论文标题
时间依赖性异质性导致瞬时抑制COVID-19的流行病,而不是群免疫
Time-dependent heterogeneity leads to transient suppression of the COVID-19 epidemic, not herd immunity
论文作者
论文摘要
流行病通常通过反映多个时间尺度因素的一系列波传播。在短时间内,超级膨胀的事件导致爆发和过度分散,而易感性的长期持续异质性有望导致感染峰和群豁免阈值的降低(命中)。在这里,我们开发了一种涵盖两个时间尺度的通用方法,包括个人社交活动的时间变化,并演示如何通过参数化将它们现象学上纳入广泛的流行病学模型。我们得出了有效繁殖数对易感人群分数的非线性依赖性。我们表明,在流行病的早期,高节奏的阶段,瞬时集体免疫(TCI)的状态远低于命中率。但是,这是一个脆弱的状态,由于社交活动水平的变化而随着时间的流逝而逐渐减弱,因此感染峰并不是牛群免疫力的迹象:随后的波浪可以并且将由于人口行为变化而出现,而季节性因素驱动(例如)。通过使用来自COVID-19的流行病以及现实生活中的面对面接触网络的经验数据来估计瞬态和长期水平的异质性。这些结果表明,在流行病的第一波浪潮之后,诸如纽约市的最难受到的地区已经达到了TCI,但可能仍低于长期命中。因此,与以前的某些主张相反,这些地区仍然可以经历随后的波浪。
Epidemics generally spread through a succession of waves that reflect factors on multiple timescales. On short timescales, super-spreading events lead to burstiness and overdispersion, while long-term persistent heterogeneity in susceptibility is expected to lead to a reduction in the infection peak and the herd immunity threshold (HIT). Here, we develop a general approach to encompass both timescales, including time variations in individual social activity, and demonstrate how to incorporate them phenomenologically into a wide class of epidemiological models through parameterization. We derive a non-linear dependence of the effective reproduction number Re on the susceptible population fraction S. We show that a state of transient collective immunity (TCI) emerges well below the HIT during early, high-paced stages of the epidemic. However, this is a fragile state that wanes over time due to changing levels of social activity, and so the infection peak is not an indication of herd immunity: subsequent waves can and will emerge due to behavioral changes in the population, driven (e.g.) by seasonal factors. Transient and long-term levels of heterogeneity are estimated by using empirical data from the COVID-19 epidemic as well as from real-life face-to-face contact networks. These results suggest that the hardest-hit areas, such as NYC, have achieved TCI following the first wave of the epidemic, but likely remain below the long-term HIT. Thus, in contrast to some previous claims, these regions can still experience subsequent waves.