期刊
SCIENCE TRANSLATIONAL MEDICINE
卷 13, 期 602, 页码 -出版社
AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/scitranslmed.abg4262
关键词
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资金
- NIHR HPRU in Modelling and Health Economics-a partnership between PHE, Imperial College London
- LSHTM [NIHR200908]
- NIHR HPRU in Emerging and Zoonotic Infections-a partnership between PHE, University of Liverpool, University of Oxford
- Liverpool School of Tropical Medicine [NIHR200907]
- MRC Centre for Global Infectious Disease Analysis - U.K. Medical Research Council (MRC) [MR/R015600/1]
- U.K. Foreign, Commonwealth & Development Office (FCDO), under the MRC/FCDO Concordat agreement
- European Union
- MRC [MR/R015600/1] Funding Source: UKRI
The study found that national lockdown was a key measure in reducing the transmission rate of SARS-CoV-2. The infection fatality ratio decreased, but was significantly higher in elderly residents in care homes. England is still far from herd immunity, emphasizing the need for high coverage and protection in vaccination campaigns to prevent a resurgence of transmission.
We fitted a model of SARS-CoV-2 transmission in care homes and the community to regional surveillance data for England. Compared with other approaches, our model provides a synthesis of multiple surveillance data streams into a single coherent modeling framework, allowing transmission and severity to be disentangled from features of the surveillance system. Of the control measures implemented, only national lockdown brought the reproduction number (R-t(eff)) below 1 consistently; if introduced 1 week earlier, it could have reduced deaths in the first wave from an estimated 48,600 to 25,600 [95% credible interval (CrI): 15,900 to 38,400]. The infection fatality ratio decreased from 1.00% (95% CrI: 0.85 to 1.21%) to 0.79% (95% CrI: 0.63 to 0.99%), suggesting improved clinical care. The infection fatality ratio was higher in the elderly residing in care homes (23.3%, 95% CrI: 14.7 to 35.2%) than those residing in the community (7.9%, 95% CrI: 5.9 to 10.3%). On 2 December 2020, England was still far from herd immunity, with regional cumulative infection incidence between 7.6% (95% CrI: 5.4 to 10.2%) and 22.3% (95% CrI: 19.4 to 25.4%) of the population. Therefore, any vaccination campaign will need to achieve high coverage and a high degree of protection in vaccinated individuals to allow nonpharmaceutical interventions to be lifted without a resurgence of transmission.
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