In regard to infectious diseases socioeconomic determinants are strongly associated with differential exposure and susceptibility however they are seldom accounted for by standard compartmental infectious disease models. These associations are explored here with a novel compartmental infectious disease model which, stratified by deprivation and age, accounts for population-level behaviour including social mixing patterns. As an exemplar using a fully Bayesian approach our model is fitted, in real-time if required, to the UKHSA COVID-19 community testing case data from England. Metrics including reproduction number and forecasts of daily case incidence are estimated from the posterior samples. From this UKHSA dataset it is observed that during the initial period of the pandemic the most deprived groups reported the most cases however this trend reversed after the summer of 2021. Forward simulation experiments based on the fitted model demonstrate that this reversal can be accounted for by differential changes in population level behaviours including social mixing and testing behaviour, but it is not explained by the depletion of susceptible individuals. In future epidemics, with a focus on socioeconomic factors the approach outlined here provides the possibility of identifying those groups most at risk with a view to helping policy-makers better target their support.
翻译:在传染病方面,社会经济决定因素与不同接触程度和易感性密切相关,但很少被标准区划传染病模式所考虑到。在这里探讨这些协会时采用了一种新型的区划传染病模式,这种模式按剥夺和年龄划分,说明人口层面的行为,包括社会混合模式;作为采用完全巴耶斯方法的范例,我们的模式在必要时实时适用于英国的英国HSACOVID-19社区测试案例数据;从后方样本中估算出包括生殖数和每日病例预测数在内的计量数据。从这个UKHSA数据集中可以看出,在大流行病初期,最贫困的群体报告了大多数病例,但这一趋势在2021年夏季后出现逆转。基于这一完善模型的前瞻性模拟实验表明,这种逆转可以由人口层面行为的差异变化(包括社会混合和测试行为)来计算,但并不是由易受感染的个人的耗竭来解释的。在未来的流行病中,这里概述的方法以社会经济因素为重点,提供了查明风险最大的群体的可能性,以便帮助决策者更好地针对他们的支持。