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中国基于情景的新型冠状病毒肺炎相关基本临床资源需求评估

A Scenario-Based Evaluation of COVID-19-Related Essential Clinical Resource Demands in China.

作者信息

Zhang Ting, Wang Qing, Leng Zhiwei, Yang Yuan, Yang Jin, Chen Fangyuan, Jia Mengmeng, Zhang Xingxing, Qi Weiran, Xu Yunshao, Chen Siya, Dai Peixi, Ma Libing, Feng Luzhao, Yang Weizhong

机构信息

School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

Division of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

出版信息

Engineering (Beijing). 2021 Jul;7(7):948-957. doi: 10.1016/j.eng.2021.03.020. Epub 2021 May 21.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is a global crisis, and medical systems in many countries are overwhelmed with supply shortages and increasing demands to treat patients due to the surge in cases and severe illnesses. This study aimed to assess COVID-19-related essential clinical resource demands in China, based on different scenarios involving COVID-19 spreads and interventions. We used a susceptible-exposed-infectious-hospitalized/isolated-removed (SEIHR) transmission dynamics model to estimate the number of COVID-19 infections and hospitalizations with corresponding essential healthcare resources needed. We found that, under strict non-pharmaceutical interventions (NPIs) or mass vaccination of the population, China would be able to contain community transmission and local outbreaks rapidly. However, under scenarios involving a low intensity of implemented NPIs and a small proportion of the population vaccinated, the use of a peacetime-wartime transition model would be needed for medical source stockpiles and preparations to ensure a normal functioning healthcare system. The implementation of COVID-19 vaccines and NPIs in different periods can influence the transmission of COVID-19 and subsequently affect the demand for clinical diagnosis and treatment. An increased proportion of asymptomatic infections in simulations will not reduce the demand for medical resources; however, attention must be paid to the increasing difficulty in containing COVID-19 transmission due to asymptomatic cases. This study provides evidence for emergency preparations and the adjustment of prevention and control strategies during the COVID-19 pandemic. It also provides guidance for essential healthcare investment and resource allocation.

摘要

2019年冠状病毒病(COVID-19)大流行是一场全球危机,许多国家的医疗系统因病例激增和重症患者数量增加而不堪重负,面临供应短缺和治疗需求不断上升的问题。本研究旨在基于COVID-19传播和干预的不同情景,评估中国与COVID-19相关的基本临床资源需求。我们使用易感-暴露-感染-住院/隔离-康复(SEIHR)传播动力学模型来估计COVID-19感染和住院人数以及所需的相应基本医疗资源。我们发现,在严格的非药物干预(NPIs)或全民大规模疫苗接种的情况下,中国将能够迅速遏制社区传播和局部疫情爆发。然而,在实施NPIs强度较低且接种疫苗人口比例较小的情景下,需要采用平时-战时过渡模式进行医疗资源储备和准备,以确保医疗系统正常运转。不同时期实施COVID-19疫苗和NPIs会影响COVID-19的传播,进而影响临床诊断和治疗需求。模拟中无症状感染比例增加并不会降低医疗资源需求;然而,必须注意由于无症状病例导致控制COVID-19传播的难度增加。本研究为COVID-19大流行期间的应急准备和防控策略调整提供了证据。它还为基本医疗保健投资和资源分配提供了指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcef/8137347/3f88109e32c5/gr1_lrg.jpg

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