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Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity?

BACKGROUND: Governments across the globe responded with different strategies to the COVID-19 pandemic. While some countries adopted measures, which have been perceived controversial, others pursued a strategy aiming for herd immunity. The latter is even more controversial and has been called unethic...

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Autores principales: Helle, Kristina Barbara, Sadiku, Arlinda, Zelleke, Girma Mesfin, Ibrahim, Toheeb Babatunde, Bouba, Aliou, Tsoungui Obama, Henri Christian, Appiah, Vincent, Ngwa, Gideon Akumah, Teboh-Ewungkem, Miranda Ijang, Schneider, Kristan Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284653/
https://www.ncbi.nlm.nih.gov/pubmed/34270576
http://dx.doi.org/10.1371/journal.pone.0253758
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author Helle, Kristina Barbara
Sadiku, Arlinda
Zelleke, Girma Mesfin
Ibrahim, Toheeb Babatunde
Bouba, Aliou
Tsoungui Obama, Henri Christian
Appiah, Vincent
Ngwa, Gideon Akumah
Teboh-Ewungkem, Miranda Ijang
Schneider, Kristan Alexander
author_facet Helle, Kristina Barbara
Sadiku, Arlinda
Zelleke, Girma Mesfin
Ibrahim, Toheeb Babatunde
Bouba, Aliou
Tsoungui Obama, Henri Christian
Appiah, Vincent
Ngwa, Gideon Akumah
Teboh-Ewungkem, Miranda Ijang
Schneider, Kristan Alexander
author_sort Helle, Kristina Barbara
collection PubMed
description BACKGROUND: Governments across the globe responded with different strategies to the COVID-19 pandemic. While some countries adopted measures, which have been perceived controversial, others pursued a strategy aiming for herd immunity. The latter is even more controversial and has been called unethical by the WHO Director-General. Inevitably, without proper control measures, viral diversity increases and multiple infectious exposures become common, when the pandemic reaches its maximum. This harbors not only a potential threat overseen by simplified theoretical arguments in support of herd immunity, but also deserves attention when assessing response measures to increasing numbers of infection. METHODS AND FINDINGS: We extend the simulation model underlying the pandemic preparedness web interface CovidSim 1.1 (http://covidsim.eu/) to study the hypothetical effect of increased morbidity and mortality due to ‘multi-infections’, either acquired at by successive infective contacts during the course of one infection or by a single infective contact with a multi-infected individual. The simulations are adjusted to reflect roughly the situation in the USA. We assume a phase of general contact reduction (“lockdown”) at the beginning of the epidemic and additional case-isolation measures. We study the hypothetical effects of varying enhancements in morbidity and mortality, different likelihoods of multi-infected individuals to spread multi-infections and different susceptibility to multi-infections in different disease phases. It is demonstrated that multi-infections lead to a slight reduction in the number of infections, as these are more likely to get isolated due to their higher morbidity. However, the latter substantially increases the number of deaths. Furthermore, simulations indicate that a potential second lockdown can substantially decrease the epidemic peak, the number of multi-infections and deaths. CONCLUSIONS: Enhanced morbidity and mortality due to multiple disease exposure is a potential threat in the COVID-19 pandemic that deserves more attention. Particularly it underlines another facet questioning disease management strategies aiming for herd immunity.
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spelling pubmed-82846532021-07-28 Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity? Helle, Kristina Barbara Sadiku, Arlinda Zelleke, Girma Mesfin Ibrahim, Toheeb Babatunde Bouba, Aliou Tsoungui Obama, Henri Christian Appiah, Vincent Ngwa, Gideon Akumah Teboh-Ewungkem, Miranda Ijang Schneider, Kristan Alexander PLoS One Research Article BACKGROUND: Governments across the globe responded with different strategies to the COVID-19 pandemic. While some countries adopted measures, which have been perceived controversial, others pursued a strategy aiming for herd immunity. The latter is even more controversial and has been called unethical by the WHO Director-General. Inevitably, without proper control measures, viral diversity increases and multiple infectious exposures become common, when the pandemic reaches its maximum. This harbors not only a potential threat overseen by simplified theoretical arguments in support of herd immunity, but also deserves attention when assessing response measures to increasing numbers of infection. METHODS AND FINDINGS: We extend the simulation model underlying the pandemic preparedness web interface CovidSim 1.1 (http://covidsim.eu/) to study the hypothetical effect of increased morbidity and mortality due to ‘multi-infections’, either acquired at by successive infective contacts during the course of one infection or by a single infective contact with a multi-infected individual. The simulations are adjusted to reflect roughly the situation in the USA. We assume a phase of general contact reduction (“lockdown”) at the beginning of the epidemic and additional case-isolation measures. We study the hypothetical effects of varying enhancements in morbidity and mortality, different likelihoods of multi-infected individuals to spread multi-infections and different susceptibility to multi-infections in different disease phases. It is demonstrated that multi-infections lead to a slight reduction in the number of infections, as these are more likely to get isolated due to their higher morbidity. However, the latter substantially increases the number of deaths. Furthermore, simulations indicate that a potential second lockdown can substantially decrease the epidemic peak, the number of multi-infections and deaths. CONCLUSIONS: Enhanced morbidity and mortality due to multiple disease exposure is a potential threat in the COVID-19 pandemic that deserves more attention. Particularly it underlines another facet questioning disease management strategies aiming for herd immunity. Public Library of Science 2021-07-16 /pmc/articles/PMC8284653/ /pubmed/34270576 http://dx.doi.org/10.1371/journal.pone.0253758 Text en © 2021 Helle et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Helle, Kristina Barbara
Sadiku, Arlinda
Zelleke, Girma Mesfin
Ibrahim, Toheeb Babatunde
Bouba, Aliou
Tsoungui Obama, Henri Christian
Appiah, Vincent
Ngwa, Gideon Akumah
Teboh-Ewungkem, Miranda Ijang
Schneider, Kristan Alexander
Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity?
title Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity?
title_full Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity?
title_fullStr Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity?
title_full_unstemmed Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity?
title_short Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity?
title_sort is increased mortality by multiple exposures to covid-19 an overseen factor when aiming for herd immunity?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284653/
https://www.ncbi.nlm.nih.gov/pubmed/34270576
http://dx.doi.org/10.1371/journal.pone.0253758
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