Reconstructing a COVID-19 outbreak within a religious group using social network analysis simulation in Korea

OBJECTIVES: We reconstructed a coronavirus disease 2019 (COVID-19) outbreak to examine how a large cluster at a church setting spread before being detected and estimate the potential effectiveness of complying with mask-wearing guidelines rec-ommended by the government. METHODS: A mathematical model with a social network analysis (SNA) approach was used to simulate a COVID-19 outbreak. A discrete-time stochastic simulation model was used to simulate the spread of COVID-19 within the Sarang Jeil church. A coun-terfactual experiment using a calibrated baseline model was conducted to examine the potential benefits of complying with a mask-wearing policy. RESULTS: Simulations estimated a mask-wearing ratio of 67% at the time of the outbreak, which yielded 953.8 (95% confidence interval [CI], 937.3 to 970.4) cases and was most consistent with the confirmed data. The counterfactual experiment with 95% mask-wearing estimated an average of 45.6 (95% CI, 43.4 to 47.9) cases with a standard deviation of 20.1. The result indicated that if the church followed government mask-wearing guidelines properly, the outbreak might have been one-twentieth the size. CONCLUSIONS: SNA is an effective tool for monitoring and controlling outbreaks of COVID-19 and other infectious diseases. Although our results are based on simulations and are thus limited, the precautionary implications of social distancing and mask-wearing are still relevant. Since person-to-person contacts and interactions are unavoidable in social and economic life, it may be beneficial to develop precise measures and guidelines for particular organizations or places that are susceptible to cluster out-breaks.

Automated summary

The study used mathematical modeling to simulate the spread of a COVID-19 outbreak in a church setting, finding that full compliance with government mask-wearing guidelines could significantly reduce the outbreak size. Developing precise measures and guidelines for organizations or places susceptible to cluster outbreaks may be beneficial in controlling the spread of infectious diseases.