Background The public and scientific discourse on how to mitigate the COVID-19 pandemic is often focused on the impact of individual protective measures, in particular on vaccination. In view of changing virus variants and conditions, however, it seems not clear if vaccination or any other protective measure alone may suffice to contain the transmission of SARS-CoV-2. Methods Here, we investigate the effectiveness and synergies of vaccination and non-pharmaceutical interventions like masking, distancing & ventilation, testing & isolation, and contact reduction as a function of compliance in the population. Our new analysis accounts for the practical compliance in the population and for both droplet transmission and aerosol transmission. Findings For realistic conditions, we find that it would be difficult to contain highly contagious SARS-CoV-2 variants by any individual measure. Instead, we show how multiple synergetic measures have to be combined to reduce the effective reproduction number (Re) below unity for different basic reproduction numbers ranging from the SARS-CoV-2 ancestral strain up to measles-like values (R0 = 3 to 18). For R0 = 5 as reported for the Delta variant and ~70% vaccination rate, the synergies of masking and distancing & ventilation with compliances around 30% appear sufficient to keep Re < 1. In combination with 2-3 tests per week, this would work also at lower vaccination rates, e.g., in schools. Interpretation If the Omicron variant were to reach R0 = 8, it could still be contained with the synergetic measures outlined above. In case of measles-like transmissibilities (R0 = 12 to 18), higher compliances and testing rates or additional measures like general contact reductions would be required. The presented findings and approach can be used to design and communicate efficient strategies for mitigating the COVID-19 pandemic. Funding Max Planck Society.
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