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http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/156| Mathematical modeling of COVID-19 transmission and mitigation strategies in the population of Ontario, Canada | |
| David N Fisman Amy L Greer Ashleigh Tuite | |
| Novel Coronavirus | |
| Acceso Abierto | |
| Atribución-NoComercial | |
| 10.1101/2020.03.24.20042705 | |
| Background: We evaluated how non-pharmaceutical interventions could be used to control the COVID-19 pandemic and reduce the burden on the healthcare system. Methods: Using an age-structured compartmental model of COVID-19 transmission in the population of Ontario, Canada, we compared a base case with limited testing, isolation, and quarantine to scenarios with: enhanced case finding; restrictive social distancing measures; or a combination of enhanced case finding and less restrictive social distancing. Interventions were either implemented for fixed durations or dynamically cycled on and off, based on projected ICU bed occupancy. We present median and credible intervals (CrI) from 100 replicates per scenario using a two-year time horizon. Results: We estimated that 56% (95% CrI: 42-63%) of the Ontario population would be infected over the course of the epidemic in the base case. At the epidemic peak, we projected 107,000 (95% CrI: 60,760-149,000) cases in hospital and 55,500 (95% CrI: 32,700-75,200) cases in ICU. For fixed duration scenarios, all interventions were projected to delay and reduce the height of the epidemic peak relative to the base case, with restrictive social distancing estimated to have the greatest effect. Longer duration interventions were more effective. Dynamic interventions were projected to reduce the proportion of the population infected at the end of the two-year period. Dynamic social distancing interventions could reduce the median number of cases in ICU below current estimates of Ontario's ICU capacity. Interpretation: Without significant social distancing or a combination of moderate social distancing with enhanced case finding, we project that ICU resources would be overwhelmed. Dynamic social distancing could maintain health system capacity and also allow periodic psychological and economic respite for populations. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The research was supported by a grant to DNF from the Canadians Institutes for Health Research (2019 COVID-19 rapid researching funding OV4-170360). ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data are available from the corresponding author on request. | |
| Cold Spring Harbor Laboratory Press | |
| 2020 | |
| Preimpreso | |
| https://www.medrxiv.org/content/10.1101/2020.03.24.20042705v1 | |
| Inglés | |
| VIRUS RESPIRATORIOS | |
| Aparece en las colecciones: | Artículos científicos |
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