González-Jaramillo Valentina, González-Jaramillo Nathalia, Gómez-Restrepo Carlos, Palacio-Acosta Carlos A, Gómez-López Arley, Franco Oscar H
VG: MD. M. Sc. Instituto de Medicina Social y Preventiva (ISPM), Universidad de Berna. Berna, Suiza.
NG: MD. M. Sc. Instituto de Medicina Social y Preventiva (ISPM), Universidad de Berna. Berna, Suiza.
Rev Salud Publica (Bogota). 2020 Mar 1;22(2):117-122. doi: 10.15446/rsap.V22n2.85789.
First case of COVID-19 in Colombia was diagnosed on March 6th. Two weeks later, cases have rapidly increased, leading the government to establish some mitigation measures.
The first objective is to estimate and model the number of cases, use of hospital resources and mortality by using different R0 scenarios in a 1-month scenario (from March 18 to April 18, 2020), based on the different isolation measures applied. This work also aims to model, without establishing a time horizon, the same outcomes given the assumption that eventually 70% of the population will be infected.
Data on the number of confirmed cases in the country as of March 18, 2020 (n=93) were taken as the basis for the achievement of the first objective. An initial transmission rate of R0= 2.5 and a factor of 27 for undetected infections per each confirmed case were taken as assumptions for the model. The proportion of patients who may need intensive care or other in-hospital care was based on data from the Imperial College of London. On the other hand, an age-specific mortality rate provided by the Instituto Superiore di Sanità in Italy was used for the second objective.
Based on the 93 cases reported as of March 18, if no mitigation measures were applied, by April 18, the country would have 613 037 cases. Mitigation measures that reduce R0 by 10% generate a 50% reduction in the number of cases. However, despite halving the number of cases, there would still be a shortfall in the number of beds required and only one in two patients would have access to this resource.
This model found that the mitigation measures implemented to date by the Colombian government and analyzed in this article are based on sufficient evidence and will help to slow the spread of SARS-CoV-2 in Colombia. Although a time horizon of one month was used for this model, it is plausible to believe that, if the current measures are sustained, the mitigation effect will also be sustained over time.
哥伦比亚于3月6日确诊首例新冠病毒肺炎病例。两周后,病例迅速增加,促使政府采取了一些缓解措施。
第一个目标是根据所采取的不同隔离措施,在1个月的时间范围内(从2020年3月18日至4月18日),使用不同的R0情景,估计并模拟病例数、医院资源使用情况和死亡率。这项工作还旨在在不设定时间范围的情况下,基于最终70%的人口将被感染这一假设,对相同结果进行模拟。
以2020年3月18日该国确诊病例数(n = 93)的数据为基础来实现第一个目标。模型假设初始传播率R0 = 2.5,每个确诊病例的未检测到感染因子为27。可能需要重症监护或其他住院治疗的患者比例基于伦敦帝国理工学院的数据。另一方面,第二个目标使用了意大利高等卫生研究院提供的特定年龄死亡率。
基于3月18日报告的93例病例,如果不采取缓解措施,到4月18日,该国将有613037例病例。将R0降低10%的缓解措施可使病例数减少50%。然而,尽管病例数减半,但所需病床数量仍会短缺,每两名患者中只有一人能够获得该资源。
该模型发现,哥伦比亚政府迄今实施并在本文中分析的缓解措施有充分证据支持,将有助于减缓新冠病毒在哥伦比亚的传播。尽管此模型使用了一个月的时间范围,但可以合理地认为,如果当前措施持续实施,缓解效果也将随时间持续。