Can informal social distancing interventions minimize demand for antiviral treatment during a severe pandemic?
Identifieur interne : 000378 ( Main/Exploration ); précédent : 000377; suivant : 000379Can informal social distancing interventions minimize demand for antiviral treatment during a severe pandemic?
Auteurs : Amy L. Greer [Canada]Source :
- BMC public health [ 1471-2458 ] ; 2013.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Antiviraux (usage thérapeutique), Besoins et demandes de services de santé, Canada (épidémiologie), Comportement de réduction des risques, Comportement en matière de santé, Distance sociale, Enfant, Enfant d'âge préscolaire, Femelle, Grippe humaine (traitement médicamenteux), Grippe humaine (transmission), Grippe humaine (épidémiologie), Humains, Jeune adulte, Modèles théoriques, Mâle, Nourrisson, Nouveau-né, Pandémies, Sujet âgé, Vaccins antigrippaux.
- MESH :
- traitement médicamenteux : Grippe humaine.
- usage thérapeutique : Antiviraux, Grippe humaine.
- épidémiologie : Canada, Grippe humaine.
- Adolescent, Adulte, Adulte d'âge moyen, Besoins et demandes de services de santé, Comportement de réduction des risques, Comportement en matière de santé, Distance sociale, Enfant, Enfant d'âge préscolaire, Femelle, Humains, Jeune adulte, Modèles théoriques, Mâle, Nourrisson, Nouveau-né, Pandémies, Sujet âgé, Vaccins antigrippaux.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Antiviral Agents (therapeutic use), Canada (epidemiology), Child, Child, Preschool, Female, Health Behavior, Health Services Needs and Demand, Humans, Infant, Infant, Newborn, Influenza Vaccines, Influenza, Human (drug therapy), Influenza, Human (epidemiology), Influenza, Human (transmission), Male, Middle Aged, Models, Theoretical, Pandemics, Risk Reduction Behavior, Social Distance, Young Adult.
- MESH :
- chemical , therapeutic use : Antiviral Agents.
- drug therapy : Influenza, Human.
- epidemiology : Canada, Influenza, Human.
- transmission : Influenza, Human.
- Adolescent, Adult, Aged, Child, Child, Preschool, Female, Health Behavior, Health Services Needs and Demand, Humans, Infant, Infant, Newborn, Influenza Vaccines, Male, Middle Aged, Models, Theoretical, Pandemics, Risk Reduction Behavior, Social Distance, Young Adult.
Abstract
BACKGROUND
In the case of a pandemic, individuals may alter their behaviour. A dynamic model incorporating social distancing can provide a mechanism to consider complex scenarios to support decisions regarding antiviral stockpile size while considering uncertainty around behavioural interventions. We have examined the impact of social distancing measures on the demand for limited healthcare resources such as antiviral drugs from a central stockpile during a severe pandemic.
METHODS
We used an existing age-structured model for pandemic influenza in Canada and biologically plausible scenarios for severe influenza transmission within the population. We incorporated data from published reports regarding stated intentions to change behaviour during a pandemic as well as the magnitude and duration of time that individuals expected to maintain the behavioural change. We ran simulations for all combinations of parameter values to identify the projected antiviral requirements in each scenario.
RESULTS
With 12 weeks of distancing, the effect is relatively small for the lowest R0 of 1.6 with a projected stockpile to treat 25.6% being required (IQR=21.7 - 28.7%) unless the proportion of people involved (81%) and magnitude of the behaviour change is large (69% reduction in contacts). If 24 weeks of distancing occurs, with only a low to moderate reduction in contacts (38% or less), it is not possible to bring treatment requirements below 20% regardless of what proportion of the population engages in distancing measures when transmissibility is high (R0=2.0; stockpile size=31%, IQR=29.2 - 33.5%).
CONCLUSIONS
Our results demonstrate that the magnitude and duration of social distancing behaviours during a severe pandemic have an impact on the need for antiviral drugs. However, significant investments over a long period of time (>16 weeks) are required to decrease the need for antiviral treatment to below 10% of the total population for a highly transmissible viral strain (R0>1.8). Encouraging individuals to adopt behaviours that decrease their daily contact rate can help to control the spread of the virus until a vaccine becomes available however; relying on these measures to justify stockpiling fewer courses of treatment will not be sufficient in the case of a severe pandemic.
DOI: 10.1186/1471-2458-13-669
PubMed: 23866760
Affiliations:
Links toward previous steps (curation, corpus...)
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Greer</name><affiliation wicri:level="1"><nlm:affiliation>Professional Guidelines and Public Health Practice Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON, Canada. amy.greer@phac-aspc.gc.ca.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Professional Guidelines and Public Health Practice Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC public health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Antiviral Agents (therapeutic use)</term><term>Canada (epidemiology)</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Health Behavior</term><term>Health Services Needs and Demand</term><term>Humans</term><term>Infant</term><term>Infant, Newborn</term><term>Influenza Vaccines</term><term>Influenza, Human (drug therapy)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (transmission)</term><term>Male</term><term>Middle Aged</term><term>Models, Theoretical</term><term>Pandemics</term><term>Risk Reduction Behavior</term><term>Social Distance</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Antiviraux (usage thérapeutique)</term><term>Besoins et demandes de services de santé</term><term>Canada (épidémiologie)</term><term>Comportement de réduction des risques</term><term>Comportement en matière de santé</term><term>Distance sociale</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Grippe humaine (traitement médicamenteux)</term><term>Grippe humaine (transmission)</term><term>Grippe humaine (épidémiologie)</term><term>Humains</term><term>Jeune adulte</term><term>Modèles théoriques</term><term>Mâle</term><term>Nourrisson</term><term>Nouveau-né</term><term>Pandémies</term><term>Sujet âgé</term><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Canada</term><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antiviraux</term><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Canada</term><term>Grippe humaine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Health Behavior</term><term>Health Services Needs and Demand</term><term>Humans</term><term>Infant</term><term>Infant, Newborn</term><term>Influenza Vaccines</term><term>Male</term><term>Middle Aged</term><term>Models, Theoretical</term><term>Pandemics</term><term>Risk Reduction Behavior</term><term>Social Distance</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Besoins et demandes de services de santé</term><term>Comportement de réduction des risques</term><term>Comportement en matière de santé</term><term>Distance sociale</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Modèles théoriques</term><term>Mâle</term><term>Nourrisson</term><term>Nouveau-né</term><term>Pandémies</term><term>Sujet âgé</term><term>Vaccins antigrippaux</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>In the case of a pandemic, individuals may alter their behaviour. A dynamic model incorporating social distancing can provide a mechanism to consider complex scenarios to support decisions regarding antiviral stockpile size while considering uncertainty around behavioural interventions. We have examined the impact of social distancing measures on the demand for limited healthcare resources such as antiviral drugs from a central stockpile during a severe pandemic.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We used an existing age-structured model for pandemic influenza in Canada and biologically plausible scenarios for severe influenza transmission within the population. We incorporated data from published reports regarding stated intentions to change behaviour during a pandemic as well as the magnitude and duration of time that individuals expected to maintain the behavioural change. We ran simulations for all combinations of parameter values to identify the projected antiviral requirements in each scenario.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>With 12 weeks of distancing, the effect is relatively small for the lowest R0 of 1.6 with a projected stockpile to treat 25.6% being required (IQR=21.7 - 28.7%) unless the proportion of people involved (81%) and magnitude of the behaviour change is large (69% reduction in contacts). If 24 weeks of distancing occurs, with only a low to moderate reduction in contacts (38% or less), it is not possible to bring treatment requirements below 20% regardless of what proportion of the population engages in distancing measures when transmissibility is high (R0=2.0; stockpile size=31%, IQR=29.2 - 33.5%).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Our results demonstrate that the magnitude and duration of social distancing behaviours during a severe pandemic have an impact on the need for antiviral drugs. However, significant investments over a long period of time (>16 weeks) are required to decrease the need for antiviral treatment to below 10% of the total population for a highly transmissible viral strain (R0>1.8). Encouraging individuals to adopt behaviours that decrease their daily contact rate can help to control the spread of the virus until a vaccine becomes available however; relying on these measures to justify stockpiling fewer courses of treatment will not be sufficient in the case of a severe pandemic.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">23866760</PMID><DateCompleted><Year>2015</Year><Month>07</Month><Day>06</Day></DateCompleted><DateRevised><Year>2019</Year><Month>01</Month><Day>08</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2458</ISSN><JournalIssue CitedMedium="Internet"><Volume>13</Volume><PubDate><Year>2013</Year><Month>Jul</Month><Day>18</Day></PubDate></JournalIssue><Title>BMC public health</Title><ISOAbbreviation>BMC Public Health</ISOAbbreviation></Journal><ArticleTitle>Can informal social distancing interventions minimize demand for antiviral treatment during a severe pandemic?</ArticleTitle><Pagination><MedlinePgn>669</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1471-2458-13-669</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">In the case of a pandemic, individuals may alter their behaviour. A dynamic model incorporating social distancing can provide a mechanism to consider complex scenarios to support decisions regarding antiviral stockpile size while considering uncertainty around behavioural interventions. We have examined the impact of social distancing measures on the demand for limited healthcare resources such as antiviral drugs from a central stockpile during a severe pandemic.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We used an existing age-structured model for pandemic influenza in Canada and biologically plausible scenarios for severe influenza transmission within the population. We incorporated data from published reports regarding stated intentions to change behaviour during a pandemic as well as the magnitude and duration of time that individuals expected to maintain the behavioural change. We ran simulations for all combinations of parameter values to identify the projected antiviral requirements in each scenario.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">With 12 weeks of distancing, the effect is relatively small for the lowest R0 of 1.6 with a projected stockpile to treat 25.6% being required (IQR=21.7 - 28.7%) unless the proportion of people involved (81%) and magnitude of the behaviour change is large (69% reduction in contacts). If 24 weeks of distancing occurs, with only a low to moderate reduction in contacts (38% or less), it is not possible to bring treatment requirements below 20% regardless of what proportion of the population engages in distancing measures when transmissibility is high (R0=2.0; stockpile size=31%, IQR=29.2 - 33.5%).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Our results demonstrate that the magnitude and duration of social distancing behaviours during a severe pandemic have an impact on the need for antiviral drugs. However, significant investments over a long period of time (>16 weeks) are required to decrease the need for antiviral treatment to below 10% of the total population for a highly transmissible viral strain (R0>1.8). Encouraging individuals to adopt behaviours that decrease their daily contact rate can help to control the spread of the virus until a vaccine becomes available however; relying on these measures to justify stockpiling fewer courses of treatment will not be sufficient in the case of a severe pandemic.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Greer</LastName><ForeName>Amy L</ForeName><Initials>AL</Initials><AffiliationInfo><Affiliation>Professional Guidelines and Public Health Practice Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON, Canada. amy.greer@phac-aspc.gc.ca.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate 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