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用于识别 COVID-19 大流行缓解策略的动态建模。

Dynamic modelling to identify mitigation strategies for the COVID-19 pandemic.

机构信息

Laboratory of Multiscale Studies in Building Physics, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzer-land.

Department of Health Sciences and Technology, Swiss Federal Institute of Technology, Zurich, Switzerland.

出版信息

Swiss Med Wkly. 2021 May 4;151:w20487. doi: 10.4414/smw.2021.20487. eCollection 2021 Apr 26.

Abstract

Relevant pandemic-spread scenario simulations can provide guiding principles for containment and mitigation policies. We devised a compartmental model to predict the effectiveness of different mitigation strategies with a main focus on mass testing. The model consists of a set of simple differential equations considering the population size, reported and unreported infections, reported and unreported recoveries, and the number of COVID-19-inflicted deaths. We assumed that COVID-19 survivors are immune (e.g., mutations are not considered) and that the virus is primarily passed on by asymptomatic and pre-symptomatic individuals. Moreover, the current version of the model does not account for age-dependent differences in the death rates, but considers higher mortality rates due to temporary shortage of intensive care units. The model parameters have been chosen in a plausible range based on information found in the literature, but it is easily adaptable, i.e., these values can be replaced by updated information any time. We compared infection rates, the total number of people getting infected and the number of deaths in different scenarios. Social distancing or mass testing can contain or drastically reduce the infections and the predicted number of deaths when compared with a situation without mitigation. We found that mass testing alone and subsequent isolation of detected cases can be an effective mitigation strategy, alone and in combination with social distancing. It is of high practical relevance that a relationship between testing frequency and the effective reproduction number of the virus can be provided. However, unless one assumes that the virus can be globally defeated by reducing the number of infected persons to zero, testing must be upheld, albeit at reduced intensity, to prevent subsequent waves of infection. The model suggests that testing strategies can be equally effective as social distancing, though at much lower economic costs. We discuss how our mathematical model may help to devise an optimal mix of mitigation strategies against the COVID-19 pandemic. Moreover, we quantify the theoretical limit of contact tracing and by how much the effect of testing is enhanced, if applied to sub-populations with increased exposure risk or prevalence.

摘要

相关的大流行传播情景模拟可以为控制和缓解政策提供指导原则。我们设计了一个房室模型,主要关注大规模检测,以预测不同缓解策略的有效性。该模型由一组简单的微分方程组成,考虑了人口规模、报告和未报告的感染、报告和未报告的康复以及 COVID-19 造成的死亡人数。我们假设 COVID-19 幸存者具有免疫力(例如,不考虑突变),并且病毒主要通过无症状和症状前个体传播。此外,当前版本的模型不考虑死亡率随年龄的差异,但考虑到由于重症监护病房暂时短缺而导致的更高死亡率。模型参数是根据文献中发现的信息在合理范围内选择的,但它很容易适应,即这些值可以随时用最新信息替换。我们比较了不同情景下的感染率、总感染人数和死亡人数。与没有缓解措施的情况相比,社交距离或大规模检测可以控制或大大减少感染和预测的死亡人数。我们发现,单独进行大规模检测并随后隔离发现的病例,以及与社交距离相结合,是一种有效的缓解策略。重要的是,可以提供检测频率与病毒有效繁殖数之间的关系。然而,除非假设通过将感染者人数减少到零来全球击败病毒,否则必须进行检测,尽管检测强度降低,以防止随后的感染浪潮。该模型表明,检测策略与社交距离同样有效,尽管经济成本要低得多。我们讨论了我们的数学模型如何帮助设计针对 COVID-19 大流行的最佳缓解策略组合。此外,我们量化了接触者追踪的理论限制,以及如果将其应用于暴露风险或患病率增加的亚人群,检测的效果会增强多少。

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