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基于情景构建的中国COVID-19相关基本临床医疗资源需求评估
Ting Zhang, Qing Wang, Zhiwei Leng, Yuan Yang, Jin Yang, Fangyuan Chen, Mengmeng Jia, Xingxing Zhang, Weiran Qi, Yunshao Xu, Siya Chen, Peixi Dai, Libing Ma, Luzhao Feng, Weizhong Yang
工程（英文） ›› 2021, Vol. 7 ›› Issue (7) : 948-957.
PDF(2093 KB)
PDF(2093 KB)
基于情景构建的中国COVID-19相关基本临床医疗资源需求评估
A Scenario-Based Evaluation of COVID-19-Related Essential Clinical Resource Demands in China
新冠病毒肺炎（COVID-19）大流行是全球性的公共危机。COVID-19疫情暴发后，感染病例和重症患者骤增，导致亟需救治的患者数量增加、医疗资源供不应求，许多国家的医疗系统不堪重负，甚至崩溃。本研究基于不同情景下的COVID-19疫情暴发和防控，旨在评估中国COVID-19疫情相关的基本临床医疗资源需求。本研究使用易感者-潜隐者-传染者-住院/隔离者-移除者（包括康复和死亡）（SEIHR）传播动力学仓储模型来估计感染者和住院/隔离患者的数量，以及所需的基本医疗资源。研究发现，在实施严格的非药物干预（NPI）措施或大规模人群接种疫苗的情景下，中国能够迅速控制社区传播和局部地区暴发的聚集性疫情。然而，在实施较低强度的NPI措施和通过疫苗接种获得免疫的人口比例较低的情景下，需要使用平疫转换模式来储备医疗资源和提高服务能力，以确保疫情发生时医疗卫生系统的正常运行。不同时期COVID-19疫苗的接种和NPI措施的实施会减缓疫情的传播，进而影响临床救治需求。在构建的情景中，无症状感染者比例的增加不会减少对医疗资源的需求，但会增大疫情防控的难度。本研究为全球抗击COVID-19疫情期间防控策略的调整提供了依据，为未来应对COVID-19疫情大流行的公共卫生应急准备提供借鉴，也为基本医疗资源储备和配置提供指导。
The coronavirus disease 2019 (COVID-19) pandemic is a global crisis, and medical systems in many countries are overwhelmed with supply shortages and increasing demands to treat patients due to the surge in cases and severe illnesses. This study aimed to assess COVID-19-related essential clinical resource demands in China, based on different scenarios involving COVID-19 outbreaks and interventions. We used a susceptible–exposed–infectious–hospitalized/isolated–removed (SEIHR) transmission dynamics model to estimate the number of COVID-19 infections and hospitalizations with corresponding essential healthcare resources needed. We found that, under strict non-pharmaceutical interventions (NPIs) or mass vaccination of the population, China would be able to contain community transmission and local outbreaks rapidly. However, under scenarios involving a low intensity of implemented NPIs and a small proportion of the population vaccinated, the use of a peacetime–wartime transition model would be needed for medical source stockpiles and preparations to ensure a normal functioning healthcare system. The implementation of COVID-19 vaccines and NPIs in different periods can influence the transmission of COVID-19 and subsequently affect the demand for clinical diagnosis and treatment. An increased proportion of asymptomatic infections in simulations will not reduce the demand for medical resources; however, attention must be paid to the increasing difficulty in containing COVID-19 transmission due to asymptomatic cases. This study provides evidence for emergency preparations and the adjustment of prevention and control strategies during the COVID-19 pandemic. It also provides guidance for essential healthcare investment and resource allocation.
COVID-19 / SEIHR动力学模型 / 临床医疗资源需求 / 疫苗接种
COVID-19 / Transmission dynamics model / Clinical resource demands / Vaccination
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