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首页> 外文期刊>Proceedings of the National Academy of Sciences of the United States of America >Protecting residential care facilities from pandemic influenza
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Protecting residential care facilities from pandemic influenza

机译：保护居民护理设施免受大流行性流感的侵害

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It is widely believed that protecting health care facilities against outbreaks of pandemic influenza requires pharmaceutical resources such as antivirals and vaccines. However, early in a pandemic, vaccines will not likely be available and antivirals will probably be of limited supply. The containment of pandemic influenza within acute-care hospitals anywhere is problematic because of open connections with communities. However, other health care institutions, especially those providing care for the disabled, can potentially control community access. We modeled a residential care facility by using a stochastic compartmental model to address the question of whether conditions exist under which nonpharmaceutical interventions (NPIs) alone might prevent the introduction of a pandemic virus. The model projected that with currently recommended staff-visitor interactions and social distancing practices, virus introductions are inevitable in all pandemics, accompanied by rapid internal propagation. The model identified staff reentry as the critical pathway of contagion, and provided estimates of the reduction in risk required to minimize the probability of a virus introduction. By using information on latency for historical and candidate pandemic viruses, we developed NPIs that simulated notions of protective isolation for staff away from the facility that reduced the probability of bringing the pandemic infection back to the facility to levels providing protection over a large range of projected pandemic severities. The proposed form of protective isolation was evaluated for social plausibility by collaborators who operate residential facilities. It appears unavoidable that NPI combinations effective against pandemics more severe than mild imply social disruption that increases with severity.
机译：普遍认为，保护医疗保健设施免于大流行性流感的爆发需要药物资源，例如抗病毒药和疫苗。但是，在大流行初期，疫苗将不太可能获得，抗病毒药物的供应可能有限。由于与社区的开放联系，任何地方的急诊医院都无法控制大流行性流感。但是，其他医疗机构，尤其是那些为残疾人提供护理的机构，可以潜在地控制社区的访问。我们通过使用随机隔室模型对居民护理设施进行建模，以解决是否存在单独的非药物干预（NPI）可能阻止大流行性病毒引入的条件的问题。该模型预测，在当前建议的工作人员与访客互动和社会疏远做法的情况下，在所有大流行中都不可避免地引入病毒，并伴随着内部快速传播。该模型将人员再入确定为传染的关键途径，并提供了将病毒引入的可能性降至最低所需的风险降低的估计值。通过使用有关历史性和候选大流行病毒潜伏期的信息，我们开发了NPI，模拟了远离设施的员工的保护隔离的概念，从而将大流行性感染带回设施的可能性降低到可以在较大范围的预计范围内提供保护的水平大流行病严重程度。运营住宅设施的合作者对拟议的保护性隔离形式进行了社会合理性评估。似乎不可避免的是，NPI组合比轻度更有效地对抗大流行，这意味着随着严重程度的增加，社会破坏也会加剧。

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