Alternating quarantine for sustainable epidemic mitigation

Abstract: Absent a drug or vaccine, containing epidemic outbreaks is achieved by means of social distancing, specifically mobility restrictions and lock-downs. Such measures impose a hurtful toll on the economy, and are difficult to sustain for extended periods. As an alternative, we propose here an alternating quarantine strategy, in which at every instance, half of the population remains under lock-down while the other half continues to be active, maintaining a routine of weekly succession between activity and quarantine. This regime affords a dual partition:\ half of the population interacts for only half of the time, resulting in a dramatic reduction in transmission, comparable to that achieved by a population-wide lock-down. All the while, it enables socioeconomic continuity at $50\%$ capacity. The proposed weekly alternations also address an additional challenge, with specific relevance to COVID-19. Indeed, SARS-CoV-2 exhibits a relatively long incubation period, in which individuals experience no symptoms, but may already contribute to the spread. Unable to selectively isolate these invisible spreaders, we resort to population-wide restrictions. However, under the alternating quarantine routine, if an individual was exposed during their active week, by the time they complete their quarantine they will, in most cases, begin to exhibit symptoms. Hence this strategy isolates the majority of pre-symptomatic individuals during their infectious phase, leading to a rapid decline in the viral spread, thus addressing one of the main challenges in COVID-19 mitigation.