A prospect on the use of antiviral drugs to control local outbreaks of COVID-19
A prospect on the use of antiviral drugs to control local outbreaks of COVID-19
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DOI：
10.1186/s12916-020-01636-4
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发表时间：
2020-06-25
期刊：
影响因子：
9.3
通讯作者：
Hens, Niel
中科院分区：
文献类型：
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作者：
Torneri, Andrea;Libin, Pieter;Hens, Niel
背景：目前新冠肺炎的暴发正威胁着全球多个国家的医疗体系。以隔离、接触者追踪和检疫为基础的控制措施可以减轻和延迟持续流行的负担。关于正在进行的新冠肺炎疫情，最近的建模工作表明，即使假设完全隔离，这些干预措施也可能不足以控制局部疫情。症状出现前的传染性和无症状感染者的影响进一步使接触者追踪的使用复杂化。我们旨在研究是否可以将降低病毒载量和降低传染性的抗病毒药物纳入控制措施，以增加控制疫情的可行性。方法：使用基于模拟的病毒传播模型，测试不同干预措施对局部新冠肺炎暴发的控制效果。对于通过接触者追踪确定身份的个人，我们评估两个程序：监测个人的症状开始和个人测试。此外，我们还结合接触者追踪过程调查了抗病毒化合物的实施情况。结果：对于可能存在无症状和无症状感染的传染病，基于接触者追踪的干预措施在与检测相结合时表现得比监测更好，前提是该检测能够检测到潜伏期的感染。抗病毒药物与接触者追踪、隔离和隔离相结合，导致最终规模和高峰发病率显著下降，并增加疫情消退的可能性。结论：在所有测试情景中，该模型突出了基于被追踪个体检测的控制措施的好处。此外，服用抗病毒药物，以及隔离、隔离和接触者追踪，被证明可以减少疫情的传播。这一控制措施可能是控制局部和再次爆发的新冠肺炎的有效策略。
Background: Current outbreaks of COVID-19 are threatening the health care systems of several countries around the world. Control measures, based on isolation, contact tracing, and quarantine, can decrease and delay the burden of the ongoing epidemic. With respect to the ongoing COVID-19 epidemic, recent modeling work shows that these interventions may be inadequate to control local outbreaks, even when perfect isolation is assumed. The effect of infectiousness prior to symptom onset combined with asymptomatic infectees further complicates the use of contact tracing. We aim to study whether antivirals, which decrease the viral load and reduce infectiousness, could be integrated into control measures in order to augment the feasibility of controlling the epidemic.Methods: Using a simulation-based model of viral transmission, we tested the efficacy of different intervention measures to control local COVID-19 outbreaks. For individuals that were identified through contact tracing, we evaluate two procedures: monitoring individuals for symptoms onset and testing of individuals. Additionally, we investigate the implementation of an antiviral compound combined with the contact tracing process.Results: For an infectious disease in which asymptomatic and presymptomatic infections are plausible, an intervention measure based on contact tracing performs better when combined with testing instead of monitoring, provided that the test is able to detect infections during the incubation period. Antiviral drugs, in combination with contact tracing, quarantine, and isolation, result in a significant decrease of the final size and the peak incidence, and increase the probability that the outbreak will fade out.Conclusion: In all tested scenarios, the model highlights the benefits of control measures based on the testing of traced individuals. In addition, the administration of an antiviral drug, together with quarantine, isolation, and contact tracing, is shown to decrease the spread of the epidemic. This control measure could be an effective strategy to control local and re-emerging outbreaks of COVID-19.