Temporary impact on medical system and effectiveness of mitigation strategies after COVID-19 policy adjustment in China: a modeling study

Chitin Hon; Jingyi Liang; Ruihan Chen; Zhijie Lin; Yangqianxi Wang; Wei He; Ruibin Liu; Jiaxi Sun; Qianyin Li; Lixi Liang; Minyi Zhang; Zichen Chang; Yinqiu Guo; Wenting Zeng; Tie Liu; Arlindo L Oliveira

doi:10.3389/fpubh.2023.1259084

Temporary impact on medical system and effectiveness of mitigation strategies after COVID-19 policy adjustment in China: a modeling study

Front Public Health. 2023 Dec 1:11:1259084. doi: 10.3389/fpubh.2023.1259084. eCollection 2023.

Authors

Chitin Hon^#^{1

2

3}, Jingyi Liang^#^{1

3}, Ruihan Chen^#^{1

3}, Zhijie Lin^#^{1

3}, Yangqianxi Wang^#^{1

3}, Wei He^{1

3}, Ruibin Liu^{1

3}, Jiaxi Sun⁴, Qianyin Li⁵, Lixi Liang⁵, Minyi Zhang⁴, Zichen Chang⁴, Yinqiu Guo⁴, Wenting Zeng⁴, Tie Liu⁴, Arlindo L Oliveira^{3

6

7}

Affiliations

¹ Department of Engineering Science, Faculty of Innovation Engineering, Macau University of Science and Technology, Taipa, Macao SAR, China.
² Guangzhou Laboratory, Guangzhou, Guangdong, China.
³ Respiratory Disease AI Laboratory on Epidemic and Medical Big Data Instrument Applications, Faculty of Innovation Engineering, Macau University of Science and Technology, Taipa, China.
⁴ Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, China.
⁵ State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
⁶ Instituto de Engenharia de Sistemas e Computadores: Investigação e Desenvolvimento em Lisboa, Lisboa, Portugal.
⁷ Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal.

^# Contributed equally.

Abstract

Background: As China amends its "zero COVID" strategy, a sudden increase in the number of infections may overwhelm medical resources and its impact has not been quantified. Specific mitigation strategies are needed to minimize disruption to the healthcare system and to prepare for the next possible epidemic in advance.

Method: We develop a stochastic compartmental model to project the burden on the medical system (that is, the number of fever clinic visits and admission beds) of China after adjustment to COVID-19 policy, which considers the epidemiological characteristics of the Omicron variant, age composition of the population, and vaccine effectiveness against infection and severe COVD-19. We also estimate the effect of four-dose vaccinations (heterologous and homologous), antipyretic drug supply, non-pharmacological interventions (NPIs), and triage treatment on mitigating the domestic infection peak.

Result: As to the impact on the medical system, this epidemic is projected to result in 398.02 million fever clinic visits and 16.58 million hospitalizations, and the disruption period on the healthcare system is 18 and 30 days, respectively. Antipyretic drug supply and booster vaccination could reduce the burden on emergency visits and hospitalization, respectively, while neither of them could not reduce to the current capacity. The synergy of several different strategies suggests that increasing the heterologous booster vaccination rate for older adult to over 90% is a key measure to alleviate the bed burden for respiratory diseases on the basis of expanded healthcare resource allocation.

Conclusion: The Omicron epidemic followed the adjustment to COVID-19 policy overloading many local health systems across the country at the end of 2022. The combined effect of vaccination, antipyretic drug supply, triage treatment, and PHSMs could prevent overwhelming medical resources.

Keywords: COVID-19; epidemic control; infectious diseases; medical rescue; vaccine.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Antipyretics* / therapeutic use
COVID-19* / epidemiology
COVID-19* / prevention & control
China / epidemiology
Fever
Humans
Policy
SARS-CoV-2

Substances

Antipyretics

Supplementary concepts

SARS-CoV-2 variants

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Basic Research Priorities Program of China (grant number: 2023YFC3041600); Science and Technology Development Fund of Macau SAR (005/2022/ALC); National Key Research and Development Program of China (No. 2022YFC2600705); Self-supporting Program of Guangzhou Laboratory, Grant No. SRPG22-007; Science and Technology Program of Guangzhou (No. 2022B01W0003); Science and Technology Program of Guangzhou (Grant No. 202102100003); Science and Technology Development Fund of Macau SAR (0045/2021/A); Macau University of Science and Technology (FRG-20-021-MISE).