模拟在非药物干预、疫苗接种和 SARS-CoV-2 变种替换的情况下 COVID-19 在老挝的传播动态。

Xu-Sheng Zhang, Hong Luo, Andre Charlett, Daniela DeAngelis, Wei Liu, Peter Vickerman, Mark Woolhouse, Linxiong Wu
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引用次数: 0

摘要

背景:了解 COVID-19 是如何在控制措施下演变成大流行病的,对于应对 SARS-CoV-2 病毒传播至关重要。老挝是一个与中国接壤的国家,但与邻国相比,COVID-19 发生较晚且负担较轻:方法:我们提出了一个包含疾病报告的传播模型,以研究 2021 年 4 月至 2022 年 5 月期间控制措施对老挝 SARS-CoV-2 病毒传播的影响。假设传播率随人们的行为、控制措施和新出现的变种而变化;易感性随疫苗接种和感染而降低。贝叶斯推断法根据确诊病例、死亡病例和康复病例数据对模型进行校准,并使用偏差信息标准选择最佳模型变体:结果:我们的模型包括非药物干预(NPI)、行为改变、疫苗接种和变化变体,很好地解释了老挝的三次疫情。据估计,阿尔法变体的基本繁殖数为 1.55(95% 置信区间:1.47-1.64),从 2021 年 9 月起被德尔塔变体所取代,后者的传播能力是阿尔法变体的 1.88 倍(95% 置信区间:1.77-2.01);从 2022 年 3 月起,德尔塔变体被奥米克龙变体所取代,后者的传播能力是奥米克龙变体的 3.33 倍(95% 置信区间:2.84-3.74)。德尔塔变种最为严重,病死率为 1.05%(95% 置信区间:0.96-1.15%),而阿尔法变种和奥米克龙变种则轻微得多。确诊率很低,而且不稳定:到 2021 年 5 月 23 日,确诊率从 13.2% 降至 1.8%,到 2022 年 3 月 15 日,确诊率又升至 23.4%。反事实模拟表明,即使在出现免疫逃逸变种的情况下,疫苗接种也能在减少感染方面发挥强有力的作用,而行为改变则会推迟疫情爆发的高峰期,但可能不会使其趋于平缓:老挝的三波疫情是由于更多可传播变异体和免疫逃逸变异体的入侵,影响了通过疫苗接种和感染建立起来的群体免疫力。即使在免疫力减弱和新变种逃逸的情况下,疫苗接种仍是控制 COVID-19 的主要手段,将行为改变和疫苗接种结合起来将是抑制未来 COVID-19 爆发的最佳方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Modelling COVID-19 transmission dynamics in Laos under non-pharmaceutical interventions, vaccination, and replacement of SARS-CoV-2 variants.

Background: Understanding how the COVID-19 pandemic evolved under control measures is crucial to tackle the SARS-CoV-2 virus spread. Laos, a country bordering China but with late occurrence and low burden of COVID-19 compared to its neighbouring countries, was used for a case study.

Methods: A transmission model with disease reporting was proposed to investigate the impact of control measures on the SARS-CoV-2 virus spread in Laos from April 2021 to May 2022. It was assumed that the transmission rate changed with people's behaviours, control measures and emerging variants; susceptibility decreased with vaccination and infection. Bayesian inference was used for model calibration to data of confirmed cases, deaths, and recoveries, and the deviance information criterion was used to select the best model variant.

Results: Our model including Non-pharmaceutical interventions (NPIs), behaviour change, vaccination, and changing variants well explained the three waves in Laos. The Alpha variant was estimated to have a basic reproduction number of 1.55 (95% CrI: 1.47-1.64) and was replaced by the Delta variant from September 2021 which was 1.88 (95% CrI: 1.77-2.01) times more transmissible; the Delta variant was replaced by Omicron variant from March 2022 which was 3.33 (95% CrI: 2.84-3.74) times more transmissible. The Delta variant was the most severe with a case fatality rate of 1.05% (95% CrI: 0.96-1.15%) while the Alpha variant and Omicron variant were much milder. The ascertainment rate was low and variable: first decreasing from 13.2 to 1.8% by 23 May 2021, and then increasing to 23.4% by 15 March 2022. Counterfactual simulations indicated that vaccination played strong roles in reducing infections even under the emergence of immune escape variants while behaviour change delayed but might not flatten the peak of outbreaks.

Conclusions: The three waves of Laos' epidemics were due to the invasion of more transmissible and immune escape variants that affected the herd immunity built via vaccination and infection. Even with immunity waning and the escape of new variants, vaccination was still the major contributor to control COVID-19 and combining behaviour changes and vaccination would best suppress future outbreaks of COVID-19.

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