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Estimating the potential impact and diagnostic requirements for SARS-CoV-2 test-and-treat programs
Oral antivirals have the potential to reduce the public health burden of COVID-19. However, now that we have exited the emergency-phase of the COVID-19 pandemic, declining SARS-CoV-2 clinical testing rates (average testing rates = [Formula: see text] 10 tests/100,000 people/day in low-and-middle inc...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693634/ https://www.ncbi.nlm.nih.gov/pubmed/38042923 http://dx.doi.org/10.1038/s41467-023-43769-z |
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author | Han, Alvin X. Hannay, Emma Carmona, Sergio Rodriguez, Bill Nichols, Brooke E. Russell, Colin A. |
author_facet | Han, Alvin X. Hannay, Emma Carmona, Sergio Rodriguez, Bill Nichols, Brooke E. Russell, Colin A. |
author_sort | Han, Alvin X. |
collection | PubMed |
description | Oral antivirals have the potential to reduce the public health burden of COVID-19. However, now that we have exited the emergency-phase of the COVID-19 pandemic, declining SARS-CoV-2 clinical testing rates (average testing rates = [Formula: see text] 10 tests/100,000 people/day in low-and-middle income countries; <100 tests/100,000 people/day in high-income countries; September 2023) make the development of effective test-and-treat programs challenging. We used an agent-based model to investigate how testing rates and strategies affect the use and effectiveness of oral antiviral test-to-treat programs in four country archetypes of different income levels and demographies. We find that in the post-emergency-phase of the pandemic, in countries where low testing rates are driven by limited testing capacity, significant population-level impact of test-and-treat programs can only be achieved by both increasing testing rates and prioritizing individuals with greater risk of severe disease. However, for all countries, significant reductions in severe cases with antivirals are only possible if testing rates were substantially increased with high willingness of people to seek testing. Comparing the potential population-level reductions in severe disease outcomes of test-to-treat programs and vaccination shows that test-and-treat strategies are likely substantially more resource intensive requiring very high levels of testing (≫100 tests/100,000 people/day) and antiviral use suggesting that vaccination should be a higher priority. |
format | Online Article Text |
id | pubmed-10693634 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-106936342023-12-04 Estimating the potential impact and diagnostic requirements for SARS-CoV-2 test-and-treat programs Han, Alvin X. Hannay, Emma Carmona, Sergio Rodriguez, Bill Nichols, Brooke E. Russell, Colin A. Nat Commun Article Oral antivirals have the potential to reduce the public health burden of COVID-19. However, now that we have exited the emergency-phase of the COVID-19 pandemic, declining SARS-CoV-2 clinical testing rates (average testing rates = [Formula: see text] 10 tests/100,000 people/day in low-and-middle income countries; <100 tests/100,000 people/day in high-income countries; September 2023) make the development of effective test-and-treat programs challenging. We used an agent-based model to investigate how testing rates and strategies affect the use and effectiveness of oral antiviral test-to-treat programs in four country archetypes of different income levels and demographies. We find that in the post-emergency-phase of the pandemic, in countries where low testing rates are driven by limited testing capacity, significant population-level impact of test-and-treat programs can only be achieved by both increasing testing rates and prioritizing individuals with greater risk of severe disease. However, for all countries, significant reductions in severe cases with antivirals are only possible if testing rates were substantially increased with high willingness of people to seek testing. Comparing the potential population-level reductions in severe disease outcomes of test-to-treat programs and vaccination shows that test-and-treat strategies are likely substantially more resource intensive requiring very high levels of testing (≫100 tests/100,000 people/day) and antiviral use suggesting that vaccination should be a higher priority. Nature Publishing Group UK 2023-12-02 /pmc/articles/PMC10693634/ /pubmed/38042923 http://dx.doi.org/10.1038/s41467-023-43769-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Han, Alvin X. Hannay, Emma Carmona, Sergio Rodriguez, Bill Nichols, Brooke E. Russell, Colin A. Estimating the potential impact and diagnostic requirements for SARS-CoV-2 test-and-treat programs |
title | Estimating the potential impact and diagnostic requirements for SARS-CoV-2 test-and-treat programs |
title_full | Estimating the potential impact and diagnostic requirements for SARS-CoV-2 test-and-treat programs |
title_fullStr | Estimating the potential impact and diagnostic requirements for SARS-CoV-2 test-and-treat programs |
title_full_unstemmed | Estimating the potential impact and diagnostic requirements for SARS-CoV-2 test-and-treat programs |
title_short | Estimating the potential impact and diagnostic requirements for SARS-CoV-2 test-and-treat programs |
title_sort | estimating the potential impact and diagnostic requirements for sars-cov-2 test-and-treat programs |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693634/ https://www.ncbi.nlm.nih.gov/pubmed/38042923 http://dx.doi.org/10.1038/s41467-023-43769-z |
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