Multifaceted strategies for the control of COVID-19 outbreaks in long-term care facilities in Ontario, Canada
Multifaceted strategies for the control of COVID-19 outbreaks in long-term care facilities in Ontario, Canada
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加拿大安大略省长期护理机构中控制 COVID-19 疫情的多方面策略
DOI：
10.1016/j.ypmed.2021
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发表时间：
2021
影响因子：
5.1
通讯作者：
Vilches TN, Nourbakhsh S
中科院分区：
文献类型：
--
作者：
Vilches TN, Nourbakhsh S
2019年新型冠状病毒病（COVID-19）在加拿大长期护理机构（LTCF）造成严重疫情。在加拿大，超过80%的COVID-19死亡病例发生在LTCF。我们试图评估在LTCF中采取的缓解措施的效果，包括频繁测试员工，以及为员工和居民接种疫苗。我们开发了一个基于病原体的传播模型，并使用疾病特异性估计值、鼻咽和唾液检测的时间敏感性、疫苗有效性试验结果以及加拿大安大略LTCF中最初COVID-19爆发的数据对其进行参数化。工作人员和居民的特点，包括接触模式，被整合到模型与年龄相关的住院和死亡的风险。获得感染和结局的估计值，并使用偏倚校正和加速自举法生成95%可信区间。与戴口罩、症状筛查和工作人员单独聚集的基线措施相比，每周对工作人员进行常规检测，2天的周转时间使居民感染减少至少25.9%（95%CrI：23.3%-28.3%）。住院和死亡人数也有类似的减少。与常规检测相比，接种疫苗避免了2-4倍的工作人员和居民感染，并在接种疫苗开始后的200天内将居民住院和死亡人数分别显著减少了95.9%（95%CrI：95.4%-96.3%）和95.8%（95%CrI：95.5%-96.1%）。疫苗接种可能对减轻居民的疾病负担产生重大影响，但在实现COVID-19的人口水平控制之前，可能不会消除对其他措施的需求。
The novel coronavirus disease 2019 (COVID-19) has caused severe outbreaks in Canadian long-term care facilities (LTCFs). In Canada, over 80% of COVID-19 deaths during the first pandemic wave occurred in LTCFs. We sought to evaluate the effect of mitigation measures in LTCFs including frequent testing of staff, and vaccination of staff and residents. We developed an agent-based transmission model and parameterized it with disease-specific estimates, temporal sensitivity of nasopharyngeal and saliva testing, results of vaccine efficacy trials, and data from initial COVID-19 outbreaks in LTCFs in Ontario, Canada. Characteristics of staff and residents, including contact patterns, were integrated into the model with age-dependent risk of hospitalization and death. Estimates of infection and outcomes were obtained and 95% credible intervals were generated using a bias-corrected and accelerated bootstrap method. Weekly routine testing of staff with 2-day turnaround time reduced infections among residents by at least 25.9% (95% CrI: 23.3%–28.3%), compared to baseline measures of mask-wearing, symptom screening, and staff cohorting alone. A similar reduction of hospitalizations and deaths was achieved in residents. Vaccination averted 2–4 times more infections in both staff and residents as compared to routine testing, and markedly reduced hospitalizations and deaths among residents by 95.9% (95% CrI: 95.4%–96.3%) and 95.8% (95% CrI: 95.5%–96.1%), respectively, over 200 days from the start of vaccination. Vaccination could have a substantial impact on mitigating disease burden among residents, but may not eliminate the need for other measures before population-level control of COVID-19 is achieved.
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BNT162B2 mRNA COVID-19疫苗的安全性和功效。
DOI：
10.1056/nejmoa2034577
发表时间：
2020-12-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Polack FP;Thomas SJ;Kitchin N;Absalon J;Gurtman A;Lockhart S;Perez JL;Pérez Marc G;Moreira ED;Zerbini C;Bailey R;Swanson KA;Roychoudhury S;Koury K;Li P;Kalina WV;Cooper D;Frenck RW Jr;Hammitt LL;Türeci Ö;Nell H;Schaefer A;Ünal S;Tresnan DB;Mather S;Dormitzer PR;Şahin U;Jansen KU;Gruber WC;C4591001 Clinical Trial Group
通讯作者：
C4591001 Clinical Trial Group
影响因子：
3.6
作者：
Najafi, Mehdi;Laskowski, Marek;Moghadas, Seyed M.
通讯作者：
Moghadas, Seyed M.
COVID-19 死亡率和长期护理：英国比较
DOI：
--
发表时间：
2020
期刊：
--
影响因子：
--
作者：
David Bell
通讯作者：
David Bell
DOI：
10.1056/nejmoa2035389
发表时间：
2021-02-04
期刊：
The New England journal of medicine
影响因子：
--
作者：
Baden LR;El Sahly HM;Essink B;Kotloff K;Frey S;Novak R;Diemert D;Spector SA;Rouphael N;Creech CB;McGettigan J;Khetan S;Segall N;Solis J;Brosz A;Fierro C;Schwartz H;Neuzil K;Corey L;Gilbert P;Janes H;Follmann D;Marovich M;Mascola J;Polakowski L;Ledgerwood J;Graham BS;Bennett H;Pajon R;Knightly C;Leav B;Deng W;Zhou H;Han S;Ivarsson M;Miller J;Zaks T;COVE Study Group
通讯作者：
COVE Study Group
长期护理领域的流行病经验：加拿大与其他国家相比如何？
DOI：
--
发表时间：
2020
期刊：
影响因子：
--
作者：
P. Rochon;Wei Wu;V. Giannakeas;N. Stall
通讯作者：
N. Stall