UCL Institute for Global Health, London, UK.
UCL Institute for Global Health, London, UK.
J Infect. 2020 Aug;81(2):260-265. doi: 10.1016/j.jinf.2020.05.037. Epub 2020 May 24.
To use mathematical models to predict the epidemiological impact of lifting the lockdown in London, UK, and alternative strategies to help inform policy in the UK.
A mathematical model for the transmission of SARS-CoV2 in London. The model was parametrised using data on notified cases, deaths, contacts, and mobility to analyse the epidemic in the UK capital. We investigated the impact of multiple non pharmaceutical interventions (NPIs) and combinations of these measures on future incidence of COVID-19.
Immediate action at the early stages of an epidemic in the affected districts would have tackled spread. While an extended lockdown is highly effective, other measures such as shielding older populations, universal testing and facemasks can all potentially contribute to a reduction of infections and deaths. However, based on current evidence it seems unlikely they will be as effective as continued lockdown. In order to achieve elimination and lift lockdown within 5 months, the best strategy seems to be a combination of weekly universal testing, contact tracing and use of facemasks, with concurrent lockdown. This approach could potentially reduce deaths by 48% compared with continued lockdown alone.
A combination of NPIs such as universal testing, contact tracing and mask use while under lockdown would be associated with least deaths and infections. This approach would require high uptake and sustained local effort but it is potentially feasible as may lead to elimination in a relatively short time scale.
利用数学模型预测英国伦敦解除封锁的流行病学影响,以及帮助英国制定政策的替代策略。
建立了一个用于伦敦地区 SARS-CoV2 传播的数学模型。该模型使用了关于已报告病例、死亡、接触和流动性的数据进行参数化,以分析英国首都的疫情。我们研究了多种非药物干预措施(NPIs)及其组合对 COVID-19 未来发病率的影响。
在受影响地区的疫情早期阶段采取紧急行动将有助于控制传播。虽然延长封锁非常有效,但其他措施,如保护老年人、全民检测和戴口罩,都有可能减少感染和死亡人数。然而,根据目前的证据,它们似乎不太可能像持续封锁那样有效。为了在 5 个月内实现消除并解除封锁,最佳策略似乎是每周进行全民检测、接触者追踪和使用口罩,并同时进行封锁。这种方法可能会使死亡人数减少 48%,而单独持续封锁只会减少 26%。
在封锁期间结合全民检测、接触者追踪和戴口罩等 NPI,可以将死亡和感染人数降到最低。这种方法需要高参与度和持续的地方努力,但由于可能会在相对较短的时间内实现消除,因此具有潜在的可行性。