Transmission of SARS-CoV-2 before and after symptom onset: impact of nonpharmaceutical interventions in China.
Transmission of SARS-CoV-2 before and after symptom onset: impact of nonpharmaceutical interventions in China.
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SARS-COV-2在症状发作前后的传播：中国非药物干预的影响。
DOI：
10.1007/s10654-021-00746-4
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发表时间：
2021-04
影响因子：
13.6
通讯作者：
Hanage WP
中科院分区：
文献类型：
--
作者：
Bushman M;Worby C;Chang HH;Kraemer MUG;Hanage WP
接触者追踪和隔离等非药物干预措施一直是控制SARS-CoV-2传播的主要手段；然而，仍不确定哪些干预措施在减少人口传播方面最有效。利用中国推出非药物干预措施前后的连续间隔数据，我们估计症状前传播的相对频率从推出前的34%增加到推出后的71%。向早期传播的转变表明，出现症状后传播的减少不成比例。我们估计，在推出非药物干预措施后，症状后传播减少了82%，而症状前传播仅减少了16%。观察到只有三分之一的传播在基线时是症状前传播，再加上npi将症状前传播减少了不到20%，这表明npi的总体影响在很大程度上是由症状出现后传播的减少所驱动的。这意味着在感染后期限制传播机会的干预措施，如接触者追踪和隔离，对控制SARS-CoV-2尤为重要。专门减少症状前传播机会的干预措施，如隔离无症状接触者，可能对总体传播产生较小但不可忽视的影响。在线版本包含补充材料，可在10.1007/s10654-021-00746-4获得。
Nonpharmaceutical interventions, such as contact tracing and quarantine, have been the primary means of controlling the spread of SARS-CoV-2; however, it remains uncertain which interventions are most effective at reducing transmission at the population level. Using serial interval data from before and after the rollout of nonpharmaceutical interventions in China, we estimate that the relative frequency of presymptomatic transmission increased from 34% before the rollout to 71% afterward. The shift toward earlier transmission indicates a disproportionate reduction in transmission post-symptom onset. We estimate that, following the rollout of nonpharmaceutical interventions, transmission post-symptom onset was reduced by 82% whereas presymptomatic transmission decreased by only 16%. The observation that only one-third of transmission was presymptomatic at baseline, combined with the finding that NPIs reduced presymptomatic transmission by less than 20%, suggests that the overall impact of NPIs was driven in large part by reductions in transmission following symptom onset. This implies that interventions which limit opportunities for transmission in the later stages of infection, such as contact tracing and isolation, are particularly important for control of SARS-CoV-2. Interventions which specifically reduce opportunities for presymptomatic transmission, such as quarantine of asymptomatic contacts, are likely to have smaller, but non-negligible, effects on overall transmission. The online version contains supplementary material available at 10.1007/s10654-021-00746-4.
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影响因子：
158.5
作者：
Li, Qun;Guan, Xuhua;Feng, Zijian
通讯作者：
Feng, Zijian
影响因子：
29.9
作者：
Haug, Nils;Geyrhofer, Lukas;Klimek, Peter
通讯作者：
Klimek, Peter
影响因子：
19
作者：
Ganyani, Tapiwa;Kremer, Cecile;Hens, Niel
通讯作者：
Hens, Niel
影响因子：
82.9
作者：
He, Xi;Lau, Eric H. Y.;Leung, Gabriel M.
通讯作者：
Leung, Gabriel M.
通过非药物干预措施，SARS-CoV-2 的序列间隔随着时间的推移而缩短
影响因子：
56.9
作者：
Ali, Sheikh Taslim;Wang, Lin;Cowling, Benjamin J.
通讯作者：
Cowling, Benjamin J.