Epidemic Landscape and Forecasting of SARS-CoV-2 in India.
Epidemic Landscape and Forecasting of SARS-CoV-2 in India.
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DOI：
10.2991/jegh.k.200823.001
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发表时间：
2021-03
影响因子：
7.3
通讯作者：
Koya MSF
中科院分区：
文献类型：
--
作者：
Rajendrakumar AL;Nair ATN;Nangia C;Chourasia PK;Chourasia MK;Syed MG;Nair AS;Nair AB;Koya MSF
背景：印度是早期对严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)实施严格控制措施的国家之一。自那时以来，疫情增长轨迹很慢，但由于当地聚集性传播，病例激增。方法：我们利用众包时间序列数据估计了印度和高负担国家的SARS-CoV-2的增长率和倍增时间。此外，我们还使用数据的序列间隔估计了基本生殖数(R0)和随时间变化的生殖数(RT)。我们比较了五种不同方法估计的R0，并将SB的R0进一步用于分析。我们将标准易感传染病恢复期(SIR)模型修正为SIR/死亡(SIRD)模型，用序贯贝叶斯方法模拟SIRD模型中的死亡病例。结果：平均每例指示病例感染2.8人。平均连续间隔3.9d。不同方法估算的R0在1.43~1.85之间。平均痊愈时间为14±5.3天。印度的日疫情增长率为0.16[95%CI；0.14，0.17]，倍增时间为4.30天[95%CI；3.96，4.70]。从SIRD模型可以推断，印度SARS-CoV-2的高峰期将在2020年7月中旬至8月初左右，在高峰期可能有12.5%的人口被感染。结论：SARS-CoV-2在印度的传播模式提示为社区传播。有必要增加对传染病研究和流行病学研究的资金。如果航空旅行和社会融合迅速恢复，目前的所有收益可能会被逆转。目前，只有在我们准备好用疫苗或药物等有效工具应对这种疾病之后，这些措施才能分阶段恢复，并应恢复到正常水平。问：对印度新型SARS-CoV-2疫情早期阶段的传染病参数估计是多少？结果：SARS-CoV-2的发病模式表明可能存在社区传播的证据。然而，估计的基本繁殖数(R0)相对低于高负荷地区的观测结果(范围为1.43-1.85)。我们使用易感-感染-康复/死亡模型进行的模拟表明，印度SARS-CoV-2的高峰期比目前预测的更远，可能会影响大约12.5%的人口。意义：较低的估计R0表明早期社会疏远措施和封锁的有效性。过早放松目前的控制措施可能会导致印度出现大量病例。
Background: India was one of the countries to institute strict measures for Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) control in the early phase. Since, then, the epidemic growth trajectory was slow before registering an explosion of cases due to local cluster transmissions. Methods: We estimated the growth rate and doubling time of SARS-CoV-2 for India and high burden states using crowdsourced time series data. Further, we also estimated the Basic Reproductive Number (R0) and Time-dependent Reproductive number (Rt) using serial intervals from the data. We compared the R0 estimated from five different methods and R0 from SB was further used in the analysis. We modified standard Susceptible-Infectious-Recovered (SIR) models to SIR/Death (SIRD) model to accommodate deaths using R0 with the sequential Bayesian method for simulation in SIRD models. Results: On average, 2.8 individuals were infected by an index case. The mean serial interval was 3.9 days. The R0 estimated from different methods ranged from 1.43 to 1.85. The mean time to recovery was 14 ± 5.3 days. The daily epidemic growth rate of India was 0.16 [95% CI; 0.14, 0.17] with a doubling time of 4.30 days [95% CI; 3.96, 4.70]. From the SIRD model, it can be deduced that the peak of SARS-CoV-2 in India will be around mid-July to early August 2020 with around 12.5% of the population likely to be infected at the peak time. Conclusion: The pattern of spread of SARS-CoV-2 in India is suggestive of community transmission. There is a need to increase funds for infectious disease research and epidemiologic studies. All the current gains may be reversed if air travel and social mixing resume rapidly. For the time being, these must be resumed only in a phased manner and should be back to normal levels only after we are prepared to deal with the disease with efficient tools like vaccines or medicine. Question: What are the estimates of infectious disease parameters of early phase of novel SARS-CoV-2 epidemic in India? Findings: Incidence pattern SARS-CoV-2 shows possible evidence of community transmission. However, the estimated Basic Reproductive Number (R0) is relatively lower than those observed in high burden regions (range 1.43–1.85). Our simulation using susceptible-infectious-recovered/death model shows that peak of SARS-CoV-2 in India is farther than currently projected and is likely to affect around 12.5% of population. Meaning: The lower estimated R0 is indicative of the effectiveness of early social distancing measures and lockdown. Premature relaxation of the current control measures may result in large numbers of cases in India.
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