Societal Learning in Epidemics: Intervention Effectiveness during the 2003 SARS Outbreak in Singapore
Identifieur interne : 001358 ( Pmc/Curation ); précédent : 001357; suivant : 001359Societal Learning in Epidemics: Intervention Effectiveness during the 2003 SARS Outbreak in Singapore
Auteurs : John M. Drake [États-Unis] ; Suok Kai Chew [Singapour] ; Stefan Ma [Singapour]Source :
- PLoS ONE [ 1932-6203 ] ; 2006.
Abstract
Rapid response to outbreaks of emerging infectious diseases is impeded by uncertain diagnoses and delayed communication. Understanding the effect of inefficient response is a potentially important contribution of epidemic theory. To develop this understanding we studied societal learning during emerging outbreaks wherein patient removal accelerates as information is gathered and disseminated.
We developed an extension of a standard outbreak model, the simple stochastic epidemic, which accounts for societal learning. We obtained expressions for the expected outbreak size and the distribution of epidemic duration. We found that rapid learning noticeably affects the final outbreak size even when learning exhibits diminishing returns (relaxation). As an example, we estimated the learning rate for the 2003 outbreak of severe acute respiratory syndrome (SARS) in Singapore. Evidence for relaxation during the first eight weeks of the outbreak was inconclusive. We estimated that if societal learning had occurred at half the actual rate, the expected final size of the outbreak would have reached nearly 800 cases, more than three times the observed number of infections. By contrast, the expected outbreak size for societal learning twice as effective was 116 cases.
These results show that the rate of societal learning can greatly affect the final size of disease outbreaks, justifying investment in early warning systems and attentiveness to disease outbreak by both government authorities and the public. We submit that the burden of emerging infections, including the risk of a global pandemic, could be efficiently reduced by improving procedures for rapid detection of outbreaks, alerting public health officials, and aggressively educating the public at the start of an outbreak.
Url:
DOI: 10.1371/journal.pone.0000020
PubMed: 17183647
PubMed Central: 1762333
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Drake</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>National Center for Ecological Analysis and Synthesis</institution><addr-line>Santa Barbara, California, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Santa Barbara, California</wicri:regionArea></affiliation></author><author><name sortKey="Chew, Suok Kai" sort="Chew, Suok Kai" uniqKey="Chew S" first="Suok Kai" last="Chew">Suok Kai Chew</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Ministry of Health</institution><addr-line>Singapore, Singapore</addr-line></nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Singapore</wicri:regionArea></affiliation></author><author><name sortKey="Ma, Stefan" sort="Ma, Stefan" uniqKey="Ma S" first="Stefan" last="Ma">Stefan Ma</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Ministry of Health</institution><addr-line>Singapore, Singapore</addr-line></nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Singapore</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">17183647</idno><idno type="pmc">1762333</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1762333</idno><idno type="RBID">PMC:1762333</idno><idno type="doi">10.1371/journal.pone.0000020</idno><date when="2006">2006</date><idno type="wicri:Area/Pmc/Corpus">001358</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001358</idno><idno type="wicri:Area/Pmc/Curation">001358</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001358</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Societal Learning in Epidemics: Intervention Effectiveness during the 2003 SARS Outbreak in Singapore</title><author><name sortKey="Drake, John M" sort="Drake, John M" uniqKey="Drake J" first="John M." last="Drake">John M. Drake</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>National Center for Ecological Analysis and Synthesis</institution><addr-line>Santa Barbara, California, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Santa Barbara, California</wicri:regionArea></affiliation></author><author><name sortKey="Chew, Suok Kai" sort="Chew, Suok Kai" uniqKey="Chew S" first="Suok Kai" last="Chew">Suok Kai Chew</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Ministry of Health</institution><addr-line>Singapore, Singapore</addr-line></nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Singapore</wicri:regionArea></affiliation></author><author><name sortKey="Ma, Stefan" sort="Ma, Stefan" uniqKey="Ma S" first="Stefan" last="Ma">Stefan Ma</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Ministry of Health</institution><addr-line>Singapore, Singapore</addr-line></nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Singapore</wicri:regionArea></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Rapid response to outbreaks of emerging infectious diseases is impeded by uncertain diagnoses and delayed communication. Understanding the effect of inefficient response is a potentially important contribution of epidemic theory. To develop this understanding we studied societal learning during emerging outbreaks wherein patient removal accelerates as information is gathered and disseminated.</p></sec><sec><title>Methods and Findings</title><p>We developed an extension of a standard outbreak model, the simple stochastic epidemic, which accounts for societal learning. We obtained expressions for the expected outbreak size and the distribution of epidemic duration. We found that rapid learning noticeably affects the final outbreak size even when learning exhibits diminishing returns (relaxation). As an example, we estimated the learning rate for the 2003 outbreak of severe acute respiratory syndrome (SARS) in Singapore. Evidence for relaxation during the first eight weeks of the outbreak was inconclusive. We estimated that if societal learning had occurred at half the actual rate, the expected final size of the outbreak would have reached nearly 800 cases, more than three times the observed number of infections. By contrast, the expected outbreak size for societal learning twice as effective was 116 cases.</p></sec><sec><title>Conclusion</title><p>These results show that the rate of societal learning can greatly affect the final size of disease outbreaks, justifying investment in early warning systems and attentiveness to disease outbreak by both government authorities and the public. We submit that the burden of emerging infections, including the risk of a global pandemic, could be efficiently reduced by improving procedures for rapid detection of outbreaks, alerting public health officials, and aggressively educating the public at the start of an outbreak.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Barnett, Dj" uniqKey="Barnett D">DJ Barnett</name></author><author><name sortKey="Balicer, Rd" uniqKey="Balicer R">RD Balicer</name></author><author><name sortKey="Lucey, Dr" uniqKey="Lucey D">DR Lucey</name></author><author><name sortKey="Everyly, Gs" uniqKey="Everyly G">GS Everyly</name></author><author><name sortKey="Omer, Sb" uniqKey="Omer S">SB Omer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Holmes, Ec" uniqKey="Holmes E">EC Holmes</name></author><author><name sortKey="Taubenberger, Jk" uniqKey="Taubenberger J">JK Taubenberger</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">17183647</article-id><article-id pub-id-type="pmc">1762333</article-id><article-id pub-id-type="publisher-id">06-PONE-RA-00032R2</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0000020</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline"><subject>Infectious Diseases</subject><subject>Public Health and Epidemiology</subject></subj-group></article-categories><title-group><article-title>Societal Learning in Epidemics: Intervention Effectiveness during the 2003 SARS Outbreak in Singapore</article-title><alt-title alt-title-type="running-head">Societal Learning in Epidemics</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Drake</surname><given-names>John M.</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="author-notes" rid="fn1"><sup>¤</sup></xref><xref ref-type="corresp" rid="n101"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Chew</surname><given-names>Suok Kai</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ma</surname><given-names>Stefan</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><institution>National Center for Ecological Analysis and Synthesis</institution><addr-line>Santa Barbara, California, United States of America</addr-line></aff><aff id="aff2"><label>2</label><institution>Ministry of Health</institution><addr-line>Singapore, Singapore</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Baune</surname><given-names>Bernhard</given-names></name><role>Academic Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1">James Cook University, Australia</aff><author-notes><corresp id="n101">* To whom correspondence should be addressed. E-mail: <email>jdrake@uga.edu</email></corresp><fn fn-type="con"><p>Conceived and designed the experiments: JD. Analyzed the data: JD. Wrote the paper: JD. Other: Contributed data: SC Contributed data, Assisted in interpretation of results: SM</p></fn><fn id="fn1" fn-type="current-aff"><label>¤</label><p>Current address: Institute of Ecology, University of Georgia, Athens, Georgia, United States of America</p></fn></author-notes><pub-date pub-type="collection"><year>2006</year></pub-date><pub-date pub-type="epub"><day>20</day><month>12</month><year>2006</year></pub-date><volume>1</volume><issue>1</issue><elocation-id>e20</elocation-id><history><date date-type="received"><day>9</day><month>8</month><year>2006</year></date><date date-type="accepted"><day>20</day><month>9</month><year>2006</year></date></history><permissions><copyright-statement>Drake et al.</copyright-statement><copyright-year>2006</copyright-year><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.</license-p></license></permissions><abstract><sec><title>Background</title><p>Rapid response to outbreaks of emerging infectious diseases is impeded by uncertain diagnoses and delayed communication. Understanding the effect of inefficient response is a potentially important contribution of epidemic theory. To develop this understanding we studied societal learning during emerging outbreaks wherein patient removal accelerates as information is gathered and disseminated.</p></sec><sec><title>Methods and Findings</title><p>We developed an extension of a standard outbreak model, the simple stochastic epidemic, which accounts for societal learning. We obtained expressions for the expected outbreak size and the distribution of epidemic duration. We found that rapid learning noticeably affects the final outbreak size even when learning exhibits diminishing returns (relaxation). As an example, we estimated the learning rate for the 2003 outbreak of severe acute respiratory syndrome (SARS) in Singapore. Evidence for relaxation during the first eight weeks of the outbreak was inconclusive. We estimated that if societal learning had occurred at half the actual rate, the expected final size of the outbreak would have reached nearly 800 cases, more than three times the observed number of infections. By contrast, the expected outbreak size for societal learning twice as effective was 116 cases.</p></sec><sec><title>Conclusion</title><p>These results show that the rate of societal learning can greatly affect the final size of disease outbreaks, justifying investment in early warning systems and attentiveness to disease outbreak by both government authorities and the public. We submit that the burden of emerging infections, including the risk of a global pandemic, could be efficiently reduced by improving procedures for rapid detection of outbreaks, alerting public health officials, and aggressively educating the public at the start of an outbreak.</p></sec></abstract><counts><page-count count="8"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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