Estimating the COVID-19 epidemic trajectory and hospital capacity requirements in South West England: a mathematical modelling framework.

Estimating the COVID-19 epidemic trajectory and hospital capacity requirements in South West England: a mathematical modelling framework.
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DOI:
10.1136/bmjopen-2020-041536
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发表时间:
2021-01-07
期刊:
影响因子:
2.9
通讯作者:
Turner KME
Turner KME
中科院分区:
医学3区
文献类型:
--
作者:
Booton RD;MacGregor L;Vass L;Looker KJ;Hyams C;Bright PD;Harding I;Lazarus R;Hamilton F;Lawson D;Danon L;Pratt A;Wood R;Brooks-Pollock E;Turner KME

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以英格兰西南部(SW)为例,开发一个新冠疫情动态区域模型,用于估算感染人数、死亡人数以及所需的急性和重症监护(IC)病床数量。 一个具有年龄结构的开源易感 - 暴露 - 感染 - 康复分区数学模型变体。采用拉丁超立方抽样和最大似然估计法,根据累计病例数和累计死亡人数进行校准。 研究的是疫情初期的英格兰西南部,当时国家医疗服务管理部门需要证据来指导本地化规划并支持决策。 关于新冠患者的公开数据。 感染病例的预期数量、因新冠感染导致的死亡人数、急性和重症监护病床的患者占用情况以及随时间变化的再生数(“R”值)。 英格兰西南部模型预测表明,截至2020年5月11日(当时“封锁”措施放宽),仍有5793人(95%可信区间为2003人到12051人)具有传染性(占英格兰西南部总人口的0.10%,95%可信区间为0.04%到0.22%),总共有189048人(95%可信区间为141580人到277955人)感染了该病毒(无症状或有症状)但已康复,占英格兰西南部人口的3.4%(95%可信区间为2.5%到5.0%)。预计2020年5月11日英格兰西南部急性和重症监护病床的患者总数分别为701人(95%可信区间为169人到1543人)和110人(95%可信区间为8人到464人)。在采取任何干预措施之前,英格兰西南部的R值预计为2.6(95%可信区间为2.0到3.2),社交距离措施使其降至2.3(95%可信区间为1.8到2.9),封锁/学校停课进一步将R值降至0.6(95%可信区间为0.5到0.7)。 所开发的模型已被证明是区域医疗服务的一项宝贵资产。随着疫情的发展,该模型将在英格兰西南部进一步使用,并且由于是开源软件,可移植到其他地区的医疗系统。
To develop a regional model of COVID-19 dynamics for use in estimating the number of infections, deaths and required acute and intensive care (IC) beds using the South West England (SW) as an example case. Open-source age-structured variant of a susceptible-exposed-infectious-recovered compartmental mathematical model. Latin hypercube sampling and maximum likelihood estimation were used to calibrate to cumulative cases and cumulative deaths. SW at a time considered early in the pandemic, where National Health Service authorities required evidence to guide localised planning and support decision-making. Publicly available data on patients with COVID-19. The expected numbers of infected cases, deaths due to COVID-19 infection, patient occupancy of acute and IC beds and the reproduction (‘R’) number over time. SW model projections indicate that, as of 11 May 2020 (when ‘lockdown’ measures were eased), 5793 (95% credible interval (CrI) 2003 to 12 051) individuals were still infectious (0.10% of the total SW population, 95% CrI 0.04% to 0.22%), and a total of 189 048 (95% CrI 141 580 to 277 955) had been infected with the virus (either asymptomatically or symptomatically), but recovered, which is 3.4% (95% CrI 2.5% to 5.0%) of the SW population. The total number of patients in acute and IC beds in the SW on 11 May 2020 was predicted to be 701 (95% CrI 169 to 1543) and 110 (95% CrI 8 to 464), respectively. The R value in SW was predicted to be 2.6 (95% CrI 2.0 to 3.2) prior to any interventions, with social distancing reducing this to 2.3 (95% CrI 1.8 to 2.9) and lockdown/school closures further reducing the R value to 0.6 (95% CrI 0.5 to 0.7). The developed model has proved a valuable asset for regional healthcare services. The model will be used further in the SW as the pandemic evolves, and—as open-source software—is portable to healthcare systems in other geographies.
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