Epidemic trends, public health response and health system capacity: the Chilean experience in four months of the COVID-19 pandemic
Epidemic trends, public health response and health system capacity: the Chilean experience in four months of the COVID-19 pandemic
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DOI：
10.26633/rpsp.2020.99
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发表时间：
2020-01-01
影响因子：
2.6
通讯作者：
Arteaga, Oscar
中科院分区：
文献类型：
--
作者：
Canals, Mauricio;Cuadrado, Cristobal;Arteaga, Oscar
目标。报告智利新冠肺炎大流行的监测情况，分析2020年3月3日至6月30日实施的公共卫生干预措施的反应，并评估卫生保健系统崩溃的风险。对SARS-CoV-2的有效繁殖数、漏报病例数、危重病床负担、病死率和诊断RT-PCR次数进行分析。在加速发作后，新冠肺炎大流行在智利似乎得到了相对控制(2020年4月下旬)，繁殖数量接近1。然而，此时，受感染患者的负担很高，有大量漏报病例；诊断工作仍然有限，而且跨地区不同。从5月1日至6月30日，重症监护病房床位占有率呈指数级增长，6月14日达到高峰。在此期间，重症监护病房床位占有率上升到饱和水平(全国为89%，大都市区为95%)。我们的调查结果表明，已实施的公共卫生干预措施初步有效地减少了大流行的传播。放松这些干预措施的过早决定可能导致医疗保健系统迅速饱和的病例出现反弹。
Objectives. To report the surveillance of COVID-19 pandemic in Chile and analyse the response to public health interventions implemented from 3 March to 30 June 2020 and to assess the risks of collapse of the health care system.Methods. We analysed the effective reproductive number, underreporting of cases, burden of critical beds, case fatality ratio and number of diagnostic RT-PCR for SARS-CoV-2.Results. After an accelerated onset, the COVID-19 pandemic seemed to be relatively controlled in Chile (late April 2020), with reproductive numbers close to 1.00. However, at this time, the load of infected patients was high, with an important number of underreported cases; the diagnostic effort was still limited and heterogeneous across regions. After 1 May up to 30 June a marked exponential increase in the number of cases was observed with a peak on June 14. In this last period the occupation of intensive care unit beds increased to saturation level (89% nationally; 95% in the Metropolitan Region).Conclusions. Our findings suggest that the implemented public health interventions have been initially effective in decreasing the spread of the pandemic. Premature decisions to relax these interventions may have resulted in a rebound in cases with a rapid saturation of the health care system.