论文标题
常规无症状测试在减少COVID-19波的影响中的作用
The role of regular asymptomatic testing in reducing the impact of a COVID-19 wave
论文作者
论文摘要
SARS-COV-2感染的测试是减少Covid-19的重要干预措施,尤其是与阳性病例的隔离和接触追踪结合时。许多具有这样做能力的国家都利用了针对症状的个体和确认病例接触的人的实验室处理的聚合酶链反应(PCR)测试。另外,横向流程测试(LFT)能够快速提供结果,而无需实验室处理,并且成本相对较低。它们的采用可以支持定期的无症状测试,从而可以早期发现感染和传染病患者的隔离。在本文中,我们扩展并应用了基于代理的流行性建模框架Covasim探索常规无症状测试对新兴Covid-19波中峰值和感染总数的影响。我们探索具有高水平免疫力且背景性PCR测试,病例隔离和接触跟踪进行测试的人群中LFT的测试。将常规无症状测试的有效性与“锁定”干预措施进行了比较,该干预措施旨在通过措施,例如强制在家工作和聚会限制,以减少整个人群的非房屋联系人的数量。由于常规的无症状测试只需要有积极结果的人才能减少接触,而锁定措施要求整个人群减少接触,因此任何寻求从感染与其他危害的危害进行危害的政策决定都不会自动偏爱另一个危害。我们的结果表明,在进行这种权衡的情况下,以适度的早期增长速度定期无症状的无症状测试率中等,有可能实现重大的感染控制,而不会与其他锁定措施相关的更广泛的危害。
Testing for infection with SARS-CoV-2 is an important intervention in reducing onwards transmission of COVID-19, particularly when combined with the isolation and contact-tracing of positive cases. Many countries with the capacity to do so have made use of lab-processed Polymerase Chain Reaction (PCR) testing targeted at individuals with symptoms and the contacts of confirmed cases. Alternatively, Lateral Flow Tests (LFTs) are able to deliver a result quickly, without lab-processing and at a relatively low cost. Their adoption can support regular mass asymptomatic testing, allowing earlier detection of infection and isolation of infectious individuals. In this paper we extend and apply the agent-based epidemic modelling framework Covasim to explore the impact of regular asymptomatic testing on the peak and total number of infections in an emerging COVID-19 wave. We explore testing with LFTs at different frequency levels within a population with high levels of immunity and with background symptomatic PCR testing, case isolation and contact tracing for testing. The effectiveness of regular asymptomatic testing was compared with `lockdown' interventions seeking to reduce the number of non-household contacts across the whole population through measures such as mandating working from home and restrictions on gatherings. Since regular asymptomatic testing requires only those with a positive result to reduce contact, while lockdown measures require the whole population to reduce contact, any policy decision that seeks to trade off harms from infection against other harms will not automatically favour one over the other. Our results demonstrate that, where such a trade off is being made, at moderate rates of early exponential growth regular asymptomatic testing has the potential to achieve significant infection control without the wider harms associated with additional lockdown measures.