Research title: Feasibility of controlling COVID-19 outbreaks by isolation of cases

and contacts

1. In some plausible scenarios, case isolation alone would be unlikely to control

transmission within 3 months.
2. Case isolation was more effective when there was little transmission before symptom
onset and when the delay from symptom onset to isolation was short.
3. Preventing transmission by tracing and isolating a larger proportion of contacts, thereby
decreasing the effective reproduction number, improved the number of scenarios in
which control was likely to be achieved.
4. In scenarios in which the reproduction number was 2·5, 15% of transmission occurred
before symptom onset, and there was a short delay to isolation, at least 80% of infected
contacts needed to be traced and isolated to give a probability of control of 90% or
more.
5. In scenarios in which the delay from onset to isolation was long, similar to the delays in
the early phase of the outbreak in Wuhan, the same contact tracing success of 80%
achieved a probability of containing an outbreak of less than 40%.
6. In most plausible outbreak scenarios, case isolation and contact tracing alone is
insufficient to control outbreaks, and that in some scenarios even near perfect contact
tracing will still be insufficient, and further interventions would be required to achieve
control.
7. Rapid and effective contact tracing can reduce the initial number of cases, which would
make the outbreak easier to control overall.
8. Effective contact tracing and isolation could contribute to reducing the overall size of an
outbreak or bringing it under control over a longer time period.

Research Title: Targeted adaptive isolation strategy for COVID-19 pandemic

1. Since the large majority of the COVID-19 infected population develops very mild or no
symptoms, transmission cannot be eliminated by detecting and isolating symptomatic
COVID-19 patients.
2. Since at the end of the epidemic a large proportion of the population remains
susceptible to infection, after relaxation of social distancing, the population is highly
susceptible to recurrent epidemic outbreaks potentially triggered by remaining
undetected or newly imported infections from other regions/countries where the
infection has not been eliminated yet.
3. Social distancing measures over extended period of time applied uniformly to a large
population lead to widespread disruption of the functioning of the society and economy
therefore it has a huge long term cost.
4. While social distancing aims to reduce the total
5. infected population by decreasing number of new infections caused by a single infected
in a fully susceptible population , an alternative or complementary approach focuses
resources to shield the vulnerable population. This could be achieved by targeted
measures: restricting mobility, providing free home-delivery of food and medication,
 increased support addressing communication and healthcare needs, and providing
separated living space where needed.
6. Since the isolation strategy targets a sub-population, a radical isolation is likely to be
more effective than uniform social distancing, and at a smaller cost for the economy and
for the general functioning of the society.
7. With limited resources available, when the strategy is primarily based on drastic
targeted isolation over a shorter time, the end result is a collectively immune population
resistant to further infections
8. Relaxing social distancing should happen before the end of isolation to allow for further
increase of the immune proportion in the low-risk group and to avoid the spread of
infections into the high-risk population.

Research title: Early diagnosis and rapid isolation: response to COVID-19 outbreak
in Korea

1. Rapid diagnosis and rapid isolation is the key to prevention of transmission.

2. Rapidly implemented diagnostic techniques enabled proactive screening of contacts and
early diagnosis. The relatively shorter period of symptom onset to diagnosis of COVID-
19 (7 days in Korea versus 10 days in China) has led to the rapid isolation of patients
and a reduction in further transmission.
3. Procedures for obtaining nasopharyngeal swabs, recommended for the detection of
SARS-CoV-2, are considered as aerosol-generating procedures, and require specific
facilities such as airborne infection isolation rooms (AIIRs) which need disinfection and
ventilation between patients.
4. Patient triage and prioritization of medical resources are essential for the prevention of a
surge during an outbreak.
5. Early diagnosis and adequate initial management are crucial for a better prognosis of
COVID-19, because no specific treatment is available. It is less likely that the hospital
systems are sufficiently prepared for all the patients with COVID-19, even in the
countries with high-performing health systems.
6. The nation should prepare for other types of care centres beyond hospital beds.
Moderately or severely ill patients need medical management or intensive care in
hospitals, while mildly ill patients can stay at home.
7. Patients with mild symptoms are shedding high viral loads in the early phase of the
disease.
8. The continuous communication and collaboration between professional societies with
health authorities and local authorities are the important component for the efficient and
rapid response to the health crisis.

Research title: Comprehensive identification and isolation policies have effectively

suppressed the spread of COVID-19
1. Forceful public health interven- tions can effectively suppress or even block the outbreak
based on Wuhan’s experiences although COVID-19 has extremely strong infectivity and
lethality.
2. Infected and death cases would sharply decrease if the quarantine strategies could be
promulgated slightly in advance. Nevertheless, postponing such plans would cause
additional millions of infected population worldwide, and undoubtedly the catastrophic
consequences of abrogating these ordinances are uncountable.
3. The governments or communities should adopt the containments such as
comprehensive investigating and tracking the temperature and traces information about
the residents, immediately isolating the suspected and diagnosed infected individuals to
prevent the spread of COVID-19 on social network
4. Although such near-compulsory national policies may cause severe economic recession
or ethical problems, we must realize that society is a community of life composed of all
human beings, and we profoundly influence each other whereupon we should
collaborate to fight this vital pandemic together. Given that there are no target
therapeutics or vaccine currently, each of us should cooperate with these policies in a
responsible manner, isolate ourselves from others, form an island, and ultimately pre-
vent the spread of the virus