COVID-19流行病控制：在ICU可持续性下平衡检测政策和封锁干预
COVID-19 pandemic control: balancing detection policy and lockdown intervention under ICU sustainability
摘要：
我们在这里考虑扩展的SIR模型，包括最近COVID-19爆发的几个特征：特别是感染和康复的个体可以被检测到（+）或未被检测到（-），我们还整合了重症监护病房（ICU）的能力。我们的模型可以使用锁定和检测干预杠杆对控制流行动态的最佳政策进行易于处理的定量分析。基于COVID-19相关文献的参数规范，我们研究了各种数量对最优策略的敏感性，同时考虑到大流行的卫生和社会经济成本之间的微妙权衡，以及ICU的有限容量水平。我们将最佳封锁政策确定为分为4个连续阶段的干预措施：首先是快速而强有力的封锁干预措施，以阻止传染病的指数增长;第二是短暂的过渡阶段，以降低病毒的流行率;第三是长期的ICU能力和稳定的病毒流行率;最后是恢复正常的社会交往，病毒消失。因此，最佳方案避免了第二波感染，前提是锁定释放得足够慢。我们还提供最佳干预措施，增加ICU容量，并优化检测传染性和免疫个体的工作。每当引入大量资源来检测感染者时，可以释放社交距离的压力，而检测免疫个体的影响则较为温和。
英文摘要：
We consider here an extended SIR model, including several features of the recent COVID-19 outbreak: in particular the infected and recovered individuals can either be detected (+) or undetected (-) and we also integrate an intensive care unit (ICU) capacity. Our model enables a tractable quantitative analysis of the optimal policy for the control of the epidemic dynamics using both lockdown and detection intervention levers. With parametric specification based on literature on COVID-19, we investigate the sensitivities of various quantities on the optimal strategies, taking into account the subtle trade-off between the sanitary and the socio-economic cost of the pandemic, together with the limited capacity level of ICU. We identify the optimal lockdown policy as an intervention structured in 4 successive phases: First a quick and strong lockdown intervention to stop the exponential growth of the contagion; second a short transition phase to reduce the prevalence of the virus; third a long period with full ICU capacity and stable virus prevalence; finally a return to normal social interactions with disappearance of the virus. The optimal scenario hereby avoids the second wave of infection, provided the lockdown is released sufficiently slowly. We also provide optimal intervention measures with increasing ICU capacity, as well as optimization over the effort on detection of infectious and immune individuals. Whenever massive resources are introduced to detect infected individuals, the pressure on social distancing can be released, whereas the impact of detection of immune individuals reveals to be more moderate.
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