Number needed to isolate - a new population health metric to quantify transmission reductions from isolation interventions for infectious diseases.

Background: We have previously developed and reported on a procedure for estimating the purported benefits of immunity mandates using a novel variant of the number needed to treat (NNT) which we called the number needed to isolate (NNI). Here we demonstrate its broader properties as a useful population health metric.

Main Body: The NNI is analogous to the number needed to treat (NNT = 1/ARR), except the absolute risk reduction (ARR) is the absolute transmission risk in a specific population. The NNI is the number of susceptible hosts in a population who need to be isolated to prevent one transmission event from them. The properties and utility of the NNI were modeled using simulated data and its model predictions were validated using real world data. The properties of the NNI are described for three categories of data from a previous study on transmissibility of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): (1) in different settings, (2) after a specific exposure and (3) depending on symptomaticity status of susceptible hosts.

Conclusions: We provide a demonstration of the utility of the NNI as a valuable population health metric to quantify the transmission reductions from isolation interventions.