Risking further COVID-19 waves despite vaccination.
Risking further COVID-19 waves despite vaccination.
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DOI：
10.1016/s1473-3099(21)00167-5
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Priesemann V
中科院分区：
文献类型：
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作者：
Contreras S;Priesemann V
新冠肺炎的突然爆发和全球传播，让世界大吃一惊。政策制定者开始与理论家并肩工作，因为过去和现在仍然有许多未知因素，特别是关于病毒变种的特性，以及随后大流行的未来发展。在不确定时期，数学模型充分利用了当前的科学知识，阐明了大流行的演变。在《柳叶刀传染病》一书中，萨姆·摩尔和他的同事们提出了一个模型，以探索疫苗接种的效果以及过早取消限制的潜在危险。随着疫苗接种的进展，我们都希望尽快取消限制。只缓慢地举起它们就像是被迫在几个月没有吃巧克力蛋糕后慢慢地吃下去。那么，人们为什么要谨慎呢？直觉上很清楚，如果过早取消限制，那么另一波大流行可能会来袭，影响那些尚未接种疫苗的人。此外，即使是那些最近接种疫苗的人中的一些人，在取消限制时可能还没有接种疫苗，因此仍有部分易感。拿这些人的健康和生命冒险是不道德的。摩尔和他的同事能告诉我们，我们什么时候可以吃到巧克力蛋糕吗？不幸的是，没有。在疫苗接种活动期间和之后，有太多未知因素可能会影响SARS-CoV-2的传播动态。包括这些不确定性是设计一个好的流行病学模型的核心。摩尔和他的同事们发现，疫苗诱导的抗感染保护水平仍然未知，这对病毒传播的进一步浪潮的时机和效果至关重要。此外，他们量化了疫苗接种率低，以及非药物干预措施(NPI)的取消将导致更多住院和死亡浪潮，其中大部分是可以预防的。他们还表明，只有在疫苗接种率高的最好情况下(对感染有85%的保护作用，对严重症状有高效率)，才能逐步放松非营利组织感染，而不会导致每天死亡人数激增超过500人。
The sudden outbreak and global spread of COVID-19 took the world by surprise. Policy makers started to work side-by-side with theoreticians, as there were and still are many unknowns, especially regarding properties of virus variants, and the subsequent future development of the pandemic. In times of uncertainty, mathematical models have shed light on the evolution of the pandemic to the best of current scientific knowledge. In The Lancet Infectious Diseases, Sam Moore and colleagues1 present a model to explore the effects of vaccination and the potential danger of lifting restrictions too early in the UK. With vaccination progressing, we all want restrictions to be lifted as soon as possible. Lifting them only slowly is like being forced to eat a chocolate cake slowly, after not having any for months. So why should one be cautious? It is intuitively clear that if restrictions are lifted too early then another pandemic wave might strike and affect those who have not yet been vaccinated. Furthermore, even some of those individuals recently vaccinated might not yet be immunised by the time of lifting restrictions and thus remain partly susceptible. Risking the health and lives of such individuals would be unethical. Can Moore and colleagues tell us when precisely we can have the chocolate cake? Unfortunately, no.There are too many unknown factors that might affect the transmission dynamics of SARS-CoV-2 during the vaccination campaign and thereafter. Including such uncertainties is at the heart of designing a good epidemiological model. Moore and colleagues found that the still unknown level of vaccine-induced protection against infection is crucial to the timing and effect of further waves on viral spread. Furthermore, they quantify how low vaccine uptake, together with a lifting of non-pharmaceutical interventions (NPIs), will induce further waves of hospitalisations and deaths, most of which could be prevented. They also show that only in a best-case scenario of high vaccine uptake (85% protection against infection and high efficacy against severe symptoms) could a gradual relaxation of NPIs be allowed without deaths surging over 500 per day.