Vo MyVan, Glasser Joshua A, Feng Zhilan
Department of Mathematics, Purdue University, West Lafayette, IN 47907, USA.
Department of Emergency Medicine, and Department of Pediatrics, Penn State School of Medicine, 500 University Drive, Hershey PA 17033, USA.
R Soc Open Sci. 2021 Nov 24;8(11):210823. doi: 10.1098/rsos.210823. eCollection 2021 Nov.
We consider a model that distinguishes susceptible; infected, but not yet infectious; pre-symptomatic, symptomatic, asymptomatic, and hospitalized infectious; recovered and dead members of two groups: healthcare workers (HCW) and members of the community that they serve. Because of the frequency or duration of their exposures to SARS-CoV-2, a greater fraction of HCW would experience severe COVID-19 symptoms that require medical care, which reduces mortality rates, absent personal protective equipment (PPE). While N95 masks (and, possibly, other scarce medical resources) are available to members of both groups, they do not use them equally well (i.e. efficacy and compliance differ). We investigated the optimal allocation of potentially scarce medical resources between these groups to control the pandemic and reduce overall infections and mortality via derivation and analysis of expressions for the reproduction numbers and final size. We also simulated prevalence and cumulative incidence, quantities relevant to surge capacity and population immunity, respectively. We found that, under realistic conditions, the optimal allocation is virtually or entirely to HCW, but that allocation of surplus masks and other medical resources to members of the general community also reduces infections and deaths.
我们考虑一个模型，该模型区分了两组人员：医护人员（HCW）以及他们所服务社区的成员，其中每组人员又分为易感者、已感染但尚未具有传染性者、症状出现前、有症状、无症状以及住院的感染者、康复者和死亡者。由于医护人员接触严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的频率或时长，在缺乏个人防护装备（PPE）的情况下，更大比例的医护人员会出现需要医疗护理的严重冠状病毒病2019（COVID-19）症状，这降低了死亡率。虽然两组人员都能获得N95口罩（以及可能的其他稀缺医疗资源），但他们使用这些资源的效果并不相同（即有效性和依从性存在差异）。我们通过推导和分析繁殖数及最终规模的表达式，研究了在这两组人员之间潜在稀缺医疗资源的最优分配，以控制疫情并减少总体感染和死亡率。我们还分别模拟了患病率和累积发病率，这两个量分别与激增能力和群体免疫力相关。我们发现，在现实条件下，最优分配实际上几乎完全是给医护人员，但将多余的口罩和其他医疗资源分配给普通社区成员也能减少感染和死亡。
