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Olen nõus
"Ministeeriumid" projekt SMVPT20243
SMVPT20243 "COVID-19 aktiivne seire (23.04.2020−31.12.2020)", Mikk Jürisson, Tartu Ülikool, Meditsiiniteaduste valdkond, peremeditsiini ja rahvatervishoiu instituut.
SMVPT20243
COVID-19 aktiivne seire
COVID-19 study
23.04.2020
31.12.2020
Teadus- ja arendusprojekt
Ministeeriumid
ETIS klassifikaatorAlamvaldkondCERCS klassifikaatorFrascati Manual’i klassifikaatorProtsent
3. Terviseuuringud3.6. RahvatervishoidB680 Rahvatervishoid, epidemioloogia3.3 Terviseteadused100,0
PerioodSumma
23.04.2020−31.12.20201 800 000,00 EUR
1 800 000,00 EUR

Me ei tea nakatumise tegelikku levikut rahvastikus ja erinevates rahvastikurühmades. Valitsuse kriisikomisjon juhib COVID-19 kriisi testide, haigestunute ja surmade arvu ning teiste riikide andmete alusel. Omades ainult raskemate haigusjuhtude ja arstiabi vajavate inimeste nakatumise infot, puuduvad meil tegelikud andmed viiruse leviku kohta rahvastikus. Epideemiat ei saa efektiivselt ohjata, kui ei tea, kes on nakatunud. Lahendus: Aktiivne seire võimaldab hinnata nakatumise tegelikku levikut. Seiresüsteemi käivitamine võimaldab jälgida nakatumist rahvastikus ja on aluseks eriolukorra lõpetamise strateegia koostamisele. TÜ pakub seire läbiviimist juhuvalimi intervjuude ja valimisse sattunute testimise kaudu. Nädalas testitakse 2000-4000 inimest, nii sümptomitega kui ilma, et hinnata üleriigilist nakkuse levikut rahvastikus ja eri maakondades/rahvastikurühmades. COVID-19 epideemia juhtimine valitsuse tasandil tugineb testitud, diagnoositud ja hospitaliseeritud sh intensiivravil olevate isikute ja surmaga lõppenud haigusjuhtude arvul. Samas teame, et oluline osa põeb haiguse läbi kergete sümptomitega või asümptomaatiliselt ja nende isikute testimismäär on madal. Seetõttu ei ole võimalik objektiivselt hinnata nakkuse levimust üldrahvastikus ja erinevates rahvastikurühmades (vanus, sugu, elukoht). Lisaks pole palju teada haigust mõjutavate tegurite kohta. Puuduvad ka andmed nakatumise dünaamika kohta, eriti maakondades, kus on vähe haigestunuid. Eesti tulevikuprognoosid tuginevad teiste riikide andmetele. Lahendus: seiresüsteemi loomine nakatumise leviku jälgimiseks. Tervisepoliitilisteks otsusteks epideemia tingimustes on vajalikud usaldatavad levimusandmed. Tartu Ülikool teeb ettepaneku luua üleriiklik seiresüsteem, et hinnata nakatumise levimust regulaarselt, esimese kuu jooksul igal nädalal ja järgneva kahe kuu jooksul iga kahe nädala tagant. Seiresüsteemi käivitamine võimaldab jälgida nakatumise levimust rahvastikus ja on aluseks eriolukorra lõpetamise strateegia koostamisele. Käesolev projekt pakub välja seire metoodika ja rakenduskava. Seire põhineb aktiivsel nakatunute leidmisel ja jälgimisel ja vastab järgmistele küsimustele: 1. Milline on SARS-CoV-2 nakkuse tegelik levimus rahvastikus, erinevates rahvastikurühmades (vanusrühmad, mehed-naised, maakonnad, rahvused) ja asümptomaatiliste isikute hulgas? Kui suur on nakatunute hulk ja osakaal? 2. Milline on SARS-CoV-2 nakkuse levimuse dünaamika? Kuidas muutub nakatunute arv ja osakaal ajas ja milliste teguritega on see seotud? Milline on rakendatud meetmete mõju? 3. Millised on põhilised SARS-CoV-2 nakkusega seotud taustatunnused ja riskifaktorid (kaasuvad haigused, leibkonna suurus, sotsiaalmajanduslik staatus, kontaktitüübid jt)? Kuidas on need seotud levimusega? 4. Milline on SARS-CoV-2 nakkuse ja COVID-19 haiguse kulg (paranemine, sümptomid, haiguse raskus, hospitaliseerimine, surm) ja kuidas on see seotud taustatunnuste ja riskifaktoritega? Kas haiguse kulg muutub ajas?
The prevalence of infection with SARS-CoV-2 remains unknown across the whole population of Estonia, as well as within its subgroups. The Government of Estonia’s COVID-19 crisis committee decisions are currently informed by data from testing some symptomatic patients, the number of clinical diagnoses made, as well as inferences from other countries. As testing is currently performed only on severe cases needing medical care, the true prevalence of the infection across the whole population remains uncertain. This makes it harder to control the epidemic, as we do not know to what extent the whole population, and regions and subpopulations with it, have been infected. Solution: Setting up active surveillance will allow us to assess the actual prevalence of the infection as the epidemic unfolds. This infection data will enable better policy evaluations of recent measures that have been taken during the ongoing state of emergency, inform similar policy decisions as the epidemic unfolds, and specifically help decide on the need and timing of mass testing. This project proposes to create a surveillance system that uses telephone surveys and testing of random population-based samples. At least 1500 individuals (including symptomatic and asymptomatic people), will be tested once every two weeks to assess the prevalence of the infection in the whole country, and within different population groups and regions. Effective national management of a COVID-19 epidemic requires accurate estimates of the number of people infected (with or without symptoms), diagnosed following symptom onset, hospitalised (incl. those needing intensive care), as well as fatalities. We know that a significant proportion of infected people will have slight symptoms or no symptoms at all, but very few of them are tested. Thus, it is not possible to objectively assess the prevalence of the infection in the general population and within its subgroups (age, sex, place of residence). Additionally, not much is known about factors that determine whether an infected person becomes ill or not, nor those that predict the severity of illness. Limited local data exists on the dynamics of the infection, especially in counties where few people have been infected. Prognostic models currently used in Estonia depend heavily on data of other countries, some of which may not be generalizable due to international variations in culture, host genotype, population density as well as variations in governmental policies. Solution: creating a surveillance system to monitor infection prevalence We need local, representative and trustworthy data on prevalence to make the most appropriate health policy decisions to best control the epidemic. The University of Tartu proposes to create a national surveillance system to assess the prevalence of the infection every two weeks until the epidemic is under control. Prevalence data will help us monitor the effectiveness of measures taken during the ongoing state of emergency, and help guide decision making the course of the epidemic. The current project outlines the method and project plan to set up such a surveillance system. More generally, this surveillance system aims to actively find those who are infected and to them observe their clinical outcomes. Specifically, it answers the following questions: 1. What is the real prevalence of SARS-CoV-2 in the population of Estonia, among different subgroups (as defined by age, gender, counties, and ethnicities) and amongst asymptomatic people? How large is the number and proportion of those infected? 2. What are the dynamics of SARS-CoV-2 infection over time? How does the number and proportion of the infected change in time and what factors are associated with it? What is the effect of policy measures taken? 3. What are the main background factors and risk factors (age, comorbidities, size of household, socio-economic status, contact types etc.) associated with the SARS-CoV-2 infection, at the level of the individual? How are these associated with prevalence, when comparing counties with one another at the level of populations? 4. What is the course of the SARS-CoV-2 infection and COVID-19 illness (recovery, symptom onset, illness severity, hospitalisation, death) and how is this associated with background factors and risk factors? Does the disease course change for the average individual, as the epidemic unfolds across the population?
KirjeldusProtsent
Rakendusuuring100,0