论文标题

Covid-19-19大流行控制:在ICU可持续性下平衡检测政策和锁定干预措施

COVID-19 pandemic control: balancing detection policy and lockdown intervention under ICU sustainability

论文作者

Charpentier, Arthur, Elie, Romuald, Laurière, Mathieu, Tran, Viet Chi

论文摘要

我们在这里考虑了一个扩展的SIR模型,包括最近的Covid-19爆发的几个特征:尤其是可以检测到的感染和回收的个体(+)或未被发现( - ),我们还整合了一个重症监护室(ICU)。我们的模型可以使用锁定和检测干预杠杆对最佳策略进行最佳策略进行易处理的定量分析。通过基于Covid-19的文献的参数规范,我们考虑了大流行的卫生和社会经济成本之间的微妙折衷,以及ICU的有限水平,我们研究了各种数量对最佳策略的敏感性。我们将最佳锁定政策确定为在4个连续阶段构成的干预措施:首先是快速而强大的锁定干预措施,以阻止传染的指数增长;其次是降低病毒患病率的短期过渡阶段;第三长时间,具有完全ICU的能力和稳定的病毒患病率;最终,随着病毒消失而重返正常的社会互动。如果锁定释放得足够缓慢,则最佳场景在此避免了第二波感染。我们还提供最佳的干预措施,以增加ICU的能力,以及在检测传染性和免疫个体的努力方面的优化。每当引入大量资源来检测受感染的人时,就可以释放社会距离的压力,而对免疫个体的检测的影响则显示更为温和。

We consider here an extended SIR model, including several features of the recent COVID-19 outbreak: in particular the infected and recovered individuals can either be detected (+) or undetected (-) and we also integrate an intensive care unit (ICU) capacity. Our model enables a tractable quantitative analysis of the optimal policy for the control of the epidemic dynamics using both lockdown and detection intervention levers. With parametric specification based on literature on COVID-19, we investigate the sensitivities of various quantities on the optimal strategies, taking into account the subtle trade-off between the sanitary and the socio-economic cost of the pandemic, together with the limited capacity level of ICU. We identify the optimal lockdown policy as an intervention structured in 4 successive phases: First a quick and strong lockdown intervention to stop the exponential growth of the contagion; second a short transition phase to reduce the prevalence of the virus; third a long period with full ICU capacity and stable virus prevalence; finally a return to normal social interactions with disappearance of the virus. The optimal scenario hereby avoids the second wave of infection, provided the lockdown is released sufficiently slowly. We also provide optimal intervention measures with increasing ICU capacity, as well as optimization over the effort on detection of infectious and immune individuals. Whenever massive resources are introduced to detect infected individuals, the pressure on social distancing can be released, whereas the impact of detection of immune individuals reveals to be more moderate.

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