Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA; Princeton School of Public and International Affairs, Princeton University, Princeton, USA.
Institut Pasteur de Madagascar, Antananarivo, Madagascar.
Epidemics. 2021 Dec;37:100507. doi: 10.1016/j.epidem.2021.100507. Epub 2021 Nov 17.
When a novel pathogen emerges there may be opportunities to eliminate transmission - locally or globally - whilst case numbers are low. However, the effort required to push a disease to elimination may come at a vast cost at a time when uncertainty is high. Models currently inform policy discussions on this question, but there are a number of open challenges, particularly given unknown aspects of the pathogen biology, the effectiveness and feasibility of interventions, and the intersecting political, economic, sociological and behavioural complexities for a novel pathogen. In this overview, we detail how models might identify directions for better leveraging or expanding the scope of data available on the pathogen trajectory, for bounding the theoretical context of emergence relative to prospects for elimination, and for framing the larger economic, behavioural and social context that will influence policy decisions and the pathogen's outcome.
当一种新病原体出现时，可能有机会在病例数量较少的情况下在局部或全球范围内消除传播。然而，在高度不确定的时期，将疾病推向消除所需要的努力可能会付出巨大的代价。目前，模型为这一问题的政策讨论提供了信息，但存在许多悬而未决的挑战，特别是考虑到病原体生物学的未知方面、干预措施的有效性和可行性，以及新病原体在政治、经济、社会学和行为方面的复杂交叉。在这篇综述中，我们详细说明了模型如何确定更好地利用或扩大现有病原体轨迹数据的范围的方向，确定相对于消除前景的出现理论背景，以及构建影响政策决策和病原体结果的更大的经济、行为和社会背景。
