COVID-19 in New Zealand and the impact of the national response: a descriptive epidemiological study.
COVID-19 in New Zealand and the impact of the national response: a descriptive epidemiological study.
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DOI：
10.1016/s2468-2667(20)30225-5
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发表时间：
2020-11
期刊：
影响因子：
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通讯作者：
Priest P
中科院分区：
文献类型：
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作者：
Jefferies S;French N;Gilkison C;Graham G;Hope V;Marshall J;McElnay C;McNeill A;Muellner P;Paine S;Prasad N;Scott J;Sherwood J;Yang L;Priest P
于二零二零年初，在COVID-19疫情期间，新西兰实施了渐进的、风险知情的国家COVID-19抑制措施，旨在消除疾病。我们调查了其对该国第一波COVID-19流行病学的影响以及应对绩效措施。我们对2020年2月2日至5月13日期间新西兰所有实验室确诊和可能的COVID-19病例以及所有接受严重急性呼吸系统综合征冠状病毒2（SARS-CoV-2）检测的患者进行了描述性流行病学研究，之后社区传播停止。我们从国家法定报告疾病数据库和国家SARS-CoV-2测试结果库中提取数据。在应对的五个阶段描述了人口统计特征和疾病结果、传播模式（感染源、疫情爆发、家庭传播）、事件间隔时间和检测覆盖范围，涵盖了不同水平的非药物干预措施。采用多变量logistic回归分析了重度结局（住院或死亡）的风险因素，并通过最大似然估计拟合参数分布分析了至事件发生时间间隔。在研究期间共发现1503例病例，包括95例（6.3%）住院和22例（1.5%）COVID-19死亡。在快速反应升级的10天期间，每百万人每天的估计病例感染率达到峰值8.5（95%CI 7.6 - 9.4），在封锁开始时下降到3.2（2.8 - 3.7），此后逐渐下降。1034例（69%）病例为输入性或与输入性相关，倾向于年轻成人、欧洲种族和较高的社会经济地位。702例（47%）病例与34起疫情有关。严重的结果与局部获得性感染有关（与进口产品相比，粗比值比[OR] 2·32 [95% CI 1·40-3·82]），年龄较大（与20-34奥尔兹相比，50-64岁人群的调整后OR范围为2·72 [1·40-5·30]，≥80岁人群为8·25 [2·59-26·31]），与欧洲人或其他种族相比，老年寄宿护理居住者（调整后OR 3.86 [1.59 - 9.35]）、太平洋裔（调整后OR 2.76 [1.14 - 6.68]）和亚裔（2.15 [1.10 - 4.20]）。在研究期间，从发病到通知和隔离的时间逐渐减少，检测增加，差异很小，女性、毛利人、太平洋岛屿族裔和社会经济地位较低群体的覆盖率不断增加。新西兰的应对措施导致了相对较低的疾病负担、较低的人口疾病差异，并初步实现了消除COVID-19的目标。新西兰商业创新和就业部战略科学投资基金和卫生部。
In early 2020, during the COVID-19 pandemic, New Zealand implemented graduated, risk-informed national COVID-19 suppression measures aimed at disease elimination. We investigated their impacts on the epidemiology of the first wave of COVID-19 in the country and response performance measures. We did a descriptive epidemiological study of all laboratory-confirmed and probable cases of COVID-19 and all patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in New Zealand from Feb 2 to May 13, 2020, after which time community transmission ceased. We extracted data from the national notifiable diseases database and the national SARS-CoV-2 test results repository. Demographic features and disease outcomes, transmission patterns (source of infection, outbreaks, household transmission), time-to-event intervals, and testing coverage were described over five phases of the response, capturing different levels of non-pharmaceutical interventions. Risk factors for severe outcomes (hospitalisation or death) were examined with multivariable logistic regression and time-to-event intervals were analysed by fitting parametric distributions using maximum likelihood estimation. 1503 cases were detected over the study period, including 95 (6·3%) hospital admissions and 22 (1·5%) COVID-19 deaths. The estimated case infection rate per million people per day peaked at 8·5 (95% CI 7·6–9·4) during the 10-day period of rapid response escalation, declining to 3·2 (2·8–3·7) in the start of lockdown and progressively thereafter. 1034 (69%) cases were imported or import related, tending to be younger adults, of European ethnicity, and of higher socioeconomic status. 702 (47%) cases were linked to 34 outbreaks. Severe outcomes were associated with locally acquired infection (crude odds ratio [OR] 2·32 [95% CI 1·40–3·82] compared with imported), older age (adjusted OR ranging from 2·72 [1·40–5·30] for 50–64 year olds to 8·25 [2·59–26·31] for people aged ≥80 years compared with 20–34 year olds), aged residential care residency (adjusted OR 3·86 [1·59–9·35]), and Pacific peoples (adjusted OR 2·76 [1·14–6·68]) and Asian (2·15 [1·10–4·20]) ethnicities relative to European or other. Times from illness onset to notification and isolation progressively decreased and testing increased over the study period, with few disparities and increasing coverage of females, Māori, Pacific peoples, and lower socioeconomic groups. New Zealand's response resulted in low relative burden of disease, low levels of population disease disparities, and the initial achievement of COVID-19 elimination. Ministry of Business Innovation and Employment Strategic Scientific Investment Fund, and Ministry of Health, New Zealand.