论文标题
最佳,最佳和强大的流行病控制
Optimal, near-optimal, and robust epidemic control
论文作者
论文摘要
在没有药物和疫苗的情况下,决策者使用非药物干预措施,例如社交疏远来降低引起疾病的接触率,以减少或延迟流行峰值。这些措施带来了社会和经济成本,因此社会可能无法在短时间内维持它们。干预政策设计通常依赖于流行病模型的数值模拟,但是比较政策并评估其鲁棒性要求跨策略适用的明确原则。在这里,我们得出了理论上最佳的策略,用于使用时间限制的干预措施来降低经典的易感感染疾病的新型疾病的峰值患病率。我们表明,易于实施策略的广泛类别几乎可以和理论上最佳策略一样。但是,最佳策略和这些近乎最佳的策略都不是实施错误的鲁棒性:计时干预措施的小错误会导致峰值患病率大大增加。我们的结果揭示了非药物疾病控制的基本原理并暴露了其潜在的脆弱性。为了进行健壮的控制,干预必须是强大,早期且理想地持续的。
In the absence of drugs and vaccines, policymakers use non-pharmaceutical interventions such as social distancing to decrease rates of disease-causing contact, with the aim of reducing or delaying the epidemic peak. These measures carry social and economic costs, so societies may be unable to maintain them for more than a short period of time. Intervention policy design often relies on numerical simulations of epidemic models, but comparing policies and assessing their robustness demands clear principles that apply across strategies. Here we derive the theoretically optimal strategy for using a time-limited intervention to reduce the peak prevalence of a novel disease in the classic Susceptible-Infectious-Recovered epidemic model. We show that broad classes of easier-to-implement strategies can perform nearly as well as the theoretically optimal strategy. But neither the optimal strategy nor any of these near-optimal strategies is robust to implementation error: small errors in timing the intervention produce large increases in peak prevalence. Our results reveal fundamental principles of non-pharmaceutical disease control and expose their potential fragility. For robust control, an intervention must be strong, early, and ideally sustained.