Investigation of the Efficiency of Mask Wearing, Contact Tracing, and Case Isolation during the COVID-19 Outbreak.

Case isolation and contact tracing are two essential parts of control measures to prevent the spread of COVID-19, however, additional interventions, such as mask wearing, are required. Taiwan successfully contained local COVID-19 transmission after the initial imported cases in the country in early 2020 after applying the above-mentioned interventions. In order to explain the containment of the disease spread in Taiwan and understand the efficiency of different non-pharmaceutical interventions, a mathematical model has been developed. A stochastic model was implemented in order to estimate the effectiveness of mask wearing together with case isolation and contact tracing. We investigated different approaches towards mask usage, estimated the effect of the interventions on the basic reproduction number (R), and simulated the possibility of controlling the outbreak. With the assumption that non-medical and medical masks have 20% and 50% efficiency, respectively, case isolation works on 100%, 70% of all people wear medical masks, and R = 2.5, there is almost 80% probability of outbreak control with 60% contact tracing, whereas for non-medical masks the highest probability is only about 20%. With a large proportion of infectiousness before the onset of symptoms (40%) and the presence of asymptomatic cases, the investigated interventions (isolation of cases, contact tracing, and mask wearing by all people), implemented on a high level, can help to control the disease spread. Superspreading events have also been included in our model in order to estimate their impact on the outbreak and to understand how restrictions on gathering and social distancing can help to control the outbreak. The obtained quantitative results are in agreement with the empirical COVID-19 data in Taiwan.