Health Capacity Planning Reduce the Burden of COVID-19 Cases and Fatalities: A Proof of Concept Study using a Stochastic Computational Simulation Model

ABSTRACT Objective In absence of any vaccine, the Corona Virus Disease 2019 (COVID-19) pandemic is being contained through a non-pharmaceutical measure termed Social Distancing (SD). However, whether SD alone is enough to flatten the epidemic curve is debatable. Using a Stochastic Computational Simulation Model, we investigated the impact of increasing SD, hospital beds and COVID-19 detection rates in preventing COVID-19 cases and fatalities. Research Design and Methods The Stochastic Simulation Model was built using the EpiModel package in R. As a proof of concept study, we ran the simulation on Kasaragod, the most affected district in Kerala. We added 3 compartments to the SEIR model to obtain a SEIQHRF (Susceptible-Exposed-Infectious-Quarantined-Hospitalised-Recovered-Fatal) model. Results Implementing SD only delayed the appearance of peak prevalence of COVID-19 cases. Doubling of hospital beds couldn’t reduce the fatal cases probably due to its overwhelming number compared to the hospital beds. Increasing detection rates could significantly flatten the curve and reduce the peak prevalence of cases (increasing detection rate by 5 times could reduce case number to half). Conclusions An effective strategy to contain the epidemic spread of COVID-19 in India is to increase detection rates in combination with SD measures and increase in hospital beds. HIGHLIGHTS Increased Detection of COVID-19 cases must accompany Social Distancing and Health Capacity Planning to reduce the burden of cases and fatalities. Interruptive Social Distancing is an effective alternative to continuous Social Distancing. Given the overwhelming burden of COVID-19 fatalities, there is immediate need of co-ordination with the Private Healthcare Sector. COVID-19 cases will be peaking after May, 2020 giving us time for Healthcare Capacity Building in the government and private sector both.