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针对接触者追踪的测试进行特定国家的优化策略,有助于在放宽限制期间保持低的繁殖数 ([公式:见正文])。

Country-specific optimization strategy for testing through contact tracing can help maintain a low reproduction number ([Formula: see text]) during unlock.

机构信息

Vantage Research, Sivasamy St, CIT Colony, Mylapore, Chennai, Tamil Nadu 600004 India.

Center for Computational Natural Sciences, International Institute of Information Technology, Hyderabad, 500032 India.

出版信息

Sci Rep. 2022 Jan 7;12(1):212. doi: 10.1038/s41598-021-03846-z.

Abstract

In response to the COVID19 pandemic, many countries have implemented lockdowns in multiple phases to ensure social distancing and quarantining of the infected subjects. Subsequent unlocks to reopen the economies started next waves of infection and imposed an extra burden on quarantine to keep the reproduction number ([Formula: see text]) < 1. However, most countries could not effectively contain the infection spread, suggesting identification of the potential sources weakening the effect of lockdowns could help design better informed lockdown-unlock cycles in the future. Here, through building quantitative epidemic models and analyzing the metadata of 50 countries from across the continents we first found that the estimated value of [Formula: see text], adjusted w.r.t the distribution of medical facilities and virus clades correlates strongly with the testing rates in a country. Since the testing capacity of a country is limited by its medical resources, we investigated if a cost-benefit trade-off can be designed connecting testing rate and extent of unlocking. We present a strategy to optimize this trade-off in a country specific manner by providing a quantitative estimate of testing and quarantine rates required to allow different extents of unlocks while aiming to maintain [Formula: see text]. We further show that a small fraction of superspreaders can dramatically increase the number of infected individuals even during strict lockdowns by strengthening the positive feedback loop driving infection spread. Harnessing the benefit of optimized country-specific testing rates would critically require minimizing the movement of these superspreaders via strict social distancing norms, such that the positive feedback driven switch-like exponential spread phase of infection can be avoided/delayed.

摘要

针对 COVID19 大流行,许多国家分阶段实施封锁,以确保社交距离和隔离感染者。随后,为了重新开放经济而进行的解锁引发了新的感染浪潮,并给隔离带来了额外的负担,以保持繁殖数 ([Formula: see text]) < 1。然而,大多数国家无法有效控制感染的传播,这表明识别削弱封锁效果的潜在传染源可能有助于在未来设计更好的封锁-解锁周期。在这里,我们通过建立定量的传染病模型,并分析来自各大洲的 50 个国家的元数据,首先发现,调整医疗设施和病毒分支分布后的 [Formula: see text] 的估计值与国家的检测率密切相关。由于一个国家的检测能力受到其医疗资源的限制,我们研究了是否可以设计一种成本效益权衡,将检测率和解锁程度联系起来。我们提出了一种策略,通过提供所需的检测和隔离率的定量估计,以维持 [Formula: see text] 为目标,以国家特定的方式优化这种权衡。我们进一步表明,即使在严格的封锁期间,少数超级传播者也可以通过加强驱动感染传播的正反馈循环,显著增加感染人数。利用优化的国家特定检测率的好处将需要通过严格的社交距离规范来最大限度地减少这些超级传播者的流动,从而避免/延迟感染呈正反馈驱动的开关状指数传播阶段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b413/8742011/decf3f9bbcf1/41598_2021_3846_Fig1_HTML.jpg

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