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If Long-Term Suppression is not Possible, how do we Minimize Mortality for Infectious Disease Outbreaks?

Published online by Cambridge University Press:  01 December 2023

Andreas Handel*
Affiliation:
Department of Epidemiology and Biostatistics, The University of Georgia, Athens, GA, USA
Joel C. Miller
Affiliation:
School of Computing, Engineering and Mathematical Sciences, La Trobe University, Bundoora, VIC, Australia
Yang Ge
Affiliation:
School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
Isaac Chun-Hai Fung*
Affiliation:
Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
*
Corresponding authors: Andreas Handel; Email: ahandel@uga.edu, Isaac Chun-Hai Fung; Email: cfung@georgiasouthern.edu.
Corresponding authors: Andreas Handel; Email: ahandel@uga.edu, Isaac Chun-Hai Fung; Email: cfung@georgiasouthern.edu.

Abstract

Objective:

For any emerging pathogen, the preferred approach is to drive it to extinction with non-pharmaceutical interventions (NPI) or suppress its spread until effective drugs or vaccines are available. However, this might not always be possible. If containment is infeasible, the best people can hope for is pathogen transmission until population level immunity is achieved, with as little morbidity and mortality as possible.

Methods:

A simple computational model was used to explore how people should choose NPI in a non-containment scenario to minimize mortality if mortality risk differs by age.

Results:

Results show that strong NPI might be worse overall if they cannot be sustained compared to weaker NPI of the same duration. It was also shown that targeting NPI at different age groups can lead to similar reductions in the total number of infected, but can have strong differences regarding the reduction in mortality.

Conclusions:

Strong NPI that can be sustained until drugs or vaccines become available are always preferred for preventing infection and mortality. However, if people encounter a worst-case scenario where interventions cannot be sustained, allowing some infections to occur in lower-risk groups might lead to an overall greater reduction in mortality than trying to protect everyone equally.

Type
Original Research
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

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