Time-variant strategies for optimizing the performance of non-pharmaceutical interventions (NPIs) in protecting lives and livelihoods during the COVID-19 pandemic

Wei Aun Yap; Dhesi Baha Raja

Many countries throughout the world have instituted strong non-pharmaceutical interventions (NPIs), such as lockdowns, in immediate response to rapid increases in COVID-19 cases to slow the contagion so that the health system can cope. As COVID-19 cases moderate where lockdowns are in place, there is debate about how these lockdowns can be withdrawn but inadequate evidence on the performance of various NPI exit strategies to inform these. Epidemiological considerations are critical but given the impact of NPIs on livelihoods and economies, both epidemiological outcomes and non-epidemiological outcomes will need to be considered in the performance of NPIs. This is the critical gap in evidence that this paper aspires to contribute towards by using a modeling platform to simulate 100 different scenarios on a hypothetical population whereby time-variant parameters related to lockdown interventions are modified individually to draw generalizable insights and highlight further knowledge and analytic gaps. Performance measures are collected during the simulation to generate evidence for and against different strategies. NPIs are inextricably linked to exit strategies and hence all simulations are run for an additional 6 months to achieve steady state so that the whole strategy until the endgame can be measured.