中国大陆 COVID-19 的传播模式及不同防控策略的效果：基于数据和模型的研究。
Transmission patterns of COVID-19 in the mainland of China and the efficacy of different control strategies: a data- and model-driven study.
机构信息
School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, 710049, China.
National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China.
出版信息
Infect Dis Poverty. 2020 Jul 6;9(1):83. doi: 10.1186/s40249-020-00709-z.
BACKGROUND
The coronavirus disease 2019 (COVID-19) outbreak has seriously endangered the health and lives of Chinese people. In this study, we predicted the COVID-19 epidemic trend and estimated the efficacy of several intervention strategies in the mainland of China.
METHODS
According to the COVID-19 epidemic status, we constructed a compartmental model. Based on reported data from the National Health Commission of People's Republic of China during January 10-February 17, 2020, we estimated the model parameters. We then predicted the epidemic trend and transmission risk of COVID-19. Using a sensitivity analysis method, we estimated the efficacy of several intervention strategies.
RESULTS
The cumulative number of confirmed cases in the mainland of China will be 86 763 (95% CI: 86 067-87 460) on May 2, 2020. Up until March 15, 2020, the case fatality rate increased to 6.42% (95% CI: 6.16-6.68%). On February 23, 2020, the existing confirmed cases reached its peak, with 60 890 cases (95% CI: 60 350-61 431). On January 23, 2020, the effective reproduction number was 2.620 (95% CI: 2.567-2.676) and had dropped below 1.0 since February 5, 2020. Due to governmental intervention, the total number of confirmed cases was reduced by 99.85% on May 2, 2020. Had the isolation been relaxed from February 24, 2020, there might have been a second peak of infection. However, relaxing the isolation after March 16, 2020 greatly reduced the number of existing confirmed cases and deaths. The total number of confirmed cases and deaths would increase by 8.72 and 9.44%, respectively, due to a 1-day delayed diagnosis in non-isolated infected patients. Moreover, if the coverage of close contact tracing was increased to 100%, the cumulative number of confirmed cases would be decreased by 88.26% on May 2, 2020.
CONCLUSIONS
The quarantine measures adopted by the Chinese government since January 23, 2020 were necessary and effective. Postponing the relaxation of isolation, early diagnosis, patient isolation, broad close-contact tracing, and strict monitoring of infected persons could effectively control the COVID-19 epidemic. April 1, 2020 would be a reasonable date to lift quarantine in Hubei and Wuhan.
背景
2019 年冠状病毒病（COVID-19）疫情严重威胁中国人民的健康和生命。本研究预测了中国内地 COVID-19 的流行趋势，并评估了几种干预策略的效果。
方法
根据 COVID-19 疫情状况，构建了一个房室模型。基于 2020 年 1 月 10 日至 2 月 17 日国家卫生健康委员会报告的数据，估计了模型参数。然后预测 COVID-19 的流行趋势和传播风险。采用敏感性分析方法，估计了几种干预策略的效果。
结果
2020 年 5 月 2 日，中国内地累计确诊病例数为 86763 例（95%可信区间：86067 至 87460）。截至 2020 年 3 月 15 日，病死率上升至 6.42%（95%可信区间：6.16%至 6.68%）。2020 年 2 月 23 日，现有确诊病例数达到峰值，为 60890 例（95%可信区间：60350 至 61431）。2020 年 1 月 23 日，有效繁殖数为 2.620（95%可信区间：2.567 至 2.676），自 2020 年 2 月 5 日以来已降至 1.0 以下。由于政府干预，2020 年 5 月 2 日，累计确诊病例数减少了 99.85%。如果 2020 年 2 月 24 日放松隔离，可能会出现第二次感染高峰。然而，3 月 16 日之后放松隔离会大大减少现有确诊病例和死亡人数。如果延迟对非隔离感染患者 1 天进行诊断，确诊病例和死亡人数将分别增加 8.72%和 9.44%。此外，如果密切接触者追踪的覆盖面增加到 100%，2020 年 5 月 2 日，累计确诊病例数将减少 88.26%。
结论
自 2020 年 1 月 23 日以来，中国政府采取的隔离措施是必要和有效的。推迟隔离放松、早期诊断、患者隔离、广泛的密切接触者追踪以及对感染者的严格监测，可以有效控制 COVID-19 疫情。2020 年 4 月 1 日可能是解除湖北和武汉隔离的合理日期。
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