RAPID: Modeling COVID-19 Coronavirus Vaccine and Nursing Homes

护理院（NH）受到COVID-19冠状病毒大流行的打击尤为严重，NH居民占所有COVID-19死亡人数的近四分之一。该项目将有助于回答有关NHS的关键问题，NHS特别容易受到COVID-19冠状病毒感染，可能是减缓大流行的关键，以及COVID-19冠状病毒疫苗。由于健康状况、频繁的互动以及接近社区的生活区，NH居民可能面临更高的COVID-19冠状病毒感染风险。一旦感染，居民也面临着严重的健康后果的风险，因为与年龄有关的疾病，晚期慢性病和虚弱。此外，以前的工作已经表明，NHS如何与一个地区的其他医疗机构高度相互关联，以及一个养老院的传染病爆发如何迅速蔓延到整个地区。因此，NHS可能会进一步加剧整体流行病。COVID-19冠状病毒疫苗是对NHS的一种潜在干预，该拟议项目将有助于解决有关COVID-19冠状病毒疫苗的重要问题。需要更好地描述疫苗特征（例如，效力/有效性、保护期、成本），以及如果不同类型的疫苗进入市场，如何最好地使用它们。了解不同人群、覆盖范围和依从性的不同优先级的影响也很有帮助。该项目的更广泛影响是更好地了解COVID-19冠状病毒如何在NH中传播以及疫苗接种和其他干预措施的影响。这将有助于决策者确定应在NHS中实施哪些预防和控制措施以及如何实施这些措施。该项目将涉及选定的养老院（NHs）及其居民和人员（包括卫生专业人员和工作人员）的计算模型的开发。这些模型将代表NH的布局，具体的居民和人员，他们的特点，以及他们的相互作用。模拟将考虑NH的感染者通过直接接触或可能通过气溶胶传播或表面污染将病毒传播给他人。模拟实验将考虑以不同的方式将严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引入养老院。这项工作将探索向NHS引入不同类型的COVID-19冠状病毒疫苗的效果和价值。例如，改变疫苗的效力、保护持续时间和其他特性。此外，这些模型可以探索不同的养老院居民和工作人员之间不同的疫苗接种覆盖率和依从性的影响（例如，如果不同类型的居民在不同时间接种疫苗会发生什么情况，如果疫苗有限，哪些居民和人员应优先接种）。模拟实验还可以探讨分层对不同的选定政策和干预措施的影响（例如，戴口罩、测试和不同类型的社交距离），有和没有COVID-19冠状病毒疫苗。为每个居民和工作人员开发并附上COVID-19临床结果和成本计算模型，可以帮助计算不同疫苗、政策和干预措施的经济影响和价值。该奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Nursing Homes (NHs) have been hit particularly hard by the COVID-19 coronavirus pandemic, with NH residents accounting for nearly a quarter of all COVID-19 deaths. This project will help answer key questions about NHs, which are particularly vulnerable to COVID-19 coronavirus infections and may be key to slowing the pandemic, and COVID-19 coronavirus vaccines. NH residents may be at a higher risk for COVID-19 coronavirus infections due to their health status, frequent interactions, and close, community-like living quarters. Once infected, residents are also at risk of serious health outcomes as a result of age-related illnesses, advanced chronic conditions, and frailty. Moreover, previous work has shown how NHs are highly interconnected with other healthcare facilities in a region and how an infectious disease outbreak in one nursing home can quickly spread throughout a region. Thus, NHs could further fuel the overall pandemic. COVID-19 coronavirus vaccines are one potential intervention in NHs and this proposed project would help address important questions about COVID-19 coronavirus vaccines. There is a need to better delineate the vaccine characteristics (e.g., efficacy/effectiveness, duration of protection, cost) that vaccine developers should aim for and how best to use different types of vaccines should they reach the market. It will also be helpful to understand the impact of varying prioritization of different populations, coverage, and compliance. A broader impact of this project is a better understanding of how COVID-19 coronavirus spreads in NHs and the impact of vaccination and other interventions. This will help decision makers determine what prevention and control measures should be implemented in NHs and how to implement these measures. This project will entail the development of computational models of selected nursing homes (NHs) and their residents and personnel (including health professionals and staff). The models would represent the layouts of the NH, the specific residents and personnel, their characteristics, and their interactions. Simulations will consider an infected person in the NH transmitting the virus to others through direct contact or potentially through aerosol transmission or surface contamination. Simulation experiments would consider introduction of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into the nursing home in different ways. This work will explore the effects and value of introducing different types of COVID-19 coronavirus vaccines to the NHs. For example, varying the efficacy, duration of protection, and other characteristics of the vaccine. Additionally, the models could explore the effects of varying vaccination coverage and compliance among different nursing home residents and personnel (e.g., what would happen if different types of residents received the vaccine at different times, which residents and personnel should be prioritized if vaccines are limited). Simulation experiments could also explore the effects of layering on different selected policies and interventions (e.g., wearing face masks, testing, and different types of social distancing) with and without COVID-19 coronavirus vaccines. Developing and attaching a COVID-19 clinical outcomes and costing model to each of the residents and personnel then can help calculate the economic impact and value of different vaccines, policies, and interventions.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.