Institute for Clinical and Translational Research, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
Corporate Medical Advisors, Houston, TX, USA.
Sci Rep. 2023 Feb 16;13(1):2779. doi: 10.1038/s41598-023-29087-w.
596 million SARS-CoV-2 cases have been reported and over 12 billion vaccine doses have been administered. As vaccination rates increase, a gap in knowledge exists regarding appropriate thresholds for escalation and de-escalation of workplace COVID-19 preventative measures. We conducted 133,056 simulation experiments, evaluating the spread of SARS-CoV-2 virus in hypothesized working environments subject to COVID-19 infections from the community. We tested the rates of workplace-acquired infections based on applied isolation strategies, community infection rates, methods and scales of testing, non-pharmaceutical interventions, variant predominance, vaccination coverages, and vaccination efficacies. When 75% of a workforce is vaccinated with a 70% efficacious vaccine against infection, then no masking or routine testing + isolation strategies are needed to prevent workplace-acquired omicron variant infections when the community infection rate per 100,000 persons is ≤ 1. A CIR ≤ 30, and ≤ 120 would result in no workplace-acquired infections in this same scenario against the delta and alpha variants, respectively. Workforces with 100% worker vaccination can prevent workplace-acquired infections with higher community infection rates. Identifying and isolating workers with antigen-based SARS-CoV-2 testing methods results in the same or fewer workplace-acquired infections than testing with slower turnaround time polymerase chain reaction methods. Risk migration measures such as mask-wearing, testing, and isolation can be relaxed, or escalated, in commensurate with levels of community infections, workforce immunization, and risk tolerance. The interactive heatmap we provide can be used for immediate, parameter-based case count predictions to inform institutional policy making. The simulation approach we have described can be further used for future evaluation of strategies to mitigate COVID-19 spread.
已报告 5.96 亿例 SARS-CoV-2 病例,接种疫苗超过 120 亿剂。随着疫苗接种率的提高,对于工作场所 COVID-19 预防措施升级和降级的适当阈值,存在知识差距。我们进行了 133,056 次模拟实验,评估了假设工作环境中 SARS-CoV-2 病毒的传播情况,这些环境受到社区 COVID-19 感染的影响。我们根据应用的隔离策略、社区感染率、检测方法和规模、非药物干预措施、变体优势、疫苗接种覆盖率和疫苗效力,测试了工作场所获得性感染的比率。当 75%的劳动力接种了针对感染的 70%有效疫苗时,如果社区每 10 万人的感染率≤1,则不需要口罩或常规检测+隔离策略来预防工作场所获得的 omicron 变体感染。在这种情况下,CIR≤30 和≤120 分别可防止 delta 和 alpha 变体的工作场所获得性感染。接种率为 100%的劳动力可以预防更高社区感染率导致的工作场所获得性感染。使用抗原为基础的 SARS-CoV-2 检测方法识别和隔离工人,与使用较慢周转时间聚合酶链反应方法相比,可导致相同或更少的工作场所获得性感染。风险迁移措施,如戴口罩、检测和隔离,可以根据社区感染水平、劳动力免疫接种和风险容忍度相应地放宽或升级。我们提供的交互式热图可用于立即进行基于参数的病例数预测,为机构政策制定提供信息。我们描述的模拟方法可以进一步用于评估减轻 COVID-19 传播的策略。