我国早期新型冠状病毒肺炎疫情传染病动力学模型分析

Early transmission dynamics of COVID-19 in China based on an epidemic model

  • 摘要:
      目的   利用传染病动力学模型模拟我国早期新型冠状病毒肺炎的传播过程,分析和评估相关防控措施对疫情的影响。
      方法  以2019年12月2日至2020年4月8日中国疾病预防控制中心传染病报告系统上报新型冠状病毒肺炎疫情数据为依据,建立动力学模型对疫情发展进行模拟分析。
      结果  我国实施的交通管制措施,使R0从疫情发展初期的4.82[95%可信区间(CrI):4.81~4.83]降低到1.13(95% CrI:1.11~1.16),新型冠状病毒感染者集中隔离和大规模核酸筛查等措施使R0进一步降低到0.31(95% CrI:0.30~0.32),模型估计得到无症状感染者的检出率为54.7%(95% CrI:45.7%~65.3%)。 保持防控措施实施的时间点不变,将无症状感染者检出率提高至75%、95%,分别能够避免新增3.4%、5.6%的感染者。 保持无症状感染者检出率不变,将防控措施实施的时间点整体前移1周、2周,分别能够避免新增78.2%、95.3%的感染者。
      结论  交通管控措施显著降低了新型冠状病毒的传播速度。对感染者的集中隔离和大规模核酸筛查消除了病毒在人群中的传播。 我国实施的大规模核酸检测能够发现一半以上隐匿的无症状感染者。 相对于提高无症状感染者的检出率,防控措施的尽早实施能够避免更多的新增感染。

     

    Abstract:
      Objective  To simulate the full-spectrum dynamics of coronavirus disease 2019 (COVID-19) in China between 2 December 2019 and 8 April 2020 by using an epidemic dynamics model, and evaluate the impact of intervention measures on the epidemic spread.
      Methods  Based on the incidence data of COVID-19 reported to the infectious disease reporting system of Chinese Center for Disease Control and Prevention, a dynamic model was established.
      Results  The traffic control measures implemented in China reduced the R0 of COVID-19 from 4.82 (95% confidence interval ( CrI): 4.81−4.83) in the early stage of the epidemic to 1.13 (95% CrI: 1.11−1.16). Centralized isolation and mass nucleic acid testing further reduced the R0 to 0.31 (95% CrI: 0.30−0.32). The model estimated that the detection rate of asymptomatic infections was 54.7% (95% CrI: 45.7%−65.3%). Increasing the detection rate of asymptomatic infections to 75% and 95%, respectively, 3.4% and 5.6% of new infections would be prevented if the prevention and control measures continued for same time. Implementing the interventions one week and two weeks early, respectively, 78.2% and 95.3% of new infections would be prevented if the asymptomatic infection detection rate maintained.
      Conclusion  Traffic control measures significantly reduced the speed of SARS-CoV-2. Centralized isolation and mass nucleic acid testing blocked the spread of SARS-CoV-2 in population. Mass nucleic acid testing in China can detect more than half of asymptomatic SARS-CoV-2 infections. Compared with increasing the detection rate of asymptomatic infections, early interventions can prevent more new infections.

     

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