Killeen Gerry F, Kiware Samson S
Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Ifakara, Morogoro, United Republic of Tanzania.
School of Biological, Earth & Environmental Sciences and Environmental Research Institute, University College Cork, Ireland.
Infect Dis Model. 2020 Jul 3;5:442-458. doi: 10.1016/j.idm.2020.06.006. eCollection 2020.
As every country in the world struggles with the ongoing COVID-19 pandemic, it is essential that as many people as possible understand the epidemic containment, elimination and exclusion strategies required to tackle it. Simplified arithmetic models of COVID-19 transmission, control and elimination are presented in user-friendly Shiny and Excel formats that allow non-specialists to explore, query, critique and understand the containment decisions facing their country and the world at large. Although the predictive model is broadly applicable, the simulations presented are based on parameter values representative of the United Republic of Tanzania, which is still early enough in its epidemic cycle and response to avert a national catastrophe. The predictions of these models illustrate (1) why ambitious lock-down interventions to represent the only realistic way for individual countries to contain their national-level epidemics before they turn into outright catastrophes, (2) why these need to be implemented so early, so stringently and for such extended periods, (3) why high prevalence of other pathogens causing similar symptoms to mild COVID-19 precludes the use of contact tracing as a substitute for lock down interventions to contain and eliminate epidemics, (4) why partial containment strategies intended to merely , by maintaining epidemics at manageably low levels, are grossly unrealistic, and (5) why local elimination may only be sustained after lock down ends if imported cases are comprehensively excluded, so international co-operation to conditionally re-open trade and travel between countries certified as free of COVID-19 represents the best strategy for motivating progress towards pandemic eradication at global level. The three sequential goals that every country needs to emphatically embrace are , and . As recently emphasized by the World Health Organization, success will require widespread and unprecedented .
由于世界上每个国家都在与持续的新冠疫情作斗争，让尽可能多的人了解应对疫情所需的防控、消除和排除策略至关重要。以用户友好的Shiny和Excel格式呈现了新冠病毒传播、控制和消除的简化算术模型，使非专业人员能够探索、查询、批评和理解其国家乃至整个世界面临的防控决策。尽管该预测模型具有广泛适用性，但所展示的模拟是基于代表坦桑尼亚联合共和国的参数值，该国在疫情周期和应对方面仍处于足够早期阶段，足以避免一场全国性灾难。这些模型的预测表明：（1）为何雄心勃勃的封锁干预是个别国家在疫情演变为彻底灾难之前控制本国疫情的唯一现实途径；（2）为何这些干预需要尽早、严格且长期实施；（3）为何其他导致与轻症新冠相似症状的病原体高流行率使得无法将接触者追踪作为替代封锁干预措施来控制和消除疫情；（4）为何旨在仅仅通过将疫情维持在可控低水平的部分防控策略极其不现实；（5）为何只有在全面排除输入病例后，封锁结束后局部消除才能持续，因此国际合作有条件地重新开放经认证无新冠病毒国家之间的贸易和旅行是推动全球层面根除疫情取得进展的最佳策略。每个国家都需要着重接受的三个相继目标是 、 和 。正如世界卫生组织最近所强调的，成功将需要广泛的 和前所未有的 。
