Tshawb nrhiav tshuaj tiv thaiv kab mob tiv thaiv kab mob thiab nws cov txiaj ntsig hauv Mitigating SARS-CoV-2 Cov kab mob sib kis hauv Suav teb
Nov 10, 2023
Abstract
Keeb kwm: Txhawm rau tso cai rov qab mus rau qhov ua ntej-COVID-19 txoj kev ua neej, yuav luag txhua lub tebchaws tau pib qhov kev txhaj tshuaj tiv thaiv kom txo tau tus kab mob hnyav thiab tswj kev sib kis. Txawm li cas los xij, nws tseem yuav pom tias kev tiv thaiv tsiaj txhu puas yuav nyob mus txog ntawm cov kev pab cuam no.
Txoj Kev: Peb tau tsim cov qauv sib xyaw ua ke ntawm SARS-CoV-2 kev sib kis rau Tuam Tshoj, cov pej xeem uas tsis muaj kev tiv thaiv ua ntej los ntawm kev kis tus kabmob. Ob qhov kev txhaj tshuaj tiv thaiv tau raug sim thiab cov qauv kev kwv yees ntawm kev tiv thaiv kab mob hauv cov pej xeem tau muab.
cistanche tubulosa- txhim kho lub cev tiv thaiv kab mob
Cov txiaj ntsig: Peb pom tias nws tsis zoo li yuav ncav cuag pab tsiaj tiv thaiv kab mob rau Delta variant muab qhov ua tau zoo ntawm cov tshuaj tiv thaiv uas siv hauv Suav teb thoob plaws xyoo 2021 thiab tsis muaj kev tiv thaiv ntuj ua ntej. Peb kwv yees tias yog tias kev txhaj tshuaj tiv thaiv kev ua tau zoo ntawm 90% tiv thaiv tus kab mob, tshuaj tiv thaiv kab mob tiv thaiv kab mob yuav xav tau kev pab ntawm 93% lossis siab dua ntawm cov neeg Suav. Txawm li cas los xij, txawm tias qhov tshuaj tiv thaiv kab mob tsis tuaj yeem ncav cuag, peb kwv yees tias cov kev txhaj tshuaj tiv thaiv tuaj yeem txo tus kab mob SARS-CoV-2 los ntawm 50–62% nyob rau hauv rooj plaub ntawm cov qauv tshuaj tiv thaiv tag nrho lossis tsis muaj dab tsi thiab muaj kev sib kis pib. tshaj tawm rau lub Kaum Ob Hlis 1, 2021.
Cov lus xaus: Yuav tsum siv zog ua kom cov pej xeem muaj kev ntseeg siab thiab txaus siab los txhaj tshuaj tiv thaiv thiab tsim cov tshuaj tiv thaiv zoo rau ntau lub hnub nyoog.
cistanche tubulosa- txhim kho lub cev tiv thaiv kab mob
Keywords: COVID-19, Herd immunity, Vaccination program, Delta variant, SLIR model
Keeb kwm
Thawj nthwv dej ntawm tus kab mob tshiab coronavirus 2{{5{51}}}}19 (COVID-19) hauv Suav teb tau poob sai sai tom qab ua raws li kev tswj hwm nruj thiab txwv kev mus ncig pib thaum Lub Peb Hlis 20 20 [1–4] ib. Raws li lub Kaum Ib Hlis 12, 2021, COVID-19 tus kab mob kis thoob ntiaj teb tau ua rau ntau dua 251 lab tus neeg mob thiab 5 lab tus neeg tuag thoob ntiaj teb [5]. Tus kab mob kis thoob qhov txhia chaw tau dhau mus lawm, vim qhov mob hnyav ua pa nyuaj ua rau tus mob coronavirus 2 (SARS-CoV-2) tau dhau los qee qhov kev hloov pauv tseem ceeb thiab ntau qhov sib txawv tau dhau mus vim muaj kev sib kis ntau ntxiv thiab / lossis kev tiv thaiv kev tiv thaiv kab mob-xws li, variants Alpha [6–12], Beta [13, 14], Gamma [13, 15], thiab Delta [16–18]. Thoob plaws hauv lub ntiaj teb, kev nce nrawm ntawm Delta cov xwm txheej sib txawv qhia pom tias muaj kev sib tw kom zoo dua piv nrog Alpha, Beta, thiab Gamma [16]; Ntau tshaj 90% ntawm txhua hnub ib ntus los ntawm cov kev pib thoob ntiaj teb ntawm kev sib qhia tag nrho cov ntaub ntawv mob khaub thuas (GISAID) yog sau rau Delta variant txij thaum Lub Xya Hli 2021 [19]. Txawm hais tias tsis muaj kev sib kis loj, Tuam Tshoj tau ntsib ntau qhov kev sib kis me me hauv zos los ntawm cov neeg tuaj txawv teb chaws ntawm Delta variant, suav nrog kev sib kis hauv Guangzhou, Nanjing, thiab lub nroog Zhengzhou [20–22]. Txhawm rau tiv thaiv kev sib kis, feem ntau ntawm lub ntiaj teb yuav tsum muaj kev tiv thaiv kab mob SARS-CoV-2, tshwj xeeb tshaj yog rau Delta variant. Cov tshuaj tiv thaiv zoo tiv thaiv COVID-19 sawv cev rau qhov kev xaiv siv tau tshaj plaws los tiv thaiv SARS-CoV-2 kev sib kis thoob ntiaj teb. Qhov kev ua tau zoo ntawm kev txhaj tshuaj tiv thaiv yog nyob ntawm ntau yam tseem ceeb, suav nrog kev muab tshuaj tiv thaiv, kev txaus siab tau txais cov tshuaj tiv thaiv, kev siv tshuaj tiv thaiv zoo, thiab cov pab pawg hnub nyoog tau tsom los ntawm kev siv tshuaj tiv thaiv. Txawm li cas los xij, kev txhaj tshuaj tiv thaiv tam sim no yog tag nrho raws li cov tshuaj tiv thaiv tsim tawm tsam thawj SARS-CoV-2 kab mob, thiab qhov ua tau zoo zoo li yuav raug txo qis rau Delta variant [23]. Hauv Suav teb, lub tsev muaj txog 1.4 billion tus neeg (~ 18% ntawm cov pej xeem hauv ntiaj teb), 2.37 billion koob tshuaj tau raug tswj hwm txij li lub Kaum Ib Hlis 12, 2021 [24]; 76.5% ntawm tag nrho cov pej xeem tau txhaj tshuaj tiv thaiv ob koob, sib npaug rau 82.4% ntawm cov neeg lub hom phiaj (xws li cov neeg muaj hnub nyoog 3 xyoos thiab laus dua). Txawm li cas los xij, nws tseem yuav pom yog tias qhov tshuaj tiv thaiv tuaj yeem ncav cuag qib txaus kom ua tiav pab tsiaj tiv thaiv kab mob. Lub teb chaws thoob plaws ntiaj teb tab tom ntsib tib lo lus nug. Cov qib kev tiv thaiv kab mob classical yog txhais tau tias yog 1-1/R0, qhov twg R0 yog tus lej tseem ceeb ntawm kev yug me nyuam - qhov nruab nrab ntawm cov kab mob tshwm sim los ntawm ib tus neeg kis tus kab mob nyob rau hauv cov pej xeem uas muaj kev cuam tshuam tag nrho [25]. Rau cov tshuaj tiv thaiv uas muaj txiaj ntsig VE uas muab kev tiv thaiv mus txog lub neej, theem ntawm kev tiv thaiv tsiaj txhu uas yuav tsum tau tiv thaiv kev sib kis yog (1-1/R0)/VE. Txawm li cas los xij, qhov kev kwv yees no yog qhov ua kom pom tseeb ntawm qhov tshwm sim nyuaj vim nws tsis quav ntsej txog qhov sib txawv ntawm cov tib neeg tiag tiag (piv txwv li, kev sib xyaw ua ke, hnub nyoog tshwj xeeb rau kev kis tus kab mob) [25, 26] nrog rau kev txhaj tshuaj tiv thaiv (xws li, kev tiv thaiv kab mob mus ntev. , sterilizing tshuaj tiv thaiv). Txhawm rau kov yeej qhov kev txwv no, ntawm no peb sib koom ua ke kev sib txuas lus tshwj xeeb rau cov pej xeem Suav [27] nrog rau cov ntaub ntawv pej xeem cov ntaub ntawv los tsim cov qauv stochastic muaj hnub nyoog los simulate SARS-CoV-2 kis (Cov ntaub ntawv ntxiv 1: Fig . S1). Tom qab ntawd peb siv tus qauv no los ntsuas seb puas muaj kev tiv thaiv kab mob tiv thaiv kab mob Delta los yog tsis yog los ntawm kev txhaj tshuaj loj.
cistanche tubulosa- txhim kho lub cev tiv thaiv kab mob
Nyem qhov no mus saib Cistanche Enhance Immunity khoom
【Nug ntxiv】 Email: cindy.xue@wecistanche.com / Whats App: 0086 18599088692 / Wechat: 18599088692
Cov txheej txheem
SARS-CoV-2 transmission and vaccination model
Peb tau tsim cov qauv sib xyaw ua ke ntawm SARS-CoV-2 kev sib kis thiab txhaj tshuaj tiv thaiv, raws li lub hnub nyoog-structured stochastic susceptible-latent-infectious-removed (SLIR) scheme, accounting for heterogeneous contact patterns by age [27] thiab heterogeneous susceptibility rau kev kis kab mob los ntawm hnub nyoog raws li kev kwv yees siv cov ntaub ntawv sib cuag hauv Hunan xeev ntawm Tuam Tshoj [28]. Hauv cov qauv, cov pej xeem tau muab faib ua plaub pawg kab mob sib kis: raug mob, latent, kis tau, thiab tshem tawm, stratified los ntawm 16 pawg hnub nyoog. Cov tib neeg raug mob tuaj yeem kis tau tom qab kev sib cuag nrog tus neeg kis tau raws li lub hnub nyoog tshwj xeeb ntawm kev kis tus kab mob. Tus nqi ntawm kev sib cuag tshwm sim yog txiav txim los ntawm cov qauv sib xyaw ntawm txhua pab pawg hnub nyoog. Lub sij hawm latent thiab lub sij hawm nruab nrab tiam tau teem tseg yog 4.4 [28–30] thiab 7 [31] hnub, feem. Peb txiav txim siab tus lej tseem ceeb (R0) ntawm 6.0 raws li kev kwv yees rau SARS-CoV-2 Delta variant [1–4, 6–12, 16–18] . Kev simulation yog pib nrog 40 tus neeg kis tus kabmob [32], sib xws rau tus lej ntawm tus kabmob thawj zaug kuaj pom muaj tus kabmob kis hauv nroog hauv Beijing thaum Lub Rau Hli 11, 2020. Peb xav txog 2-cov tshuaj tiv thaiv kab mob uas tsuas yog cov neeg raug tsim nyog tau txais kev txhaj tshuaj ( peb nco qab tias kev tiv thaiv ib puag ncig yog ze rau 0 hauv Suav teb txij lub Kaum Ib Hlis 2021 [33]) thiab tias lub sijhawm ntawm kev tiv thaiv kab mob tiv thaiv kab mob ntev dua li lub sij hawm lub qab ntug txiav txim siab hauv txoj kev tshawb no (piv txwv li, 1 xyoo). Cov ntsiab lus hais txog tus qauv thiab qhov ntsuas tau qhia hauv Cov ntaub ntawv ntxiv 1: Sec. 1 and Tab. S1.
Lub hauv paus scenario
Raws li lub hauv paus scenario, peb xav txog cov kev xav hauv qab no:
i) Epidemic seeding: Ib qho kev sib kis tau xav tias yuav tshwm sim los ntawm 40 SARS-CoV-2 cov tib neeg kis rau lub Kaum Ob Hlis 1, 2021 [32].
ii) Kev txhaj tshuaj tiv thaiv: Cov tshuaj tiv thaiv tau muab tso rau hauv Suav teb txij thaum Lub Kaum Ib Hlis 30, 2020 [24], uas yog hnub ntxov tshaj plaws los ntawm tsoomfwv tau tshaj tawm, thiab tau txuas ntxiv rau cov neeg muaj hnub nyoog 3+ xyoo txij thaum lub Kaum Ib Hlis, thiab peb tau sim ob lub tswv yim txhaj tshuaj sib txawv:
a) Lub tswv yim 1—random faib cov tshuaj tiv thaiv rau cov tib neeg hnub nyoog 12+ xyoo, tom qab ntawd txuas mus rau cov tib neeg hnub nyoog 3+ xyoo pib txij lub Kaum Ib Hlis 1, 2021;
b) Lub Tswv Yim 2—Kev faib cov tshuaj tiv thaiv tsis sib xws rau cov tib neeg hnub nyoog 3+ xyoo txij li pib qhov kev pab cuam txhaj tshuaj, uas yog lub Kaum Ib Hlis 30, 2020.
Peb tau txiav txim siab tias ib feem ntawm cov pej xeem (kwv yees li 2% -Cov ntaub ntawv ntxiv 1: Tab. S2) tsis tsim nyog tau txais cov tshuaj tiv thaiv li cov poj niam cev xeeb tub thiab cov neeg muaj kev fab tshuaj lossis lwm yam mob tsis suav nrog kev txhaj tshuaj tiv thaiv hauv Suav teb txij lub Kaum Ib Hlis 2021. [34–40] (saib cov ntaub ntawv ntxiv 1: Sec. 2 kom ntxaws).
iii) Muaj peev xwm txhaj tshuaj: Peb tau siv cov ntaub ntawv keeb kwm ntawm kev tswj hwm txhua hnub hauv Suav teb txog thaum Lub Kaum Ib Hlis 2, 2021 (Cov ntaub ntawv ntxiv 1: Fig. S2), tom qab ntawd tau npaj lub peev xwm niaj hnub rau yav tom ntej raws li qhov nruab nrab noj txhua hnub tau tswj hwm lub sijhawm Lub Kaum Hli 2– Nov 2, 2021 [24]. Yog li, txij lub Kaum Ib Hlis 3, 2021, thiab dhau mus, peb kwv yees qhov kev tswj hwm tshuaj tiv thaiv txhua hnub muaj peev xwm ntawm 2.30 lab koob tshuaj rau cov pej xeem Suav (cov ntsiab lus tau tshaj tawm hauv Cov ntaub ntawv ntxiv 1: Sec. 3).
iv) Kev siv tshuaj tiv thaiv zoo: Lub sijhawm txhaj tshuaj yuav tsum muaj ob koob tshuaj nrog lub sijhawm {{0}}hnub. VE tiv thaiv kab mob rau cov tib neeg hnub nyoog 18-59 xyoo nce mus txog nws qhov siab tshaj plaws 14 hnub tom qab txhaj tshuaj tiv thaiv 2 koob thiab kwv yees li ntawm 54.3% rau Delta variant [41-43]. Qhov kev kwv yees no yog ua raws li qhov ua tau zoo tau ntsuas tawm tsam thawj cov kab mob thiab txo qis ntawm cov tshuaj tiv thaiv kab mob uas tau kwv yees rau Delta variant hauv kev tshawb fawb soj ntsuam (saib cov ntaub ntawv ntxiv 1: Tab. S1 kom paub meej). Tus txheeb ze VE tiv thaiv kab mob hauv 0- 13 hnub tom qab koob thib ob piv nrog kev tiv thaiv siab tshaj plaws yog 83.8% rau Delta variant [44]. VE tiv thaiv kev tuag rau cov tib neeg hnub nyoog 18-59 xyoo yog 93% rau Delta variant [45-47]. Peb tshawb nrhiav VE cov txiaj ntsig siab dua tiv thaiv kab mob [48] thiab tau sim ob koob tshuaj nrog lub sijhawm 14-hnub raws li kev soj ntsuam rhiab heev (Cov ntaub ntawv ntxiv 1: Tab. S1). Tsis tas li ntawd, cov tshuaj tiv thaiv COVID-19 tej zaum yuav tsis zoo sib npaug ntawm cov hnub nyoog hauv kev tiv thaiv kab mob. Txhawm rau kom nkag siab qhov cuam tshuam ntawm qhov kev xav no, peb kuj tau sim cov txheeb ze VE ntawm 50% thiab 75% rau cov tib neeg hnub nyoog 3-17 thiab 60+ xyoo piv rau VE rau cov tib neeg hnub nyoog 18-59 xyoo.
v) Cov tshuaj tiv thaiv: Peb tau txiav txim siab ob lub tswv yim los ua qauv tshuaj tiv thaiv kev ua tau zoo: ib qho tshuaj tiv thaiv "tag nrho lossis tsis muaj dab tsi" (kev tshuaj ntsuam xyuas hauv paus), uas cov tshuaj tiv thaiv muaj kev tiv thaiv tag nrho rau ib feem VE ntawm cov tib neeg uas tau txhaj tshuaj tiv thaiv thiab tsis muaj kev tiv thaiv rau qhov seem. 1-VE tau txhaj tshuaj rau tib neeg. Qhov kev xaiv thib ob uas peb suav hais tias yog tshuaj tiv thaiv "txo" uas txhua tus neeg tau txhaj tshuaj muaj qee qib kev tiv thaiv los ntawm tus kab mob sib raug rau VE [49].
vi) Kev tiv thaiv thawj zaug: Raws li lub Kaum Ib Hlis 2021, tseem tsis tau muaj kev tiv thaiv pej xeem los ntawm kev kis kab mob hauv Suav teb [33]. Rau lub hom phiaj ntawm kev nthuav dav ntawm cov txiaj ntsig mus rau lwm lub teb chaws uas muaj kev sib kis thoob plaws, peb tau tshawb xyuas qhov xwm txheej uas 30% ntawm cov pej xeem pib tiv thaiv kab mob, thiab feem ntawm cov neeg tiv thaiv kab mob los ntawm pawg hnub nyoog yog proportional rau cov pej xeem loj.
vii) Kev kis tus kab mob los ntawm hnub nyoog: Cov menyuam yaus hnub nyoog qis dua 15 xyoos raug kwv yees tias muaj kev cuam tshuam qis dua rau SARS-CoV-2 tus kab mob piv rau cov neeg laus (piv txwv li, cov tib neeg hnub nyoog 15 txog 64 xyoo), thaum cov tib neeg muaj hnub nyoog { {5}} xyoo muaj qhov kis tau zoo tshaj plaws [28].
viii) Lub sijhawm tiv thaiv kab mob: Peb cia tus qauv kis tau tus mob mus txog 1 xyoos, piv txwv li kev tiv thaiv lub neej ntev los ntawm kev kis kab mob lossis kev txhaj tshuaj.
ix) Kab mob hnyav: Tus kab mob tuag taus rau thawj kab mob tshwm sim hauv {{0}}.0923% rau cov tib neeg hnub nyoog 0-19, nce mus rau 6.7959% rau cov neeg muaj hnub nyoog tshaj 80 xyoo [50, 51]. Qhov kev pheej hmoo ntawm kev tuag cuam tshuam nrog Delta variant piv rau thawj kab yog 2.37 [52].
Kev soj ntsuam rhiab heev los ntsuas qhov cuam tshuam ntawm cov kev xav hauv paus ntawm peb cov txiaj ntsig tau ua tiav ib yam (Cov ntaub ntawv ntxiv 1: Tab. S1).
cistanche tubulosa- txhim kho lub cev tiv thaiv kab mob
Lwm yam kev txhaj tshuaj tiv thaiv scenarios
Peb tau sim peb qhov xwm txheej tshiab los tshawb txog qhov muaj peev xwm txhaj tshuaj tiv thaiv kab mob tiv thaiv kab mob, qhov twg (i) pib kis tus kab mob ncua sijhawm txij lub Kaum Ob Hlis 1, 2021, txog rau Lub Ib Hlis 1, 2022, thiab Lub Ob Hlis 1, 2022 ; (ii) tus nqi ntawm tus lej luam tawm hauv cov pej xeem uas muaj kev cuam tshuam tag nrho thiab nyob rau hauv ib theem ntawm cov tshuaj tsis yog tshuaj (NPIs), qhia tias yog RNPIs 0, txawv ntawm 1.1 thiab 6; (iii) kev sib txuas ntawm scenarios I thiab ii. Rau qhov xwm txheej (ii), peb tsis tau qhia meej txog tus qauv NPIs ib leeg xws li kev cais tawm, kev sib cuag, hnav lub qhov ncauj qhov ntswg, nyob sib nrug deb, thiab txhim kho kev nyiam huv. Hloov chaw, qhov sib xyaw ua ke ntawm cov kev ntsuas no tau suav tias yog qhov txo qis ntawm kev tsim tawm tus lej.
Cov ntaub ntawv tsom xam
Rau txhua qhov xwm txheej, 100 stochastic simulations tau ua, thiab qhov nruab nrab thiab 95% kev ntseeg siab ib ntus (95% CI) tau kwv yees.
Peb tau siv lub sijhawm tom ntej matrix (NGM) [53] mus kom ze los kwv yees tus naj npawb zoo dua qub, Re. Herd kev tiv thaiv yog suav tias ua tiav thaum Re<1. Details are reported in Additional file 1: Sec. 4 and 5.
Cov txiaj ntsig
Lub hauv paus scenario
Los ntawm kev simulating 1 xyoo ntawm kev sib kis thiab xav tias tsis muaj tshuaj tiv thaiv tsis txaus ntseeg, kev siv tshuaj tiv thaiv txuas ntxiv yuav ua rau muaj kev pov hwm zaum kawg ntawm 90.7% ntawm cov pej xeem lub hom phiaj, uas sib raug rau 88.6% ntawm tag nrho cov pej xeem rau lub tswv yim 1 (Fig. 1a). Rau lub tswv yim 2, qhov kwv yees kwv yees ntawm tag nrho cov pej xeem yog 88.7% (Fig. 1b). Raws li txhua qhov xwm txheej, qhov nruab nrab qhov xwm txheej niaj hnub yeej tsis ncav cuag 250 tshaj 10,000 cov neeg nyob hauv (Daim duab 1c, d). Peb kwv yees tias tus naj npawb ntawm kev tsim tawm tau zoo thaum lub sij hawm cov noob qoob loo (Re) tseem zoo tshaj qhov kev sib kis, uas yog 4.03 (95% CI 3.19-4.70) thiab 3.18 (95% CI 3.15-3.24) rau lub tswv yim 1 thiab 2. , raws li (Fig. 1e, f). Cov kev kwv yees no qhia tias qhov tshuaj tiv thaiv thaum Lub Kaum Ob Hlis 1, 2021, tsis txaus los tiv thaiv kev kis mus ntxiv, tsis hais txog kev txhaj tshuaj tiv thaiv. Nws tau kwv yees tias yuav hla tus kab mob sib kis (piv txwv li, 1) thaum Lub Ib Hlis 31 thiab Lub Ob Hlis 5, 2022, rau cov tswv yim 1 thiab 2, raws li, vim muaj cov neeg tiv thaiv kab mob sib sau ua ke los ntawm kev siv tshuaj tiv thaiv txuas ntxiv thiab kev kis kab mob ntuj (Fig. 1g, h). Qhov kwv yees tus kab mob kis tau tus kab mob (uas suav nrog tag nrho cov kab mob SARS-CoV-2, ywj siab ntawm seb ib tus neeg puas muaj cov tsos mob los yog tsis) yog 45.2% (95% CI 37.2–48.5%) thiab 45.7% (95% CI 40.6– 48.8%) rau cov tswv yim 1 thiab 2, raws li (Fig. 1g, h). Nco ntsoov tias qhov feem pua ntawm cov tshuaj tiv thaiv-tiv thaiv cov tib neeg tsis tau nce ntxiv thaum qhov feem pua ntawm cov neeg tiv thaiv kab mob tseem nce ntxiv. Qhov tseeb, thaum txhua tus neeg tau txhaj tshuaj tiv thaiv lossis kis tus kab mob, qhov feem pua ntawm cov tshuaj tiv thaiv kab mob yuav tsum tsis txhob nce ntxiv. Txawm li cas los xij, nyob rau hauv qhov xwm txheej no, cov neeg tsis muaj kev tiv thaiv / tiv thaiv ib feem tseem tuaj yeem kis tus kab mob, uas ua rau muaj kev nce ntxiv ntawm cov neeg tiv thaiv kab mob.
Fig. 1 Lub Sijhawm koob tshuaj tiv thaiv kab mob, qhov tshwm sim niaj hnub, tus naj npawb ntawm cov menyuam muaj txiaj ntsig zoo, thiab feem ntau ntawm cov neeg tiv thaiv kab mob. Kev txhaj tshuaj tiv thaiv hnub nyoog tshwj xeeb rau lub sijhawm rau lub tswv yim 1. Cov kab dotted sib raug rau qhov pib muaj kev sib kis. Cov lus hais qhia txog cov hnub nyoog tshwj xeeb rau ob lub sijhawm tseem ceeb (piv txwv li, Lub Kaum Ob Hlis 1, 2021) thiab lub sijhawm uas cov kev pabcuam tseem nyob tas li (piv txwv li, Lub Peb Hlis 11)). Cov kab sib raug rau tus nqi nruab nrab, thaum qhov chaw ntxoov ntxoo sawv cev rau 95% CI. b Raws li a, tab sis rau lub tswv yim 2. c Cov xwm txheej txhua hnub rau 10, 000 rau lub tswv yim 1 (txhais tau tias thiab 95% CI). d Raws li c, tab sis rau lub tswv yim 2. e Tus naj npawb rov ua tau zoo Re dhau lub sij hawm (txhais tau tias thiab 95% CI) rau lub tswv yim 1. Qhov chaw ntxoov ntxoo hauv grey qhia txog kev kis kab mob sib kis Re =1. Cov lej nyob ib ncig ntawm thaj chaw ntxoov ntxoo qhia thaum Re hla qhov pib no (piv txwv li, Lub Ib Hlis 31) rau lub tswv yim 1. f Raws li e, tab sis rau lub tswv yim 2. g Feem ntau ntawm cov neeg tiv thaiv kab mob vim yog kab mob los yog tshuaj tiv thaiv lub sijhawm rau lub tswv yim 1. h Raws li g, tab sis rau lub tswv yim 2
Txawm hais tias kev txhaj tshuaj tiv thaiv kab mob tsis txaus los tiv thaiv kev kis kab mob, txhua qhov xwm txheej tau txiav txim siab yog cuam tshuam nrog kev txo qis ntawm COVID-19 lub nra. Peb kwv yees tus kab mob kis tus kab mob rau ob txoj kev txhaj tshuaj tiv thaiv kom txo qis dua 50% nrog rau kev siv cov xwm txheej uas tsis muaj kev cuam tshuam (Daim duab 2a, b). Ob lub tswv yim ua rau ntau dua 90% txo cov neeg tuag (Fig. 2c, d). Cov txiaj ntsig no tau ua raws li qhov kev xav ntawm cov tshuaj tiv thaiv "tag nrho lossis tsis muaj dab tsi". Txhawm rau ntsuas qhov muaj zog ntawm peb qhov kev tshawb pom rau qhov kev xav no, peb tau sim tshuaj tiv thaiv "tshuaj lom". Hauv qhov no, peb kwv yees qhov txo qis ntawm tus kabmob kis tus kabmob (12% piv rau li 50%); Txawm li cas los xij, peb kwv yees qhov txo qis ntawm cov neeg tuag (kwv yees li 85% piv rau kwv yees li 90%), Fig. 2e–h. Cov txiaj ntsig tau pom tau hais tias kev tiv thaiv tsiaj tsis tuaj yeem ncav cuag thaum Lub Kaum Ob Hlis 1, 2021, txawm tias qhov kev siv tshuaj tiv thaiv zoo li cas thaum R0 tau teeb tsa ntawm 5 lossis 7 (Cov ntaub ntawv ntxiv 1: Fig. S3), thaum thawj cov noob muaj ntau yam sib txawv hauv qhov ntau ntawm 10 mus rau 100 (Cov ntaub ntawv ntxiv 1: Fig. S4), thiab thaum muaj kev sib npaug ntawm kev kis tus kab mob los ntawm lub hnub nyoog yog kwv yees (Cov ntaub ntawv ntxiv 1: Fig. S5). Tib qhov kev txiav txim siab tau txais thaum peb suav tias yog tus qauv parsimonious ntau dua nrog 3 pawg hnub nyoog (Cov ntaub ntawv ntxiv 1: Fig. S6). Thaum kawg, peb kuj tau ua qhov kev ntsuam xyuas tsis tseeb uas peb xav tias ib feem ntawm cov pej xeem twb muaj kev tiv thaiv kab mob ua ntej pib kev txhaj tshuaj tiv thaiv (zoo ib yam li cov xwm txheej hauv Western lub tebchaws). Raws li qhov kev xav no, peb pom tias 30% kev tiv thaiv thawj zaug yuav tsis ua rau Re qis dua qhov kev sib kis rau ob lub tswv yim ua ntej Lub Kaum Ob Hlis 1, 2021, (Cov ntaub ntawv ntxiv 1: Fig. S7). Raws li cov kev txwv tsis pub tswj cov txheej txheem txhaj tshuaj, peb pom tias kev siv tshuaj tiv thaiv 14 hnub tom qab koob thib ob muaj qhov cuam tshuam loj tshaj plaws, ua raws li kev siv tshuaj tiv thaiv ntawm cov tib neeg hnub nyoog 3–17 thiab 60+ txheeb ze rau cov tib neeg hnub nyoog 18–59. xyoo (Cov ntaub ntawv ntxiv 1: Fig. S8 thiab S9). Ntawm qhov tod tes, qhov txheeb ze ntawm cov tshuaj tiv thaiv kev ua tau zoo hauv 0-13 hnub tom qab koob thib ob thiab lub sijhawm ncua ntawm qhov koob thib ib thiab thib ob muaj kev cuam tshuam ntau dua rau tag nrho cov txiaj ntsig ntawm kev tshuaj xyuas cov tswv yim txhaj tshuaj (Cov ntaub ntawv ntxiv 1: Fig. S10 thiab S11).
Fig. 2 Tus kab mob hnyav ntawm COVID-19 hauv qhov xwm txheej hauv paus. Tus naj npawb ntawm cov kab mob ntau ntxiv rau 1{{10}}},000 cov tib neeg tom qab 1 xyoo simulated rau kev siv scenario thiab ob lub tswv yim txhaj tshuaj uas siv cov qauv tshuaj tiv thaiv "tag nrho lossis tsis muaj dab tsi" (txhais tau tias thiab 95% CI). b Kev txo qis hauv kev kis kab mob (txhais tau tias thiab 95% CI) hais txog kev siv cov xwm txheej hauv ntau pawg hnub nyoog thiab tag nrho cov pej xeem. 95% CI ntawm kev txo qis tuaj yeem hla 0 raws li lub nra ntawm qhov kev siv scenario thiab qhov kev txhaj tshuaj tiv thaiv yog kwv yees li tib yam hauv qee qhov kev sim. Yog li peb tau txiav qhov qis qis ntawm 95% CI ntawm 0 thoob plaws hauv cov ntawv sau. c, d rau a, b, tab sis rau kev tuag. e-h raws li rau a-d, tab sis rau cov qauv tshuaj tiv thaiv "leaky".
Scenario 1: ncua sij hawm pib ntawm kev sib kis
Cov kev tshawb pom tam sim no qhia tias kev tiv thaiv tsiaj txhu tiv thaiv kab mob Delta tsis tuaj yeem tsim los ntawm kev txhaj tshuaj tiv thaiv thaum Lub Kaum Ob Hlis 1, 2021. Tom ntej no, peb tau sim seb qhov pib ntawm tus kab mob kis tshiab yuav tsum tau ncua ntev npaum li cas (piv txwv li, los ntawm kev tswj cov kev txwv nruj rau kev mus ncig thoob ntiaj teb) kom tso cai rau kev tiv thaiv kab mob hauv cov pej xeem, muaj peev xwm ncav cuag pab pawg tiv thaiv kab mob. Raws li lub peev xwm tshuaj tiv thaiv niaj hnub siv nyob rau hauv qhov xwm txheej hauv paus (raws li keeb kwm ntawm cov ntaub ntawv muaj peev xwm txhaj tshuaj txhua hnub mus txog rau lub Kaum Ib Hlis 2, 2021), peb kwv yees tias Re tseem nyob saum cov kab mob sib kis rau ob lub tswv yim txawm tias cov noob ntawm kev sib kis. ncua mus rau Lub Ob Hlis 1, 2022 (Daim duab 3a), thaum qhov txo qis ntawm kev kis kab mob nce mus rau 56.8% thiab 57.4% rau cov tswv yim 1-2, raws li. Nws yog ib qho tseem ceeb rau kev ntxhov siab tias qhov chaw ntawm qhov tsis paub tseeb hauv peb qhov kev kwv yees ntawm Re yog khau raj-strapped tiv tauj matrix los ntawm lub hnub nyoog thiab qhov kev faib tawm tom qab ntawm qhov raug mob los ntawm lub hnub nyoog. Qhov no piav qhia yog vim li cas qhov kev kwv yees kev ntseeg siab ntawm Re rau lub tswv yim 1 yog dav dua rau lub tswv yim 2 (uas, hauv daim duab 3a, yog me dua qhov loj ntawm qhov chaw). Qhov tseeb, rau lub tswv yim 2, kev txhaj tshuaj tiv thaiv yog qhov tseem ceeb ntawm lub hnub nyoog thiab yog li qhov tsis paub tseeb ntawm cov hnub nyoog raws li qhov tsis muaj qhov tsis txaus ntseeg. Ntawm qhov tsis sib xws, rau lub tswv yim 1, cov tub ntxhais hluas tau txhaj tshuaj tiv thaiv nyob rau theem tom qab, uas txhais tau hais tias qhov tsis paub tseeb ntawm cov hnub nyoog raws li qhov tsis muaj qhov cuam tshuam loj dua qhov tsis paub tseeb ntawm Re. Peb kuj tau tshaj tawm txog qhov cuam tshuam ntawm kev ncua sij hawm pib muaj kev sib kis ntawm cov tshuaj tiv thaiv thiab qhov tshwm sim txhua hnub hauv Cov ntaub ntawv ntxiv 1: Fig. S12.
Daim duab 3 Kev cuam tshuam ntawm kev ncua sij hawm pib muaj kev sib kis thiab siv NPIs. tus lej muaj txiaj ntsig zoo Re (txhais tau tias thiab 95% CI) raws li kev ua haujlwm ntawm cov tshuaj tiv thaiv thaum lub sijhawm kis kab mob. Cov xim xa mus rau qhov xwm txheej ntawm kev ncua sijhawm pib kis mus rau lwm hnub. Qhov chaw ntxoov ntxoo hauv grey qhia tias Re Less dua lossis sib npaug rau 1. b Ntau tus kab mob kis tau rau 10,000 cov tib neeg tom qab 1 xyoo simulated rau kev siv scenario thiab ob txoj kev txhaj tshuaj tiv thaiv (txhais tau tias thiab 95% CI). c Kev txo qis hauv kev kis kab mob (txhais tau tias thiab 95% CI) hais txog qhov kev siv cov xwm txheej. d Raws li ib tug, tab sis rau net reproduction naj npawb Rt (txhais tau tias thiab 95% CI) txais kev sib txawv ntawm NPIs. e Raws li b, tab sis rau qhov xwm txheej ntawm kev siv qhov sib txawv ntawm NPIs. f Raws li c, tab sis rau qhov xwm txheej ntawm kev siv qhov sib txawv ntawm NPIs
Scenario 2: Txais NPIs thaum muaj tus kab mob tshiab
Cov txiaj ntsig tau nthuav tawm txog tam sim no qhia tias kev tiv thaiv tsiaj txhu tiv thaiv Delta variant tsis tuaj yeem ua tiav txhua lub sijhawm. Kev siv NPIs los ua cov lus teb rau kev kis tus kabmob tuaj yeem txo qis kev kis tus kabmob. Nws yog li tsim nyog tshawb xyuas cov txiaj ntsig kev sib koom ua ke ntawm kev txhaj tshuaj tiv thaiv ua ke nrog NPIs ntawm ntau qhov sib txawv. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias peb tsis qhia meej meej txog txhua qhov kev ntsuas los txwv kev kis tus kab mob (xws li, cais cov ntaub ntawv, kev sib cuag, hnav lub qhov ncauj qhov ntswg, nyob sib nrug deb, txhim kho kev nyiam huv). Cov kev ntsuas no yog implicit raws li cov tswv yim sib koom ua ke uas ua rau muaj tus lej qis dua. Peb tshawb nrhiav RNPIs {{0}} nyob rau hauv thaj tsam 1.1–6.{15}} cuam tshuam rau qhov sib txawv ntawm kev cuam tshuam. Qhov tseem ceeb ntawm 1 thiab 2 tau pom nyob rau hauv cov ntawv tseem ceeb, thaum cov txiaj ntsig loj dua tau pom hauv Cov ntaub ntawv ntxiv 1: Fig. S13. Peb kuj tau tshaj tawm txog qhov cuam tshuam ntawm kev siv NPIs nyob rau hauv rooj plaub ntawm qhov tshwm sim tshiab ntawm qhov tshwm sim niaj hnub hauv Cov ntaub ntawv ntxiv 1: Fig. S14. Tus naj npawb nruab nrab ntawm kev yug me nyuam (txhais tau tias yog tus lej yug me nyuam uas suav nrog kev tiv thaiv thiab kev cuam tshuam) thaum Lub Kaum Ob Hlis 1, 2021, rau lub tswv yim 1 tuaj yeem txo qis qis dua 1 tsuas yog thaum RNPIs 0 Tsawg dua lossis sib npaug rau 1.5, thaum lub tswv yim 2, RNPIs 0 tuaj yeem nce mus txog 1.8 (Daim duab 3d). Los ntawm kev txhaj tshuaj tiv thaiv yav tom ntej thiab simulating 1 xyoos ntawm kev sib kis, kev kis kab mob loj tuaj yeem txo qis (ze li 100%) ua tsaug rau kev sib koom ua ke ntawm kev txhaj tshuaj tiv thaiv thiab NPIs (Fig. 3e, f). Nco ntsoov tias qhov txo qis ntawm cov kab mob no pom tseeb tsawg dua 100% rau RNPIs 0 Tsawg dua lossis sib npaug rau 1.3, vim tias tus naj npawb ntawm cov kab mob sib kis tau tsawg heev hauv qhov kev siv scenario.
Scenario 3: ncua kev pib kis tus kab mob thiab siv NPIs
Txhawm rau txhim kho qhov muaj peev xwm txhaj tshuaj tiv thaiv kab mob tiv thaiv kab mob thiab txo tus kab mob COVID-19 lub nra, ntawm no peb tau sim ua ke ntawm ob qhov xwm txheej uas tau hais los saum toj no: ncua kev pib kis mob thiab siv NPIs ntawm ntau theem ntawm kev siv zog hauv kev teb. mus rau qhov tshwm sim tshiab. Yuav tsum muaj kev sib kis pib thaum Lub Kaum Ob Hlis 2021– Lub Ob Hlis 2022, cov tswv yim 1 thiab 2 tuaj yeem ua tiav hauv kev thaiv kev sib kis tsuas yog tias nruab nrab NPIs (RNPIs 0 hauv thaj tsam 1.5–2.0) tau txais yuav (Daim duab . 4). Cov txiaj ntsig ntawm kev txo qis kev kis kab mob piv nrog cov xwm txheej siv rau ob lub tswv yim tau pom hauv Cov ntaub ntawv ntxiv 1: Fig. S15. Qhov ua tau zoo ntawm cov tswv yim txhaj tshuaj tiv thaiv hnub nyoog yog nyob ntawm cov hnub nyoog sib xyaw ntawm cov pej xeem [54]. Txhawm rau ntsuas qhov muaj zog ntawm peb qhov kev tshawb pom, peb tau sim lwm qhov kev sib cuag matrix rau Tuam Tshoj [55] thiab pom cov txiaj ntsig zoo ib yam (Cov ntaub ntawv ntxiv 1: Fig. S16 thiab S17).
Herd immunity pib
Txog tam sim no, kev tiv thaiv tsiaj txhu tsis muaj peev xwm ua tau rau txhua qhov kev txhaj tshuaj tiv thaiv uas xav txog qhov ua tau zoo tsawg (54.3%) ntawm cov tshuaj tiv thaiv tshuaj tiv thaiv kab mob los ntawm Delta. Yog li peb tau tshawb nrhiav lub peev xwm ntawm kev tiv thaiv tsiaj txhu rau ob lub tswv yim txhaj tshuaj tiv thaiv uas tau txais txiaj ntsig zoo dua (95%) (Cov ntaub ntawv ntxiv 1: Fig. S18). Peb kwv yees tias Re tuaj yeem txo qis dua 1.0 rau ob lub tswv yim (Cov ntaub ntawv ntxiv 1: Fig. S18a). Qhov kwv yees kwv yees kev tiv thaiv kab mob nyob rau hauv ob lub tswv yim no yog 91.3% thiab 84.5% feem, uas qhia tias qib ntawm kev tiv thaiv kab mob xav tau los ua tus lej muaj txiaj ntsig zoo hauv qab tus kab mob kis tau qis dua yog tias txhaj tshuaj tiv thaiv txuas ntxiv rau cov neeg muaj hnub nyoog 3+ xyoo. thaum ntxov. Peb kuj tau kwv yees tus kab mob kis tus kab mob nyob rau hauv cov tshuaj tiv thaiv sib txawv raws li qhov kev xav tias kev txhaj tshuaj nres thaum lub sij hawm muaj kev sib kis. Qhov xwm txheej zoo li no qhia tau hais tias thaum cov tib neeg muaj hnub nyoog 12+ xyoo yog qhov tseem ceeb (lub tswv yim 1), txawm hais tias muaj kev kwv yees kwv yees loj heev thaum cov tshuaj tiv thaiv sib npaug sib npaug 80% (3.2), qhov kwv yees tus kab mob tawm tsam yog kuj tsawg (10.0%) (Cov ntaub ntawv ntxiv 1: Fig. S18b). Qhov tseeb, muab qhov kev pab cuam txhaj tshuaj tiv thaiv hnub nyoog thiab qhov tsis muaj kev tiv thaiv ntuj tsim, cov neeg raug tsim txom feem ntau yog tsom rau cov tub ntxhais hluas. Cov neeg coob coob ntawm cov neeg muaj hnub nyoog qis dua, suav nrog kev txhaj tshuaj tiv thaiv siab hauv cov pej xeem, ua rau muaj tus lej loj dua, tab sis, tib lub sijhawm, cov kab mob tau tsom mus rau ib ntu me ntawm cov pej xeem nkaus xwb ( cov tub ntxhais hluas) thiab yog li tag nrho cov kab mob kis tus kab mob tseem qis qis. Peb kuj tau tshawb xyuas seb kev tiv thaiv tsiaj txhu puas tuaj yeem ua tiav lossis tsis tau thiab dab tsi yog qhov kev tiv thaiv tsiaj txhu los ntawm kev kwv yees Re raws li kev xav tias txhua tus neeg muaj cai tau txhaj tshuaj tiv thaiv thiab tau txhaj tshuaj tiv thaiv 2 koob ua ntej kev sib kis pib. Peb tau txiav txim siab txog qhov ua tau zoo ntawm cov tshuaj tiv thaiv nyob rau hauv thaj tsam ntawm 60–100% thiab tshawb xyuas cov xwm txheej sib txawv ntawm qhov kev pab cuam txhaj tshuaj. Peb cov txiaj ntsig tau pom tias, rau cov tshuaj tiv thaiv uas muaj txiaj ntsig qis dua 85%, kev tiv thaiv tsiaj txhu tsis tuaj yeem ua tiav, txawm tias qhov xwm txheej hnyav uas qhov tshuaj tiv thaiv yog 100% (Daim duab 5). Kev txhaj tshuaj tiv thaiv tsiaj txhu tsuas yog ua tiav nrog VE siab dua thiab kev pab them nqi. Piv txwv li, rau cov tshuaj tiv thaiv uas muaj txiaj ntsig 90% tiv thaiv kab mob los ntawm Delta variant, ntau dua 93% ntawm cov pej xeem yuav tsum tau txhaj tshuaj tiv thaiv kab mob (Daim duab 5). Nyob rau hauv lub xub ntiag ntawm NPIs, tus naj npawb ntawm cov noob qoob loo tuaj yeem raug txo qis hauv qab chav tsev kom txo qis kev siv tshuaj tiv thaiv thiab kev pab them nqi (Cov ntaub ntawv ntxiv 1: Fig. S19).
Fig. 4 Kev cuam tshuam ntawm kev ncua sij hawm pib ntawm kev kis tus kab mob pib thiab siv NPIs ntawm tus lej tsim tawm. ib tug Net reproduction naj npawb Rt raws li ib tug muaj nuj nqi ntawm RNPIs 0 thiab kis pib hnub pib rau lub tswv yim 1. Cov kab bold nyob rau hauv dub qhia Rt =1. b Raws li a, tab sis rau lub tswv yim 2
Kev sib tham
Peb txoj kev tshawb fawb tau soj ntsuam qhov ua tau kom ncav cuag pab tsiaj tiv thaiv kab mob SARS-CoV-2 Delta variant los ntawm kev txhaj tshuaj tiv thaiv, txiav txim siab heterogeneity nyob rau hauv pej xeem cov qauv, hnub nyoog tshwj xeeb tus qauv, tshuaj tiv thaiv zoo, thiab cov yam ntxwv lom ntawm SARS-CoV{{4 } }, suav nrog tus lej tseem ceeb ntawm kev yug me nyuam, kev kis tus kab mob los ntawm lub hnub nyoog, thiab lub sijhawm tseem ceeb-rau-kev tshwm sim (xws li, lub sijhawm latent, lub sijhawm tiam). Peb qhov kev tshawb pom tau pom tias kev tiv thaiv tsiaj txhu tsis zoo li tsis tuaj yeem tiv thaiv Delta variant tau muab qhov ua tau zoo ntawm cov tshuaj tiv thaiv tam sim no (tsim tawm tawm tsam thawj SARS-CoV-2 kab mob), thiab nyob rau hauv lub xub ntiag ntawm kev tiv thaiv ntuj ua ntej mus txog. 30%. Txawm hais tias xav txog cov tshuaj tiv thaiv uas muaj txiaj ntsig zoo dua, peb cov txiaj ntsig tau pom tias txuas ntxiv qhov kev txhaj tshuaj tiv thaiv rau cov menyuam yaus sai sai ua lub luag haujlwm tseem ceeb los ua kom muaj peev xwm ncav cuag pab tsiaj tiv thaiv kab mob thiab txo tus kab mob. Yog tias peb xav txog kev tiv thaiv Delta variant ntawm 90% (uas mus dhau cov tshuaj tiv thaiv tam sim no), kev tiv thaiv tsiaj txhu yuav tsum tau txhaj tshuaj tiv thaiv ntawm 93% ntawm tag nrho cov pejxeem. Kev coj noj coj ua ntawm NPIs tuaj yeem tiv thaiv kev sib kis ntawm tus kabmob kis loj txawm tias thaum cov tsiaj tiv thaiv tsis tau mus txog, tab sis qhov kev xaiv no pom tseeb suav nrog cov nqi kev noj qab haus huv thiab nyiaj txiag. Tsis tas li ntawd, ob lub tswv yim uas tau txiav txim siab hauv txoj kev tshawb no yuav txo qis cov kab mob feem ntau. Peb txoj kev tshawb fawb tshawb fawb yog tias thiab thaum twg txhaj tshuaj tiv thaiv kab mob tuaj yeem ncav cuag hauv Suav teb. Raws li qhov kev xav tias cov kab mob sib kis muaj qhov sib kis tau zoo ib yam li Delta variant thiab qhov kev txhaj tshuaj tiv thaiv yuav tsis qeeb vim tsis muaj tshuaj tiv thaiv, kev tiv thaiv tsiaj txhu zoo li tsis tuaj yeem ncav cuag txawm tias qhov xwm txheej hnyav uas qhov tshuaj tiv thaiv yog 100%. Txawm li cas los xij, nws yog ib qho tseem ceeb uas yuav tsum tau hais tias qhov kev ua tau zoo ntawm kev txhaj tshuaj tiv thaiv tau cuam tshuam rau ob qho tib si los ntawm kev tiv thaiv ib puag ncig hauv cov pej xeem (uas yog ze rau 0 hauv Suav teb txij li lub Kaum Ib Hlis 2021) thiab cov qauv hnub nyoog ntawm cov pej xeem. Qhov tseeb, hauv cov neeg uas muaj kev tiv thaiv kab mob siab dua thiab qis dua ntawm cov menyuam yaus, kev tiv thaiv tsiaj txhu tuaj yeem ua tiav.
Peb qhov kev tshawb pom tau taw qhia txog qhov tseem ceeb ntawm kev siv NPIs thiab / lossis kev tiv thaiv tus kheej kom txog thaum muaj kev tiv thaiv kab mob los yog lub nra ntawm tus kab mob kis tau. Cov kev ntsuas no tuaj yeem pab ncua kev cog qoob loo ntawm tus kab mob (xws li kev tswj hwm ciam teb nruj) lossis yuav tsum muaj kev sib kis pib nthuav dav, txo nws lub nra (xws li, kev nyob sib nrug deb, kev sib cuag, kev sim, hnav lub qhov ncauj qhov ntswg, kev tu cev, txwv kev sib cuag) . Txawm li cas los xij, cov lus nug tseem tshuav txog qhov twg NPIs yuav tsum tau ua, lawv qhov kev siv zog, thiab sijhawm. Cov kev tshawb fawb yav tom ntej yog xav tau los teb cov lus nug no.
cistanche tubulosa- txhim kho lub cev tiv thaiv kab mob
Lub luag haujlwm tseem ceeb hauv kev txiav txim siab qhov kev vam meej ntawm kev txhaj tshuaj tiv thaiv yog ua los ntawm kev txaus siab los txhaj tshuaj tiv thaiv cov pej xeem. Raws li cov kev tshawb fawb yav dhau los ntawm COVID{{0}} tshuaj tiv thaiv tsis txaus ntseeg, kev lees txais tshuaj tiv thaiv hauv Suav teb tau kwv yees sib txawv ntawm 60.4 thiab 91.3% rau cov pej xeem muaj hnub nyoog 18 xyoo thiab siab dua [56–59] thiab tej zaum qis dua rau cov laus [59]. Cov kev kwv yees zoo sib xws tau txais rau ntau lub tebchaws suav nrog UK (71.5%) [60] thiab Asmeskas (75.4%) [60]. Muab cov tshuaj tiv thaiv tsis txaus siab no, kev ua tiav qib siab ntawm kev pab them nqi yuav tseem yog lub hom phiaj tsis pom. Kev siv zog los ua kom cov pej xeem muaj kev ntseeg siab thiab txaus siab txhaj tshuaj tiv thaiv yuav yog qhov tseem ceeb tshaj plaws kom tso cai rov qab mus rau lub neej ua ntej-COVID{16}}. Peb txoj kev tshawb fawb qhia tau hais tias kev sib kis ntawm qhov sib kis tau ntau dua Delta qhov sib txawv tau nce ntau qhov kev tiv thaiv kab mob mus rau theem uas yuav tsis muaj peev xwm ua tau rau txhua tus pej xeem yog li cov tswv yim txo qis yuav cuam tshuam ntau dua. Cov kev tshawb fawb yav dhau los tau kwv yees qhov kev tiv thaiv tsiaj txhu los ntawm kev kis kab mob los yog kev txhaj tshuaj raws li qhov kev xav ntawm cov neeg sib xyaw ua ke [61-63], tab sis kev sib txawv ntawm cov qauv sib cuag, cov qauv hnub nyoog ntawm cov pej xeem, kev kis kab mob los ntawm hnub nyoog, thiab kev txiav txim nyob rau hauv uas cov tib neeg tau txhaj tshuaj tiv thaiv yog txhua yam tseem ceeb uas ua rau muaj kev tiv thaiv kab mob sib kis [25]. Txhawm rau tshawb xyuas qhov cuam tshuam ntawm cov heterogeneities suav nrog hauv cov qauv ntawm cov txiaj ntsig tau, peb tau sim lwm tus qauv raws li cov neeg muaj homogeneous tag nrho, yog li tsis quav ntsej txog cov qauv kev sib cuag, cov qauv hnub nyoog ntawm cov pej xeem, kev raug mob los ntawm lub hnub nyoog, thiab kev txiav txim nyob rau hauv uas Cov tib neeg tau txhaj tshuaj tiv thaiv uas suav nrog hauv kev tshuaj xyuas tseem ceeb (Cov ntaub ntawv ntxiv 1: Fig. S20). Thaum xav txog R0=6.0 thiab tshuaj tiv thaiv kab mob tiv thaiv tus kab mob=95%, peb kwv yees lub theoretical herd immunity threshold (ie, tsis suav txog qhov kev tiv thaiv kab mob waning thiab tshwm sim ntawm qhov hloov pauv tshiab nrog kev tiv thaiv kab mob) los ua 87.7% rau homogeneous qauv piv rau 91.3% thiab 84.5% ntawm cov tswv yim txhaj tshuaj 1 thiab 2 rau cov qauv heterogeneous. Peb cov qauv tsim yog raws li cov qauv sib xyaw hauv zej zog kwv yees rau cov pej xeem Shanghai [27] thiab ntawm Tuam Tshoj cov ntaub ntawv tshwj xeeb ntawm COVID-19 kev kis mob (kev tiv thaiv pej xeem, thiab lwm yam). Txawm li cas los xij, cov qauv tsim qauv qhia tau hloov pauv tau thiab tuaj yeem hloov kho rau lwm lub tebchaws. Peb tau sim qhov xwm txheej zoo ib yam li qhov xwm txheej hauv Tebchaws Meskas, qhov uas peb suav tias yog kev tiv thaiv ib puag ncig [64] thiab kev siv tshuaj tiv thaiv BNT162b2 / Pfizer, uas nws qhov ua tau zoo tiv thaiv Delta variant yog kwv yees li ntawm 79% [48]. Tsis tas li ntawd, nyob rau hauv qhov xwm txheej no, peb kwv yees tias kev tiv thaiv tsiaj txhu tsis tuaj yeem ncav cuag (Cov ntaub ntawv ntxiv 1: Fig. S21). Tsis tas li ntawd, kev tsis kam txhaj tshuaj tiv thaiv tuaj yeem ua rau muaj kev phom sij rau kev txhaj tshuaj tiv thaiv hauv Asmeskas thiab lwm lub tebchaws sab hnub poob ib yam nkaus.
Txoj kev tshawb no muaj feem xyuam rau cov kev txwv uas cuam tshuam rau kev ua qauv qhia. Ua ntej, VE tiv thaiv kev kis kab mob los ntawm Delta variant tau txiav txim siab tsis yog ntsuas ncaj qha los ntawm kev soj ntsuam kab mob. Ntxiv mus, VE rau cov menyuam yaus tsis tau kwv yees rau cov tshuaj tiv thaiv uas siv hauv Suav teb; yog li ntawd, peb tau xav tib yam VE ib yam li cov neeg laus raws li kev tshawb fawb txog kev tiv thaiv kab mob [65]. Raws li qhov tsis muaj pov thawj hauv cheeb tsam no, peb tau ua qhov kev soj ntsuam rhiab heev uas qhov kev ua tau zoo ntawm cov tshuaj tiv thaiv qis dua rau cov menyuam yaus. Tag nrho cov lus xaus ntawm txoj kev tshawb no tsis hloov. Txawm li cas los xij, cov ntaub ntawv ntxiv txog kev siv tshuaj tiv thaiv hnub nyoog tshwj xeeb tuaj yeem pab kho qhov kev kwv yees tau. Qhov thib ob, peb xav tias kev tiv thaiv kev tiv thaiv los ntawm kev kis kab mob lossis kev txhaj tshuaj tiv thaiv ntev dua li lub sijhawm lub qab ntug txiav txim siab hauv qhov simulations (piv txwv li, 1 xyoo). Muaj pov thawj los ntawm kev tshawb fawb hauv chaw soj nstuam thiab thaj chaw qhia tias kev tiv thaiv kav ntev li ob peb lub hlis [66]. Txawm hais tias cov ntaub ntawv pov thawj ua ntej no, lub sijhawm ntawm kev tiv thaiv kev tiv thaiv tseem yog ib qho kev tshawb fawb ntawm qhov tseem ceeb tshaj plaws thiab muaj feem cuam tshuam nrog cov kab mob evolution. Nws kuj tseem muaj peev xwm hais tias kev tiv thaiv kab mob waning yuav txuas ntxiv tiv thaiv kab mob hnyav tab sis tsuas yog ib feem ntawm kev tiv thaiv kab mob los yog kev sib kis, uas cuam tshuam rau kev tiv thaiv tsiaj txhu. Zuag qhia tag nrho, lub sijhawm thiab kev tiv thaiv zoo yuav txiav txim siab lub sijhawm ntawm COVID-19 kis thoob ntiaj teb [67, 68]. Ntxiv mus, kev txhaj tshuaj tiv thaiv kab mob tuaj yeem yog txoj hauv kev zoo los txhim kho cov tshuaj tiv thaiv zoo [69–71]. Piv txwv li, hauv Chile tsab ntawv ceeb toom txog kev ua tau zoo ntawm koob tshuaj booster [69–71], cov tshuaj tiv thaiv zoo ntawm CoronaVac tiv thaiv kab mob nce los ntawm 50.18 mus rau 70.89% tom qab txhaj tshuaj tiv thaiv kab mob. Kev ua tau zoo ntawm kev txhaj tshuaj tiv thaiv kab mob cuam tshuam nrog kev txhaj tshuaj tiv thaiv kab mob tuaj yeem ua rau muaj kev tiv thaiv kab mob hauv cov pej xeem thiab tsim nyog tshawb nrhiav ntxiv.
Qhov thib peb, hauv qhov xwm txheej hauv paus, peb tau xa mus rau cov tshuaj tiv thaiv kab mob SARS-CoV-2 inactivated (BBIBP-CorV) coj los ua 54.3% ua tau zoo tiv thaiv tus kab mob Delta variant. Txawm li cas los xij, ob peb lwm cov tshuaj tiv thaiv (xws li CoronaVac, WBIP-CorV, Ad5-nCoV, thiab ZF2001) tau ntawv tso cai thiab tau siv hauv Suav teb. Peb sib txawv cov tshuaj tiv thaiv kev ua tau zoo txog li 79% hauv kev tshuaj ntsuam rhiab heev. Lub ntsiab lus xaus txog lub peev xwm ntawm kev tiv thaiv tsiaj txhu thiab kev xav tau txuas ntxiv kev txhaj tshuaj tiv thaiv kab mob rau cov menyuam yaus thaum ntxov thiab siv cov tshuaj tiv thaiv zoo dua yog qhov tsis hloov pauv.
Xaus
Hauv kev xaus, raws li cov pov thawj tam sim no, ncav cuag cov tshuaj tiv thaiv kab mob tiv thaiv kab mob hauv cov pej xeem uas muaj kev tiv thaiv me me / tsis muaj kev tiv thaiv ntuj yog qhov nyuaj. Ib kauj ruam tseem ceeb tau ua thaum lub Kaum Ib Hlis 2021 nrog kev tso cai tshuaj tiv thaiv rau cov neeg muaj hnub nyoog 3+ xyoo. Kev txo cov tshuaj tiv thaiv tsis txaus nyob rau hauv txhua pab pawg hnub nyoog yuav yog lwm kauj ruam tseem ceeb los txhawb kev tiv thaiv kab mob ntawm cov pej xeem. Cov no, ua ke nrog cov tshuaj tiv thaiv uas muaj txiaj ntsig zoo lossis kev txhaj tshuaj tiv thaiv kab mob, yuav yog qhov tseem ceeb tshaj vim tias muaj peev xwm tshwm sim ntawm tus kab mob SARS-CoV-2 tshiab uas kis tau ntau dua lossis nrog kev tiv thaiv kab mob. Qhov tseem ceeb, txawm tias kev tiv thaiv tsiaj txhu tsis zoo li yuav ncav cuag vim qhov kev tiv thaiv tsis zoo thiab qhov tshwm sim ntawm cov kev hloov pauv tshiab, kev txhaj tshuaj yuav txuas ntxiv txo tus kab mob COVID-19 hnyav heev.
Cov ntaub ntawv
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