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Spread and dynamics of the COVID-19 epidemic in Italy: Effects of emergency containment measures.

意大利新型冠状病毒肺炎疫情的传播和动态: 紧急遏制措施的影响。

  • 影响因子:8.58
  • DOI:10.1073/pnas.2004978117
  • 作者列表:"Gatto M","Bertuzzo E","Mari L","Miccoli S","Carraro L","Casagrandi R","Rinaldo A
  • 发表时间:2020-05-12
Abstract

:The spread of coronavirus disease 2019 (COVID-19) in Italy prompted drastic measures for transmission containment. We examine the effects of these interventions, based on modeling of the unfolding epidemic. We test modeling options of the spatially explicit type, suggested by the wave of infections spreading from the initial foci to the rest of Italy. We estimate parameters of a metacommunity Susceptible-Exposed-Infected-Recovered (SEIR)-like transmission model that includes a network of 107 provinces connected by mobility at high resolution, and the critical contribution of presymptomatic and asymptomatic transmission. We estimate a generalized reproduction number ([Formula: see text] = 3.60 [3.49 to 3.84]), the spectral radius of a suitable next-generation matrix that measures the potential spread in the absence of containment interventions. The model includes the implementation of progressive restrictions after the first case confirmed in Italy (February 21, 2020) and runs until March 25, 2020. We account for uncertainty in epidemiological reporting, and time dependence of human mobility matrices and awareness-dependent exposure probabilities. We draw scenarios of different containment measures and their impact. Results suggest that the sequence of restrictions posed to mobility and human-to-human interactions have reduced transmission by 45% (42 to 49%). Averted hospitalizations are measured by running scenarios obtained by selectively relaxing the imposed restrictions and total about 200,000 individuals (as of March 25, 2020). Although a number of assumptions need to be reexamined, like age structure in social mixing patterns and in the distribution of mobility, hospitalization, and fatality, we conclude that verifiable evidence exists to support the planning of emergency measures.

摘要

: 冠状病毒疾病 2019 (新型冠状病毒肺炎) 在意大利的传播促使采取严厉措施遏制传播。我们根据正在展开的流行病建模,检查这些干预措施的效果。我们测试了空间显式类型的建模选项,建议从初始病灶传播到意大利其他地区的感染波。我们估计了一个包括由 107 个省组成的网络以高分辨率通过移动性连接的元社区易感-暴露-感染-恢复 (SEIR) 样传播模型的参数,以及症状前和无症状传播的关键贡献。我们估计一个广义再现数 ([公式: 见正文] = 3.60 [3.49 至 3.84]),在没有遏制干预的情况下测量潜在传播的合适的下一代矩阵的谱半径。该模型包括在意大利确诊的第一个病例 (2020 年 2 月 21 日) 后实施渐进限制,并运行至 2020 年 3 月 25 日。我们解释了流行病学报告的不确定性,以及人类流动性矩阵和意识依赖性暴露概率的时间依赖性。我们绘制了不同遏制措施及其影响的情景。结果表明,对移动性和人与人之间相互作用的限制顺序使传播减少了 45% (42-49%)。通过选择性放宽强加的限制获得的运行场景来衡量避免的住院情况,总计约 200,000 人 (截至 2020 年 3 月 25 日)。虽然一些假设需要重新审视,比如社会混合模式中的年龄结构以及流动性、住院和死亡率的分布,我们得出结论,存在可证实的证据支持应急措施的规划。

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呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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