Li Tangjuan, Xiao Yanni
School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, 710049, PR China.
Math Comput Simul. 2023 May;207:533-555. doi: 10.1016/j.matcom.2023.01.017. Epub 2023 Jan 20.
It becomes challenging to identify feasible control strategies for simultaneously relaxing the countermeasures and containing the Covid-19 pandemic, given China's huge population size, high susceptibility, persist vaccination waning, and relatively weak strength of health systems. We propose a novel mathematical model with waning of immunity and solve the optimal control problem, in order to provide an insight on how much detecting and social distancing are required to coordinate socio-economic activities and epidemic control. We obtain the optimal intensity of countermeasures, i.e., the dynamic nucleic acid screening and social distancing, under which the health system is functioning normally and people can engage in a certain level of socio-economic activities. We find that it is the isolation capacity or the restriction of the case fatality rate (CFR) rather than the hospital capacity that mainly determines the optimal strategies. And the solved optimal controls under quarterly CFR restrictions exhibit oscillations. It is worth noticing that, if without considering booster or very low booster rate, the optimal strategy is a "on-off" mode, alternating between lock down and opening with certain social distancing, which reflects the importance and necessity of China's static management on a certain area during Covid-19 outbreak. The findings suggest some feasible paths to smoothly transit from the Covid-19 pandemic to an endemic phase.
鉴于中国人口基数庞大、易感性高、疫苗接种效果持续减弱以及卫生系统相对薄弱,要确定同时放松防控措施和遏制新冠疫情的可行控制策略变得具有挑战性。我们提出了一种考虑免疫力下降的新型数学模型并求解最优控制问题,以便深入了解为协调社会经济活动和疫情防控需要进行多少检测及保持多大程度的社交距离。我们得出了最优防控强度,即动态核酸筛查和社交距离,在此强度下卫生系统能够正常运转,人们也能够开展一定程度的社会经济活动。我们发现,主要决定最优策略的是隔离能力或对病死率(CFR)的限制,而非医院收治能力。并且在按季度限制病死率的情况下求解出的最优控制呈现出振荡。值得注意的是,如果不考虑加强针接种或加强针接种率非常低的情况,最优策略是一种“开关”模式,即在实施一定社交距离的封控和解封之间交替,这体现了中国在新冠疫情暴发期间对特定区域实施静态管理的重要性和必要性。研究结果为从新冠疫情平稳过渡到地方病阶段提供了一些可行路径。