Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Mathematics, Yonsei University, Seoul, Republic of Korea.
PLoS One. 2020 Oct 26;15(10):e0241169. doi: 10.1371/journal.pone.0241169. eCollection 2020.
Novel coronavirus (named SARS-CoV-2) can spread widely in confined settings including hospitals, cruise ships, prisons, and places of worship. In particular, a healthcare-associated outbreak could become the epicenter of coronavirus disease (COVID-19). This study aimed to evaluate the effects of different intervention strategies on the hospital outbreak within a tertiary hospital. A mathematical model was developed for the COVID-19 transmission within a 2500-bed tertiary hospital of South Korea. The SEIR (susceptible-exposed-infectious-recovered) model with a compartment of doctor, nurse, patient, and caregiver was constructed. The effects of different intervention strategies such as front door screening, quarantine unit for newly admitted patients, early testing of suspected infected people, and personal protective equipment for both medical staff and visitors were evaluated. The model suggested that the early testing (within eight hours) of infected cases and monitoring the quarantine ward for newly hospitalized patients are effective measures for decreasing the incidence of COVID-19 within a hospital (81.3% and 70% decrease of number of incident cases, respectively, during 60 days). Front door screening for detecting suspected cases had only 42% effectiveness. Screening for prohibiting the admission of COVID-19 patients was more effective than the measures for patients before emergency room or outpatient clinic. This model suggests that under the assumed conditions, some effective measures have a great influence on the incidence of COVID-19 within a hospital. The implementation of the preventive measures could reduce the size of a hospital outbreak.
新型冠状病毒（命名为 SARS-CoV-2）可在包括医院、游轮、监狱和礼拜场所等密闭环境中广泛传播。特别是，与医疗保健相关的疫情可能成为冠状病毒病（COVID-19）的中心。本研究旨在评估不同干预策略对一家三级医院内医院疫情爆发的影响。我们为韩国一家 2500 床位的三级医院内的 COVID-19 传播建立了一个数学模型。该模型采用了 SEIR（易感-暴露-感染-恢复）模型，设有医生、护士、患者和护理人员等不同隔间。评估了不同干预策略的效果，如正门筛查、新入院患者隔离区、疑似感染者的早期检测以及医护人员和访客的个人防护设备。该模型表明，早期检测（八小时内）感染者和监测新住院患者的隔离病房是减少医院内 COVID-19 发病率的有效措施（在 60 天内，感染病例数分别减少 81.3%和 70%）。对疑似病例的正门筛查仅有效 42%。筛查以禁止 COVID-19 患者入院的措施比急诊室或门诊患者的措施更有效。该模型表明，在假设条件下，一些有效措施对医院内 COVID-19 的发病率有重大影响。预防措施的实施可以减少医院疫情的规模。
