转个英国论文，不赞成，但做个参考：学校关闭后对于2019新冠病毒死亡率的影响_风闻

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原文链接https://mp.weixin.qq.com/s/uZeiVtgIN4EBu5E3zgpsvQ

16 October 2020

Effect of school closures on mortality from coronavirus disease 2019: old and new predictions

Correspondence to: G J Ackland [email protected]

Rice K, Wynne B, Martin V, Ackland GJ. Effect of school closures on mortality from coronavirus disease 2019: old and new predictions. BMJ 2020;371:m3588

Objective 目的

To replicate and analyse the information available to UK policymakers when the lockdown decision was taken in March 2020 in the United Kingdom.

为了复制和分析英国政策制定者在2020年3月做出封锁决定时获得的信息。

Design 设计

Independent calculations using the CovidSim code, which implements Imperial College London s individual based model, with data available in March 2020 applied to the coronavirus disease 2019 (covid-19) epidemic. 

设计使用CovidSim代码的独立计算，该代码实现了伦敦帝国理工学院基于个人的模型，将2020年3月的数据应用于2019年冠状病毒疾病(新冠肺炎)流行。

Setting  设定

Simulations considering the spread of covid-19 in Great Britain and Northern Ireland. 

考虑新冠肺炎在大不列颠和北爱尔兰扩散的模拟

Population 人群

About 70 million simulated people matched as closely as possible to actual UK demographics, geography, and social behaviours. 

大约7000万模拟人群，尽可能接近英国的实际人口统计、地理和社会行为。

Main outcome measures 主要结果

Replication of summary data on the covid-19 epidemic reported to the UK government Scientific Advisory Group for Emergencies (SAGE), and a detailed study   of unpublished results, especially the effect of school closures. 

复制向英国政府紧急情况科学咨询小组(SAGE)报告的新冠肺炎疫情汇总数据，以及对未公布结果的详细研究，特别是学校关闭的影响

Results 结果

The CovidSim model would have produced a good forecast of the subsequent data if initialised with a reproduction number of about 3.5 for covid-19. The model predicted that school closures and isolation of younger people would increase the total number of deaths, albeit postponed to a second and subsequent waves. The findings of this study suggest that prompt interventions were shown to be highly effective at reducing peak demand for intensive care unit (ICU) beds but also prolong the epidemic, in some cases resulting in more deaths long term. This happens because covid-19 related mortality is highly skewed towards older age groups. In the absence of an effective vaccination programme, none of the proposed mitigation strategies in the UK would reduce the predicted total number of deaths below 200000. 

如果将新冠模拟模型初始化时covid-19的再现数约为3.5，那么该模型将对后续数据做出良好的预测。该模型预测，学校关闭和隔离年轻人将增加死亡总数，尽管推迟到第二波和随后的浪潮。这项研究的结果表明，及时的干预措施在减少对重症监护室(ICU)床位的高峰需求方面非常有效，但也会延长疫情，在某些情况下会导致更多的长期死亡。发生这种情况是因为与新冠肺炎相关的死亡率高度偏向老年群体。在缺乏有效的疫苗接种计划的情况下，英国提出的缓解策略都不能将预计的总死亡人数减少到20万以下。

Conclusions结论

It was predicted in March 2020 that in response to covid-19 a broad lockdown, as opposed to a focus on shielding the most vulnerable members of society, would reduce immediate demand for ICU beds at the cost of more deaths long term. The optimal strategy for saving lives in a covid-19 epidemic is different from that anticipated for an influenza epidemic with a different mortality age profile.

根据2020年3月的预测，为了应对新冠肺炎疫情，一场大范围的封锁，而不是集中于保护社会中最脆弱的成员，将减少对重症监护室床位的直接需求，而代价是更多的人长期死亡。在新冠肺炎疫情中拯救生命的最佳策略不同于对具有不同死亡年龄特征的流感疫情的预期。