Limited efficacy of forward contact tracing in epidemics

Abstract: Infectious diseases that spread silently through asymptomatic or pre-symptomatic infections represent a challenge for policy makers. A traditional way of achieving isolation of silent infectors from the community is through forward contact tracing, aiming at identifying individuals that might have been infected by a known infected person. In this work we investigate how efficient this measure is in preventing a disease from becoming endemic. We introduce an SIS-based compartmental model where symptomatic individuals may self-isolate and trigger a contact tracing process aimed at quarantining asymptomatic infected individuals. Imperfect adherence and delays affect both measures. We derive the epidemic threshold analytically and find that contact tracing alone can only lead to a very limited increase of the threshold. We quantify the effect of imperfect adherence and the impact of incentivizing asymptomatic and symptomatic populations to adhere to isolation. Our analytical results are confirmed by simulations on complex networks and by the numerical analysis of a much more complex model incorporating more realistic in-host disease progression.