Hand-hygiene mitigation strategies against global disease spreading through the air transportation network

Christos Nicolaides; Demetris Avraam; Luis Cueto-Felgueroso; Marta C. González; Ruben Juanes

In this work we have analysed contagion dynamics through the world air transportation network and the impact of hand-hygiene behavioural changes of air travelers against global epidemic spreading. Using well-established methodologies, we have applied simulations to track traveling agents and their hand washing activity and analysed the expansion of flu-type epidemics through the world air transportation network. From the simulation results, we have measured the early-time spreading power of the major airports in the world under different hand-hygiene interventions. Using data-driven calculations, we estimated that mostly 1 over 5 people are cleaned at any given moment in time (i.e. 20% of airport population). This is translated to hand washing engagement rate among the non-cleaned individuals equal to 0.12 per hour (i.e. every hour about 12% of the non-cleaned individuals are washing their hands). From simulation results we have shown that, if we are able to increase the level of hand cleanliness at all airports in the world from 20% to 30% (or equivalently to increase the hand washing engagement rate from 0.12 to 0.21 per hour), either by increasing the capacity of hand washing and/or by increasing the awareness among individuals and/or by giving the right incentives to individuals, a potential infectious disease will have a worldwide impact that is about 21.2% smaller compared to the impact that the same disease would have with the 20% level of hand cleanliness (or 0.12 per hour hand washing engagement rate). Increasing the level of hand cleanliness to 60% (or equivalently the hand washing engagement rate among non-cleaned individuals to 0.73 per hour) at all airports in the world would have a reduction of 64.6% in the impact of a potential disease spreading. Moreover, we have identified the ten most important airports of the network, for which increasing the level of hand cleanliness (or hand washing engagement rate) only at those, the impact of the disease spreading would decrease by 9% to 37%.