不仅仅是 "拉平曲线":利用纯粹的非药物干预措施对流行病进行最佳控制。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2020-01-01 Epub Date: 2020-08-18 DOI:10.1186/s13362-020-00091-3
Markus Kantner, Thomas Koprucki
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引用次数: 0

摘要

在无法获得有效医疗和疫苗接种的情况下,社会隔离、家庭检疫和大范围的公共生活封锁等非药物干预措施是防止流行病传播的唯一可用策略。基于扩展的 SEIR(易感者-暴露者-感染者-康复者)模型和连续时间最优控制理论,我们计算了在永远找不到疫苗和不可能完全遏制(根除疫情)的情况下的最优非药物干预策略。在这种情况下,最优控制必须满足相互竞争的要求:首先,最大限度地减少与疾病相关的死亡;其次,在措施结束时建立足够程度的自然免疫,以排除第二波疫情。此外,干预措施的社会经济成本应保持在最低水平。通过数值计算得出的最佳控制策略是一种单一干预方案,它超越了启发式干预和简单的 "拉平曲线"。然而,对计算出的控制策略进行仔细分析后发现,所获得的解决方案实际上是在系统稳定边界附近走钢丝,在此过程中必须不断平衡社会经济成本和新疫情爆发的风险。对模型系统进行了校准,以再现德国 COVID-19 大流行的初始指数增长阶段。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Beyond just "flattening the curve": Optimal control of epidemics with purely non-pharmaceutical interventions.

Beyond just "flattening the curve": Optimal control of epidemics with purely non-pharmaceutical interventions.

Beyond just "flattening the curve": Optimal control of epidemics with purely non-pharmaceutical interventions.

Beyond just "flattening the curve": Optimal control of epidemics with purely non-pharmaceutical interventions.

When effective medical treatment and vaccination are not available, non-pharmaceutical interventions such as social distancing, home quarantine and far-reaching shutdown of public life are the only available strategies to prevent the spread of epidemics. Based on an extended SEIR (susceptible-exposed-infectious-recovered) model and continuous-time optimal control theory, we compute the optimal non-pharmaceutical intervention strategy for the case that a vaccine is never found and complete containment (eradication of the epidemic) is impossible. In this case, the optimal control must meet competing requirements: First, the minimization of disease-related deaths, and, second, the establishment of a sufficient degree of natural immunity at the end of the measures, in order to exclude a second wave. Moreover, the socio-economic costs of the intervention shall be kept at a minimum. The numerically computed optimal control strategy is a single-intervention scenario that goes beyond heuristically motivated interventions and simple "flattening of the curve". Careful analysis of the computed control strategy reveals, however, that the obtained solution is in fact a tightrope walk close to the stability boundary of the system, where socio-economic costs and the risk of a new outbreak must be constantly balanced against one another. The model system is calibrated to reproduce the initial exponential growth phase of the COVID-19 pandemic in Germany.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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