The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom.
The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, CV4 7AL, United Kingdom; Midlands Integrative Biosciences Training Partnership, School of Life Sciences, University of Warwick, Coventry, CV4 7AL, United Kingdom.
Epidemics. 2021 Dec;37:100526. doi: 10.1016/j.epidem.2021.100526. Epub 2021 Dec 2.
COVID-19 in the UK has been characterised by periods of exponential growth and decline, as different non-pharmaceutical interventions (NPIs) are brought into play. During the early uncontrolled phase of the outbreak (March 2020) there was a period of prolonged exponential growth with epidemiological observations such as hospitalisation doubling every 3-4 days. The enforcement of strict lockdown measures led to a noticeable decline in all epidemic quantities that slowed during the summer as control measures were relaxed. From August 2020, infections, hospitalisations and deaths began rising once more and various NPIs were applied locally throughout the UK in response. Controlling any rise in infection is a compromise between public health and societal costs, with more stringent NPIs reducing cases but damaging the economy and restricting freedoms. Typically, NPI imposition is made in response to the epidemiological state, are of indefinite length and are often imposed at short notice, greatly increasing the negative impact. An alternative approach is to consider planned, limited duration periods of strict NPIs aiming to purposefully reduce prevalence before such emergency NPIs are required. These "precautionary breaks" may offer a means of keeping control of the epidemic, while their fixed duration and the forewarning may limit their societal impact. Here, using simple analysis and age-structured models matched to the UK SARS-CoV-2 epidemic, we investigate the action of precautionary breaks. In particular we consider their impact on the prevalence of SARS-CoV-2 infection, as well as the total number of predicted hospitalisations and deaths caused by COVID-19 disease. We find that precautionary breaks provide the biggest gains when the growth rate is low, but offer a much needed brake on increasing infection when the growth rate is higher, potentially allowing other measures to regain control.
在英国，由于不同的非药物干预措施（NPIs）的实施，新冠疫情经历了指数增长和下降的阶段。在疫情早期未受控制的阶段（2020 年 3 月），有一段持续的指数增长期，流行病学观察表明，住院人数每 3-4 天翻一番。严格封锁措施的实施导致所有疫情数量明显下降，随着控制措施的放松，夏季下降速度放缓。自 2020 年 8 月以来，感染、住院和死亡人数再次开始上升，英国各地针对这一情况采取了各种 NPI。控制感染的任何上升都是公共卫生和社会成本之间的妥协，更严格的 NPI 减少了病例，但会损害经济并限制自由。通常，NPI 的实施是针对流行病学状况的，没有固定的时间长度，并且经常在短时间内实施，这大大增加了负面影响。另一种方法是考虑实施有计划的、有限时间的严格 NPI，以在需要紧急 NPI 之前有目的地降低流行率。这些“预防性休息”可能提供一种控制疫情的手段，同时其固定的持续时间和预警可能会限制其对社会的影响。在这里，我们使用简单的分析和与英国 SARS-CoV-2 疫情相匹配的年龄结构模型，研究了预防性休息的作用。特别是，我们考虑了它们对 SARS-CoV-2 感染流行率的影响，以及 COVID-19 疾病导致的预计住院和死亡人数的总数。我们发现，当增长率较低时，预防性休息带来的收益最大，但当增长率较高时，它们为抑制感染提供了急需的刹车，这可能使其他措施重新获得控制。
