US-UK Collab Linking models and policy: Using active adaptive management for optimal control of disease outbreaks.

美英合作链接模型和政策：使用主动适应性管理来最佳控制疾病爆发。

• 批准号: BB/K010972/4
• 负责人: Michael Tildesley
• 金额: $ 24.72万
• 依托单位: University of Warwick
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2016
• 资助国家: 英国
• 起止时间: 2016 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=BB%2FK010972%2F4
• 关键词: US; UK; Collab; Linking; models

In the event of an outbreak of an infectious disease, management strategies to control further spread of infection are generally implemented based either upon strategies employed during previous epidemics or a pre-conceived expectation of the likelihood of success. However, at the onset of an outbreak, there is a great amount of uncertainty regarding the epidemiological properties of the disease and this may have a significant influence upon the ability of the chosen management strategy to contain or control the epidemic. Mathematical models can be developed to simulate spread of disease and evaluate the effectiveness of potential control strategies. However, the effectiveness of these models may be restricted by our limited knowledge of the epidemic as it unfolds.Extensive analyses of the 2001 Foot and Mouth (FMD) outbreak in the UK have provided valuable information about both the dynamics of disease spread and the implementation of management actions. However, those observations are specific both to the UK setting and to the strain of. A future outbreak in the UK or an outbreak in another country such as the US will not necessarily follow the same pattern. Thus, key aspects of disease spread, and the optimal response, cannot be resolved until an outbreak occurs. Adaptive management (AM) seeks to address this limitation by incorporating monitoring, evaluation, and response into management actions such that management strategies can be modified and updated in response to improved understanding of the outbreak dynamics. The AM framework has previously been applied in conservation management but is yet to be applied to the management of infectious diseases.AM provides a framework for switching from the early strategy that optimises the average outcome (when uncertainties are yet to be resolved), to the one that optimises the outcome for the specific model (or models) that best matches by the outbreak at hand. Additionally, active adaptive management seeks to make this switch as soon as possible, by initially using sub-optimal controls that allow the specific model to be identified as soon as possible. Thus, early management actions can be used to improve knowledge of the dynamics and more rapidly transition to the strategy that maximizes the global objective.Although we are interested in the general application of AM to a range of outbreak scenarios; in this project we will use the 2001 FMD epidemic as a detailed, well-defined example. Despite a decade of modelling efforts, key uncertainties concerning optimal control remain, AM will allow us to address these issues. In particular we propose to: 1. Use the observed surveillance from the 2001 outbreak to identify the optimal adaptive strategy and the economic benefit of that strategy relative to a static (fixed) strategy.2. Simulate the use of active AM to discriminate amongst competing models and selection of the optimal strategy. To that end we will consider the application of management strategies to facilitate learning and rapid updating of control policies.3. Use AM to determine optimal management strategies for other disease scenarios, helping to generate a more generic understanding.4. Using the FMD case-study developed in 1 and 2, we will support workshops that engage members of the US and UK policy community in the use of adaptive management for an outbreak. 5. Based on the understanding gained in the workshops, we will develop a US-based outbreak case-study that will be used as the subject of training workshops in the second half of the grant period. This case study would demonstrate the utility of AM in a scenario of extreme uncertainty.The outputs of this project would elucidate the ability of AM to provide efficient policy advice in the event of future unknown outbreaks of infectious disease. A single, flexible policy that is able to adapt to the observed outbreak would have massive implications in reducing the impact of future outbreaks.

在传染病爆发的情况下，控制感染进一步传播的管理战略通常是根据以前流行病期间采用的战略或预先设想的成功可能性的预期来实施的。然而，在疫情爆发之初，该疾病的流行病学特性存在很大的不确定性，这可能对所选择的控制或控制该流行病的管理战略的能力产生重大影响。可以建立数学模型来模拟疾病的传播并评估潜在控制策略的有效性。然而，随着疫情的发展，我们对疫情的了解有限，这些模型的有效性可能受到限制。对2001年英国口蹄疫暴发的广泛分析提供了有关疾病传播动态和管理行动实施的宝贵信息。然而，这些观察结果对英国的环境和压力都是特定的。未来在英国或美国等其他国家爆发的疫情不一定遵循同样的模式。因此，在疾病爆发之前，疾病传播的关键方面以及最佳应对措施无法得到解决。适应性管理（AM）试图通过将监测、评估和应对纳入管理行动来解决这一限制，从而可以根据对疫情动态的进一步了解修改和更新管理战略。AM框架以前已应用于保护管理，但尚未应用于传染病的管理。AM提供了一个框架，用于从优化平均结果（当不确定性尚未解决时）的早期战略转向优化与当前疫情最匹配的特定模型（或多个模型）的结果的战略。此外，主动自适应管理通过最初使用次优控制来尽可能快地识别特定模型，从而寻求尽快完成这种转换。因此，早期管理行动可用于提高对动态的认识，并更迅速地过渡到实现全球目标最大化的战略。虽然我们对AM在一系列爆发场景中的一般应用感兴趣；在本项目中，我们将使用2001年口蹄疫流行作为一个详细的、定义明确的例子。尽管经过了十年的建模努力，但关于最优控制的关键不确定性仍然存在，AM将使我们能够解决这些问题。我们特别建议：1。1 .利用观察到的2001年疫情监测情况，确定最佳适应战略以及该战略相对于静态（固定）战略的经济效益。模拟使用主动调幅来区分竞争模型和选择最优策略。为此目的，我们将考虑应用管理战略，以促进控制政策的学习和迅速更新。使用AM来确定其他疾病情景的最佳管理策略，有助于产生更一般的理解。利用第1和第2节中开展的口蹄疫案例研究，我们将支持举办研讨会，让美国和英国政策界的成员参与对疫情采用适应性管理。5. 根据在讲习班中获得的了解，我们将在美国开展一项疫情案例研究，该研究将作为赠款期下半年培训讲习班的主题。本案例研究将展示AM在极端不确定情况下的效用。这个项目的产出将阐明，在未来未知传染病爆发的情况下，管理研究所是否有能力提供有效的政策咨询意见。能够适应观察到的疫情的单一、灵活的政策将对减少未来疫情的影响产生重大影响。

项目成果

Dynamics of the 2004 avian influenza H5N1 outbreak in Thailand: The role of duck farming, sequential model fitting and control.

2004年泰国鸟类流感H5N1爆发的动力学：鸭式耕作，顺序模型拟合和控制的作用。

• DOI: 10.1016/j.prevetmed.2018.09.014
• 发表时间: 2018-11-01
• 期刊: Preventive veterinary medicine
• 影响因子: 2.6
• 作者: Retkute R;Jewell CP;Van Boeckel TP;Zhang G;Xiao X;Thanapongtharm W;Keeling M;Gilbert M;Tildesley MJ
• 通讯作者: Tildesley MJ

Decision-making for foot-and-mouth disease control: Objectives matter.

• DOI: 10.1016/j.epidem.2015.11.002
• 发表时间: 2016-06
• 期刊: Epidemics
• 影响因子: 3.8
• 作者: Probert WJ;Shea K;Fonnesbeck CJ;Runge MC;Carpenter TE;Dürr S;Garner MG;Harvey N;Stevenson MA;Webb CT;Werkman M;Tildesley MJ;Ferrari MJ
• 通讯作者: Ferrari MJ

Table S2 from Concurrent assessment of epidemiological and operational uncertainties for optimal outbreak control: Ebola as a case study

表 S2 来自对最佳疫情控制的流行病学和操作不确定性的同时评估：以埃博拉病毒为案例研究

• DOI: 10.6084/m9.figshare.8215898
• 发表时间: 2019
• 作者: Shou-Li LI

Real-time decision-making during emergency disease outbreaks.

• DOI: 10.1371/journal.pcbi.1006202
• 发表时间: 2018-07
• 期刊: PLoS computational biology
• 影响因子: 4.3
• 作者: Probert WJM;Jewell CP;Werkman M;Fonnesbeck CJ;Goto Y;Runge MC;Sekiguchi S;Shea K;Keeling MJ;Ferrari MJ;Tildesley MJ
• 通讯作者: Tildesley MJ

Quantifying the Value of Perfect Information in Emergency Vaccination Campaigns.

• DOI: 10.1371/journal.pcbi.1005318
• 发表时间: 2017-02
• 期刊: PLoS computational biology
• 影响因子: 4.3
• 作者: Bradbury NV;Probert WJ;Shea K;Runge MC;Fonnesbeck CJ;Keeling MJ;Ferrari MJ;Tildesley MJ
• 通讯作者: Tildesley MJ