tetano
Editor, Senior Moderator
BMC Public Health
. 2021 Sep 7;21(1):1638.
doi: 10.1186/s12889-021-11631-w.
Investigating the effectiveness of re-opening policies before vaccination during a pandemic: SD modelling research based on COVID-19 in Wuhan
Ying Qian[SUP] #[/SUP][SUP] 1 [/SUP], Wei Xie[SUP] #[/SUP][SUP] 2 [/SUP], Jidi Zhao[SUP] 3 [/SUP], Ming Xue[SUP] 4 [/SUP], Shiyong Liu[SUP] 5 [/SUP], Lei Wang[SUP] 6 [/SUP], Wanglai Li[SUP] 7 [/SUP], Luojia Dai[SUP] 8 [/SUP], Yuyang Cai[SUP] 8 [/SUP]
Affiliations
Abstract
Background: Lockdown policies were widely adopted during the coronavirus disease 2019 (COVID-19) pandemic to control the spread of the virus before vaccines became available. These policies had significant economic impacts and caused social disruptions. Early re-opening is preferable, but it introduces the risk of a resurgence of the epidemic. Although the World Health Organization has outlined criteria for re-opening, decisions on re-opening are mainly based on epidemiologic criteria. To date, the effectiveness of re-opening policies remains unclear.
Methods: A system dynamics COVID-19 model, SEIHR(Q), was constructed by integrating infection prevention and control measures implemented in Wuhan into the classic SEIR epidemiological model and was validated with real-world data. The input data were obtained from official websites and the published literature.
Results: The simulation results showed that track-and-trace measures had significant effects on the level of risk associated with re-opening. In the case of Wuhan, where comprehensive contact tracing was implemented, there would have been almost no risk associated with re-opening. With partial contact tracing, re-opening would have led to a minor second wave of the epidemic. However, if only limited contact tracing had been implemented, a more severe second outbreak of the epidemic would have occurred, overwhelming the available medical resources. If the ability to implement a track-trace-quarantine policy is fixed, the epidemiological criteria need to be further taken into account. The model simulation revealed different levels of risk associated with re-opening under different levels of track-and-trace ability and various epidemiological criteria. A matrix was developed to evaluate the effectiveness of the re-opening policies.
Conclusions: The SEIHR(Q) model designed in this study can quantify the impact of various re-opening policies on the spread of COVID-19. Integrating epidemiologic criteria, the contact tracing policy, and medical resources, the model simulation predicts whether the re-opening policy is likely to lead to a further outbreak of the epidemic and provides evidence-based support for decisions regarding safe re-opening during an ongoing epidemic.
Keyords: COVID-19; Risk of re-opening; Effectiveness of re-opening policies; IPC measures; SD modelling.
. 2021 Sep 7;21(1):1638.
doi: 10.1186/s12889-021-11631-w.
Investigating the effectiveness of re-opening policies before vaccination during a pandemic: SD modelling research based on COVID-19 in Wuhan
Ying Qian[SUP] #[/SUP][SUP] 1 [/SUP], Wei Xie[SUP] #[/SUP][SUP] 2 [/SUP], Jidi Zhao[SUP] 3 [/SUP], Ming Xue[SUP] 4 [/SUP], Shiyong Liu[SUP] 5 [/SUP], Lei Wang[SUP] 6 [/SUP], Wanglai Li[SUP] 7 [/SUP], Luojia Dai[SUP] 8 [/SUP], Yuyang Cai[SUP] 8 [/SUP]
Affiliations
- PMID: 34493226
- DOI: 10.1186/s12889-021-11631-w
Abstract
Background: Lockdown policies were widely adopted during the coronavirus disease 2019 (COVID-19) pandemic to control the spread of the virus before vaccines became available. These policies had significant economic impacts and caused social disruptions. Early re-opening is preferable, but it introduces the risk of a resurgence of the epidemic. Although the World Health Organization has outlined criteria for re-opening, decisions on re-opening are mainly based on epidemiologic criteria. To date, the effectiveness of re-opening policies remains unclear.
Methods: A system dynamics COVID-19 model, SEIHR(Q), was constructed by integrating infection prevention and control measures implemented in Wuhan into the classic SEIR epidemiological model and was validated with real-world data. The input data were obtained from official websites and the published literature.
Results: The simulation results showed that track-and-trace measures had significant effects on the level of risk associated with re-opening. In the case of Wuhan, where comprehensive contact tracing was implemented, there would have been almost no risk associated with re-opening. With partial contact tracing, re-opening would have led to a minor second wave of the epidemic. However, if only limited contact tracing had been implemented, a more severe second outbreak of the epidemic would have occurred, overwhelming the available medical resources. If the ability to implement a track-trace-quarantine policy is fixed, the epidemiological criteria need to be further taken into account. The model simulation revealed different levels of risk associated with re-opening under different levels of track-and-trace ability and various epidemiological criteria. A matrix was developed to evaluate the effectiveness of the re-opening policies.
Conclusions: The SEIHR(Q) model designed in this study can quantify the impact of various re-opening policies on the spread of COVID-19. Integrating epidemiologic criteria, the contact tracing policy, and medical resources, the model simulation predicts whether the re-opening policy is likely to lead to a further outbreak of the epidemic and provides evidence-based support for decisions regarding safe re-opening during an ongoing epidemic.
Keyords: COVID-19; Risk of re-opening; Effectiveness of re-opening policies; IPC measures; SD modelling.