When Do Epidemics End? Scientific Insights from Mathematical Modelling Studies
When Do Epidemics End? Scientific Insights from Mathematical Modelling Studies
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DOI：
10.1484/j.cnt.5.130125
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发表时间：
2022-01-01
期刊：
影响因子：
1.2
通讯作者：
Nishiura, Hiroshi
中科院分区：
文献类型：
--
作者：
Linton, Natalie M.;Lovell-Read, Francesca A.;Nishiura, Hiroshi
对传染病暴发何时结束进行量化评估至关重要，因为在宣布暴发结束之前，用于应对暴发的资源通常保持不变。最近在确定疫情何时结束的数学方法方面的改进和创新为公共卫生当局在宣布疫情结束时提供了更多的信心。虽然对暴发的定量分析有很长的历史，但在20世纪初开发了更复杂的数学和统计方法来分析暴发数据，并继续改进。从历史上看，这种方法主要侧重于影响暴发早期和中期的因素，较少关注如何以及何时结束暴发。这篇综述讨论了过去20年来为确定传染病暴发的终点而开发的数学建模方法，并考虑了影响此类确定的准确性的因素。当疾病监测系统提供及时和有代表性的数据为模型提供信息时，可以微调疫情结束声明的时间，以便快速宣布疫情结束，并降低错误风险。过早宣布疫情已经结束可能会破坏早先在疾病控制方面取得的成就，并可能导致病例死灰复燃，但宣布疫情结束的不必要拖延可能会造成重大的经济和社会损害。适当的声明可以平衡放松控制措施的好处和病例激增的风险，从而节省公共卫生资源(并减少经济和社会压力)，同时限制额外传播的可能性。
Quantitative assessments of when infectious disease outbreaks end are crucial, as resources targeted towards outbreak responses typically remain in place until outbreaks are declared over. Recent improvements and innovations in mathematical approaches for determining when outbreaks end provide public health authorities with more confidence when making end-of-outbreak declarations. Although quantitative analyses of outbreaks have a long history, more complex mathematical and statistical methodologies for analysing outbreak data were developed early in the 20th century and continue to be refined. Historically, such methodologies focused primarily on factors affecting the early and middle phases of an outbreak, with less attention given to determining how and when outbreaks end. This review discusses mathematical modelling methods from the last 20 years that have been developed for determining the ends of infectious disease outbreaks, and considers factors that affect the accuracy of such determinations. When disease surveillance systems provide timely and representative data to inform models, the timings of end-of-outbreak declarations can be fine-tuned to allow outbreaks to be declared over quickly and with a low risk of being incorrect. Premature declarations that outbreaks are over can undermine earlier achievements in disease control and may result in a resurgence of cases, but unnecessary delays in declaring outbreaks over can cause significant economic and social harm. Appropriate declarations that balance the benefits of relaxing control measures against the risk of a surge in cases allow public health resources to be conserved (and economic and social pressures to be reduced) while limiting the potential for additional transmission.