论文标题

一个机械模型,用于评估在有限容量下测试 - 迹线隔离和测量的有效性

A mechanistic model to assess the effectiveness of test-trace-isolate-and-quarantine under limited capacities

论文作者

Heidecke, Julian, Fuhrmann, Jan, Barbarossa, Maria Vittoria

论文摘要

诊断测试,然后分离出随后的追踪和隔离接触的鉴定病例 - 通常称为测试 - 轨道隔离和提议(TTIQ)策略 - 是传染病控制的基石之一。 COVID-19大流行强调,对爆发的适当反应要求我们意识到此类遏制策略的有效性。这可以使用数学模型来评估。我们提出了用于感染疾病控制的TTIQ干预措施的延迟微分方程模型。我们的模型结合了有限的TTIQ能力引起的状态依赖性动力学的详细机械描述。此外,我们考虑了SARS-COV-2感染的早期阶段的传播,包括预症状传播,这可能对基于TTIQ的控制尤其不利。受到共同-19在德国的早期蔓延的启发的数值实验揭示了TTIQ在人口中的免疫力低且没有药物干预措施的情况下的有效性 - 代表了(重新)出现在哪种治疗药物或疫苗的感染性疾病中的典型情况。稳定性和灵敏度分析强调因素,部分与特定疾病有关,这会阻碍或增强TTIQ的成功。研究TTIQ沿着流行病的模拟的有效性降低,我们强调了干预策略的后果。

Diagnostic testing followed by isolation of identified cases with subsequent tracing and quarantine of close contacts - often referred to as test-trace-isolate-and-quarantine (TTIQ) strategy - is one of the cornerstone measures of infectious disease control. The COVID-19 pandemic has highlighted that an appropriate response to outbreaks requires us to be aware about the effectiveness of such containment strategies. This can be evaluated using mathematical models. We present a delay differential equation model of TTIQ interventions for infectious disease control. Our model incorporates a detailed mechanistic description of the state-dependent dynamics induced by limited TTIQ capacities. In addition, we account for transmission during the early phase of SARS-CoV-2 infection, including presymptomatic transmission, which may be particularly adverse to a TTIQ based control. Numerical experiments, inspired by the early spread of COVID-19 in Germany, reveal the effectiveness of TTIQ in a scenario where immunity within the population is low and pharmaceutical interventions are absent - representative of a typical situation during the (re-)emergence of infectious diseases for which therapeutic drugs or vaccines are not yet available. Stability and sensitivity analyses emphasize factors, partially related to the specific disease, which impede or enhance the success of TTIQ. Studying the diminishing effectiveness of TTIQ along simulations of an epidemic wave we highlight consequences for intervention strategies.

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