Lan Xiaomin, Chen Guangmin, Zhou Ruiyang, Zheng Kuicheng, Cai Shaojian, Wei Fengying, Jin Zhen, Mao Xuerong
School of Mathematics and Statistics, Fuzhou University, Fuzhou, 350116, Fujian, China.
Fujian Provincial Center for Disease Control and Prevention, Fuzhou, 350012, Fujian, China.
Infect Dis Model. 2024 Apr 22;9(3):728-743. doi: 10.1016/j.idm.2024.04.003. eCollection 2024 Sep.
The structure of age groups and social contacts of the total population influenced infection scales and hospital-bed requirements, especially influenced severe infections and deaths during the global prevalence of COVID-19. Before the end of the year 2022, Chinese government implemented the national vaccination and had built the herd immunity cross the country, and announced Twenty Measures (November 11) and Ten New Measures (December 7) for further modifications of dynamic zero-COVID polity on the Chinese mainland. With the nation-wide vaccination and modified measures background, Fuzhou COVID-19 large wave (November 19, 2022-February 9, 2023) led by Omicron BA.5.2 variant was recorded and prevailed for three months in Fujian Province.
A multi-age groups susceptible-exposed-infected-hospitalized-recovered (SEIHR) COVID-19 model with social contacts was proposed in this study. The main object was to evaluate the impacts of age groups and social contacts of the total population. The idea of Least Squares method was governed to perform the data fittings of four age groups against the surveillance data from Fujian Provincial Center for Disease Control and Prevention (Fujian CDC). The next generation matrix method was used to compute basic reproduction number for the total population and for the specific age group. The tendencies of effective reproduction number of four age groups were plotted by using the Epiestim R package and the SEIHR model for in-depth discussions. The sensitivity analysis by using sensitivity index and partial rank correlation coefficients values (PRCC values) were operated to reveal the differences of age groups against the main parameters.
The main epidemiological features such as basic reproduction number, effective reproduction number and sensitivity analysis were extensively discussed for multi-age groups SEIHR model in this study. Firstly, by using of the next generation matrix method, basic reproduction number of the total population was estimated as 1.57 using parameter values of four age groups of Fuzhou COVID-19 large wave. Given age group , the values of (age group to age group ), the values of (an infected of age group to the total population) and the values of (an infected of the total population to age group ) were also estimated, in which the explorations of the impacts of age groups revealed that the relationship was valid. Then, the fluctuating tendencies of effective reproduction number were demonstrated by using two approaches (the surveillance data and the SEIHR model) for Fuzhou COVID-19 large wave, during which high-risk group (G4 group) mainly contributed the infection scale due to high susceptibility to infection and high risks to basic diseases. Further, the sensitivity analysis using two approaches (the sensitivity index and the PRCC values) revealed that susceptibility to infection of age groups played the vital roles, while the numerical simulation showed that infection scale varied with the changes of social contacts of age groups. The results of this study claimed that the high-risk group out of the total population was concerned by the local government with the highest susceptibility to infection against COVID-19.
This study verified that the partition structure of age groups of the total population, the susceptibility to infection of age groups, the social contacts among age groups were the important contributors of infection scale. The less social contacts and adequate hospital beds for high-risk group were profitable to control the spread of COVID-19. To avoid the emergence of medical runs against new variant in the future, the policymakers from local government were suggested to decline social contacts when hospital beds were limited.
总人口的年龄结构和社会接触情况影响感染规模和医院床位需求,在新冠疫情全球流行期间尤其影响严重感染和死亡情况。2022年底前,中国政府实施了全民接种疫苗,建立了全国性的群体免疫,并且公布了“二十条措施”(11月11日)和“新十条措施”(12月7日),以进一步调整中国大陆的动态清零政策。在全国疫苗接种和政策调整的背景下,由奥密克戎BA.5.2变异株引发的福州新冠疫情大流行(2022年11月19日至2023年2月9日)在福建省持续了三个月。
本研究提出了一个包含社会接触情况的多年龄组易感-暴露-感染-住院-康复(SEIHR)新冠模型。主要目的是评估总人口的年龄组和社会接触情况的影响。运用最小二乘法的思路,对四个年龄组的数据与福建省疾病预防控制中心(福建疾控)的监测数据进行拟合。使用下一代矩阵法计算总人口和特定年龄组的基本再生数。利用Epiestim R包和SEIHR模型绘制四个年龄组有效再生数的趋势图,进行深入讨论。通过敏感性指数和偏秩相关系数值(PRCC值)进行敏感性分析,以揭示年龄组对主要参数的差异。
本研究对多年龄组SEIHR模型的基本再生数、有效再生数和敏感性分析等主要流行病学特征进行了广泛讨论。首先,使用下一代矩阵法,根据福州新冠疫情大流行四个年龄组的参数值,估计总人口的基本再生数为1.57。对于给定年龄组,还估计了(年龄组到年龄组)的值、(年龄组的感染者到总人口)的值和(总人口的感染者到年龄组)的值,其中对年龄组影响的探索表明关系是有效的。然后,通过两种方法(监测数据和SEIHR模型)展示了福州新冠疫情大流行期间有效再生数的波动趋势,在此期间,高风险组(G4组)由于对感染的高易感性和对基础疾病的高风险,主要导致了感染规模。此外,通过两种方法(敏感性指数和PRCC值)进行的敏感性分析表明,年龄组的感染易感性起着至关重要的作用,而数值模拟表明感染规模随年龄组社会接触情况的变化而变化。本研究结果表明,当地政府关注总人口中的高风险组,他们对新冠病毒感染的易感性最高。
本研究证实,总人口的年龄组划分结构、年龄组的感染易感性、年龄组之间的社会接触是感染规模的重要影响因素。减少社会接触并为高风险组提供足够的医院床位有利于控制新冠疫情的传播。为避免未来出现针对新变异株的医疗挤兑情况,建议地方政府政策制定者在医院床位有限时减少社会接触。