评估应对COVID-19流行病的全球边境管制,使用现实世界的数据和目标试验模拟
Zhiyao Li1, Xin Wang1, Senke Chen1
1Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, PR China; Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, Guangdong, PR China.
The Journal of infection
|August 14, 2025
概括
严格的边境控制 (BC) 没有减缓COVID-19的传播,如果延迟. 早期采用时机,而不仅仅是严格,是有效的流行病边境措施的关键.
科学领域:
- 流行病学 流行病学
- 公共卫生政策 公共卫生政策
- 传染病控制和控制传染病
背景情况:
- 边境管制 (BCs) 是一个共同的策略,以减轻传染病的传播.
- 准则的有效性可能取决于它们的严格性和实施时间.
- 以前的分析往往忽略了延迟采用对BC有效性的影响.
研究的目的:
- 为了评估更严格的边境检查 (BCs) 与基本查相比,与较慢的初始阶段流行病进展有关.
- 调查BC采用时间在流行病进展中的作用.
- 分析不同的BC严格措施的有效性,包括隔离,区域禁令和完全关闭边境.
主要方法:
- 利用了来自174个国家的BC和COVID-19流行病进展 (2020年1月1日至7月31日) 的现实数据.
- 雇佣了目标试验模拟和克隆审查权重,以解决从阶段性BC采用的不朽时间偏差.
- 应用Kaplan-Meier模型与反向概率审查权重 (IPCW) 来估计BC有效性,承认诊断测试数据的局限性.
主要成果:
- 与基本查相比,更严格的BCs,包括完全关闭边境,与达到第一个感染峰值的风险降低无关 (HR:1.07,95%CI:0.88-1.30).
- 具有严格的BC的国家在达到首次感染峰值时经历了延迟,这表明了潜在的机制.
- 不管严格程度如何,BC的采用时间与达到第一个感染峰值的风险独立相关.
结论:
- 严格的边境管制本身并不能保证流行病的进展缓慢;延迟实施会降低有效性.
- 有效的流行病边境战略需要考虑措施的时间和严格性.
- 这些发现对于为未来的公共卫生政策提供信息,以管理新出现的传染病急剧增长至关重要.
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