Yu Zhuoting, Keskinocak Pinar, Steimle Lauren N, Yildirim Inci
H. Milton Stewart School of Industrial & Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia.
Department of Pediatrics, Yale School of Medicine, Yale University, New Haven, Connecticut.
AJPM Focus. 2022 Sep;1(1):100006. doi: 10.1016/j.focus.2022.100006. Epub 2022 May 20.
Diagnostic tests can play an important role in reducing the transmission of infectious respiratory diseases, particularly during a pandemic. The potential benefit of diagnostic testing depends on at least 4 factors: (1) how soon testing becomes available after the beginning of the pandemic and (2) at what capacity; (3) compliance with isolation after testing positive; and (4) compliance with isolation when experiencing symptoms, even in the absence of testing.
To understand the interplay between these factors and provide further insight into policy decisions for future pandemics, we developed a compartmental model and simulated numerous scenarios using the dynamics of COVID-19 as a case study.
Our results quantified the significant benefits of early start of testing and high compliance with isolation. Early start of testing, even with low testing capacity over time, could significantly slow down the disease spread if compliance with isolation is high. By contrast, when the start of testing was delayed, the benefit of testing on reducing infection spread was limited, even when testing capacity was high; the additional testing capacity required increased superlinearly for each day of delay to achieve a similar infection attack rate as in starting testing earlier.
Our study highlighted the importance of the early start of testing and public health messaging to promote isolation compliance when needed for an ongoing effective response to COVID-19 and future pandemics.
诊断检测在减少传染性呼吸道疾病传播方面可发挥重要作用，尤其是在大流行期间。诊断检测的潜在益处至少取决于4个因素：（1）大流行开始后多久能够进行检测以及（2）检测能力如何；（3）检测呈阳性后遵守隔离规定的情况；以及（4）即使未进行检测，出现症状时遵守隔离规定的情况。
为了解这些因素之间的相互作用，并为未来大流行的政策决策提供进一步的见解，我们开发了一个分区模型，并以新冠疫情动态为例模拟了多种情况。
我们的结果量化了早期开始检测和高度遵守隔离规定的显著益处。如果遵守隔离规定的情况良好，即使随着时间推移检测能力较低，早期开始检测也能显著减缓疾病传播。相比之下，当检测开始延迟时，检测对减少感染传播的益处有限，即使检测能力很高；为了达到与早期开始检测时相似的感染攻击率，每延迟一天所需的额外检测能力呈超线性增加。
我们的研究强调了早期开始检测以及公共卫生宣传的重要性，以便在应对新冠疫情和未来大流行时，在需要时促进对隔离规定的遵守，从而持续做出有效应对。
