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PONE-D-21-17066

Network assessment and modeling the management of an epidemic on a college campus with testing, contact tracing, and masking

PLOS ONE

Dear Dr. Hartvigsen,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Specifically, both reviewers ask for more details, like the motivation for studying COVID-19 transmission in a college setting, why only undergraduates are included in the study and not graduate students and faculty members, layouts of the dormitories and classrooms, and why the focus on mask wearing and testing, as opposed to hand washing or social distancing. Given the narrow focus of the study on the college setting, both reviewers also asked for the inclusion of a limitations section. Please address these comments, as well as other comments by the reviewers.

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We look forward to receiving your revised manuscript.

Kind regards,

Siew Ann Cheong, Ph.D.

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Overall the manuscript provides important information about the importance of mask efficacy and testing, however, now that the vaccine has become readily available and the mask mandate for individuals who are vaccinated is no longer applicable this paper seems a little untimely based on the arguments presented by the author. Mask efficacy and testing can still be an effective non-pharmaceutical intervention for large gathering areas that are sustained for long periods, such as a college campus, where vaccination rates may vary and transmission is much easier. However, the paper would benefit from incorporating a more time sensitive analysis that includes some discussion of pharmaceutical intervention (i.e., vaccination) and why that was not included in the work shown here. Additionally, I would encourage the author to make major grammatical edits and use a third-person narrative instead of a first-person one.

Introduction

I think overall this just needs to be re-vamped more from a grammatical standpoint then content; overall the points feel slightly behind the times of where we are at with COVID-19 interventions, additionally more emphasis could be put on why you are looking at a college campus and the significance. I’m unsure why it needs to be a college campus compared to another high traffic area, or why you are focusing on this group as well.

Line 7-8: Explaining this famous network is an Influenza model, it’s easy to point the reader to the citation however it becomes a more accessible paper to know that this model is based on a virus transmission.

Line 10: Is 5539 people a medium sized college? Seems more worth while to just state the number instead of this abstract idea of “medium”

Line 11-15: was this work previously done before the era of contact tracing being utilized as a major public health intervention? I understand the background presented here but it’s worded in a way that is confusing.

Methods

Can the author explain the make up of the students and possibly the rationale as to why only undergraduate students where looked at and do not include graduate degrees; a rational as to why graduate students and faculty were not included is needed, as these are people that come into contact with undergrad students and could be links in transmission chains.

Additionally, what is the layout of the residential university housing?

How many people are on a dorm floor, are there shared facilities (shower, laundry, dinning etc.), is it one building for all the students? These probably don’t impact the numbers but is important when folks are generalizing results to similar colleges across the US.

Why did you only focus on masking and testing? Why not also look at hand washing or social distancing as a non-dharma intervention?

Results

Line 119: What is the n for the 89%? Please add that number.

Line 150: What are the five factors again? Would remind the reader

Line 163: Please define “higher-order interactions” for the reader

Section, Which students contract COVID-19: This section points out that there is little relationship about the characteristics described in this paper with transmission across students, this demonstrates a major limitation of the work where there is no discussion about the variations across race/gender, if someone is working on or off campus or at all, apart of greek life and other sociodemographic markers as well. I understand the convenience of pulling the data but there are some serious generalization issues that are not addressed in the discussion section.

Discussion

As noted above this paper needs a limitation section; I would recommend discussing the inability to analyze occupation/socio-economic status, cost and resources need to do every day or every other day testing, inclusion of graduate students, professors or other on campus staff they’d encounter, and not including vaccinated folks in addition to the briefly mentioned limitations.

I am confused by lines 240-242, as a reader I am under the impression that all students are being tested every day regardless of symptoms but this line states that there were low numbers of test administered every day, so are they not really tested everyday? The statement is contrasting to the methods and my interpretation of how testing interventions work in your model.

Reviewer #2: An interesting article based on the real world school networks of students in the context of SARS-CoV2.Its provides insights on the contact patterns in an education setting in US and provides some take away points based on simulations. However there are few concerns which need to be addresses.

1) The author uses subjective reference (I found, I analysed etc) a lot through the text. I guess this would not be fit for this particular journals style.

2) Provide some background details ion the school setting based on which the network data was constructed. Why it was selected, the location, type of students , etc. Data quality obtained from there etc. How missing information were addressed. ethical compliance etc.

3) Provide details/references for parameters which were used for epidemiological transition (R0, Mask protection etc). Are they based on real work epidemiological studies or assumptions?

4) There is no reference towards the assumed frequency of students interaction or distance between them in the class room. These considerations into the parameters could be influencing. This is important considering the transmission differences based on interaction intensity and assumed distance between which in the context of SAR-CoV2

5) the authors says that larger path length reduces transmission and larger classes might result in more transmission. need more discussion and references on this. could this be discussed in detail based on other publications (Per Block, Nature Human Behaviour 4, 588-596 2020).

6) The authors could provide a more clearer network diagram. Rather than providing the whole network, a clique or component with larger and smaller path length could be shown. the present ones dont would hardly make sense for the reader

7) provide the practical implications of this more detailly and also the limitations of the method

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Reviewer #1: No

Reviewer #2: No

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Network assessment and modeling the management of an epidemic on a college campus with testing, contact tracing, and masking

PONE-D-21-17066R1

Dear Dr. Hartvigsen,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Siew Ann Cheong, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The revisions completed by the author have greatly improved not only the overall readability of the paper, but also have addressed the questions previously brought up. As we continue to learn more about SARS-CoV-2 and move through the COVID-19 pandemic and consistently changing mandates and guidelines from the CDC and local public health departments, information about masking, testing, quarantine and contact tracing efficiency will prove useful for colleges when deciding to implement protective health policies.

The addition and expansion of the limitation sections really strengthens the paper by address the questions that arose with the large scale roll out of vaccines, variations by demographic categories that we have seen in previous studies, and other short comings that cannot be addressed in modeling experiments.

I have minor suggestions about the grammatical structure of the paper as you will see below referenced via line number;

#2: Reframing to this demonstrate more that the information can be applicable to airborne infectious that was spurred on by the COVID-19 pandemic.

#21: "In this paper we explore..." can be changed to "This paper explores the..."

#119: Would rework this sentence to remove the term 'we'

#141: Remove "we can see that a"

#151: Remove "we can see that"

#219: Remove "In Fig 11 we can see" and put '(Fig 11)' after "subgraphs by major"

Reviewer #2: All my major comment has been addressed by the author. I have further no comments for this manuscript.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: Yes: KARIKALAN NAGARAJAN