Transmission dynamics and successful control measures of SARS-CoV-2 in the mega-size city of Guangzhou, China.
Transmission dynamics and successful control measures of SARS-CoV-2 in the mega-size city of Guangzhou, China.
复制标题
中国广州特大城市中 SARS-CoV-2 的传播动态和成功控制措施
DOI：
10.1097/md.0000000000027846
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发表时间：
2021-12-03
期刊：
影响因子：
1.6
通讯作者：
Yang, Zhicong
中科院分区：
文献类型：
--
作者：
Zhao, Hongjun;Zhang, Zhoubin;Lun, Wenhui;Chen, Zongqiu;Lu, Xiaoxiao;Li, Jingrong;Qiu, Fuman;Li, Shunming;Mao, Chun;Lu, Ying;Chen, Jinbin;He, Qing;Lu, Jiachun;Yang, Zhicong
关键词：
摘要严重急性呼吸综合征冠状病毒2已引起全球大流行。控制措施因国家而异，其有效性程度也各不相同，这需要进行评估。按干预措施分为1月7日至22日（无干预）、1月23日至2月23日（实施强化干预）、2月24日至5月17日（新冠肺炎防控常态化模式）3个时段，对广州市2019冠状病毒病（COVID-19）公共卫生干预效果进行评价。收集2020年1月7日至5月17日广州市745例新冠肺炎患者及其密切接触者信息及防控措施。我们估计了3个时期的流行病学特征、COVID-19病例的疾病谱、关键时间间隔和有效繁殖数。计算了第1时期的冠状病毒2型基本繁殖数。无症状、有症状和严重的密切接触者分别占45.8%、49.8%和4.4%。潜伏期中位数为5.3 d（2.5 ~ 97.5、1.5 ~ 18.4天），符合伽玛分布的序列间隔中位数为5.1 d（2.5 ~ 97.5、0.8 ~ 15.9天）。第1至3期从发病到隔离的时间中位数分别为7.5、3.4和2.9天（2.5-97.5、2.1-14.2、3.9-14.7和6.0-20.0天），第1至3期从发病到确诊的时间中位数分别为8.9、4.9和2.4天（2.5-97.5、2.6-16.6、0.9-14.6和0.5-11.8天）。在第1期，再现数为0.9(95%置信区间为0.5-1.4)，除1月14日外，在1月22日之前波动在1.0以下。第2期有效繁殖数逐渐下降，2月20日达到最低点0.1,3月27日开始回升，4月12日达到峰值1.8。4月17日以后下降到1.0以下，5月7日以后进一步下降到0.2以下。在前瞻性动态观察下，密切接触者转化为感染病例可以提供来自现实环境的COVID-19病例谱。武汉封城和进广州人员闭环管理，有效遏制了疫情向广州扩散。广州市通过保持社会距离、戴口罩、勤洗手、重点场所消毒、大规模检测、广泛追踪接触者、严格隔离密切接触者等措施，成功控制了疫情传播。
Supplemental Digital Content is available in the text Abstract The severe acute respiratory syndrome coronavirus 2 has caused a worldwide pandemic. Control measures differ among countries and have a varying degree of effectiveness, which requires assessment. To evaluate the effectiveness of public health interventions of the coronavirus disease 2019 (COVID-19) in Guangzhou by 3 periods according to interventions: January 7 to 22 (no intervention), January 23 to February 23 (implemented intensive interventions), and February 24 to May 17 (the normalization mode of COVID-19 prevention and control). We collected the information of 745 COVID-19 patients and their close contacts as well as control measures in Guangzhou from January 7 to May 17, 2020. We estimated the epidemiological characteristics, disease spectrum of COVID-19 cases, key time-to-event intervals, and effective reproduction number over the 3 periods. The basic reproduction number of severe acute respiratory syndrome coronavirus 2 was also calculated over period 1. Approximately 45.8%, 49.8%, and 4.4% of cases from close contacts were asymptomatic, symptomatic, and severe, respectively. The median incubation period was 5.3 days (the percentiles of 2.5–97.5, 1.5–18.4 days) and the median serial interval fitted with gamma distribution was 5.1 days (the percentiles of 2.5–97.5, 0.8–15.9 days). The estimated median of onset-to-quarantined time in Period 1 to 3 were 7.5, 3.4, and 2.9 days (the percentiles of 2.5–97.5, 2.1–14.2, 3.9–14.7, and 6.0–20.0 days) respectively and the median of onset-to-confirmation time in period 1 to 3 were 8.9, 4.9 and 2.4 days (the percentiles of 2.5–97.5, 2.6–16.6, 0.9–14.6, and 0.5–11.8 days). In period 1, the reproduction number was 0.9 (95% confidence interval, 0.5–1.4) and fluctuated below 1.0 before January 22 except for January 14. The effective reproduction number gradually decreased in the period 2 with the lowest point of 0.1 on February 20, then increased again since March 27 and reach a spike of 1.8 on April 12. The number decreased to below 1.0 after April 17 and decreased further to <0.2 after May 7 in the period 3. Under prospective dynamic observation, close contacts turned into infected cases could provide a spectrum of COVID-19 cases from real-world settings. The lockdown of Wuhan and closed-loop management of people arriving Guangzhou were effective in halting the spread of the COVID-19 cases to Guangzhou. The spread of COVID-19 was successfully controlled in Guangzhou by social distancing, wearing a face mask, handwashing, disinfection in key places, mass testing, extensive contact tracing, and strict quarantine of close contacts.