Epidémiolgie - Santé Publique (Epidemiology - Public Health) - NOSOCOVID: Prévention de la transmission du COV-19 dans les établissements de santé égyptiens NOSOCOVID : Preventing the spread of COVID-19 in Egyptian healthcare settings

Egypt had the first reported confirmed case of COVID-19 on the African continent on Feb 14, 2020. Local transmission has been confirmed since, and as of Apr 10, 2020, Egypt ranked among the countries the most affected in Africa with 1,699 confirmed cases. The Egyptian health authorities' response was one of the first to be implemented on the continent. Currently, the healthcare response relies on several quarantine hospitals devoted for COVID-19 patients only. This strategy could be completed with a broader mobilization of general hospitals in case of COVID-19 patients overload. In this context, healthcare institutions are facing major challenges. First, the community spread is leading to a large demand in available beds and to a saturation in hospitals dedicated to COVID-19 patients, particularly in intensive care units. Second, the outbreak, its managements, and the fact that healthcare workers are particularly exposed to the virus are causing a large-scale disorganization of the entire healthcare system. Third, healthcare settings have been shown to be hotspots of transmission of coronaviruses, notably due to the high density of contacts. Mathematical modelling has become a standard to analyse the spread of infectious diseases. It has provided a theoretical framework for understanding complex transmission dynamics within healthcare settings and a quantitative approach to estimating the impact of various infection control strategies and their combined effects. This approach has already been widely developed to understand, anticipate and assess possibilities for controlling the current COVID-19 epidemic in the community. However, no model has yet been specifically proposed to assess control measures in healthcare settings. Moreover, models for nosocomial transmission in healthcare settings for various pathogens have gathered important interest in high-income countries. However, there has been a scarcity of research efforts to model pathogen spread in healthcare settings in low- and middle-income countries. The objective of this project is to address the risk associated with SARS-Cov-2 nosocomial transmission and support its control in an Egyptian healthcare setting. More specifically, the project will rely on the adaptation of an existing mathematical model to simulate different healthcare organization and control strategies. The model will be calibrated in order to reproduce the SARS-Cov-2 circulation in an Egyptian quarantine hospital (15th of May Hospital, Cairo). Then, we will evaluate various control strategies, including those considered by local health authorities, in terms of risk of COVID-19 acquisition by healthcare workers. In a second step, the model will reproduce the virus circulation in a general hospital with a dedicated section for COVID-19 management, and strategies will be evaluated in terms of risk of COVID-19 acquisition by patients and healthcare workers. Results of this project will provide insight for the control of nosocomial dissemination of SARS-Cov-2 in Egypt. Results may also be informative at a broader scale, on the African and above. Keywords: mathematical modelling, transmission, healthcare setting, control strategies, healthcare workers