Challenges in control of COVID-19: short doubling time and long delay to effect of interventions.
Challenges in control of COVID-19: short doubling time and long delay to effect of interventions.
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DOI：
10.1098/rstb.2020.0264
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发表时间：
2021-07-19
期刊：
影响因子：
--
通讯作者：
University of Manchester COVID-19 Modelling Group
中科院分区：
文献类型：
--
作者：
Pellis L;Scarabel F;Stage HB;Overton CE;Chappell LHK;Fearon E;Bennett E;Lythgoe KA;House TA;Hall I;University of Manchester COVID-19 Modelling Group
COVID-19增长率的早期评估存在很大的不确定性，正如预期的那样，数据有限且难以确定病例，但由于多个国家记录了病例，因此可以做出更可靠的推断。使用多个国家、数据流和方法，我们估计，在不受限制的情况下，欧洲COVID-19确诊病例平均每3天翻一番（范围为2.2-4.3天），意大利医院和重症监护室入院率每2-3天翻一番;这些数值显著低于早期发表文献中占主导地位的5-7天。此外，我们发现，物理距离干预措施的影响通常要到实施后至少9天才能看到，在此期间，确诊病例可能会增加8倍。我们认为，这样的时间模式比精确估计时间不敏感的基本再生数R 0启动干预措施更重要，快速增长和长时间的检测延迟相结合，比单独的大值R 0更好地解释了各国疫情应对的斗争。在首次报告这些结果的一年后，生殖数量继续主导媒体和公共话语，但对无约束增长的稳健估计对于规划最坏情况仍然至关重要，检测延迟仍然是放松和重新实施干预措施的关键。本文是主题问题“塑造英国早期COVID-19大流行应对的模型”的一部分。
Early assessments of the growth rate of COVID-19 were subject to significant uncertainty, as expected with limited data and difficulties in case ascertainment, but as cases were recorded in multiple countries, more robust inferences could be made. Using multiple countries, data streams and methods, we estimated that, when unconstrained, European COVID-19 confirmed cases doubled on average every 3 days (range 2.2–4.3 days) and Italian hospital and intensive care unit admissions every 2–3 days; values that are significantly lower than the 5–7 days dominating the early published literature. Furthermore, we showed that the impact of physical distancing interventions was typically not seen until at least 9 days after implementation, during which time confirmed cases could grow eightfold. We argue that such temporal patterns are more critical than precise estimates of the time-insensitive basic reproduction number R0 for initiating interventions, and that the combination of fast growth and long detection delays explains the struggle in countries' outbreak response better than large values of R0 alone. One year on from first reporting these results, reproduction numbers continue to dominate the media and public discourse, but robust estimates of unconstrained growth remain essential for planning worst-case scenarios, and detection delays are still key in informing the relaxation and re-implementation of interventions. This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK’.
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