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用于追踪 COVID-19 疫情时变超级传播潜力的统计框架。

A statistical framework for tracking the time-varying superspreading potential of COVID-19 epidemic.

机构信息

Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.

Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Centre for Health Systems and Policy Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China.

出版信息

Epidemics. 2023 Mar;42:100670. doi: 10.1016/j.epidem.2023.100670. Epub 2023 Jan 24.

Abstract

Timely detection of an evolving event of an infectious disease with superspreading potential is imperative for territory-wide disease control as well as preventing future outbreaks. While the reproduction number (R) is a commonly-adopted metric for disease transmissibility, the transmission heterogeneity quantified by dispersion parameter k, a metric for superspreading potential is seldom tracked. In this study, we developed an estimation framework to track the time-varying risk of superspreading events (SSEs) and demonstrated the method using the three epidemic waves of COVID-19 in Hong Kong. Epidemiological contact tracing data of the confirmed COVID-19 cases from 23 January 2020 to 30 September 2021 were obtained. By applying branching process models, we jointly estimated the time-varying R and k. Individual-based outbreak simulations were conducted to compare the time-varying assessment of the superspreading potential with the typical non-time-varying estimate of k over a period of time. We found that the COVID-19 transmission in Hong Kong exhibited substantial superspreading during the initial phase of the epidemics, with only 1 % (95 % Credible interval [CrI]: 0.6-2 %), 5 % (95 % CrI: 3-7 %) and 10 % (95 % CrI: 8-14 %) of the most infectious cases generated 80 % of all transmission for the first, second and third epidemic waves, respectively. After implementing local public health interventions, R estimates dropped gradually and k estimates increased thereby reducing the risk of SSEs to approaching zero. Outbreak simulations indicated that the non-time-varying estimate of k may overlook the possibility of large outbreaks. Hence, an estimation of the time-varying k as a compliment of R as a monitoring of both disease transmissibility and superspreading potential, particularly when public health interventions were relaxed is crucial for minimizing the risk of future outbreaks.

摘要

及时发现具有超级传播潜力的传染病的演变事件对于全地区疾病控制以及预防未来的爆发至关重要。虽然繁殖数(R)是用于衡量疾病传播性的常用指标,但传播异质性量化指标分散参数 k(用于衡量超级传播潜力)却很少被跟踪。在本研究中,我们开发了一个估计框架来跟踪超级传播事件(SSE)的时变风险,并使用香港 COVID-19 的三次疫情波次演示了该方法。我们获取了 2020 年 1 月 23 日至 2021 年 9 月 30 日期间确诊 COVID-19 病例的流行病学接触追踪数据。通过应用分支过程模型,我们共同估计了时变的 R 和 k。我们进行了基于个体的暴发模拟,以比较超级传播潜力的时变评估与在一段时间内典型的非时变 k 估计。我们发现,香港的 COVID-19 传播在疫情的初始阶段表现出了显著的超级传播现象,仅 1%(95%可信区间[CrI]:0.6-2%)、5%(95%CrI:3-7%)和 10%(95%CrI:8-14%)最具传染性的病例产生了所有传播的 80%,分别为第一、第二和第三波疫情。在实施了局部公共卫生干预措施后,R 估计值逐渐下降,k 估计值上升,从而使 SSE 风险接近于零。暴发模拟表明,k 的非时变估计可能会忽略大暴发的可能性。因此,作为疾病传播性和超级传播潜力监测的补充,对 k 的时变估计是至关重要的,特别是在公共卫生干预措施放宽时,这对于最小化未来暴发的风险至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0593/9872564/0542e6c90c18/gr1_lrg.jpg

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