Societal learning in epidemics: intervention effectiveness during the 2003 SARS outbreak in Singapore.
Societal learning in epidemics: intervention effectiveness during the 2003 SARS outbreak in Singapore.
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DOI：
10.1371/journal.pone.0000020
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发表时间：
2006-12-20
期刊：
影响因子：
3.7
通讯作者：
Ma S
中科院分区：
文献类型：
--
作者：
Drake JM;Chew SK;Ma S
对新出现的传染病暴发的快速反应受到不确定的诊断和延迟的沟通的阻碍。理解无效反应的影响是流行病理论的一个潜在的重要贡献。为了发展这种理解，我们研究了新出现的疫情期间的社会学习，其中随着信息的收集和传播，患者的转移加速。我们开发了一个扩展的标准爆发模型，简单的随机流行病，它占社会学习。我们得到了预期的爆发规模和流行持续时间的分布表达式。我们发现，快速学习明显影响最终爆发的规模，即使学习表现出收益递减（放松）。作为一个例子，我们估计了2003年在新加坡爆发的严重急性呼吸系统综合征（SARS）的学习率。在疫情爆发的前八周，放松的证据是不确定的。我们估计，如果社会学习以实际速度的一半发生，预计疫情的最终规模将达到近800例，是观察到的感染人数的三倍多。相比之下，社会学习两倍有效的预期爆发规模为116例。这些结果表明，社会学习的速度可以极大地影响疾病爆发的最终规模，证明政府当局和公众有理由投资于预警系统和关注疾病爆发。我们认为，新出现的感染的负担，包括全球大流行的风险，可以有效地减少，通过改进程序，快速检测疫情，提醒公共卫生官员，并积极教育公众在疫情爆发之初。
Rapid response to outbreaks of emerging infectious diseases is impeded by uncertain diagnoses and delayed communication. Understanding the effect of inefficient response is a potentially important contribution of epidemic theory. To develop this understanding we studied societal learning during emerging outbreaks wherein patient removal accelerates as information is gathered and disseminated. We developed an extension of a standard outbreak model, the simple stochastic epidemic, which accounts for societal learning. We obtained expressions for the expected outbreak size and the distribution of epidemic duration. We found that rapid learning noticeably affects the final outbreak size even when learning exhibits diminishing returns (relaxation). As an example, we estimated the learning rate for the 2003 outbreak of severe acute respiratory syndrome (SARS) in Singapore. Evidence for relaxation during the first eight weeks of the outbreak was inconclusive. We estimated that if societal learning had occurred at half the actual rate, the expected final size of the outbreak would have reached nearly 800 cases, more than three times the observed number of infections. By contrast, the expected outbreak size for societal learning twice as effective was 116 cases. These results show that the rate of societal learning can greatly affect the final size of disease outbreaks, justifying investment in early warning systems and attentiveness to disease outbreak by both government authorities and the public. We submit that the burden of emerging infections, including the risk of a global pandemic, could be efficiently reduced by improving procedures for rapid detection of outbreaks, alerting public health officials, and aggressively educating the public at the start of an outbreak.
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