论文标题
建模在19-19-like流行病中过多的死亡率
Modelling Excess Mortality in Covid-19-like Epidemics
论文作者
论文摘要
我们开发了一个基于代理的模型，以评估假设COVID-19类样流行病期间的累积死亡人数，以用于各种非药物干预策略。我们认为局部和非本地疾病传播模式。第一个模拟通过社会接触的传播在居住地附近的社会接触，而第二次通过公共场所的社会接触：学校，医院，机场等，许多人见面，居住在偏远的地理位置。流行病扩散被建模为随机几何网络上的离散时间随机过程。我们在模拟中使用蒙特卡洛方法。做出以下假设。基本的繁殖编号为2.5，传染期持续约十天。在大约1％的病例中，感染导致SARS，除非患者接受适当的治疗，否则可能会导致呼吸违约和死亡。 〜医疗保健系统的容量是通过呼吸道通风机或重症监护床的可用性模拟的。该模型的某些参数，例如死亡率或每100000居民的呼吸道呼吸器数量，以模拟美国和波兰的实际值。在模拟中，我们将“不做”策略与基于社会疏远和减少社会混合的缓解策略进行了比较。我们研究疫苗前时代的流行病，其中仅通过感染获得免疫力。该模型仅适用于罕见恢复且可以忽略的流行病。模拟的结果表明，在早期阶段过多发展流行病的策略并不能显着减少长期死亡的总数，但会增加流行病的持续时间。特别是，一种锁定了一段时间并完全释放的混合策略效率低下。
We develop an agent-based model to assess the cumulative number of deaths during hypothetical Covid-19-like epidemics for various non-pharmaceutical intervention strategies. We consider local and non-local modes of disease transmission. The first simulates transmission through social contacts in the vicinity of the place of residence while the second through social contacts in public places: schools, hospitals, airports, etc., where many people meet, who live in remote geographic locations. Epidemic spreading is modeled as a discrete-time stochastic process on random geometric networks. We use the Monte-Carlo method in the simulations. The~following assumptions are made. The basic reproduction number is 2.5 and the infectious period lasts approximately ten days. Infections lead to SARS in about one percent of cases, which are likely to lead to respiratory default and death, unless the patient receives an appropriate medical treatment. The~healthcare system capacity is simulated by the availability of respiratory ventilators or intensive care beds. Some parameters of the model, like mortality rates or the number of respiratory ventilators per 100000 inhabitants, are chosen to simulate the real values for the USA and Poland. In the simulations we compare `do-nothing' strategy with mitigation strategies based on social distancing and reducing social mixing. We study epidemics in the pre-vaccine era, where immunity is obtained only by infection. The model applies only to epidemics for which reinfections are rare and can be neglected. The results of the simulations show that strategies that slow the development of an epidemic too much in the early stages do not significantly reduce the overall number of deaths in the long term, but increase the duration of the epidemic. In particular, a~hybrid strategy where lockdown is held for some time and is then completely released, is inefficient.
