Larner College of Medicine at the University of Vermont, Burlington, VT, USA.
RAND Corporation, Santa Monica, CA, USA.
Sci Rep. 2023 Feb 10;13(1):2416. doi: 10.1038/s41598-023-28936-y.
The COVID-19 pandemic has called for swift action from local governments, which have instated non-pharmaceutical interventions (NPIs) to curb the spread of the disease. The swift implementation of social distancing policies has raised questions about the costs and benefits of strategies that either aim to keep cases as low as possible (suppression) or aim to reach herd immunity quickly (mitigation) to tackle the COVID-19 pandemic. While curbing COVID-19 required blunt instruments, it is unclear whether a less-transmissible and less-deadly emerging pathogen would justify the same response. This paper illuminates this question using a parsimonious transmission model by formulating the social distancing lives vs. livelihoods dilemma as a boundary value problem using calculus of variations. In this setup, society balances the costs and benefits of social distancing contingent on the costs of reducing transmission relative to the burden imposed by the disease. We consider both single-objective and multi-objective formulations of the problem. To the best of our knowledge, our approach is distinct in the sense that strategies emerge from the problem structure rather than being imposed a priori. We find that the relative time-horizon of the pandemic (i.e., the time it takes to develop effective vaccines and treatments) and the relative cost of social distancing influence the choice of the optimal policy. Unsurprisingly, we find that the appropriate policy response depends on these two factors. We discuss the conditions under which each policy archetype (suppression vs. mitigation) appears to be the most appropriate.
COVID-19 大流行要求地方政府迅速采取行动,这些政府实施了非药物干预(NPIs)以遏制疾病的传播。迅速实施社会隔离政策引发了关于旨在尽可能降低病例数的策略(抑制)或旨在快速达到群体免疫以应对 COVID-19 大流行的策略(缓解)的成本效益问题。虽然遏制 COVID-19 需要采取直接手段,但尚不清楚传染性和致命性较低的新病原体是否需要采取同样的应对措施。本文使用一种简洁的传播模型来阐明这个问题,通过使用变分法将社会隔离的生活与生计困境表述为边值问题。在这种设置中,社会根据降低传播的成本相对于疾病带来的负担来平衡社会隔离的成本和收益。我们考虑了问题的单目标和多目标公式化。据我们所知,我们的方法的独特之处在于,策略是从问题结构中产生的,而不是预先设定的。我们发现,大流行的相对时间跨度(即开发有效疫苗和治疗方法所需的时间)和社会隔离的相对成本会影响最佳政策的选择。毫不奇怪,我们发现适当的政策反应取决于这两个因素。我们讨论了每种政策原型(抑制与缓解)似乎最合适的条件。