易感性的传染病模型,暴露,感染,恢复和死亡(SEIRD)假定同质性,恒定速率和固定速率,双线性结构。他们生产短程,单峰响应,在限制性措施下几乎无法实现。通过不确定我调整,R,D数据,它们不能忠实地代表长期进化。提出了一个稳健的流行病模型,该模型通过人口平均值将感染与进入医疗机构(HCU)的比率相关联。通过不假定任何特定的模型结构来规避模型不确定性,或恒定的利率。该模型通过低不确定性数据进行调整,通过直接监控:(A)HCU的条目(准确已知,与延迟和不可靠的I相比,R,D数据)和(B)缩放模型参数,代表人口平均数。该模型包括感染的随机传播,延迟,随机分配到HCU的条目和不同的非住院患者的外流,随着疾病严重程度的减弱。它密切关注流行病的多模式增长,并可能复发,病毒株和突变,不同的环境条件,免疫水平,控制措施及其效力,包括疫苗接种。结果能够实时识别感染和感染率。它们允许弹性设计,实时具有成本效益的政策,直接瞄准要控制的关键变量(输入到HCU)低于当前HCU容量。正如事后案例研究所证明的那样,该政策可以降低流行病的总体成本,通过平衡感染的社会成本和与社会距离和流动性限制措施相关的经济收缩之间的权衡。
Epidemic models of susceptibles, exposed, infected, recovered and deceased (SΕIRD) presume homogeneity, constant rates and fixed, bilinear structure. They produce short-range, single-peak responses, hardly attained under restrictive measures. Tuned via uncertain I,R,D data, they cannot faithfully represent long-range evolution. A robust epidemic model is presented that relates infected with the entry rate to health care units (HCUs) via population averages. Model uncertainty is circumvented by not presuming any specific model structure, or constant rates. The model is tuned via data of low uncertainty, by direct monitoring: (a) of entries to HCUs (accurately known, in contrast to delayed and non-reliable I,R,D data) and (b) of scaled model parameters, representing population averages. The model encompasses random propagation of infections, delayed, randomly distributed entries to HCUs and varying exodus of non-hospitalized, as disease severity subdues. It closely follows multi-pattern growth of epidemics with possible recurrency, viral strains and mutations, varying environmental conditions, immunity levels, control measures and efficacy thereof, including vaccination. The results enable real-time identification of infected and infection rate. They allow design of resilient, cost-effective policy in real time, targeting directly the key variable to be controlled (entries to HCUs) below current HCU capacity. As demonstrated in ex post case studies, the policy can lead to lower overall cost of epidemics, by balancing the trade-off between the social cost of infected and the economic contraction associated with social distancing and mobility restriction measures.