Applied Mathematics, University of Waterloo, Waterloo, Canada.
WeHealth Solutions PBC, University of Arizona, Tucson, AZ, USA.
J R Soc Interface. 2021 Sep;18(182):20210459. doi: 10.1098/rsif.2021.0459. Epub 2021 Sep 8.
Some infectious diseases, such as COVID-19 or the influenza pandemic of 1918, are so harmful that they justify broad-scale social distancing. Targeted quarantine can reduce the amount of indiscriminate social distancing needed to control transmission. Finding the optimal balance between targeted versus broad-scale policies can be operationalized by minimizing the total amount of social isolation needed to achieve a target reproductive number. Optimality is achieved by quarantining on the basis of a risk threshold that depends strongly on current disease prevalence, suggesting that very different disease control policies should be used at different times or places. Aggressive quarantine is warranted given low disease prevalence, while populations with a higher base rate of infection should rely more on social distancing by all. The total value of a quarantine policy rises as case counts fall, is relatively insensitive to vaccination unless the vaccinated are exempt from distancing policies, and is substantially increased by the availability of modestly more information about individual risk of infectiousness.
有些传染病，如 COVID-19 或 1918 年的流感大流行，危害极大，需要大规模的社会隔离。有针对性的隔离可以减少控制传播所需的无差别社会隔离的数量。通过将实现目标繁殖数所需的社会隔离总量最小化，可以实现针对目标的隔离与广泛隔离政策之间的最佳平衡。通过基于强烈依赖当前疾病流行率的风险阈值进行隔离来实现最优性，这表明在不同时间或地点应该使用非常不同的疾病控制政策。在疾病流行率较低的情况下，有理由采取严格的隔离措施，而感染基础率较高的人群应该更多地依靠所有人的社交距离。随着病例数的下降，隔离政策的总价值会上升，除非接种疫苗的人豁免隔离政策，否则疫苗接种的效果相对不敏感，并且通过获得更多关于个体传染性风险的适度信息，隔离政策的总价值会大大增加。
