Is Lockdown Effective in Limiting SARS-CoV-2 Epidemic Progression?-a Cross-Country Comparative Evaluation Using Epidemiokinetic Tools.
Is Lockdown Effective in Limiting SARS-CoV-2 Epidemic Progression?-a Cross-Country Comparative Evaluation Using Epidemiokinetic Tools.
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封锁能否有效限制 SARS-CoV-2 流行病的进展？——使用流行病动力学工具进行的跨国比较评估。
DOI：
10.1007/s11606-020-06345-5
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发表时间：
2021-03
影响因子：
5.7
通讯作者：
Scherrmann JM
中科院分区：
文献类型：
--
作者：
Mégarbane B;Bourasset F;Scherrmann JM
到目前为止，在控制严重急性呼吸综合征冠状病毒-2(SARS-CoV-2)疫情方面，封锁的风险/利益平衡仍存在争议。我们的目标是调查在九个不同的国家(新西兰、法国、西班牙、德国、荷兰、意大利、英国、瑞典和美国)封锁SARS-CoV-2疫情进展的有效性。我们使用基于易感-感染-康复(SIR)的模型进行了一项跨国比较评估，该模型采用了药代动力学方法。这九个国家每日新增SARS-CoV-2病例的比率是根据世界卫生组织公布的数据计算的。利用基于SIR的模型，我们确定了感染(β)和恢复(γ)速率常数；它们相应的半衰期(T1/2β和T1/2γ)；基本繁殖数(R0为β/γ)；易感S(T)、感染I(T)和恢复R(T)的比率；以及封锁的有效性。由于这种方法需要流行病终止来建立(I)隔室，所以我们在流行病早期使用简单的线性回归来确定S(T)。在新西兰、法国、西班牙、德国、荷兰、意大利和英国，早起的居家命令和限制，然后逐步解除限制，使SARS-CoV-2感染者的R0β≤1.5R0和快速恢复(T1/2≤18天)迅速减少(T1/2γ≤14天)。相比之下，在瑞典(没有封锁)和美国(异质状态依赖的封锁，然后突然解除限制的情景)，观察到R0升高(分别为4.9d和4.4d)和持续恢复(末期t1/2β分别为112d和179d)的SARS-CoV-2感染者(分别为23天和40天的T1/2末期γ)长期处于平台期。早期的封锁和逐步解除限制使SARS-CoV-2疫情得以缩短，减少了污染。封锁应被视为有效的公共卫生干预措施，以遏制疫情的发展。
To date, the risk/benefit balance of lockdown in controlling severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemic is controversial. We aimed to investigate the effectiveness of lockdown on SARS-CoV-2 epidemic progression in nine different countries (New Zealand, France, Spain, Germany, the Netherlands, Italy, the UK, Sweden, and the USA). We conducted a cross-country comparative evaluation using a susceptible-infected-recovered (SIR)-based model completed with pharmacokinetic approaches. The rate of new daily SARS-CoV-2 cases in the nine countries was calculated from the World Health Organization’s published data. Using a SIR-based model, we determined the infection (β) and recovery (γ) rate constants; their corresponding half-lives (t1/2β and t1/2γ); the basic reproduction numbers (R0 as β/γ); the rates of susceptible S(t), infected I(t), and recovered R(t) compartments; and the effectiveness of lockdown. Since this approach requires the epidemic termination to build the (I) compartment, we determined S(t) at an early epidemic stage using simple linear regressions. In New Zealand, France, Spain, Germany, the Netherlands, Italy, and the UK, early-onset stay-at-home orders and restrictions followed by gradual deconfinement allowed rapid reduction in SARS-CoV-2-infected individuals (t1/2β ≤ 14 days) with R0 ≤ 1.5 and rapid recovery (t1/2γ ≤ 18 days). By contrast, in Sweden (no lockdown) and the USA (heterogeneous state-dependent lockdown followed by abrupt deconfinement scenarios), a prolonged plateau of SARS-CoV-2-infected individuals (terminal t1/2β of 23 and 40 days, respectively) with elevated R0 (4.9 and 4.4, respectively) and non-ending recovery (terminal t1/2γ of 112 and 179 days, respectively) was observed. Early-onset lockdown with gradual deconfinement allowed shortening the SARS-CoV-2 epidemic and reducing contaminations. Lockdown should be considered as an effective public health intervention to halt epidemic progression.
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