Beyond just "flattening the curve": Optimal control of epidemics with purely non-pharmaceutical interventions
Beyond just "flattening the curve": Optimal control of epidemics with purely non-pharmaceutical interventions
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DOI：
10.1186/s13362-020-00091-3
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发表时间：
2020-08-18
影响因子：
2.6
通讯作者：
Koprucki, Thomas
中科院分区：
文献类型：
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作者：
Kantner, Markus;Koprucki, Thomas
当无法获得有效的医疗和疫苗接种时，非药物干预措施，如保持社交距离、家庭隔离和广泛关闭公共生活，是防止流行病传播的唯一可用战略。基于扩展的SEIR（易感-暴露-感染-恢复）模型和连续时间最优控制理论，我们计算了在无法找到疫苗且无法完全控制（根除流行病）的情况下的最优非药物干预策略。在这种情况下，最优控制必须满足相互竞争的要求：首先，使与疾病有关的死亡人数最小化，其次，在措施结束时建立足够程度的自然免疫力，以排除第二波。此外，干预的社会经济成本应保持在最低限度。数值计算的最优控制策略是一种单一干预方案，超越了启发式动机干预和简单的“曲线平坦化”。然而，对计算控制策略的仔细分析表明，所得到的解决方案实际上是接近系统稳定边界的走钢丝，在那里，社会经济成本和新爆发的风险必须不断相互平衡。该模型系统经过校准，以重现德国COVID-19大流行的初始指数增长阶段。
When effective medical treatment and vaccination are not available, non-pharmaceutical interventions such as social distancing, home quarantine and far-reaching shutdown of public life are the only available strategies to prevent the spread of epidemics. Based on an extended SEIR (susceptible-exposed-infectious-recovered) model and continuous-time optimal control theory, we compute the optimal non-pharmaceutical intervention strategy for the case that a vaccine is never found and complete containment (eradication of the epidemic) is impossible. In this case, the optimal control must meet competing requirements: First, the minimization of disease-related deaths, and, second, the establishment of a sufficient degree of natural immunity at the end of the measures, in order to exclude a second wave. Moreover, the socio-economic costs of the intervention shall be kept at a minimum. The numerically computed optimal control strategy is a single-intervention scenario that goes beyond heuristically motivated interventions and simple "flattening of the curve". Careful analysis of the computed control strategy reveals, however, that the obtained solution is in fact a tightrope walk close to the stability boundary of the system, where socio-economic costs and the risk of a new outbreak must be constantly balanced against one another. The model system is calibrated to reproduce the initial exponential growth phase of the COVID-19 pandemic in Germany.