Department of Mathematical and Physical Sciences, La Trobe University, Melbourne, Australia.
Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
J R Soc Interface. 2024 Feb;21(211):20230612. doi: 10.1098/rsif.2023.0612. Epub 2024 Feb 7.
Interventions to mitigate the spread of infectious diseases, while succeeding in their goal, have economic and social costs associated with them. These limit the duration and intensity of the interventions. We study a class of interventions which reduce the reproduction number and find the optimal strength of the intervention which minimizes the final epidemic size for an immunity inducing infection. The intervention works by eliminating the overshoot part of an epidemic, and avoids a second wave of infections. We extend the framework by considering a heterogeneous population and find that the optimal intervention can pose an ethical dilemma for decision and policymakers. This ethical dilemma is shown to be analogous to the trolley problem. We apply this optimization strategy to real-world contact data and case fatality rates from three pandemics to underline the importance of this ethical dilemma in real-world scenarios.
干预措施可以成功地减轻传染病的传播，但也会带来经济和社会成本。这些成本限制了干预措施的持续时间和强度。我们研究了一类可以降低传染病传播率的干预措施，并找到了使诱导免疫的传染病的最终疫情规模最小化的最优干预强度。该干预措施通过消除疫情的超调部分来发挥作用，并避免了第二波感染。我们通过考虑一个异质人群来扩展这个框架，并发现最优干预措施可能会给决策者带来伦理困境。这个伦理困境类似于电车难题。我们将这个优化策略应用于来自三次大流行的真实接触数据和病死率，以强调在现实场景中这个伦理困境的重要性。
