King Steven, Striolo Alberto
Department of Chemical Engineering, University College London, Torrington Place, London WC1E 7JE, UK.
UCL Open Environ. 2021 Jun 30;3:e020. doi: 10.14324/111.444/ucloe.000020. eCollection 2021.
Much media and societal attention is today focused on how to best control the spread of coronavirus (COVID-19). Every day brings us new data, and policy makers are implementing different strategies in different countries to manage the impact of COVID-19. To respond to the first 'wave' of infection, several countries, including the UK, opted for isolation/lockdown initiatives, with different degrees of rigour. Data showed that these initiatives have yielded the expected results in terms of containing the rapid trajectory of the virus. When this article was first prepared (April 2020), the affected societies were wondering when the isolation/lockdown initiatives should be lifted. While detailed epidemiological, economic as well as social studies would be required to answer this question completely, here we employ a simple engineering model. Albeit simple, the model is capable of reproducing the main features of the data reported in the literature concerning the COVID-19 trajectory in different countries, including the increase in cases in countries following the initially successful isolation/lockdown initiatives. Keeping in mind the simplicity of the model, we attempt to draw some conclusions, which seem to suggest that a decrease in the number of infected individuals after the initiation of isolation/lockdown initiatives does not necessarily guarantee that the virus trajectory is under control. Within the limit of this model, it would seem that rigid isolation/lockdown initiatives for the medium term would lead to achieving the desired control over the spread of the virus. This observation seems consistent with the 2020 summer months, during which the COVID-19 trajectory seemed to be almost under control across most European countries. Consistent with the results from our simple model, winter 2020 data show that the virus trajectory was again on the rise. Because the optimal solution will achieve control over the spread of the virus while minimising negative societal impacts due to isolation/lockdown, which include but are not limited to economic and mental health aspects, the engineering model presented here is not sufficient to provide the desired answer. However, the model seems to suggest that to keep the COVID-19 trajectory under control, a series of short-to-medium term isolation measures should be put in place until one or more of the following scenarios is achieved: a cure has been developed and has become accessible to the population at large; a vaccine has been developed, tested and distributed to large portions of the population; a sufficiently large portion of the population has developed resistance to the COVID-19 virus; or the virus itself has become less aggressive. It is somewhat remarkable that an engineering model, despite all its approximations, provides suggestions consistent with advanced epidemiological models developed by several experts in the field. The model proposed here is however not expected to be able to capture the emergence of variants of the virus, which seem to be responsible for significant outbreaks, notably in India, in the spring of 2021, it cannot describe the effectiveness of vaccine strategies, as it does not differentiate among different age groups within the population, nor does it allow us to consider the duration of the immunity achieved after infection or vaccination.
如今,许多媒体和社会关注都聚焦于如何最好地控制冠状病毒(COVID-19)的传播。每天都有新的数据,不同国家的政策制定者正在实施不同的策略来应对COVID-19的影响。为应对第一波感染,包括英国在内的几个国家选择了不同程度严格的隔离/封锁举措。数据显示,这些举措在控制病毒的快速传播方面取得了预期效果。在撰写本文初稿时(2020年4月),受影响的社会都在思考何时应解除隔离/封锁举措。虽然要完全回答这个问题需要详细的流行病学、经济以及社会研究,但在此我们采用一个简单的工程模型。尽管该模型简单,但它能够重现文献中报道的不同国家COVID-19传播轨迹的主要特征,包括在最初成功实施隔离/封锁举措的国家中病例的增加。牢记该模型的简单性,我们试图得出一些结论,这些结论似乎表明,在开始实施隔离/封锁举措后感染个体数量的减少并不一定保证病毒传播轨迹得到控制。在该模型的限制范围内,似乎中期严格的隔离/封锁举措将有助于实现对病毒传播的理想控制。这一观察结果似乎与2020年夏季相符,在此期间,大多数欧洲国家的COVID-19传播轨迹似乎几乎得到了控制。与我们简单模型的结果一致,2020年冬季的数据显示病毒传播轨迹再次上升。由于最优解决方案应在控制病毒传播的同时,将因隔离/封锁产生的负面社会影响降至最低,这些影响包括但不限于经济和心理健康方面,所以这里提出的工程模型不足以提供理想的答案。然而,该模型似乎表明,为了控制COVID-19的传播轨迹,应实施一系列短期到中期的隔离措施,直到实现以下一种或多种情况:研发出治愈方法并可供广大民众使用;研发出疫苗并进行测试,然后分发给大部分人口;足够大比例的人口对COVID-19病毒产生抵抗力;或者病毒本身的攻击性减弱。值得注意的是,尽管有各种近似之处,但一个工程模型提供的建议与该领域几位专家开发的先进流行病学模型一致。然而,这里提出的模型预计无法捕捉病毒变种的出现,这些变种似乎是导致重大疫情爆发的原因,特别是在2021年春季的印度;它无法描述疫苗策略的有效性,因为它没有区分人群中的不同年龄组;也不允许我们考虑感染或接种疫苗后获得的免疫力的持续时间。