Seminar for Statistics, Department of Mathematics, ETH Zurich, Rämistrasse 101, 8092 Zurich, Switzerland; School of Public Health, Harvard University, Huntington Ave 677, Boston, MA 02115, United States.
Department of Medicine, Northwestern University Feinberg School of Medicine, 676 N St. Clair Street Arkes Pavilion, Chicago, IL 60611, United States.
Int J Infect Dis. 2021 Jul;108:309-319. doi: 10.1016/j.ijid.2021.04.029. Epub 2021 Apr 13.
While the role of contact tracing in the containment of the COVID-19 epidemic remains important until vaccines are widely available, literature on objectively measurable indicators for the effectiveness of contact tracing is scarce. We suggest the diagnostic serial interval, the time between the diagnosis of the infector and infectee, as a new indicator for the effectiveness of contact tracing.
Using an agent-based simulation model, we demonstrate how the diagnostic serial interval correlates with the course of the epidemic. We consider four scenarios of how diagnosis and subsequent isolation are triggered: 1. never, 2. by symptoms, 3. by symptoms and loose contact tracing, 4. by symptoms and tight contact tracing. We further refine scenarios 3 and 4 with different lengths of target diagnostic serial intervals.
Scenarios 1 and 2 did not yield a notable difference. In scenarios 3 and 4, however, contact tracing led to a decrease of the height of the epidemic as well as the cumulative proportion of infected agents. Generally, the shorter the diagnostic serial interval was, the smaller the peak of the epidemic became, and the more proportion of the population remained susceptible at the end of the epidemic.
A short target diagnosis interval is critical for contact tracing to be effective in the epidemic control. The diagnosis interval can be used to assess and guide the contact tracing strategy.
虽然接触者追踪在疫苗广泛使用之前对于控制 COVID-19 疫情仍然很重要,但关于接触者追踪有效性的客观可衡量指标的文献却很少。我们建议将诊断序列间隔(感染者和被感染者之间的诊断时间)作为接触者追踪有效性的新指标。
我们使用基于代理的模拟模型,展示了诊断序列间隔如何与疫情的发展相关。我们考虑了四种诊断和随后隔离触发的情况:1. 从不,2. 出现症状时,3. 出现症状和松散的接触者追踪时,4. 出现症状和严格的接触者追踪时。我们进一步细化了情景 3 和 4,使用不同长度的目标诊断序列间隔。
情景 1 和 2 没有产生显著差异。然而,在情景 3 和 4 中,接触者追踪导致疫情高峰期和感染人群的累积比例降低。一般来说,诊断序列间隔越短,疫情高峰期就越小,疫情结束时易感人群的比例就越大。
短的目标诊断间隔对于接触者追踪在疫情控制中的有效性至关重要。诊断间隔可用于评估和指导接触者追踪策略。