In 2019, our competitive renewal for our NIDA-funded work on opioids, HIV, and HCV was funded with a
MERIT award. In this supplement to our MERIT grant, we will address pressing issues in vulnerable
populations at risk from SARS-CoV-2. We will adapt the modeling frameworks we have developed to
address how best to protect vulnerable populations from COVID-19, including people who inject drugs
(PWID), people who are incarcerated, and people in other vulnerable settings, including long-term care
facilities, and schools. We will address strategies to protect vulnerable populations, including physical
distancing measures, scaled-up and targeted testing and tracing, and strategic deployment of new
technological innovations in diagnostics, therapeutics and vaccines as they arise. Our aims are to:
1. Model the intersecting epidemics of SARS-CoV-2, HIV and HCV in opioid-using and related
vulnerable populations. We will extend our foundational epidemic models of HIV and HCV to include SARS-
CoV-2. Doing so enables us to analyze the impacts of strategies in Aims 2 and 3.
2. Model the epidemiologic and population health impacts of currently available strategies to prevent
and mitigate the harms from transmission of SARS-CoV-2 in vulnerable populations. We will evaluate
prevention strategies involving physical distancing and intensive testing programs for vulnerable populations.
We will assess the impact of strategies on epidemiologic outcomes including incidence, prevalence, mortality,
life expectancy, quality of life, and quality-adjusted life years (QALYs).
3. Model the epidemiologic and population health impacts of future strategies, including improved
therapeutics and vaccines, to prevent and mitigate the harms from transmission of SARS-CoV-2 in
populations of interest. Because no single and sustainable strategy based on currently available
technologies will likely have sufficient impact on reducing risks of continuing SARS-CoV-2 transmission, we will
examine selected key strategies based on technologies that may become available in the next 18 months,
particularly the use of a partially effective vaccine.
The proposed work will synergistically expand on our current project and provide clinicians and policymakers
with critically needed guidance about which strategies can most efficiently mitigate the national public health
crisis from COVID-19 in vulnerable populations and settings.