Modeling behavioral change and COVID-19 containment in Mexico: A trade-off between lockdown and compliance
Modeling behavioral change and COVID-19 containment in Mexico: A trade-off between lockdown and compliance
复制标题
DOI：
10.1016/j.mbs.2020.108370
复制
发表时间：
2020-07-01
影响因子：
4.3
通讯作者：
Velasco-Hernandez, Jorge X.
中科院分区：
文献类型：
--
作者：
Adrian Acuna-Zegarra, Manuel;Santana-Cibrian, Mario;Velasco-Hernandez, Jorge X.
墨西哥于2020年3月30日实施了卫生紧急措施（SEM），要求暂停非必要活动。此次行动是继2020年3月23日的健康距离卫生行动之后。这两项措施的目的是通过降低有效接触率来减少COVID-19在墨西哥的社区传播。使用修改的Kermack-McKendrick SEIR模型，我们探讨了通过引入随时间变化的接触率来降低社区传播所需的行为变化的影响，以及疾病传播在暂停非必要活动的人群中的后果。我们的研究表明，在SEM下的人口比例与个人致力于实现有效社交距离所需的所有行为变化的平均时间之间存在权衡。在严格的缓解措施下，这种权衡产生了人口比例的最佳值，在某些情况下显著低于1，最大限度地减少了COVID-19的最大发病率。我们研究了三个关键因素对人口水平的影响：行为改变控制措施的实施、降低有效接触率所需的时间范围以及在抗击COVID 19方面处于SEM下的人口比例。我们的模型与现有的数据相吻合。从2020年2月17日至3月23日的疫情初始阶段用于估计接触率，感染期和死亡率，使用确诊病例（症状开始日期）和每日死亡率。2020年3月23日之后的死亡数据用于估计缓解措施实施后的死亡率。我们的模拟表明，在高SEM合规性和低SEM放弃率的情况下，最大发生率的最可能日期是2020年5月底至6月初。
Sanitary Emergency Measures (SEM) were implemented in Mexico on March 30th, 2020 requiring the suspension of non-essential activities. This action followed a Healthy Distance Sanitary action on March 23rd, 2020. The aim of both measures was to reduce community transmission of COVID-19 in Mexico by lowering the effective contact rate. Using a modification of the Kermack-McKendrick SEIR model we explore the effect of behavioral changes required to lower community transmission by introducing a time-varying contact rate, and the consequences of disease spread in a population subject to suspension of non-essential activities. Our study shows that there exists a trade-off between the proportion of the population under SEM and the average time an individual is committed to all the behavioral changes needed to achieve an effective social distancing. This trade-off generates an optimum value for the proportion of the population under strict mitigation measures, significantly below 1 in some cases, that minimizes maximum COVID-19 incidence. We study the population-level impact of three key factors: the implementation of behavior change control measures, the time horizon necessary to reduce the effective contact rate and the proportion of people under SEM in combating COVID19. Our model is fitted to the available data. The initial phase of the epidemic, from February 17th to March 23rd, 2020, is used to estimate the contact rates, infectious periods and mortality rate using both confirmed cases (by date of symptoms initiation), and daily mortality. Data on deaths after March 23rd, 2020 is used to estimate the mortality rate after the mitigation measures are implemented. Our simulations indicate that the most likely dates for maximum incidence are between late May and early June, 2020 under a scenario of high SEM compliance and low SEM abandonment rate.