The challenges of containing SARS-CoV-2 via test-trace-and-isolate.

The challenges of containing SARS-CoV-2 via test-trace-and-isolate.
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DOI:
10.1038/s41467-020-20699-8
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发表时间:
2021-01-15
影响因子:
16.6
通讯作者:
Priesemann V
Priesemann V
中科院分区:
综合性期刊1区
文献类型:
--
作者:
Contreras S;Dehning J;Loidolt M;Zierenberg J;Spitzner FP;Urrea-Quintero JH;Mohr SB;Wilczek M;Wibral M;Priesemann V

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在没有治愈方法、疫苗或经证实的针对SARS-CoV-2的长期免疫力的情况下,测试跟踪和隔离(TTI)策略是遏制其传播的有希望的工具。然而,对于任何TTI策略,缓解都面临着无症状传播前和无症状传播、避免TTI者和未被发现的传播者的挑战,这些都是“隐藏”感染链的重要因素。在这里,我们研究了一个半分析模型,并确定了受控和不受控传播之间的两个临界点:(1)隐藏链的行为驱动的复制数量变得太大,无法通过TTI功能进行补偿,以及(2)新感染的数量超过了跟踪能力。两者都引发了自我加速的蔓延。我们研究这些临界点如何取决于有限的合作,缺少联系和不完美的隔离等挑战。我们的研究结果表明,TTI本身不足以遏制SARS-CoV-2的传播,这意味着社交距离和改善卫生等补充措施仍然是必要的。检测、追踪和隔离计划是COVID-19控制的核心。在这里,Viola Priesemann及其同事评估了如何分配稀缺资源以保持低数量,并发现如果病例数量超过测试,跟踪和隔离能力,将出现自我加速传播。
Without a cure, vaccine, or proven long-term immunity against SARS-CoV-2, test-trace-and-isolate (TTI) strategies present a promising tool to contain its spread. For any TTI strategy, however, mitigation is challenged by pre- and asymptomatic transmission, TTI-avoiders, and undetected spreaders, which strongly contribute to ”hidden" infection chains. Here, we study a semi-analytical model and identify two tipping points between controlled and uncontrolled spread: (1) the behavior-driven reproduction number of the hidden chains becomes too large to be compensated by the TTI capabilities, and (2) the number of new infections exceeds the tracing capacity. Both trigger a self-accelerating spread. We investigate how these tipping points depend on challenges like limited cooperation, missing contacts, and imperfect isolation. Our results suggest that TTI alone is insufficient to contain an otherwise unhindered spread of SARS-CoV-2, implying that complementary measures like social distancing and improved hygiene remain necessary. Test, trace, and isolate programmes are central to COVID-19 control. Here, Viola Priesemann and colleagues evaluate how to allocate scarce resources to keep numbers low, and find that if case numbers exceed test, trace and isolate capacity, there will be a self-accelerating spread.
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