A stochastic agent-based model of the SARS-CoV-2 epidemic in France
A stochastic agent-based model of the SARS-CoV-2 epidemic in France
复制标题
DOI：
10.1038/s41591-020-1001-6
复制
发表时间：
2020-07-14
期刊：
影响因子：
82.9
通讯作者：
Leleu, Henri
中科院分区：
文献类型：
--
作者：
Hoertel, Nicolas;Blachier, Martin;Leleu, Henri
许多欧洲国家已通过实施全国性的保护措施和封锁来应对COVID-19大流行（1）。然而，当这些措施放松时，疫情可能会反弹，可能导致需要第二次或更多次重复封锁（2）。在这里，我们介绍了法国COVID-19流行病的基于随机代理的微观模拟模型的结果。我们研究了封锁后措施的潜在影响，包括物理距离、戴口罩和屏蔽最容易受到严重COVID-19感染的个人，对累积疾病发病率和死亡率以及重症监护病房（ICU）床位占用率的影响。虽然封锁措施有效遏制了病毒传播，但一旦解除，无论持续时间长短，都不太可能阻止反弹。物理距离和戴口罩虽然在减缓疫情和降低死亡率方面有效，但在最终防止ICU不堪重负和随后的第二次封锁方面也是无效的。然而，这些措施加上对弱势群体的保护将与更好的结果相关，包括降低死亡率和保持足够的ICU能力以防止第二次封锁。然而，如果大多数人不遵守这些措施，或者如果这些措施没有维持足够长的时间，福利将明显减少。一项模拟法国COVID-19疫情的新研究表明，尽管第二个高峰可能不可避免，但在解除封锁限制时保持社交距离和戴口罩，以及继续庇护脆弱的个人，将降低死亡率并避免重症监护室设施不堪重负。
Many European countries have responded to the COVID-19 pandemic by implementing nationwide protection measures and lockdowns(1). However, the epidemic could rebound when such measures are relaxed, possibly leading to a requirement for a second or more, repeated lockdowns(2). Here, we present results of a stochastic agent-based microsimulation model of the COVID-19 epidemic in France. We examined the potential impact of post-lockdown measures, including physical distancing, mask-wearing and shielding individuals who are the most vulnerable to severe COVID-19 infection, on cumulative disease incidence and mortality, and on intensive care unit (ICU)-bed occupancy. While lockdown is effective in containing the viral spread, once lifted, regardless of duration, it would be unlikely to prevent a rebound. Both physical distancing and mask-wearing, although effective in slowing the epidemic and in reducing mortality, would also be ineffective in ultimately preventing ICUs from becoming overwhelmed and a subsequent second lockdown. However, these measures coupled with the shielding of vulnerable people would be associated with better outcomes, including lower mortality and maintaining an adequate ICU capacity to prevent a second lockdown. Benefits would nonetheless be markedly reduced if most people do not adhere to these measures, or if they are not maintained for a sufficiently long period.A new study that models the COVID-19 epidemic in France suggests that although a second peak is likely unavoidable, maintaining social distancing and wearing masks when lockdown restrictions are lifted, as well as continuing to shelter vulnerable individuals, will reduce mortality and avoid overwhelming ICU facilities.