Using high-resolution contact networks to evaluate SARS-CoV-2 transmission and control in large-scale multi-day events

Pung, Rachael and Firth, Josh A. and Spurgin, Lewis G. and Chang, Annie and Kong, Jade and Wong, Jazzy and Jin, Ooi Jo and Selvaraj, Deepa and Yong, Dominique and Lang, Jocelyn and Sivalingam, Abilash and Procter, Simon R. and Flasche, Stefan and Waites, William and Prem, Kiesha and Pearson, Carl A.B. and Gibbs, Hamish P. and Sherratt, Katharine and Villabona-Arenas, C. Julian and Wong, Kerry L.M. and Liu, Yang and Mee, Paul and Chapman, Lloyd A.C. and Atkins, Katherine E. and Quaife, Matthew and Munday, James D. and Funk, Sebastian and Eggo, Rosalind M. and Huè, Stèphane and Davies, Nicholas G. and Hodgson, David and Abbas, Kaja and McCarthy, Ciara V. and Hellewell, Joel and Abbott, Sam and Bosse, Nikos I. and Brady, Oliver and Barnard, Rosanna C. and Jit, Mark and Tully, Damien C. and Medley, Graham and Sun, Fiona Yueqian and Jarvis, Christopher I. and Lowev, Rachel and O’Reilly, Kathleen and Meakin, Sophie R. and Endo, Akira and Sandmann, Frank G. and Edmunds, W. John and Koltai, Mihaly, Singapore CruiseSafe working group, CMMID COVID-19 Working Group (2022) Using high-resolution contact networks to evaluate SARS-CoV-2 transmission and control in large-scale multi-day events. Nature Communications, 13 (1). 1956. ISSN 2041-1723 (

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The emergence of highly transmissible SARS-CoV-2 variants has created a need to reassess the risk posed by increasing social contacts as countries resume pre-pandemic activities, particularly in the context of resuming large-scale events over multiple days. To examine how social contacts formed in different activity settings influences interventions required to control Delta variant outbreaks, we collected high-resolution data on contacts among passengers and crew on cruise ships and combined the data with network transmission models. We found passengers had a median of 20 (IQR 10–36) unique close contacts per day, and over 60% of their contact episodes were made in dining or sports areas where mask wearing is typically limited. In simulated outbreaks, we found that vaccination coverage and rapid antigen tests had a larger effect than mask mandates alone, indicating the importance of combined interventions against Delta to reduce event risk in the vaccine era.