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- Publisher Website: 10.1016/S0140-6736(20)30746-7
- Scopus: eid_2-s2.0-85083303331
- PMID: 32277878
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Article: First-wave COVID-19 transmissibility and severity in China outside Hubei after control measures, and second-wave scenario planning: a modelling impact assessment
Title | First-wave COVID-19 transmissibility and severity in China outside Hubei after control measures, and second-wave scenario planning: a modelling impact assessment |
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Authors | |
Issue Date | 2020 |
Publisher | The Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/lancet |
Citation | The Lancet, 2020, v. 395 n. 10233, p. 1382-1393 How to Cite? |
Abstract | Background:
As of March 18, 2020, 13 415 confirmed cases and 120 deaths related to coronavirus disease 2019 (COVID-19) in mainland China, outside Hubei province—the epicentre of the outbreak—had been reported. Since late January, massive public health interventions have been implemented nationwide to contain the outbreak. We provide an impact assessment of the transmissibility and severity of COVID-19 during the first wave in mainland Chinese locations outside Hubei.
Methods:
We estimated the instantaneous reproduction number (Rt) of COVID-19 in Beijing, Shanghai, Shenzhen, Wenzhou, and the ten Chinese provinces that had the highest number of confirmed COVID-19 cases; and the confirmed case-fatality risk (cCFR) in Beijing, Shanghai, Shenzhen, and Wenzhou, and all 31 Chinese provinces. We used a susceptible–infectious–recovered model to show the potential effects of relaxing containment measures after the first wave of infection, in anticipation of a possible second wave.
Findings:
In all selected cities and provinces, the Rt decreased substantially since Jan 23, when control measures were implemented, and have since remained below 1. The cCFR outside Hubei was 0·98% (95% CI 0·82–1·16), which was almost five times lower than that in Hubei (5·91%, 5·73–6·09). Relaxing the interventions (resulting in Rt >1) when the epidemic size was still small would increase the cumulative case count exponentially as a function of relaxation duration, even if aggressive interventions could subsequently push disease prevalence back to the baseline level.
Interpretation:
The first wave of COVID-19 outside of Hubei has abated because of aggressive non-pharmaceutical interventions. However, given the substantial risk of viral reintroduction, particularly from overseas importation, close monitoring of Rt and cCFR is needed to inform strategies against a potential second wave to achieve an optimal balance between health and economic protection.
Funding:
Health and Medical Research Fund, Hong Kong, China. |
Persistent Identifier | http://hdl.handle.net/10722/281983 |
ISSN | 2021 Impact Factor: 202.731 2020 SCImago Journal Rankings: 13.103 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Leung, K | - |
dc.contributor.author | Wu, JT | - |
dc.contributor.author | Liu, D | - |
dc.contributor.author | Leung, GM | - |
dc.date.accessioned | 2020-04-19T03:33:44Z | - |
dc.date.available | 2020-04-19T03:33:44Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | The Lancet, 2020, v. 395 n. 10233, p. 1382-1393 | - |
dc.identifier.issn | 0140-6736 | - |
dc.identifier.uri | http://hdl.handle.net/10722/281983 | - |
dc.description.abstract | Background: As of March 18, 2020, 13 415 confirmed cases and 120 deaths related to coronavirus disease 2019 (COVID-19) in mainland China, outside Hubei province—the epicentre of the outbreak—had been reported. Since late January, massive public health interventions have been implemented nationwide to contain the outbreak. We provide an impact assessment of the transmissibility and severity of COVID-19 during the first wave in mainland Chinese locations outside Hubei. Methods: We estimated the instantaneous reproduction number (Rt) of COVID-19 in Beijing, Shanghai, Shenzhen, Wenzhou, and the ten Chinese provinces that had the highest number of confirmed COVID-19 cases; and the confirmed case-fatality risk (cCFR) in Beijing, Shanghai, Shenzhen, and Wenzhou, and all 31 Chinese provinces. We used a susceptible–infectious–recovered model to show the potential effects of relaxing containment measures after the first wave of infection, in anticipation of a possible second wave. Findings: In all selected cities and provinces, the Rt decreased substantially since Jan 23, when control measures were implemented, and have since remained below 1. The cCFR outside Hubei was 0·98% (95% CI 0·82–1·16), which was almost five times lower than that in Hubei (5·91%, 5·73–6·09). Relaxing the interventions (resulting in Rt >1) when the epidemic size was still small would increase the cumulative case count exponentially as a function of relaxation duration, even if aggressive interventions could subsequently push disease prevalence back to the baseline level. Interpretation: The first wave of COVID-19 outside of Hubei has abated because of aggressive non-pharmaceutical interventions. However, given the substantial risk of viral reintroduction, particularly from overseas importation, close monitoring of Rt and cCFR is needed to inform strategies against a potential second wave to achieve an optimal balance between health and economic protection. Funding: Health and Medical Research Fund, Hong Kong, China. | - |
dc.language | eng | - |
dc.publisher | The Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/lancet | - |
dc.relation.ispartof | The Lancet | - |
dc.title | First-wave COVID-19 transmissibility and severity in China outside Hubei after control measures, and second-wave scenario planning: a modelling impact assessment | - |
dc.type | Article | - |
dc.identifier.email | Leung, K: ksmleung@hku.hk | - |
dc.identifier.email | Wu, JT: joewu@hku.hk | - |
dc.identifier.email | Leung, GM: gmleung@hku.hk | - |
dc.identifier.authority | Leung, K=rp02563 | - |
dc.identifier.authority | Wu, JT=rp00517 | - |
dc.identifier.authority | Leung, GM=rp00460 | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1016/S0140-6736(20)30746-7 | - |
dc.identifier.pmid | 32277878 | - |
dc.identifier.pmcid | PMC7195331 | - |
dc.identifier.scopus | eid_2-s2.0-85083303331 | - |
dc.identifier.hkuros | 309742 | - |
dc.identifier.volume | 395 | - |
dc.identifier.issue | 10233 | - |
dc.identifier.spage | 1382 | - |
dc.identifier.epage | 1393 | - |
dc.identifier.isi | WOS:000552401700030 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 0140-6736 | - |