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探访和群体隔离政策对保护养老院居民免受 COVID-19 传播的影响:基于代理的模型。

Impact of visitation and cohorting policies to shield residents from covid-19 spread in care homes: an agent-based model.

机构信息

Department of Management Science, Strathclyde Business School, University of Strathclyde, Glasgow, United Kingdom.

Department of Management Science, Strathclyde Business School, University of Strathclyde, Glasgow, United Kingdom.

出版信息

Am J Infect Control. 2021 Sep;49(9):1105-1112. doi: 10.1016/j.ajic.2021.07.001. Epub 2021 Jul 8.

Abstract

BACKGROUND

This study examines the impact of visitation and cohorting policies as well as the care home population size upon the spread of COVID-19 and the risk of outbreak occurrence in this setting.

METHODS

Agent-based modelling RESULTS: The likelihood of the presence of an outbreak in a care home is associated with the care home population size. Cohorting of residents and staff into smaller, self-contained units reduces the spread of COVID-19. Restricting the number of visitors to the care home to shield its residents does not significantly impact the cumulative number of infected residents and risk of outbreak occurrence in most scenarios. Only when the community prevalence where staff live is considerably lower than the prevalence where visitors live (the former prevalence is less than or equal to 30% of the latter), relaxing visitation increases predicted infections much more significantly than it does in other scenarios. Maintaining a low infection probability per resident-visitor contact helps reduce the effect of allowing more visitors into care homes.

CONCLUSIONS

Our model predictions suggest that cohorting is effective in controlling the spread of COVID-19 in care homes. However, according to predictions shielding residents in care homes is not as effective as predicted in a number of studies that have modelled shielding of vulnerable population in the wider communities.

摘要

背景

本研究考察了探视和分组政策以及养老院人口规模对 COVID-19 在该环境中的传播和爆发风险的影响。

方法

基于代理的建模。

结果

养老院中爆发的可能性与养老院的人口规模有关。将居民和工作人员分组到更小的、独立的单元中,可以减少 COVID-19 的传播。将进入养老院的访客人数限制在一定数量,以保护其居民,在大多数情况下不会显著影响受感染居民的累积数量和爆发风险。只有当工作人员居住的社区流行率明显低于访客居住的流行率(前者流行率低于或等于后者流行率的 30%)时,放宽探视限制才会比其他情况下更显著地增加预测感染人数。保持每个居民-访客接触的低感染概率有助于降低允许更多访客进入养老院的影响。

结论

我们的模型预测表明,分组对于控制养老院 COVID-19 的传播是有效的。然而,根据预测,在养老院中保护居民的效果不如在许多对更广泛社区中弱势群体进行屏蔽建模的研究中预测的那么有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a8/8264278/216ab8af72ff/gr1_lrg.jpg

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