Epidemiological control measures and predicted number of infections for SARS-CoV-2 pandemic: case study Serbia march-april 2020

Background: In this paper, we are studying the response of the Serbian government and health authorities to the SARS-CoV-2 pandemic in the early stage of the local outbreak between Mar. 15 th and Apr. 15 th , 2020 by pre- dictive numerical models. Such a study should be helpful to access the effectiveness of measures conducted to suppress the pandemic at a local scale. Methods: We have performed extrapolation of the number of SARS-CoV-2 infections with the first stable set of data exploiting exponential growth (linear in logarithmic scale). Based on obtained coef ficients it is performed pre- diction of a number of cases until the end of March. After initial exponential growth, we have changed predictive model to the generalized gamma function. Obtained results are compared with the number of infections and the prediction for the remainder of the outbreak is given. Findings: We have found that the daily growth rate was above 21.5% at the beginning of the period, increased slightly after the introduction of the State of Emergency and the first set of strict epidemical control measures. It took about 13 days after the first set of strict measures to smooth daily growth. It seems that early government measures had an only moderate impact to reduce growth due to the social behavior of citizens and in flux of diaspora returning to Serbia from highly affected areas, i.e., the exponential growth of infected persons is kept but with a reduced slope of about 14 -15%. Anyway, it is demonstrated that period required that any measure has effect is up to 15 days after introduction, firstly to exponential growth with a smaller rate and after to smooth function representing the number of infected persons below exponential growth rate. Conclusions: Obtained results are consistent with findings from other countries, i.e., initial exponential growth slows down within the presumed incubation period of 2 weeks after adopting lockdown and other non - pharmaceutical epidemiological measures. However, it is also shown that the exponential growth can continue after this period with a smaller slope. Therefore, quarantine and other social distancing measures should be adopted as soon as possible in a case of any similar outbreak since alternatives mean prolonged epidemical sit- uation and growing costs in human life, pressure on the health system, economy, etc. For modeling the remainder of the outbreak generalized gamma function is used showing accurate results but requiring more samples and pre- processing (data filtering) concerning exponential part of the outbreak. We have estimated the number of infected persons for the remaining part of the outbreak until the end of June.