Non-Pharmaceutical Interventions (NPI) are currently the only mechanism governments can use to mitigate the impact of the COVID-19 epidemic. Similarly to the actual spread of the disease, the dynamics of the contention patterns emerging from the application of NPIs are complex and depend on interactions between people within a specific region as well as other stochastic factors associated to demographic, geographic, political and economical conditions. Agent-based models simulate microscopic rules of simultaneous spatial interactions between multiple agents within a population, in an attempt to reproduce the complex dynamics of the effect of the contention measures. In this way, it is possible to design individual behaviours along with NPI scenarios, measuring how the simulation dynamics is affected and therefore, yielding rapid insights to perform a broad assessment of the potential of composite interventions at different stages of the epidemic. In this paper we describe a model and a tool to experiment with such kind of analysis applied to a conceptual city, considering a number of widely-applied NPIs such as social distancing, case isolation, home quarantine, total lockdown, sentinel testing, mask wearing and a distinctive "zonal" enforcement measure, requiring these interventions to be applied gradually to separated enclosed districts (zones). We find that the model is able to capture emerging dynamics associated to these NPIs; besides, the zonal contention strategy yields an improvement on the mitigation impact across all scenarios of combination with individual NPIs. The model and tool are open to extensions to account for omitted or newer factors affecting the planning and design of NPIs intended to counter the late stages or forthcoming waves of the COVID-19 crisis.
El nuevo coronavirus (SARS-CoV-2) apareció en China en diciembre de 2019. Desde su inicio hasta abril de 2020 se ha expandido por todo el mundo, afectando a más de tres millones de personas. Su ascenso exponencial sigue creciendo, generando miles de muertes. Su contagiosidad es persona a persona por gotitas, pudiendo llegar a generar un cuadro clínico de infección respiratoria conocido como COVID-19. Algunos pacientes tienen más riesgos de tener un curso desfavorable; adultos mayores, pacientes con enfermedad cardiovascular, hipertensos y diabéticos. Nuestros pacientes con enfermedad inflamatoria intestinal son un grupo de pacientes con características particulares, muchos de ellos reciben tratamiento inmunosupresor por largos períodos, lo que pudiese suponer un riesgo específico. Las sociedades científicas de Europa y Norteamérica han realizado un esfuerzo conjunto para generar datos, compartir experiencias y dictar recomendaciones de buen manejo clínico. Esta es una revisión de la evidencia disponible, opiniones de expertos y formas de trabajo propuestos durante la pandemia.
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