Yang Haoxiang, Sürer Özge, Duque Daniel, Morton David P, Singh Bismark, Fox Spencer J, Pasco Remy, Pierce Kelly, Rathouz Paul, Valencia Victoria, Du Zhanwei, Pignone Michael, Escott Mark E, Adler Stephen I, Johnston S Claiborne, Meyers Lauren Ancel
Los Alamos National Laboratory, Los Alamos, NM, USA.
Industrial Engineering and Management Sciences, Northwestern University, Evanston, IL, USA.
Nat Commun. 2021 Jun 18;12(1):3767. doi: 10.1038/s41467-021-23989-x.
Community mitigation strategies to combat COVID-19, ranging from healthy hygiene to shelter-in-place orders, exact substantial socioeconomic costs. Judicious implementation and relaxation of restrictions amplify their public health benefits while reducing costs. We derive optimal strategies for toggling between mitigation stages using daily COVID-19 hospital admissions. With public compliance, the policy triggers ensure adequate intensive care unit capacity with high probability while minimizing the duration of strict mitigation measures. In comparison, we show that other sensible COVID-19 staging policies, including France's ICU-based thresholds and a widely adopted indicator for reopening schools and businesses, require overly restrictive measures or trigger strict stages too late to avert catastrophic surges. As proof-of-concept, we describe the optimization and maintenance of the staged alert system that has guided COVID-19 policy in a large US city (Austin, Texas) since May 2020. As cities worldwide face future pandemic waves, our findings provide a robust strategy for tracking COVID-19 hospital admissions as an early indicator of hospital surges and enacting staged measures to ensure integrity of the health system, safety of the health workforce, and public confidence.
应对新冠疫情的社区缓解策略，从保持良好卫生习惯到就地避难令，都需要付出巨大的社会经济成本。明智地实施和放宽限制措施，既能增强其公共卫生效益，又能降低成本。我们利用每日新冠住院人数推导出在缓解阶段之间切换的最优策略。在公众配合的情况下，该政策触发机制能大概率确保有足够的重症监护病房容量，同时尽量缩短严格缓解措施的持续时间。相比之下，我们发现，其他合理的新冠疫情分级政策，包括法国基于重症监护病房的阈值以及一种广泛采用的学校和企业重新开放指标，要么需要采取过度严格的措施，要么触发严格阶段过晚，无法避免灾难性的激增。作为概念验证，我们描述了自2020年5月以来指导美国一个大城市（德克萨斯州奥斯汀）新冠疫情政策的分级警报系统的优化和维护。随着全球各城市面临未来的疫情浪潮，我们的研究结果提供了一个强有力的策略，即追踪新冠住院人数作为医院激增的早期指标，并实施分级措施，以确保卫生系统的完整性、医护人员的安全以及公众信心。
