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逐步终止针对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的非药物干预措施的影响:一项数学建模分析

The impacts of gradually terminating nonpharmaceutical interventions for SARS-CoV-2: A mathematical modelling analysis.

作者信息

Wu Bin, Yu Yuetian, Feng Xing Lin

机构信息

Medical Decision and Economic Group, Department of Pharmacy, Ren Ji Hospital, South Campus, School of Medicine, Shanghai Jiaotong University, Shanghai 200000, China.

Department of Critical Care Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China.

出版信息

Fundam Res. 2022 May 17;4(2):401-411. doi: 10.1016/j.fmre.2022.05.007. eCollection 2024 Mar.

Abstract

With the expansion of vaccination programs, the policy of terminating nonpharmaceutical interventions for preventing the SARS-CoV-2 pandemic should become more flexible. The current study investigated the clinical and economic outcomes of intervention policies combining nonpharmaceutical interventions and vaccination programs for dealing with the SARS-CoV-2 pandemic. An agent-based transmission model was adopted that describes how a SARS-CoV-2 virus spreads in the populations of China. The model inputs were derived from the literature and expert opinion. The following intervention policies were simulated: no intervention, strict nonpharmaceutical interventions, and nonpharmaceutical interventions for workplace, community, school and home gradually terminated by combining vaccination programs for specified age groups (vaccination age in years: 20-60, 20-70, 20-80, ≥ 20, ≥ 10 and whole population). Cumulative infections and deaths in one calendar year, costs and quality-adjusted life years (QALYs) were measured. When the vaccination program was taken up in at least the ≥ 20 years age group in all populations, nonpharmaceutical interventions for workplace and community settings could be gradually terminated because the cumulative number of infections was < 100 per 100,000 persons. Further ending nonpharmaceutical interventions in school and home settings could not meet the target even when the vaccination program had been taken up in all populations. When cumulative deaths were used as the endpoint, nonpharmaceutical interventions in workplace, community and school settings could be gradually terminated. Vaccine efficacy and coverage have substantial impacts. Terminating nonpharmaceutical interventions in workplace settings could produce the lowest cost when vaccination programs are taken up at least in the ≥ 10 years age group; this method dominates most intervention strategies due to its lower costs and higher QALYs. According to our findings, nonpharmaceutical interventions might be gradually terminated in Chinese settings.

摘要

随着疫苗接种计划的扩大,终止针对预防新冠疫情的非药物干预措施的政策应变得更加灵活。本研究调查了将非药物干预措施与疫苗接种计划相结合以应对新冠疫情的干预政策的临床和经济结果。采用了基于主体的传播模型来描述新冠病毒在中国人群中的传播方式。模型输入数据来源于文献和专家意见。模拟了以下干预政策:不干预、严格的非药物干预,以及通过为特定年龄组(接种疫苗年龄(岁):20 - 60、20 - 70、20 - 80、≥20、≥10和全体人群)实施疫苗接种计划,逐步终止针对工作场所、社区、学校和家庭的非药物干预。测量了一历年中的累计感染和死亡人数、成本以及质量调整生命年(QALY)。当至少在所有人群的≥20岁年龄组开展疫苗接种计划时,由于每10万人中的累计感染数<100,工作场所和社区环境的非药物干预措施可以逐步终止。即使在所有人群中都开展了疫苗接种计划,进一步终止学校和家庭环境中的非药物干预措施也无法实现目标。以累计死亡作为终点时,工作场所、社区和学校环境中的非药物干预措施可以逐步终止。疫苗效力和覆盖率有重大影响。当至少在≥10岁年龄组开展疫苗接种计划时,终止工作场所的非药物干预措施成本最低;由于成本较低且QALY较高,这种方法优于大多数干预策略。根据我们的研究结果,在中国环境下,非药物干预措施可能会逐步终止。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5a9/11197694/eaffd562cd51/ga1.jpg

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