| 研究生: |
鄭珺元 Cheng, Chun-Yuan |
|---|---|
| 論文名稱: |
不同介入措施對於COVID19疫情控制的成效探討 Discussion on the effect of different intervention measures on controlling COVID-19 |
| 指導教授: |
王亮懿
Wang, Liang-Yi |
| 學位類別: |
碩士 Master |
| 系所名稱: |
醫學院 - 公共衛生學系 Department of Public Health |
| 論文出版年: | 2022 |
| 畢業學年度: | 110 |
| 語文別: | 中文 |
| 論文頁數: | 63 |
| 中文關鍵詞: | 新冠肺炎 、COVID-19 、介入措施 、分枝模型 |
| 外文關鍵詞: | COVID-19, intervention measures, branching model |
| 相關次數: | 點閱:132 下載:35 |
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前言:新冠肺炎自2019年底席捲全球,許多國家藉由不同的介入措施來達到控制疫情的目的,可分為針對個人層面的個案型介入(如接觸者回溯或檢疫)與針對大眾的群體型介入(如口罩與疫苗),隨著抗疫時間拉長,介入措施也導致民怨與經濟衰退,適度放寬並與之共存成為各國政府首要課題,在目前流行的Omicron變種病毒下,本研究希望能細緻地針對不同介入措施間交互影響與疫情控制進行討論,並且進一步了解這些措施對減緩醫療資源消耗的成效。
研究方法:本研究使用Hellewell等人於2020年開發出的分枝模型(branching model)進行模擬,並搭配近期主要流行的Omicron變種病毒的流行病學資料與不同假設情境,藉由模擬個案在不同條件下的病程資料,計算不同介入措施組合下的介入後再生數(Ri)、累計每日個案數與每日住院人數,作為評價不同介入措施與介入組合優劣的依據。
研究結果:本研究發現若搭配檢疫期篩檢的措施,由14天縮短為7天檢疫期是合理的,但不建議直接取消檢疫措施,整體而言,群體型介入比個案型介入有效,但若在較高強度的群體型介入下加入個案型介入,累計個案與每日住院人數皆會顯著降低。想僅由單一群體型介入措施便控制疫情實屬不易,多種不同介入措施彼此合作,可降低對單一介入措施的強度需求,也較符合現實情境。然而,在針對疫苗避免感染有效性與疫苗覆蓋率之間的權衡,發現若疫苗能有效降低染疫後住院率,先以提高疫苗覆蓋率為主,減緩對醫療量能的衝擊。
研究結論:以目前各國鬆綁防疫措施的方向來看,縮短檢疫期是可行的,在加強群體型介入措施下減少個案型的介入強度亦可為,但仍不建議貿然取消這些政策,同時,亦須努力提高疫苗覆蓋率以控制中重症住院人數。
We used branching model which was introduced by Hellewell in 2020 to simulate the effectiveness of different combination of interventions (like self-protective measures, vaccination, contact tracing, quarantine) in controlling COVID-19 (Omicron variant). We found that reducing quarantine period was reasonable if conducting a test at the end of quarantine. Although case-based interventions (contact tracing, quarantine) worked worse than population-based interventions (self-protective measures, vaccination), the effectiveness of case-based interventions was obviously excellent under high population-based intervention level. Using one kind of population-based intervention to control the pandemic sound unrealistic in practical, but implementing other ones together could help and the requirement of the strength of each intervention would be lower. If people who get vaccination would have a lower hospitalization rate than non-vaccination, increasing vaccine coverage might be more important than vaccine efficacy to reach a reduction in the number of daily hospitalization patients.
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