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. 2008 Jul 2;3(7):e2606. doi: 10.1371/journal.pone.0002606

Figure 4. Epidemic effects without and with various mitigation strategies.

Figure 4

Plots of numbers of individuals infected, symptomatic, given antivirals, and adult days at home by day of pandemic without mitigation strategies and with mitigation strategies applied for an IF 1.5 (1918-like; Pandemic Severity Index [PSI] 4–5 pandemic); with Ferguson-like disease manifestation and strategies implemented at 90% compliance with regional mitigation. Plots are averages of all 100 simulations done. Comparisons are to the plot with no mitigation strategies applied. a—no mitigation strategies applied. Note the early peak of 1500 symptomatic cases at day 28 and that approximately 900 adults (9% of the population) are at home from illness at peak. Epidemic effects end by day 60. b—all case-based interventions applied (Q+PEx). Note the significant requirements for antiviral drugs (>30% of population receives antivirals at peak). Symptomatic cases are contained to <250 at peak and adult days at home peak at 500 from illness or home quarantine. The epidemic effects last for 160 days. c—all network-based interventions applied (S+CTsd+ASsd). Note the significant, sustained increase in adult days at home because of the school closings and childcare required, peaking at approximately 1400 adults home/day and tapering off slowly. However, symptomatic cases are contained to <200 at peak. The epidemic effects last approximately 120 days. d—the best strategy we found in these simulations (P+S+CTsd+ASsd). Ill persons are treated with antivirals, household members of ill persons receive antiviral prophylaxis, schools are closed and children's and teenagers' contacts are reduced by 90%, adults' and seniors' non-work contacts are decreased by 90% and workplace contacts by 50%. Note the similar peak of adult days at home (at around 1400) as when only network-based strategies are applied, but with rapid fall-off, with nearly no adult days at home required after approximately day 50. Symptomatic cases are minimized to <200 at peak. Epidemic effects end around day 100. e—the best strategy (P+S+CTsd+ASsd) with Q added. Note that the addition of Q does not change the number of symptomatic cases, but does extend required adult days at home and lengthens the epidemic effects to approximately 120 days.