Mechanistic transmission modeling of COVID-19 on the Diamond Princess cruise ship demonstrates the importance of aerosol transmission.
Mechanistic transmission modeling of COVID-19 on the Diamond Princess cruise ship demonstrates the importance of aerosol transmission.
复制标题
DOI：
10.1073/pnas.2015482118
复制
发表时间：
2021-02-23
影响因子：
11.1
通讯作者：
Allen JG
中科院分区：
文献类型：
--
作者：
Azimi P;Keshavarz Z;Cedeno Laurent JG;Stephens B;Allen JG
我们发现，在钻石公主号游轮上，空气传播可能占疾病传播的50%，包括在近距离接触和更远距离接触期间吸入气雾剂。这些调查结果突出表明，除了正在采取的控制大水滴和甲氧基苯丙胺传播的措施外，还必须实施旨在控制吸入气雾剂的公共卫生措施，不仅是在游轮上，而且在其他室内环境中也是如此。卫生组织的指导应该包括更多地强调控制措施，以减少通过空气传播的传播。最后，虽然我们的工作是基于一次邮轮新冠肺炎疫情，但该模型方法也可以应用于其他室内环境和其他传染病。有几条现有证据支持2019年冠状病毒病通过空气传播的可能性(新冠肺炎)。然而，关于严重急性呼吸综合征冠状病毒2(SARS-CoV-2)传播途径相对重要性的定量信息仍然有限。为了评估多种传播途径对SARS-CoV-2的相对重要性，我们开发了一个建模框架，并利用了2020年初发生的钻石公主号邮轮疫情的详细信息。我们对21,600个情景进行了建模，以生成针对八个未知或不确定的流行病和机械性传播因素的全范围假设的解决方案矩阵。共有132次模型迭代符合可接受标准(R2&>0.95用于建模与报告的每日累积病例，R2&>；0用于每日病例)。只分析这些成功的模型迭代可以量化每种定义的传输模式的可能贡献。在整个模拟期间，对短距离、远程和融合传播方式对感染病例的贡献的平均估计分别为35%、35%和30%。对较大的呼吸性水滴和较小的呼吸性气溶胶的贡献的平均估计分别为41%和59%。我们的结果表明，即使考虑到邮轮高通风率和没有空气再循环的保守假设，气雾剂吸入也可能是新冠肺炎在乘客中传播的主要贡献因素。此外，近距离和远程传播可能对船上疾病的发展起到了类似的作用，而甲型流感病毒的传播起到的作用较小。旅客隔离也影响了每种模式的重要性，展示了干预措施的影响。
We find that airborne transmission likely accounted for >50% of disease transmission on the Diamond Princess cruise ship, which includes inhalation of aerosols during close contact as well as longer range. These findings underscore the importance of implementing public health measures that target the control of inhalation of aerosols in addition to ongoing measures targeting control of large-droplet and fomite transmission, not only aboard cruise ships but in other indoor environments as well. Guidance from health organizations should include a greater emphasis on controls for reducing spread by airborne transmission. Last, although our work is based on a cruise ship outbreak of COVID-19, the model approach can be applied to other indoor environments and other infectious diseases. Several lines of existing evidence support the possibility of airborne transmission of coronavirus disease 2019 (COVID-19). However, quantitative information on the relative importance of transmission pathways of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains limited. To evaluate the relative importance of multiple transmission routes for SARS-CoV-2, we developed a modeling framework and leveraged detailed information available from the Diamond Princess cruise ship outbreak that occurred in early 2020. We modeled 21,600 scenarios to generate a matrix of solutions across a full range of assumptions for eight unknown or uncertain epidemic and mechanistic transmission factors. A total of 132 model iterations met acceptability criteria (R2 > 0.95 for modeled vs. reported cumulative daily cases and R2 > 0 for daily cases). Analyzing only these successful model iterations quantifies the likely contributions of each defined mode of transmission. Mean estimates of the contributions of short-range, long-range, and fomite transmission modes to infected cases across the entire simulation period were 35%, 35%, and 30%, respectively. Mean estimates of the contributions of larger respiratory droplets and smaller respiratory aerosols were 41% and 59%, respectively. Our results demonstrate that aerosol inhalation was likely the dominant contributor to COVID-19 transmission among the passengers, even considering a conservative assumption of high ventilation rates and no air recirculation conditions for the cruise ship. Moreover, close-range and long-range transmission likely contributed similarly to disease progression aboard the ship, with fomite transmission playing a smaller role. The passenger quarantine also affected the importance of each mode, demonstrating the impacts of the interventions.
登录
查看更多内容
影响因子：
3.8
作者：
Jones, Rachael M.;Adida, Elodie
通讯作者：
Adida, Elodie
影响因子：
8.4
作者：
Lednickya, John A.;Lauzardo, Michael;Wu, Chang-Yu
通讯作者：
Wu, Chang-Yu
影响因子：
3.8
作者：
Jones, Rachael M.;Masago, Yoshifumi;Rose, Joan B.
通讯作者：
Rose, Joan B.
影响因子：
5.2
作者：
Chen, Chun;Liu, Wei;Chen, Qingyan
通讯作者：
Chen, Qingyan
DOI：
10.1080/15459624.2020.1784427
发表时间：
2020-07-08
影响因子：
2
作者：
Jones, Rachael M.
通讯作者：
Jones, Rachael M.