英国爱丁堡大学Graeme J Ackland团队研究了关闭学校对Covid-19死亡率的影响。2020年10月7日，《英国医学杂志》发表了该成果。
为了复制和分析英国决策者在2020年3月做出封锁决定时的可用信息，研究组使用Covid- Sim代码和2020年3月可用数据进行了独立计算，对英国和北爱尔兰的Covid-19疫情进行模拟。
研究组共使用了大约7000万模拟人口，与英国的实际人口统计、地理和社会行为尽可能地接近。主要结局为Covid-19疫情简要数据的重复，并对未发表的结果，特别是关闭学校的影响进行了详细研究。
如果初始Covid-19的复制数约为3.5，则Covid-Sim模型将对后续数据产生良好的预测。该模型预测，关闭学校和隔离年轻人将增加死亡总人数，即使推迟到第二波和随后的一波也是如此。
研究结果表明，迅速采取干预措施在减少重症监护病房（ICU）病床高峰需求方面非常有效，但也延长了疫情流行时间，在某些情况下会导致长期死亡。之所以发生这种情况是因为与covid-19相关的死亡高度偏向年龄较大的人群。在没有有效的疫苗接种规划的情况下，英国拟议的任何抗疫战略都不能将预测的死亡总人数降低到20万以下。
总之，在2020年3月应对covid-19时，大规模的封锁将缓解ICU病床的即时需求，但会增加长期死亡人数。
附：英文原文
Title: Effect of school closures on mortality from coronavirus disease 2019: old and new predictions
Author: Ken Rice, Ben Wynne, Victoria Martin, Graeme J Ackland
Issue&Volume: 2020/10/07
Abstract:
Objective To replicate and analyse the information available to UK policymakers when the lockdown decision was taken in March 2020 in the United Kingdom.
Design Independent calculations using the CovidSim code, which implements Imperial College London’s individual based model, with data available in March 2020 applied to the coronavirus disease 2019 (covid-19) epidemic.
Setting Simulations considering the spread of covid-19 in Great Britain and Northern Ireland.
Population About 70 million simulated people matched as closely as possible to actual UK demographics, geography, and social behaviours.
Main outcome measures Replication of summary data on the covid-19 epidemic reported to the UK government Scientific Advisory Group for Emergencies (SAGE), and a detailed study of unpublished results, especially the effect of school closures.
Results The CovidSim model would have produced a good forecast of the subsequent data if initialised with a reproduction number of about 3.5 for covid-19. The model predicted that school closures and isolation of younger people would increase the total number of deaths, albeit postponed to a second and subsequent waves. The findings of this study suggest that prompt interventions were shown to be highly effective at reducing peak demand for intensive care unit (ICU) beds but also prolong the epidemic, in some cases resulting in more deaths long term. This happens because covid-19 related mortality is highly skewed towards older age groups. In the absence of an effective vaccination programme, none of the proposed mitigation strategies in the UK would reduce the predicted total number of deaths below 200000.
Conclusions It was predicted in March 2020 that in response to covid-19 a broad lockdown, as opposed to a focus on shielding the most vulnerable members of society, would reduce immediate demand for ICU beds at the cost of more deaths long term. The optimal strategy for saving lives in a covid-19 epidemic is different from that anticipated for an influenza epidemic with a different mortality age profile.
DOI: 10.1136/bmj.m3588
Source: https://www.bmj.com/content/371/bmj.m3588
BMJ-British Medical Journal:《英国医学杂志》，创刊于1840年。隶属于BMJ出版集团，最新IF：93.333
官方网址：http://www.bmj.com/
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本期文章：《英国医学杂志》：Online/在线发表
