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COVID-19 长期疾病管理干预场景。

COVID-19 Intervention Scenarios for a Long-term Disease Management.

机构信息

Department of Geoinformatics - Z_GIS, University of Salzburg, Salzburg, Austria.

出版信息

Int J Health Policy Manag. 2020 Dec 1;9(12):508-516. doi: 10.34172/ijhpm.2020.130.

Abstract

BACKGROUND

The first outbreak of coronavirus disease 2019 (COVID-19) was successfully restrained in many countries around the world by means of a severe lockdown. Now, we are entering the second phase of the pandemics in which the spread of the virus needs to be contained within the limits that national health systems can cope with. This second phase of the epidemics is expected to last until a vaccination is available or herd immunity is reached. Long-term management strategies thus need to be developed.

METHODS

In this paper we present a new agent-based simulation model "COVID-19 ABM" with which we simulate 4 alternative scenarios for the second "new normality" phase that can help decision-makers to take adequate control and intervention measures.

RESULTS

The scenarios resulted in distinctly different outcomes. A continued lockdown could regionally eradicate the virus within a few months, whereas a relaxation back to 80% of former activity-levels was followed by a second outbreak. Contact-tracing as well as adaptive response strategies could keep COVID-19 within limits.

CONCLUSION

The main insights are that low-level voluntary use of tracing apps shows no relevant effects on containing the virus, whereas medium or high-level tracing allows maintaining a considerably higher level of social activity. Adaptive control strategies help in finding the level of least restrictions. A regional approach to adaptive management can further help in fine-tuning the response to regional dynamics and thus minimise negative economic effects.

摘要

背景

通过严格的封锁,世界上许多国家成功地遏制了新冠肺炎(COVID-19)的首次爆发。现在,我们正进入大流行的第二阶段,在此阶段,需要在国家卫生系统能够应对的范围内控制病毒的传播。预计第二阶段的大流行将持续到疫苗接种或群体免疫达到为止。因此,需要制定长期管理策略。

方法

在本文中,我们提出了一种新的基于代理的仿真模型“COVID-19 ABM”,我们可以用它来模拟第二阶段“新常态”的 4 种替代方案,这有助于决策者采取适当的控制和干预措施。

结果

不同的方案产生了明显不同的结果。在几个月内,持续的封锁可能会在局部地区消灭病毒,而放松到以前活动水平的 80%,则会导致第二次爆发。接触者追踪以及适应性反应策略可以将 COVID-19 控制在一定范围内。

结论

主要观点是,低水平自愿使用追踪应用程序对控制病毒没有明显效果,而中高水平的追踪则可以维持更高水平的社交活动。适应性控制策略有助于找到限制最小的水平。区域性的适应性管理方法可以进一步帮助调整对区域动态的响应,从而将对经济的负面影响降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0bd/7947653/e6df897e3fe5/ijhpm-9-508-g001.jpg

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