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[意大利中部托斯卡纳地区新冠病毒疫情分析与未来情景]

[Analysis and future scenarios of the SARS-CoV-2 epidemic in Tuscany Region (Central Italy)].

作者信息

Cereda Giulia, Viscardi Cecilia, Gottard Anna, Mealli Fabrizia, Baccini Michela

机构信息

Florence Center for Data Scienze, Università di Firenze.

Dipartimento di statistica, informatica, applicazioni (DISIA), Università di Firenze.

出版信息

Epidemiol Prev. 2020 Sep-Dec;44(5-6 Suppl 2):120-127. doi: 10.19191/EP20.5-6.S2.110.

Abstract

OBJECTIVES

about two months after the end of the lockdown imposed for the containment of the SARS-CoV-2 epidemic, the contagion dynamics in the Tuscany Region (Central Italy) have been assessed from the beginning of the emergency to the end of June through a compartmental model, and future medium-long term projections have been produced.

DATA AND METHODS

this study used a SIRD model in which the infection reproduction number R0 varied over time, according to a piecewise constant function. The fatality parameter and the time from contagion to infection resolution (death or recovery) were fixed to ensure parameter identifiability, and the model was calibrated on the Covid-19 deaths notified from March 9th to June 30th 2020. The uncertainty around the estimates was quantified through parametric bootstrap. Finally, the resulting model was used to produce medium-long term projections of the epidemic dynamics.

RESULTS

the date of the first infection in Tuscany was estimated as February 21st 2020. The value of R0(t) ranged from 7.78 (95%CI 7.55-7.89), at the beginning of the outbreak, to a value very close to 0 between April 27th and May 17th. Finally, R0(t) rose, reaching an average of 0.66 (0.32, 0.88) between May 18th and June 30th. At the epidemic peak, estimated at the beginning of April, the notified infected people circulating in the region were just 22% of those predicted by the model. According to the estimated SIRD, under the hypothetical scenario that R0(t) slightly exceeds 1 from the beginning of October 2020, a new wave of contagion could arise by next spring.

CONCLUSIONS

the estimated trend of R0(t) is suggestive of a strong effect of the lockdown in Tuscany and of a mild increase of the contagion potentially attributable to the easing of the containment measures. Medium-long term projections unequivocally indicate that the danger of a new epidemic wave has not been averted.

摘要

目的

在为遏制SARS-CoV-2疫情而实施的封锁结束约两个月后,通过一个 compartments 模型评估了托斯卡纳地区(意大利中部)从紧急情况开始到6月底的传染动态,并做出了未来中长期预测。

数据与方法

本研究使用了一个SIRD模型,其中感染繁殖数R0随时间变化,根据分段常数函数变化。固定致死率参数和从传染到感染解决(死亡或康复)的时间以确保参数可识别性,并根据2020年3月9日至6月30日通报的新冠肺炎死亡病例对模型进行校准。通过参数自助法对估计值周围的不确定性进行量化。最后,使用所得模型对疫情动态进行中长期预测。

结果

托斯卡纳首次感染日期估计为2020年2月21日。R0(t)的值从疫情开始时的7.78(95%置信区间7.55 - 7.89),到4月27日至5月17日之间非常接近0的值。最后,R0(t)上升,在5月18日至6月30日期间平均达到0.66(0.32,0.88)。在4月初估计的疫情高峰时该地区通报的感染人数仅为模型预测人数的22%。根据估计的SIRD模型,在假设R0(t)从2020年10月初开始略超过1的情况下,明年春天可能会出现新一轮传染。

结论

R0(t)的估计趋势表明托斯卡纳的封锁措施效果显著,以及由于遏制措施放松可能导致传染略有增加。中长期预测明确表明新一波疫情的危险尚未消除。

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