Фармакоэкономика (Apr 2020)
COVID-19 in Moscow: prognoses and scenarios
Abstract
Aim: to present a mathematical model of the development of COVID-19 in Moscow along with the analysis of some scenarios of epidemic control and possible epidemic consequences.Materials and Methods. The modeling of the epidemics was based on the extended SEIR model proposed lately in the group of Prof. R. Neher and realized as a freely available software program. The authors based the choice of the parameters of modeling on published data on the epidemiological properties of the novel coronavirus SARS-CoV-2 and open access data on the registered cases of COVID-19 in Moscow for 8-27 March 2020.Results. Five potential scenarios of the development of COVID-19 epidemics are studied. The scenarios are differed by the levels of the control measures: Null Scenario corresponded to the lack of protective measures, Scenario A – mild measures of the epidemic control (closing of schools and universities, recommendations for senior citizens to stay inside), Scenario B – medium level of control (closing of all public places, recommendation for the citizens to stay inside), Scenarios C and D – complete lockdown (from the beginning of May 2020 within Scenario C and from the beginning of April 2020 within Scenario D). It was shown that within the Null Scenario, the lethality from the novel coronavirus in Moscow will exceed 100 thousand people, and the number of critically ill patients on the peak of the epidemics will exceed the capacities of the system of healthcare. Scenarios A and B did not provide for a radical decrease in the fatality rate, and the number of critically ill patients at the peak of epidemics will still exceed the capacities of the system of healthcare. Besides, within Scenario B, the epidemics will last for more than a year. Scenarios C and D will allow for the control of epidemics and a significant decrease in the rate of letha lity (by 30 and 400 times, respectively). At the same time, these two scenarios prevent the population from developing herd immunity, which would result in the population susceptibility to repeated epidemics outbreaks. Conclusion. The scenarios intended for the slow development of herd immunity in the conditions of epidemic control would not bring sufficient results: the lethality would remain unacceptably high, the capacities of the system of healthcare would be overloaded, and the time of limiting measures would be unacceptably long. Such measures as complete lockdown would stop the present epidemics. The earlier they are introduced, the more efficient will be the results. To prevent further repeated outbreaks of the epidemics, it is necessary to establish a system of available, quick, and efficient testing in combination with point isolation of the infected patients and their contacts.
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