{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T12:56:42Z","timestamp":1768827402080,"version":"3.49.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Hong Kong Special Administrative Region","award":["11218221"],"award-info":[{"award-number":["11218221"]}]},{"name":"Hong Kong Special Administrative Region","award":["C7154-20GF"],"award-info":[{"award-number":["C7154-20GF"]}]},{"name":"Hong Kong Special Administrative Region","award":["C7151-20GF"],"award-info":[{"award-number":["C7151-20GF"]}]},{"name":"Hong Kong Special Administrative Region","award":["C1143-20GF"],"award-info":[{"award-number":["C1143-20GF"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Long-lasting nonpharmaceutical interventions (NPIs) suppressed the infection of COVID-19 but came at a substantial economic cost and the elevated risk of the outbreak of respiratory infectious diseases (RIDs) following the pandemic. Policymakers need data-driven evidence to guide the relaxation with adaptive NPIs that consider the risk of both COVID-19 and other RIDs outbreaks, as well as the available healthcare resources.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Combining the COVID-19 data of the sixth wave in Hong Kong between May 31, 2022 and August 28, 2022, 6-year epidemic data of other RIDs (2014\u20132019), and the healthcare resources data, we constructed compartment models to predict the epidemic curves of RIDs after the COVID-19-targeted NPIs. A deep reinforcement learning (DRL) model was developed to learn the optimal adaptive NPIs strategies to mitigate the outbreak of RIDs after COVID-19-targeted NPIs are lifted with minimal health and economic cost. The performance was validated by simulations of 1000 days starting August 29, 2022. We also extended the model to Beijing context.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>Without any NPIs, Hong Kong experienced a major COVID-19 resurgence far exceeding the hospital bed capacity. Simulation results showed that the proposed DRL-based adaptive NPIs successfully suppressed the outbreak of COVID-19 and other RIDs to lower than capacity. DRL carefully controlled the epidemic curve to be close to the full capacity so that herd immunity can be reached in a relatively short period with minimal cost. DRL derived more stringent adaptive NPIs in Beijing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>DRL is a feasible method to identify the optimal adaptive NPIs that lead to minimal health and economic cost by facilitating gradual herd immunity of COVID-19 and mitigating the other RIDs outbreaks without overwhelming the hospitals. The insights can be extended to other countries\/regions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocad116","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T18:28:07Z","timestamp":1687804087000},"page":"1543-1551","source":"Crossref","is-referenced-by-count":7,"title":["Optimal adaptive nonpharmaceutical interventions to mitigate the outbreak of respiratory infections following the COVID-19 pandemic: a deep reinforcement learning study in Hong Kong, China"],"prefix":"10.1093","volume":"30","author":[{"given":"Yao","family":"Yao","sequence":"first","affiliation":[{"name":"School of Data Science, City University of Hong Kong , Hong Kong, China"}]},{"given":"Hanchu","family":"Zhou","sequence":"additional","affiliation":[{"name":"School of Data Science, City University of Hong Kong , Hong Kong, China"}]},{"given":"Zhidong","family":"Cao","sequence":"additional","affiliation":[{"name":"Institute of Automation, Chinese Academy of Sciences , Beijing, China"}]},{"given":"Daniel Dajun","family":"Zeng","sequence":"additional","affiliation":[{"name":"Institute of Automation, Chinese Academy of Sciences , Beijing, China"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6819-0686","authenticated-orcid":false,"given":"Qingpeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Musketeers Foundation Institute of Data Science, The University of Hong Kong , Hong Kong, China"},{"name":"Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong , Hong Kong, China"}]}],"member":"286","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"2023081808482334000_ocad116-B1","doi-asserted-by":"crossref","first-page":"100282","DOI":"10.1016\/j.lanwpc.2021.100282","article-title":"Co-benefits of nonpharmaceutical intervention against COVID-19 on infectious diseases in China: A large population-based observational study","volume":"17","author":"Xiao","year":"2021","journal-title":"Lancet Reg Health West Pac"},{"issue":"6502","key":"2023081808482334000_ocad116-B2","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1126\/science.abc0035","article-title":"The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries","volume":"369","author":"Walker","year":"2020","journal-title":"Science"},{"key":"2023081808482334000_ocad116-B3","doi-asserted-by":"crossref","first-page":"100139","DOI":"10.1016\/j.lanepe.2021.100139","article-title":"Effects of non-pharmaceutical interventions against COVID-19 on the incidence of other diseases","volume":"6","author":"M\u00fcller","year":"2021","journal-title":"Lancet Reg Health Eur"},{"issue":"7825","key":"2023081808482334000_ocad116-B4","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1038\/s41586-020-2293-x","article-title":"Effect of non-pharmaceutical interventions to contain COVID-19 in China","volume":"585","author":"Lai","year":"2020","journal-title":"Nature"},{"issue":"4","key":"2023081808482334000_ocad116-B5","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/resp.14191","article-title":"Comparison of the immunogenicity of BNT162b2 and CoronaVac COVID-19 vaccines in Hong Kong","volume":"27","author":"Mok","year":"2022","journal-title":"Respirology"},{"key":"2023081808482334000_ocad116-B6","doi-asserted-by":"crossref","first-page":"100535","DOI":"10.1016\/j.epidem.2021.100535","article-title":"Impact of vaccination and non-pharmaceutical interventions on SARS-CoV-2 dynamics in Switzerland","volume":"38","author":"Shattock","year":"2022","journal-title":"Epidemics"},{"issue":"48","key":"2023081808482334000_ocad116-B7","doi-asserted-by":"crossref","first-page":"30547","DOI":"10.1073\/pnas.2013182117","article-title":"The impact of COVID-19 nonpharmaceutical interventions on the future dynamics of endemic infections","volume":"117","author":"Baker","year":"2020","journal-title":"Proc Natl Acad Sci USA"},{"issue":"4","key":"2023081808482334000_ocad116-B8","doi-asserted-by":"crossref","first-page":"e54932","DOI":"10.15252\/embr.202254932","article-title":"The return of the seasonal flu and cold: Other diseases are set to rebound as Covid-19 restrictions ease","volume":"23","author":"Hunter","year":"2022","journal-title":"EMBO Rep"},{"key":"2023081808482334000_ocad116-B9","doi-asserted-by":"crossref","first-page":"100303","DOI":"10.1016\/j.lanwpc.2021.100303","article-title":"Benefits of COVID-19 non-pharmaceutical interventions on the prevention of other notifiable infectious diseases","volume":"17","author":"Zhang","year":"2021","journal-title":"Lancet Reg Health West Pac"},{"key":"2023081808482334000_ocad116-B10","author":"Statistic on 5th wave of COVID-19","year":"2022"},{"key":"2023081808482334000_ocad116-B11","author":"Government extends existing social distancing measures [Internet]. 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