Feedback Between Behavioral Adaptations and Disease Dynamics
Feedback Between Behavioral Adaptations and Disease Dynamics
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DOI：
10.1038/s41598-018-30471-0
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发表时间：
2018-08-20
影响因子：
4.6
通讯作者：
Marathe，Madhav
中科院分区：
文献类型：
--
作者：
Chen，Jiangzhuo;Marathe，Achla;Marathe，Madhav
我们研究流感大流行期间私人和公共部门共享有限库存的抗病毒药物时个人行为、疾病流行、干预措施和社交网络之间的反馈过程。利用患病率弹性需求进行干预的经济模型与详细的社交网络和疾病传播模型相结合，以了解流行病动态、市场行为、个人感知和社交网络之间的反馈机制。模拟城市和农村地区以评估结果的稳健性。结果表明，私营部门和公共部门之间可以实现最佳分配以遏制这种疾病，但私营部门抗病毒药物的可及性偏向最富有的收入四分之一。此外，向私营部门提供更多拨款会导致浪费，不需要的人可以购买，但需要的人却买不起。疾病患病率随着家庭规模和总接触时间的增加而增加，但与社交网络的程度无关，而抗病毒药物的浪费随着家庭规模和接触时间的增加而减少。当接触时间长的人（通常是大家庭的学龄儿童）使用药物时，可以实现药物的最佳利用。
We study the feedback processes between individual behavior, disease prevalence, interventions and social networks during an influenza pandemic when a limited stockpile of antivirals is shared between the private and the public sectors. An economic model that uses prevalence-elastic demand for interventions is combined with a detailed social network and a disease propagation model to understand the feedback mechanism between epidemic dynamics, market behavior, individual perceptions, and the social network. An urban and a rural region are simulated to assess the robustness of results. Results show that an optimal split between the private and public sectors can be reached to contain the disease but the accessibility of antivirals from the private sector is skewed towards the richest income quartile. Also, larger allocations to the private sector result in wastage where individuals who do not need it are able to purchase it but who need it cannot afford it. Disease prevalence increases with household size and total contact time but not by degree in the social network, whereas wastage of antivirals decreases with degree and contact time. The best utilization of drugs is achieved when individuals with high contact time use them, who tend to be the school-aged children of large families.