Меры должны быть комплексными
Nov. 25th, 2021 06:35 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
chuka_lisДля того чтобы бороться с пандемией и эпидемией ковида, принимаемые меры должны быть комплексными.
Одна только вакцинация не в состоянии будет предотвратить появление новых вспышек и волн.
Если привито около 70% людей, оставшиеся 30% компенсировать могут взятые все вместе- дистанционное обучение-работа, скрининговые тесты 2-3 раза в неделю, маски, фильтрация воздуха и поддерживание социальной дистанции, кроме, разумеется, обязательного карантина заболевших.
Только так можно будет снизить коеффициент передачи ниже 1 (что позволит держать распространение под контролем, а госпитали не перегруженными)
The public and scientific discourse on how to mitigate the COVID-19 pandemic is often focused on the impact of individual protective measures, in particular on immunization by vaccination. In view of changing virus variants and conditions, however, it seems not clear if vaccination or any other single protective measure alone may suffice to contain the transmission of SARS-CoV-2. Here, we investigate the effectiveness and synergies of vaccination and different non-pharmaceutical interventions such as universal masking (surgical, N95/FFP2), distancing & ventilation, contact reduction, and testing & isolation as a function of compliance in the population. We find that it would be difficult to contain SARS-CoV-2 transmission by any individual measure as currently available under realistic conditions. Instead, we show how multiple synergetic measures can be and have to be combined to decrease and keep the effective reproduction number (Re) below unity, even for virus variants with increased basic reproduction number (R0). We suggest that the presented approach and results can be used to design and communicate efficient strategies for mitigating the COVID-19 pandemic, depending on R0 as well as the efficacy and compliance achieved with each protective measure. At vaccination rates around 70%, the combination and synergies of universal masking, distancing & ventilation, and testing & isolation with moderate compliances around 30% appear well suited to keep Re below 1 and prevent or suppress infection waves. Higher compliance or additional measures like contact reductions (confinement/lockdown) are required to effectively and swiftly break intense waves of infection. For schools, we find that the transmission of SARS-CoV-2 can be contained by 2-3 tests per week combined with distancing & ventilation and masking.
Другая работа (симуляционная модель идеальной вакцины от ковида) -показывает, что вообще, шансы на то, что эпидемию можно будет сдерживать только одной вакцинацией, невелики. Другие противоэпидемические мероприятия- обязательны даже в случае если привиты почти все, и быстро, и прививка дает стерильный иммунитет не менее чем на год.
This paper simulates an ideal COVID-19 vaccine that confers immediate sterilizing immunity against all SARS-CoV-2 variants. The purpose was to explore how well this ideal vaccine could protect a population against common conditions (such as vaccine hesitancy) that might impair vaccine effectiveness. Simulations were done with an SEIRS spreadsheet model that ran two parallel subpopulations: one that accepted vaccination, and another that refused it. The two subpopulations could transmit infections to one another. Success was judged by the rate of new cases in the period from 1-5 years after the introduction of the vaccine. Under good conditions, including a small subpopulation that refused vaccination, rapid distribution of the vaccine, duration of vaccinal immunity longer than 12 months, good retention of interest in getting vaccinated after the first year, strict maintenance of nonpharmaceutical interventions (NPIs) such as masking, and new variants with R0s less than 4.0, the vaccine was able to end the epidemic. With violation of these conditions, the post-vaccine era futures ranged from endemic COVID at a low or medium level to rates of COVID cases worse than anything seen in the US up to late 2021. The most important conditions for keeping case rates low were a fast speed of vaccine distribution, a low percentage of the population that refuses vaccination, a long duration of vaccinal immunity, and continuing maintenance of NPIs after vaccination began. On the other hand, a short duration of vaccinal immunity, abandonment of NPIs, and new variants with a high R0 were powerful barriers to disease control. New variants with high R0s were particularly damaging, producing high case rates except when vaccination speed was unrealistically rapid. A recurring finding was that most disease afflicting the vaccinated population in these simulations originated in the unvaccinated population, and cutting off interaction with the unvaccinated population caused a sharp drop in the case rate of the vaccinated population. In conclusion, multiple common conditions can compromise the effectiveness of even an ideal vaccine.
Одна только вакцинация не в состоянии будет предотвратить появление новых вспышек и волн.
Если привито около 70% людей, оставшиеся 30% компенсировать могут взятые все вместе- дистанционное обучение-работа, скрининговые тесты 2-3 раза в неделю, маски, фильтрация воздуха и поддерживание социальной дистанции, кроме, разумеется, обязательного карантина заболевших.
Только так можно будет снизить коеффициент передачи ниже 1 (что позволит держать распространение под контролем, а госпитали не перегруженными)
The public and scientific discourse on how to mitigate the COVID-19 pandemic is often focused on the impact of individual protective measures, in particular on immunization by vaccination. In view of changing virus variants and conditions, however, it seems not clear if vaccination or any other single protective measure alone may suffice to contain the transmission of SARS-CoV-2. Here, we investigate the effectiveness and synergies of vaccination and different non-pharmaceutical interventions such as universal masking (surgical, N95/FFP2), distancing & ventilation, contact reduction, and testing & isolation as a function of compliance in the population. We find that it would be difficult to contain SARS-CoV-2 transmission by any individual measure as currently available under realistic conditions. Instead, we show how multiple synergetic measures can be and have to be combined to decrease and keep the effective reproduction number (Re) below unity, even for virus variants with increased basic reproduction number (R0). We suggest that the presented approach and results can be used to design and communicate efficient strategies for mitigating the COVID-19 pandemic, depending on R0 as well as the efficacy and compliance achieved with each protective measure. At vaccination rates around 70%, the combination and synergies of universal masking, distancing & ventilation, and testing & isolation with moderate compliances around 30% appear well suited to keep Re below 1 and prevent or suppress infection waves. Higher compliance or additional measures like contact reductions (confinement/lockdown) are required to effectively and swiftly break intense waves of infection. For schools, we find that the transmission of SARS-CoV-2 can be contained by 2-3 tests per week combined with distancing & ventilation and masking.
Другая работа (симуляционная модель идеальной вакцины от ковида) -показывает, что вообще, шансы на то, что эпидемию можно будет сдерживать только одной вакцинацией, невелики. Другие противоэпидемические мероприятия- обязательны даже в случае если привиты почти все, и быстро, и прививка дает стерильный иммунитет не менее чем на год.
This paper simulates an ideal COVID-19 vaccine that confers immediate sterilizing immunity against all SARS-CoV-2 variants. The purpose was to explore how well this ideal vaccine could protect a population against common conditions (such as vaccine hesitancy) that might impair vaccine effectiveness. Simulations were done with an SEIRS spreadsheet model that ran two parallel subpopulations: one that accepted vaccination, and another that refused it. The two subpopulations could transmit infections to one another. Success was judged by the rate of new cases in the period from 1-5 years after the introduction of the vaccine. Under good conditions, including a small subpopulation that refused vaccination, rapid distribution of the vaccine, duration of vaccinal immunity longer than 12 months, good retention of interest in getting vaccinated after the first year, strict maintenance of nonpharmaceutical interventions (NPIs) such as masking, and new variants with R0s less than 4.0, the vaccine was able to end the epidemic. With violation of these conditions, the post-vaccine era futures ranged from endemic COVID at a low or medium level to rates of COVID cases worse than anything seen in the US up to late 2021. The most important conditions for keeping case rates low were a fast speed of vaccine distribution, a low percentage of the population that refuses vaccination, a long duration of vaccinal immunity, and continuing maintenance of NPIs after vaccination began. On the other hand, a short duration of vaccinal immunity, abandonment of NPIs, and new variants with a high R0 were powerful barriers to disease control. New variants with high R0s were particularly damaging, producing high case rates except when vaccination speed was unrealistically rapid. A recurring finding was that most disease afflicting the vaccinated population in these simulations originated in the unvaccinated population, and cutting off interaction with the unvaccinated population caused a sharp drop in the case rate of the vaccinated population. In conclusion, multiple common conditions can compromise the effectiveness of even an ideal vaccine.
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