Boston Medical Center, Boston, Massachusetts.
Boston University Schools of Medicine and Public Health, Boston, Massachusetts.
JAMA Health Forum. 2022 Apr 1;3(4):e220760. doi: 10.1001/jamahealthforum.2022.0760. eCollection 2022 Apr.
A key question for policy makers and the public is what to expect from the COVID-19 pandemic going forward as states lift nonpharmacologic interventions (NPIs), such as indoor mask mandates, to prevent COVID-19 transmission.
To project COVID-19 deaths between March 1, 2022, and December 31, 2022, in each of the 50 US states, District of Columbia, and Puerto Rico assuming different dates of lifting of mask mandates and NPIs.
This simulation modeling study used the COVID-19 Policy Simulator compartmental model to project COVID-19 deaths from March 1, 2022, to December 31, 2022, using simulated populations in the 50 US states, District of Columbia, and Puerto Rico. Projected current epidemiologic trends for each state until December 31, 2022, assuming the current pace of vaccination is maintained into the future and modeling different dates of lifting NPIs.
Date of lifting statewide NPI mandates as March 1, April 1, May 1, June 1, or July 1, 2022.
Projected COVID-19 incident deaths from March to December 2022.
With the high transmissibility of current circulating SARS-CoV-2 variants, the simulated lifting of NPIs in March 2022 was associated with resurgences of COVID-19 deaths in nearly every state. In comparison, delaying by even 1 month to lift NPIs in April 2022 was estimated to mitigate the amplitude of the surge. For most states, however, no amount of delay was estimated to be sufficient to prevent a surge in deaths completely. The primary factor associated with recurrent epidemics in the simulation was the assumed high effective reproduction number of unmitigated viral transmission. With a lower level of transmissibility similar to those of the ancestral strains, the model estimated that most states could remove NPIs in March 2022 and likely not see recurrent surges.
This simulation study estimated that the SARS-CoV-2 virus would likely continue to take a major toll in the US, even as cases continued to decrease. Because of the high transmissibility of the recent Delta and Omicron variants, premature lifting of NPIs could pose a substantial threat of rebounding surges in morbidity and mortality. At the same time, continued delay in lifting NPIs may not prevent future surges.
随着各州取消非药物干预措施（如室内口罩令）以防止 COVID-19 传播，决策者和公众的一个关键问题是，未来会对 COVID-19 疫情有何预期。
假设不同的口罩令和非药物干预措施取消日期，预测 2022 年 3 月 1 日至 12 月 31 日期间美国 50 个州、哥伦比亚特区和波多黎各的 COVID-19 死亡人数。
设计、设置和参与者：本仿真建模研究使用 COVID-19 政策模拟房室模型，使用美国 50 个州、哥伦比亚特区和波多黎各的模拟人群，预测 2022 年 3 月 1 日至 12 月 31 日的 COVID-19 死亡人数。假设未来继续保持当前的疫苗接种速度，并模拟不同的非药物干预措施取消日期，预测截至 2022 年 12 月 31 日的当前流行趋势。
假设全州性非药物干预措施于 2022 年 3 月 1 日、4 月 1 日、5 月 1 日、6 月 1 日或 7 月 1 日取消。
预测 2022 年 3 月至 12 月的 COVID-19 发病死亡人数。
鉴于当前 SARS-CoV-2 变异株的高传染性，2022 年 3 月取消非药物干预措施与几乎每个州 COVID-19 死亡人数的再次上升有关。相比之下，即使将非药物干预措施的取消时间延迟到 2022 年 4 月 1 日，预计也能减轻疫情的峰值幅度。然而，对于大多数州来说，预计任何延迟都不足以完全防止死亡人数的激增。模拟中与反复出现疫情相关的主要因素是假设未缓解的病毒传播的高有效繁殖数。如果病毒的传播率较低，与原始毒株相似，模型估计大多数州可以在 2022 年 3 月取消非药物干预措施，并且不太可能出现疫情反复。
本模拟研究估计，即使病例继续减少，SARS-CoV-2 病毒仍可能继续在美国造成重大损失。由于最近的 Delta 和 Omicron 变异株具有高传染性，过早取消非药物干预措施可能会对发病率和死亡率的反弹造成严重威胁。与此同时，继续延迟取消非药物干预措施可能无法防止未来的疫情反弹。
