SARS-CoV-2 epidemics demonstrate considerable heterogeneity in what conditions lead to disproportionate risks of acquisition and onward transmission. In this talk, we examine the data in Ontario and elsewhere on potential mediators of inequities in rates of COVID-19 diagnoses, test positivity, and testing. We then use simple transmission dynamics models to discuss how examining underlying heterogeneity in mechanisms of onward transmissions could help inform a more tailored response, and the challenges in translating insights from transmission modeling into the implementation of public health prevention measures. We discuss how we might answer the following question: under what combination of assumptions and intervention strategies, could a public health response decrease, perpetuate, or increase inequities in the spread and health consequences of SARS-CoV-2?

Sharmistha Mishra, MD, MSc, PhD is an infectious disease physician and epidemiologist, and a Tier 2 Canada Research Chair in Mathematical Modeling and Program Science. Her research focuses on disentangling sources of heterogeneity in risks of onward transmission and is grounded in the implementation of adaptive public health strategies tailored to meet the needs of populations at differential risks.

www.mishra-lab.ca

Relevant publications: Endo et al. https://wellcomeopenresearch.org/articles/5-67

Laxminarayan et al. https://science.sciencemag.org/content/early/2020/09/29/science.abd7672

Davies NG, Klepac P, Liu Y, Prem K, Jit M, Eggo RM. Age-dependent effects in the transmission and control of COVID-19 epidemics. medRxiv 2020:2020.03.24.20043018.

Gomes MGM, Aguas R, Corder RM, King JG, Langwig KE, Souto-Maior C, Carneiro J, Ferreira MU, Penha-Goncalves C. Individual variation in susceptibility or exposure to SARS-CoV-2 lowers the herd immunity threshold. medRxiv 2020:2020.04.27.20081893.