ArticleBMC public health2025
Quantitative analysis of self-reporting and contact tracing in heterogeneous risk groups: a stochastic modeling study of the COVID-19 outbreak in Daegu, Korea.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn the early stages of a novel infectious disease outbreak, when vaccines, treatments, and herd immunity are lacking, non-pharmaceutical interventions-particularly self-reporting and contact tracing-play a critical role in suppressing transmission. During the first wave of COVID-19 in Korea, a large outbreak centered around a religious community in Daegu rapidly escalated, thus highlighting the transmission risks associated with a closed and low-reporting high-risk group. This study aimed to quantitatively assess the effectiveness of self-reporting and contact tracing strategies across heterogeneous risk groups.
methodsThe population of Daegu was stratified into two groups: a high-risk group characterized by high transmissibility and low reporting rate, and a low-risk group with lower transmissibility and higher reporting compliance. We developed a stochastic model and applied a modified Gillespie algorithm incorporating both Markovian and non-Markovian processes. Scenario-based simulations were conducted to evaluate the impact of changes in self-reporting rates and delays in contact tracing. We simulated each scenario 10,000 times to estimate the mean and 95% credible intervals for the number of infections.
resultsWhen the self-reporting rate in the high-risk group was lowered to 0.1, the total infections increased by approximately 22%, while unreported infections rose by 164% compared to the baseline. Conversely, increasing the self-reporting rate in the high-risk group to 0.8 reduced the total cases by approximately 21% and unreported infections by 86%. Notably, unreported infections in the low-risk group increased by approximately 416% when their reporting rate declined to 0.4, although this group had a lower transmission potential. Even a modest contact tracing delay of 4-7 d resulted in an 85% increase in unreported cases, with diminishing returns for longer delays, highlighting the critical importance of timely tracing in outbreak control.
conclusionsIn situations with heterogeneous risk groups, improving the self-reporting behavior of high-risk populations and maintaining high compliance in the low-risk group are essential for effective outbreak control. Contact tracing should be completed within 1-4 d to prevent further spread. Our study which accounts for behavioral heterogeneity, provides a scientific foundation for designing group-specific intervention strategies in future outbreaks of emerging infectious diseases.
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