The effect of delayed awareness and fatigue on the efficacy of self-isolation in epidemic control

TL;DR

This study models how delayed awareness, fatigue, and adherence issues affect the success of self-isolation in controlling epidemics, revealing optimal durations and the impact of individual heterogeneity on epidemic thresholds.

Contribution

It introduces a network-based epidemic model incorporating delayed awareness, fatigue, and limited adherence, providing insights into optimal quarantine durations and the effects of individual heterogeneity.

Findings

Optimal isolation duration can be shorter than infectious period with improved adherence.

Heterogeneity in contact patterns reduces effectiveness of self-isolation.

Epidemic threshold is highly sensitive to combined effects of compliance, awareness delay, and fatigue.

Abstract

The isolation of infectious individuals is a key measure of public health for the control of communicable diseases. However, involving a strong perturbation of daily life, it often causes psychosocial distress, and severe financial and social costs. These may act as mechanisms limiting the adoption of the measure in the first place or the adherence throughout its full duration. In addition, difficulty of recognizing mild symptoms or lack of symptoms may impact awareness of the infection and further limit adoption. Here, we study an epidemic model on a network of contacts accounting for limited adherence and delayed awareness to self-isolation, along with fatigue causing overhasty termination. The model allows us to estimate the role of each ingredient and analyze the tradeoff between adherence and duration of self-isolation. We find that the epidemic threshold is very sensitive to an effective compliance that combines the effects of imperfect adherence, delayed awareness and fatigue. If adherence improves for shorter quarantine periods, there exists an optimal duration of isolation, shorter than the infectious period. However, heterogeneities in the connectivity pattern, coupled to a reduced compliance for highly active individuals, may almost completely offset the effectiveness of self-isolation measures on the control of the epidemic.