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Intervenciones no farmacéuticas, vacunación y la variante delta del SARS-CoV-2 en Inglaterra: un estudio de modelado

Raphael Sonabend¹, Lilith K Whittles², Natsuko Imai¹

¹MRC Centre for Global Infectious Disease Analysis, Jameel Institute, School of Public Health, Imperial College London, London, UK.

Lancet (London, England)

|October 31, 2021

Resumen

La hoja de ruta de COVID-19 de Inglaterra compensó con éxito los aumentos iniciales de transmisión con la vacunación. Sin embargo, la variante Delta requirió retrasar el levantamiento total de las intervenciones no farmacéuticas (IPN) para evitar una gran ola de hospitalizaciones.

Área de la Ciencia:

Epidemiología
Modelado matemático
Política de salud pública

Sus antecedentes:

La hoja de ruta de COVID-19 de Inglaterra describió la relajación gradual de las intervenciones no farmacéuticas (IPN) junto con el despliegue de la vacunación.
El surgimiento de la variante Delta del SARS-CoV-2 presentó un desafío significativo para la estrategia de reapertura planificada.

Objetivo del estudio:

Evaluar el impacto de la política de hoja de ruta de COVID-19 de Inglaterra en las trayectorias de la epidemia.
Para modelar la influencia de la variante Delta y la vacunación en posibles futuras olas de COVID-19.
Evaluar los diferentes esquemas de relajación de las IPN.

Principales métodos:

Utilizó un modelo de transmisión matemática extendido para la vacunación y la dinámica de múltiples cepas, incluida la variante Delta.
Calibró el modelo utilizando datos de vigilancia en inglés (ingresos hospitalarios, ocupación, seroprevalencia, pruebas de PCR) a través de la síntesis de evidencia bayesiana.
Trayectorias epidémicas simuladas bajo varios esquemas de relajación de IPN y escenarios de mezcla.

Principales resultados:

La hoja de ruta inicialmente compensó el aumento de la transmisión, pero la mayor transmisibilidad de la variante Delta planteó un riesgo.
El levantamiento total de los NPI el 21 de junio de 2021 podría haber resultado en un máximo de 3900 admisiones diarias al hospital; retrasarlo hasta el 19 de julio lo redujo a 1400.
La trayectoria epidémica mostró sensibilidad a la transmisibilidad de Delta, niveles de mezcla y eficacia de la vacuna.

Conclusiones:

Equilibrar el tiempo de relajación del NPI con la cobertura de vacunación puede mitigar los ingresos hospitalarios por COVID-19.
La variante Delta puede requerir IPN continuas incluso con una alta cobertura de vacunación para evitar nuevas olas.
El monitoreo continuo de las variantes de preocupación, la efectividad de la vacuna y la absorción es crucial durante la relajación de la política.

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