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1.
MMWR Morb Mortal Wkly Rep ; 69(40): 1464-1468, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031360

RESUMO

Wild poliovirus type 1 (WPV1) transmission is ongoing only in Afghanistan and Pakistan (1). Following a decline in case numbers during 2013-2016, the number of cases in Afghanistan has increased each year during 2017-2020. This report describes polio eradication activities and progress toward polio eradication in Afghanistan during January 2019-July 2020 and updates previous reports (2,3). Since April 2018, insurgent groups have imposed bans on house-to-house vaccination. In September 2019, vaccination campaigns in areas under insurgency control were restarted only at health facilities. In addition, during March-June 2020, all campaigns were paused because of the coronavirus disease 2019 (COVID-19) pandemic. The number of WPV1 cases reported in Afghanistan increased from 21 in 2018 to 29 in 2019. During January-July 2020, 41 WPV1 cases were reported as of August 29, 2020 (compared with 15 during January-July 2019); in addition, 69 cases of circulating vaccine-derived poliovirus type 2 (cVDPV2), and one case of ambiguous vaccine-derived poliovirus type 2 (aVDPV2) (isolates with no evidence of person-to-person transmission or from persons with no known immunodeficiency) were detected. Dialogue with insurgency leaders through nongovernmental and international organizations is ongoing in an effort to recommence house-to-house campaigns, which are essential to stopping WPV1 transmission in Afghanistan. To increase community demand for polio vaccination, additional community health needs should be addressed, and polio vaccination should be integrated with humanitarian services.


Assuntos
Erradicação de Doenças , Poliomielite/prevenção & controle , Vigilância da População , Adolescente , Afeganistão/epidemiologia , Criança , Pré-Escolar , Humanos , Programas de Imunização , Esquemas de Imunização , Lactente , Poliomielite/epidemiologia , Poliovirus/isolamento & purificação , Vacina Antipólio Oral/administração & dosagem , Vacinação/estatística & dados numéricos
2.
Glob Health Sci Pract ; 8(3): 396-412, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33008854

RESUMO

This article assesses the CORE Group Polio Project (CGPP) experience over a 20-year period in 5 countries. It examines how a program designed to provide social mobilization to eradicate one disease, and which did so effectively, functioned within the general framework of community health workers (CHWs). Vertical health programs often have limited impact on broader community health. CGPP has a 20-year history of social mobilization and effective program interventions. This history provided an opportunity to assess how CGPP community mobilizers (CMs) functioned in polio and maternal and child health. The Updated Program Functionality Matrix for Optimizing Community Health Programs tool of the CHW Assessment and Improvement Matrix (AIM) was used to examine CGPP CM roles across different contexts. The analysis determined that CGPP CMs met the basic level of functioning (level 3) for 6 of the 10 components of the AIM tool. This cross-country descriptive analysis of the CGPP demonstrates the importance of embracing the full range of CHW AIM components, even in a vertical program. Use of data, community involvement, local adaptation, and linkage with the health system are especially critical for success. This general lesson could be applied to other community mobilization and disease/epidemic control initiatives, especially as we face the issues of the COVID-19 pandemic.


Assuntos
Agentes Comunitários de Saúde , Erradicação de Doenças/métodos , Poliomielite/prevenção & controle , Avaliação de Programas e Projetos de Saúde/métodos , Serviços de Saúde Rural , África , Ásia , Humanos , População Rural
4.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(4): 414-418, 2020 Jun 11.
Artigo em Chinês | MEDLINE | ID: mdl-32935520

RESUMO

OBJECTIVE: To analyze the advantages, disadvantages, opportunities and challenges for schistosomiasis elimination in Laos, so as to propose the corresponding healthy policies and suggestions. METHODS: A SWOT analysis was performed to analyze the strength, weakness, opportunity and threat for the schistosomiasis elimination program in Laos, and the corresponding policy suggestions were proposed. RESULTS: The national schistosomiasis elimination program of Laos receives governmental emphases and great supports. A strategy based on mass drug administration was proposed and a sentinel site-bases surveillance system has been built for schistosomiasis elimination in Laos; however, there are several challenges for the national schistosomiasis elimination program in Laos, including insufficient financial supports, inadequate professional capability, weak schistosomiasis control awareness in community populations and difficulty in vector control. CONCLUSIONS: Persistent governmental leadership, increasing financial supports, strengthening professional team building and improving schistosomiasis control awareness in community populations are required to facilitate the progress towards schistosomiasis elimination in Laos.


Assuntos
Erradicação de Doenças , Programas Nacionais de Saúde , Esquistossomose , Erradicação de Doenças/normas , Humanos , Laos , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/normas , Controle de Pragas , Esquistossomose/prevenção & controle
5.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(4): 419-422, 2020 Jun 29.
Artigo em Chinês | MEDLINE | ID: mdl-32935521

RESUMO

This paper summarizes the changes in the policy associated with schistosmiasis control in the new era, analyzes the background of Health China Strategy and its association with the current schistosomiasis control program in China, describes several schistosomiasis control models and proposes some suggestions responding to the challenges in current schistosomiasis control program of China, so as to provide insights into the development of the effective control strategy for schistosomiasis.


Assuntos
Erradicação de Doenças , Políticas , Esquistossomose , China , Humanos , Esquistossomose/prevenção & controle
6.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(4): 436-440, 2020 May 08.
Artigo em Chinês | MEDLINE | ID: mdl-32935526

RESUMO

With the joint efforts of countries and global non-state actors, great achievements have been made in the global malaria control programme; however, malaria remains a serious threat to human health. As the global leader for combating malaria, WHO formulated The Global Technical Strategy for Malaria 2016-2030, and the Global Malaria Programme, under the leadership of WHO, is responsible for implementing 5 key projects to achieve the goal proposed in The Global Technical Strategy for Malaria 2016-2030. In addition, the Global Fund, the U.S. President's Malaria Initiative and Bill & Melinda Gates Foundation also play an important role in global malaria elimination programme. This review describes the currently main non-state actors participating in the global malaria elimination programme, and calls for the enhanced inter-actor coordination and close collaboration with state governments to achieve the great goal of malaria elimination in the world.


Assuntos
Erradicação de Doenças , Malária , Erradicação de Doenças/economia , Erradicação de Doenças/organização & administração , Erradicação de Doenças/tendências , Saúde Global , Programas Governamentais , Humanos , Malária/prevenção & controle , Organizações
7.
Artigo em Inglês | MEDLINE | ID: mdl-32978339

RESUMO

Almost half of the deaths worldwide caused by tuberculosis in 2018 occurred in the World Health Organization (WHO) South-East Asia Region, home to around a quarter of the global population. Maintaining robust progress in this region is therefore essential if the global goal of ending the tuberculosis epidemic is to be realized. Substantial gains have been made in the region, but the threat to health worldwide posed by the coronavirus disease 2019 (COVID-19) pandemic includes not only the direct effects of the pandemic but also the potential eclipsing of the global tuberculosis emergency. The results of modelling studies present stark warnings of a reversal of years of progress and a significant resurgence in deaths from tuberculosis. The COVID-19 pandemic has had variable impacts in the WHO South-East Asia Region to date, but in the countries most affected there has been targeted diversion and repurposing of tuberculosis services, health-care workers and diagnostic equipment. The combined effects of COVID-19, containment measures and fragmentation of tuberculosis services have resulted in delays in diagnosis or non-diagnosis and disruption in treatment resulting in increased morbidity, mortality, transmission and drug resistance. Countries of the region have made attempts to ensure continuity of services and civil society and nongovernmental organizations have instituted a range of innovative mechanisms to support national programmes. However, a comprehensive approach - including scaling up successful initiatives, empowering community leadership, harnessing digital tools, and implementing easily accessible cash transfers and nutrition support - will be critical to success. As COVID-19 recedes, countries will need "catch-up plans" to deploy supplementary measures to address the increased tuberculosis burden. Urgent, targeted and agile responses have the potential to mitigate and reverse the impact of the COVID-19 pandemic on tuberculosis in South-East Asia.


Assuntos
Infecções por Coronavirus/epidemiologia , Erradicação de Doenças , Pandemias , Pneumonia Viral/epidemiologia , Tuberculose/prevenção & controle , Ásia Sudeste/epidemiologia , Humanos , Tuberculose/epidemiologia , Organização Mundial da Saúde
8.
J Transl Med ; 18(1): 345, 2020 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-32891155

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spreads rapidly and has attracted worldwide attention. METHODS: To improve the forecast accuracy and investigate the spread of SARS-CoV-2, we constructed four mathematical models to numerically estimate the spread of SARS-CoV-2 and the efficacy of eradication strategies. RESULTS: Using the Susceptible-Exposed-Infected-Removed (SEIR) model, and including measures such as city closures and extended leave policies implemented by the Chinese government that effectively reduced the ß value, we estimated that the ß value and basic transmission number, R0, of SARS-CoV-2 was 0.476/6.66 in Wuhan, 0.359/5.03 in Korea, and 0.400/5.60 in Italy. Considering medicine and vaccines, an advanced model demonstrated that the emergence of vaccines would greatly slow the spread of the virus. Our model predicted that 100,000 people would become infected assuming that the isolation rate α in Wuhan was 0.30. If quarantine measures were taken from March 10, 2020, and the quarantine rate of α was also 0.3, then the final number of infected people was predicted to be 11,426 in South Korea and 147,142 in Italy. CONCLUSIONS: Our mathematical models indicate that SARS-CoV-2 eradication depends on systematic planning, effective hospital isolation, and SARS-CoV-2 vaccination, and some measures including city closures and leave policies should be implemented to ensure SARS-CoV-2 eradication.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Erradicação de Doenças , Modelos Teóricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Epidemias/prevenção & controle , Governo , Humanos , Itália/epidemiologia , Pneumonia Viral/epidemiologia , Quarentena , República da Coreia/epidemiologia , Vacinação
9.
MMWR Morb Mortal Wkly Rep ; 69(37): 1330-1333, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32941411

RESUMO

Since 1988, when World Health Organization (WHO) Member States and partners launched the Global Polio Eradication Initiative, the number of wild poliovirus (WPV) cases has declined from 350,000 in 125 countries to 176 in only two countries in 2019 (1). The Global Commission for the Certification of Poliomyelitis Eradication (GCC) declared two of the three WPV types, type 2 (WPV2) and type 3 (WPV3), eradicated globally in 2015 and 2019, respectively (1). Wild poliovirus type 1 (WPV1) remains endemic in Afghanistan and Pakistan (1). Containment under strict biorisk management measures is vital to prevent reintroduction of eradicated polioviruses into communities from poliovirus facilities. In 2015, Member States committed to contain type 2 polioviruses (PV2) in poliovirus-essential facilities (PEFs) certified in accordance with a global standard (2). Member states agreed to report national PV2 inventories annually, destroy unneeded PV2 materials, and, if retaining PV2 materials, establish national authorities for containment (NACs) and a PEF auditing process. Since declaration of WPV3 eradication in October 2019, these activities are also required with WPV3 materials. Despite challenges faced during 2019-2020, including the coronavirus disease 2019 (COVID-19) pandemic, the global poliovirus containment program continues to work toward important milestones. To maintain progress, all WHO Member States are urged to adhere to the agreed containment resolutions, including officially establishing legally empowered NACs and submission of PEF Certificates of Participation.


Assuntos
Erradicação de Doenças , Saúde Global/estatística & dados numéricos , Poliomielite/prevenção & controle , Humanos , Poliomielite/epidemiologia , Vacina Antipólio Oral/administração & dosagem
11.
Lancet Glob Health ; 8(10): e1345-e1351, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32916086

RESUMO

On Aug 25 2020, the Africa Regional Commission for the Certification of Poliomyelitis Eradication declared that the WHO African region had interrupted transmission of all indigenous wild polioviruses. This declaration marks the African region as the fifth of the six WHO regions to celebrate this extraordinary achievement. Following the Yaoundé Declaration on Polio Eradication in Africa by heads of state and governments in 1996, Nelson Mandela launched the Kick Polio out of Africa campaign. In this Health Policy paper, we describe the long and turbulent journey to the certification of the interruption of wild poliovirus transmission, focusing on 2016-20, lessons learned, and the strategies and analyses that convinced the Regional Commission that the African region is free of wild polioviruses. This certification of the WHO African region shows the feasibility of polio eradication in countries with chronic insecurity, inaccessible and hard-to-reach populations, and weak health systems. Challenges have been daunting and the sacrifices enormous-dozens of health workers and volunteers have lost their lives in the pursuit of a polio-free Africa.


Assuntos
Erradicação de Doenças/métodos , Saúde Global , Poliomielite/prevenção & controle , Organização Mundial da Saúde , África , Humanos , Poliomielite/transmissão
13.
Caracas; Observatorio Nacional de Ciencia, Tecnología e Innovación; ago. 2020. 46-56 p. ilus.(Observador del Conocimiento. Revista Especializada de Gestión Social del Conocimiento, 5, 3).
Monografia em Espanhol | LILACS, LIVECS | ID: biblio-1120112

RESUMO

A más de cuatro meses de la pandemia que azota al planeta, existe la urgente necesidad de proyectar cómo la transmisión del nuevo SARS-CoV-2 se desarrollará en los meses venideros. En el interés de modelar el comportamiento del SARS-CoV-2 en la República Bolivariana de Venezuela, desde el Observatorio Nacional de Ciencia, Tecnología e Innovación (ONCTI), realizamos análisis estadísticos a objeto de pronosticar con base en los valores de las series de tiempo de contagios de la Covid-19 de procedencia comunitaria, la Estimación Promedio de Contagios Comunitarios. Dichos análisis han permitido evidenciar que la inédita dinámica de propagación de esta pandemia dependerá de la estacionalidad, la duración en encontrarse una vacuna de inmunidad y de los otros factores como, por ejemplo, la erradicación de procedencia de los contagios de orígenes transnacionales o importados. De allí que, utilizando datos que reflejan el comportamiento del SARS-CoV-2 durante los primeros 120 días de pandemia en la República Bolivariana de Venezuela, medimos cómo estos factores afectan la transmisión comunitaria. Para ello construimos un modelo matemático que permitió observar el comportamiento de la transmisión de SARS-CoV-2; y proyectamos qué tan recurrentes serán los brotes de SARS-CoV-2 durante las próximas 3 semanas, los cuales probablemente ocurrirán después del brote de la ola pandémica inicial(AU)


More than four months after the start of the pandemic that plagues the planet, there is an urgent need to project how the transmission of the new SARS-CoV-2 will develop in the upcoming months. Intending to model the behavior of SARS-CoV2 in the Bolivarian Republic of Venezuela, the Observatorio Nacional de Ciencia y Tecnologia (ONTIC) carried out statistical analysis to forecast based on the values of the time series of Covid-19 infections of communitarian origin, the Estimate Average of Community Contagions. These analyzes have shown that the unprecedented spread's dynamics of this pandemic will depend on seasonality, the finding of a vaccine, and other factors such as, for example, the eradication of origin of contagions of transnational or imported origin. Hence, using data that reflects the behavior of SARS-CoV2 during the first 120 days of the pandemic in the Bolivarian Republic of Venezuela, we measure how these factors affect communitarian transmission. To do this, we built a mathematical model that allowed us to observe the behavior of SARS-CoV-2 transmission, projecting how recurrent outbreaks of SARS-CoV-2 will appear over the next 3 weeks, which are likely to occur after the first wave of the pandemic(AU)


Assuntos
Humanos , Estudos de Séries Temporais , Infecções por Coronavirus , Síndrome Respiratória Aguda Grave , Pandemias , Erradicação de Doenças/métodos , Modelos Teóricos
14.
Proc Biol Sci ; 287(1932): 20201405, 2020 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-32781946

RESUMO

Combinations of intense non-pharmaceutical interventions (lockdowns) were introduced worldwide to reduce SARS-CoV-2 transmission. Many governments have begun to implement exit strategies that relax restrictions while attempting to control the risk of a surge in cases. Mathematical modelling has played a central role in guiding interventions, but the challenge of designing optimal exit strategies in the face of ongoing transmission is unprecedented. Here, we report discussions from the Isaac Newton Institute 'Models for an exit strategy' workshop (11-15 May 2020). A diverse community of modellers who are providing evidence to governments worldwide were asked to identify the main questions that, if answered, would allow for more accurate predictions of the effects of different exit strategies. Based on these questions, we propose a roadmap to facilitate the development of reliable models to guide exit strategies. This roadmap requires a global collaborative effort from the scientific community and policymakers, and has three parts: (i) improve estimation of key epidemiological parameters; (ii) understand sources of heterogeneity in populations; and (iii) focus on requirements for data collection, particularly in low-to-middle-income countries. This will provide important information for planning exit strategies that balance socio-economic benefits with public health.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Imunidade Coletiva , Modelos Teóricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Criança , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/prevenção & controle , Erradicação de Doenças , Características da Família , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/imunologia , Pneumonia Viral/prevenção & controle , Instituições Acadêmicas , Estudos Soroepidemiológicos
15.
MMWR Morb Mortal Wkly Rep ; 69(34): 1161-1165, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32853186

RESUMO

In 2016, the World Health Organization (WHO) set hepatitis elimination targets of 90% reduction in incidence and 65% reduction in mortality worldwide by 2030 (1). Hepatitis B virus (HBV) and hepatitis C virus (HCV) infection prevalences are high in Uzbekistan, which lacks funding for meeting WHO's targets. In the absence of large financial donor programs for eliminating HBV and HCV infections, insufficient funding is an important barrier to achieving those targets in Uzbekistan and other low- and middle-income countries. A pilot program using a catalytic funding model, including simplified test-and-treat strategies, was launched in Tashkent, Uzbekistan, in December 2019. Catalytic funding is a mechanism by which the total cost of a program is paid for by multiple funding sources but is begun with upfront capital that is considerably less than the total program cost. Ongoing costs, including those for testing and treatment, are covered by payments from 80% of the enrolled patients, who purchase medications at a small premium that subsidizes the 20% who cannot afford treatment and therefore receive free medication. The 1-year pilot program set a target of testing 250,000 adults for HBV and HCV infection and treating all patients who have active infection, including those who had a positive test result for hepatitis B surface antigen (HBsAg) and those who had a positive test result for HCV core antigen. During the first 3 months of the program, 24,821 persons were tested for HBV and HCV infections. Among those tested, 1,084 (4.4%) had positive test results for HBsAg, and 1,075 (4.3%) had positive test results for HCV antibody (anti-HCV). Among those infected, 275 (25.4%) initiated treatment for HBV, and 163 (15.2%) initiated treatment for HCV, of whom 86.5% paid for medications and 13.5% received medications at no cost. Early results demonstrate willingness of patients to pay for treatment if costs are low, which can offset elimination costs. However, improvements across the continuum of care are needed to recover the upfront investment. Lessons learned from this program, including the effectiveness of using simplified test-and-treat guidelines, general practitioners in lieu of specialist physicians, and innovative financing to reduce costs, can guide similar initiatives in other countries and help curb the global epidemic of viral hepatitis, especially among low- and middle-income countries.


Assuntos
Erradicação de Doenças/economia , Saúde Global/economia , Hepatite B/prevenção & controle , Hepatite C/prevenção & controle , Modelos Econométricos , Adulto , Feminino , Objetivos , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Humanos , Masculino , Projetos Piloto , Prevalência , Avaliação de Programas e Projetos de Saúde , Uzbequistão/epidemiologia , Organização Mundial da Saúde
16.
Trans R Soc Trop Med Hyg ; 114(10): 730-732, 2020 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-32853370

RESUMO

Countries around the world are facing an enormous challenge due to the COVID-19 pandemic. The pressure that the pandemic inflicts on health systems could certainly impact on the care, control, and elimination of neglected tropical diseases (NTDs). From mid-January 2020, Ethiopia started to prepare for the prevention and treatment of COVID-19. The Federal Ministry of Health pledged to continue essential healthcare, including NTD care, during this pandemic. However, some hospitals have been closed for other healthcare services and have been turned into isolation and treatment centers for COVID-19. In addition to the healthcare facility measures, all community-based health promotion and disease prevention services have been stopped. The current shift in attention towards COVID-19 is expected to have a negative impact on NTD prevention and care.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Doenças Negligenciadas/terapia , Pneumonia Viral/epidemiologia , Animais , Betacoronavirus , Erradicação de Doenças , Etiópia/epidemiologia , Programas Governamentais , Fechamento de Instituições de Saúde , Humanos , Doenças Negligenciadas/epidemiologia , Pandemias , Medicina Tropical
18.
PLoS Negl Trop Dis ; 14(8): e0007009, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32804967

RESUMO

Ghana has been implementing Mass Drug Administration (MDA) since the year 2001, and Lymphatic Filariasis transmission has been interrupted in 76 out of the 98 targeted districts. The remaining districts have a microfilaria prevalence above the 1% threshold needed for the interruption of transmission. This study assesses the level of lymphatic filariasis MDA coverage and explored factors affecting the quality of implementation of the MDA in the Bole and Central Gonja Districts of Northern Ghana. A concurrent mixed methods study design approach was used to provide both a quantitative and qualitative insight. A descriptive analysis was carried out, and the results are presented in tables and charts. The transcripts of the qualitative interviews were imported into Nvivo and framework methods of analysis were used. The results were summarized based on the themes and buttressed with narratives with key quotes presented within the texts. The overall MDA coverage in Central Gonja is 89.3% while that of Bole district is 82.9%. Refusal to ingest the drug and adverse drug reactions were higher in Bole district than the Central Gonja District. The persistent transmission of lymphatic filariasis in Bole District was characterized by poor community mobilization and sensitization, nonadherence to the directly observed treatment strategy, refusal to ingest the drug due to the fear of adverse drug reactions, inadequate knowledge and misconceptions about the disease. Reported mass drug administration coverage will not necessarily result into interruption of transmission of the disease without strict compliance to the directly observed treatment strategy, strong stakeholder engagement coupled with evidence-based context-specific multi-channel community education strategies with key educational messages on the cause of the disease and adverse drug reactions. While the clock for the elimination of lymphatic filariasis by the year 2020 and meeting of the Sustainable Development Goal 3 target 3.3 by 2030 is ticking, there is an urgent need for a concerted effort to improve the fidelity of the ongoing lymphatic filariasis MDA campaigns in the Bole District of Northern Ghana.


Assuntos
Filariose Linfática/prevenção & controle , Filaricidas/uso terapêutico , Administração Massiva de Medicamentos/estatística & dados numéricos , Adulto , Erradicação de Doenças/métodos , Erradicação de Doenças/normas , Feminino , Filaricidas/administração & dosagem , Filaricidas/efeitos adversos , Gana/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Administração Massiva de Medicamentos/efeitos adversos , Administração Massiva de Medicamentos/métodos , Pessoa de Meia-Idade , Recusa do Paciente ao Tratamento/estatística & dados numéricos
19.
Am J Prev Med ; 59(4): 493-503, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32778354

RESUMO

INTRODUCTION: Given the continuing COVID-19 pandemic and much of the U.S. implementing social distancing owing to the lack of alternatives, there has been a push to develop a vaccine to eliminate the need for social distancing. METHODS: In 2020, the team developed a computational model of the U.S. simulating the spread of COVID-19 coronavirus and vaccination. RESULTS: Simulation experiments revealed that to prevent an epidemic (reduce the peak by >99%), the vaccine efficacy has to be at least 60% when vaccination coverage is 100% (reproduction number=2.5-3.5). This vaccine efficacy threshold rises to 70% when coverage drops to 75% and up to 80% when coverage drops to 60% when reproduction number is 2.5, rising to 80% when coverage drops to 75% when the reproduction number is 3.5. To extinguish an ongoing epidemic, the vaccine efficacy has to be at least 60% when coverage is 100% and at least 80% when coverage drops to 75% to reduce the peak by 85%-86%, 61%-62%, and 32% when vaccination occurs after 5%, 15%, and 30% of the population, respectively, have already been exposed to COVID-19 coronavirus. A vaccine with an efficacy between 60% and 80% could still obviate the need for other measures under certain circumstances such as much higher, and in some cases, potentially unachievable, vaccination coverages. CONCLUSIONS: This study found that the vaccine has to have an efficacy of at least 70% to prevent an epidemic and of at least 80% to largely extinguish an epidemic without any other measures (e.g., social distancing).


Assuntos
Controle de Doenças Transmissíveis , Simulação por Computador , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Vacinação , Vacinas Virais/farmacologia , Betacoronavirus/isolamento & purificação , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Erradicação de Doenças/métodos , Erradicação de Doenças/estatística & dados numéricos , Humanos , Determinação de Necessidades de Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Resultado do Tratamento , Estados Unidos/epidemiologia , Vacinação/métodos , Vacinação/estatística & dados numéricos , Cobertura Vacinal , Vacinas Virais/normas
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