| Objective:Based on the principle of infectious disease dynamics,an improved SEIR model considering vaccination and asymptomatic infected persons was constructed,and the scenario analysis method was used to predict and analyze the resource demand and cost-benefit related to nucleic acid testing of Novel Coronavirus Disease 2019(COVID-19)under the conditions of different nucleic acid testing range,Non-Pharmacological interventions NPIs intensity,the proportion of asymptomatic infected persons,and nucleic acid sampling to isolation time,to provide a reference for the subsequent dynamic allocation of resources and the implementation of prevention and control measures.Methods:This study obtained the COVID-19 infection index,incubation period,and other parameter information through rich news reports and a large amount of literature,combined with the actual transmission situation of COVID-19 and expert opinions to build six COVID-19 epidemic scenarios and SVEAI_iQHR model considering asymptomatic infected persons and COVID-19 vaccination factors.According to the predicted results of the model and the consumption ratio of laboratory testing,the demand for health resources related to nucleic acid testing under different transmission scenarios of COVID-19 in areas with a population of 500000 was calculated.Python 3.6 was used for modeling and analysis,and Origin2022 and Excel 2019 were used for mapping the trend of epidemic spread and the demand for resources related to nucleic acid testing.According to the field survey results of large-scale nucleic acid testing in C city,Xinjiang,estimated the cost-related data,and calculated the cost,benefit,Benefit Cost Ratio(BCR)and Net Present Value(NPV)of nucleic acid testing under different scenarios in combination with the number of positive cases simulated by the model and the number of health resources required for nucleic acid testing,The cost-benefit analysis method was used to evaluate the cost-benefit of nucleic acid testing under different scenarios.Through single-factor sensitivity analysis and two-factor sensitivity analysis,the factors affecting the optimization results of different scenarios were discussed.Results:1.In this study,the predicted number of infected people simulated by the SVEAIi QHR model was compared with the actual number of daily reported cases of the fifth wave of the epidemic in Hong Kong to verify the model.The Mean Absolute Percentage Error(MAPE)=1.67%,R2=0.998.It showed that the model fitting effect is good,and the simulated curve is highly consistent with the epidemic data of Hong Kong.2.The comparison of the results of scenario 3 and scenario 6 showed that when the nucleic acid testing range,the proportion of asymptomatic infected persons and the time from nucleic acid sampling to isolate infected persons were the same,the implementation of strict NPIs could reduce the peak number of current cases by 58.6%.The daily peak number of COVID-19 infected persons in scenario 3 was the lowest among all scenarios,2428 persons.The result of scenario 6 showed that if NPIs were relaxed,the demand for laboratory testing resources will increase by at least 1.5 times.Due to the implementation of regional nucleic acid testing,the resource requirements of scenario 3 and scenario 6 were at a low level.3.The comparison of the results of scenario 2 and scenario 6 showed that when the intensity of NPIs,the proportion of asymptomatic infected persons,and the time from nucleic acid sampling to isolate infected persons were the same,the more accurate regional nucleic acid testing implemented in scenario 6could not only significantly reduce the number of epidemic peak to 5853 people but also reduce the demand for various laboratory testing resources by 78.5%,compared with the total nucleic acid testing implemented in scenario 2.In addition,the demand for human resources in scenario 2 was 4.7 times that in scenario 6.4.The comparison of the results of scenario 1 and scenario 5 showed that when the NPIs intensity,nucleic acid testing range,and the proportion of asymptomatic infected persons were the same,scenario 5had a large spread of the epidemic due to the delay in nucleic acid sampling to isolate infected persons;In addition to the peak number of epidemic cases reaching 99131,the peak number of infected persons will account for 19.8%of the population in the region at this time.There was a high demand for nucleic acid sampling and laboratory testing personnel(the maximum daily demand was more than 10000 people)for16 days,and it took a long time to reach the peak of the epidemic,which will further increase the labor time.The resource demand for consumables,equipment and protective articles related to nucleic acid testing in scenario 5 had reached 2.6 times that in scenario 1.5.The comparison of the results of scenario 1 and scenario 4 showed that when the NPIs intensity,nucleic acid testing range,and the time from nucleic acid sampling to isolate infected persons were the same,the epidemic scale of scenario 1 was significantly lower than that of scenario 4 based on the different proportion of asymptomatic infected persons.However,due to the implementation of whole-person nucleic acid testing,the total daily peak demand of nucleic acid sampling personnel and laboratory testing personnel in scenario 1 had exceeded 70.8 times the reserve of testing personnel in urban hospitals with a population of 500000 in China,More than 573.6 times the reserve of laboratory personnel of the CDC;The demand for nucleic acid testing related resources in scenario 1 and scenario 4 differ by 1.4 times.6.The total cost of nucleic acid testing measures in scenarios 1-6 during the simulation period was 49million yuan,127 million yuan,19 million yuan,115 million yuan,127 million yuan,and 28 million yuan,respectively.Under the same scenario,the change in labor cost and material cost is similar to the total cost of nucleic acid testing.The result of the cost-benefit analysis showed that the BCR of scenarios 1-6 was greater than 1,and the NPV was greater than 0,that was,positive benefits could be obtained;Among them,scenario 3 had the highest BCR of 87.32;scenario 6 took the second place with 71.43,and scenario 5 had the lowest BCR with 3.15.That was,when regional nucleic acid testing was implemented and the time from nucleic acid sampling to isolate infected persons was short,the NPIs intensity was set to 80%as the optimal scheme.7.The results of the single-factor sensitivity analysis showed that the cost of nucleic acid testing was the main factor affecting BCR.When the nucleic acid testing cost,infection index,and incubation period,which had a greater impact in the single-factor sensitivity analysis,were included in the two-factor sensitivity analysis,it was found that the BCR will gradually increase when the infection index decreases and the cost of nucleic acid testing decreases;When the incubation period gradually decreases but the cost of nucleic acid testing increases,the BCR will gradually decrease.Conclusions:1.The SVEAI_iQHR model,which included asymptomatic infected persons and vaccination rooms,had obvious applicability and reliability for simulating the spread of COVID-19 in various scenarios.The study obtained the number of COVID-19 infection cases under different scenarios,which could meet the needs of quantitative optimization and cost-benefit analysis of various prevention and control measures.2.Adopting strict NPIs,implementing nucleic acid testing in the region and ensuring a short time for nucleic acid sampling to isolate positive infected persons could reduce the epidemic scale and become the most cost-effective scenario combination with the minimum use of human and material resources.3.When the testing range was extended to all nucleic acids and the time from nucleic acid sampling to isolate infected persons was extended,even if strict NPIs were adopted,the spread of the epidemic could not be controlled,further leading to a sharp increased in the demand for resources related to nucleic acid testing.4.When carrying out large-scale nucleic acid testing,the higher the proportion of asymptomatic infected people,the better the effect of nucleic acid testing in the population,and the fewer resources required.5.The parameters that had a significant impact on the cost and benefit of nucleic acid testing measures in various scenarios mainly included nucleic acid testing cost,infection index and incubation period,etc.The follow-up epidemic prevention and control work should focus on the above aspects. |
PDF Full Text Request