论文标题
低案例数量可以实现长期稳定的大流行控制,而无需封锁
Low case numbers enable long-term stable pandemic control without lockdowns
论文作者
论文摘要
传统的流行病控制解决方案涉及根除或种群免疫。在这里,我们分析得出了第三个可行解决方案的存在:在低案例数下的稳定平衡,其中测试跟踪和分离的策略部分补偿了局部扩散事件,并且只有中等限制仍然是必要的。在这种均衡中,每日病例稳定在百万分之十或更少的新感染中。但是,如果限制放松或案例数量过高,稳定性会濒临灭绝。后者的不稳定标志着一个转折点,超越了传播自我加速。我们表明,锁定可以重新建立控制,并且如果持续的,中等的接触减少,则无需重复锁定。我们说明了这种策略如何从疫苗接种中获利,并有助于减轻关注的变体。该策略比仅避免医院崩溃的策略减少了累积病例(和死亡)4倍。从长远来看,免疫,大规模测试和国际协调将进一步促进控制。
The traditional long-term solutions for epidemic control involve eradication or population immunity. Here, we analytically derive the existence of a third viable solution: a stable equilibrium at low case numbers, where test-trace-and-isolate policies partially compensate for local spreading events, and only moderate restrictions remain necessary. In this equilibrium, daily cases stabilize around ten new infections per million people or less. However, stability is endangered if restrictions are relaxed or case numbers grow too high. The latter destabilization marks a tipping point beyond which the spread self-accelerates. We show that a lockdown can reestablish control and that recurring lockdowns are not necessary given sustained, moderate contact reduction. We illustrate how this strategy profits from vaccination and helps mitigate variants of concern. This strategy reduces cumulative cases (and fatalities) 4x more than strategies that only avoid hospital collapse. In the long term, immunization, large-scale testing, and international coordination will further facilitate control.