scholarly journals Epidemiological characteristics of the first 100 cases of coronavirus disease 2019 (COVID-19) in Hong Kong Special Administrative Region, China, a city with a stringent containment policy

2020 ◽  
Vol 49 (4) ◽  
pp. 1096-1105 ◽  
Author(s):  
Christopher K C Lai ◽  
Rita W Y Ng ◽  
Martin C S Wong ◽  
Ka Chun Chong ◽  
Yun Kit Yeoh ◽  
...  
Keyword(s):  
Hong Kong ◽  
Incubation Period ◽  
Mainland China ◽  
Control Measures ◽  
Contact Tracing ◽  
Border Control ◽  
Government Information ◽  
Epidemic Curve ◽  
Containment Policy ◽  
Epidemiological Characteristics

Abstract Background Hong Kong (HK) is a densely populated city near the epicentre of the coronavirus disease 2019 (COVID-19) outbreak. Stringent border control together with aggressive case finding, contact tracing, social distancing and quarantine measures were implemented to halt the importation and spread of the virus. Methods We performed an epidemiological study using government information covering the first 100 confirmed cases to examine the epidemic curve, incidence, clusters, reproduction number (Rt), incubation period and time to containment. Results A total of 93 of the 100 cases were HK residents (6 infected in Mainland China, 10 on the Diamond Princess Cruise). Seven were visitors infected in Mainland China before entering HK. The majority (76%) were aged ≥45 years, and the incidence increased with age (P < 0.001). Escalation of border control measures correlated with a decrease in the proportion (62.5% to 0%) of cases imported from Mainland China, and a reduction in Rt (1.07 to 0.75). The median incubation period was 4.2 days [95% confidence interval (CI), 4.0–4.5; 5th and 95th percentiles: 1.3 and 14.0). Most clusters with identifiable epidemiological links were households involving 2–4 people. Three medium-spreading events were identified: two from New Year gatherings (6–11 people), and another from environmental contamination of a worship hall (12 people). Despite intensified contact tracing, containment was delayed in 78.9% of cases (mean = 5.96 days, range = 0–24 days). An unusual transmission in a multi-storey building via faulty toilet plumbing was suspected with >100 residents evacuated overnight. Our analysis indicated that faulty plumbing was unlikely to be the source of this transmission. Conclusion Timely stringent containment policies minimized the importation and transmission of COVID-19 in HK.

An Epidemiological Analysis of COVID-19 Confirmed Cases, Reported at National Institute of Health, Pakistan (Preprint)

2020 ◽  
Author(s):  
Ambreen Chaudhry
Keyword(s):  
Age Groups ◽  
Target Population ◽  
Control Measures ◽  
Contact Tracing ◽  
Bivariate Analysis ◽  
Travel History ◽  
Disease Epidemiology ◽  
Hygiene Practices ◽  
Multi Center Study ◽  
Epidemiological Characteristics

BACKGROUND Coronavirus disease (Covid-19) is a zoonotic disease of novel origin that posed a continuous threat to health worldwide after taking the shape of the pandemic. An understanding of disease epidemiology is supportive in timely preventive and control measures as well as contact tracing and curbing surveillance activities. OBJECTIVE The objective of our study was to determine the epidemiological characteristics of COVID-19 confirmed cases reported at the National Institute of Health Pakistan and elements of its spread in Pakistan. METHODS A retrospective record review was conducted at the National Institute of Health (NIH) Islamabad, Pakistan from January 25 to April 4, 2020. Univariate and bivariate analysis was done with 95% CI and p<0.05. RESULTS A total of 14,422 samples of suspected COVID-19 cases were received with a positivity rate of 9% (n=1348). Among all 70% (n=939) were male. The median age was 41years of age (range: 01-99Years). Among all, 19% were from 30-39 years old followed by 50-59 years old (17%). Children remained the least affected by 3% (n=35). Of the total reported cases, 55% (n=735) have reported the travel history within the last 14 days. Among these travelers’ international travelers were 23% (n=166) and domestic travelers were 77% (n=569). Travel history including both international and domestic remained significantly associated with the different age groups and Young adults remained more vulnerable to COVID-19 (P=0.03). Fever, SOB, and Cough remained the most significantly associated (P<0.05) in all age groups. CONCLUSIONS A higher incidence of COVID-19 among elderly men suggests robust quarantine measures for this target population. An escalating incidence of local transmission needs strict social distancing and hygiene practices to help flatten the curve. An extensive multi-center study is also recommended for a full understanding of disease dynamics.

scholarly journals Effective COVID-19 Control: A Comparative Analysis of the Stringency and Timeliness of Government Responses in Asia

2021 ◽  
Vol 18 (16) ◽  
pp. 8686
Author(s):  
Shu Chen ◽  
Lei Guo ◽  
Taghred Alghaith ◽  
Di Dong ◽  
Mohammed Alluhidan ◽  
...  
Keyword(s):  
Public Health ◽  
Hong Kong ◽  
South Korea ◽  
Health System ◽  
Mainland China ◽  
Initial Response ◽  
Control Measures ◽  
System Control ◽  
East And Southeast Asia ◽  
Study Sites

Aim: Many governments in East and Southeast Asia responded promptly and effectively at the onset of the COVID-19 pandemic. Synthesizing and analyzing these responses is vital for disease control evidence-based policymaking. Methods: An extensive review of COVID-19 control measures was conducted in selected Asian countries and subregions, including Mainland China, Hong Kong, Taiwan, South Korea, Singapore, Japan, and Vietnam from 1 January to 30 May 2020. Control measures were categorized into administrative, public health, and health system measures. To evaluate the stringency and timeliness of responses, we developed two indices: the Initial Response Index (IRI) and the Modified Stringency Index (MSI), which builds on the Oxford COVID-19 Government Response Tracker (OxCGRT). Results: Comprehensive administrative, public health, and health system control measures were implemented at the onset of the outbreak. Despite variations in package components, the stringency of control measures across the study sites increased with the acceleration of the outbreak, with public health control measures implemented the most stringently. Variations in daily average MSI scores are observed, with Mainland China scoring the highest (74.2), followed by Singapore (67.4), Vietnam (66.8), Hong Kong (66.2), South Korea (62.3), Taiwan (52.1), and Japan (50.3). Variations in IRI scores depicting timeliness were higher: Hong Kong, Taiwan, Vietnam, and Singapore acted faster (IRI > 50.0), while Japan (42.4) and Mainland China (4.2) followed. Conclusions: Timely setting of stringency of the control measures, especially public health measures, at dynamically high levels is key to optimally controlling outbreaks.

scholarly journals Transmission dynamics, serial interval and epidemiology of COVID-19 diseases in Hong Kong under different control measures

2020 ◽  
Vol 5 ◽  
pp. 91
Author(s):  
Yung-Wai Desmond Chan ◽  
Stefan Flasche ◽  
Tin-Long Terence Lam ◽  
Mei-Hung Joanna Leung ◽  
Miu-Ling Wong ◽  
...  
Keyword(s):  
Hong Kong ◽  
Population Level ◽  
Credible Interval ◽  
Control Measures ◽  
Transmission Dynamics ◽  
Local Data ◽  
First Case ◽  
Serial Interval ◽  
Imported Cases ◽  
Epidemiological Characteristics

Background: The outbreak of coronavirus disease 2019 (COVID-19) started in Wuhan, China in late December 2019, and subsequently became a pandemic. Hong Kong had implemented a series of control measures since January 2020, including enhanced surveillance, isolation and quarantine, border control and social distancing. Hong Kong recorded its first case on 23 January 2020, who was a visitor from Wuhan. We analysed the surveillance data of COVID-19 to understand the transmission dynamics and epidemiology in Hong Kong. Methods: We constructed the epidemic curve of daily COVID-19 incidence from 23 January to 6 April 2020 and estimated the time-varying reproduction number (Rt) with the R package EpiEstim, with serial interval computed from local data. We described the demographic and epidemiological characteristics of reported cases. We computed weekly incidence by age and residential district to understand the spatial and temporal transmission of the disease. Results: COVID-19 disease in Hong Kong was characterised with local cases and clusters detected after two waves of importations, first in late January (week 4 to 6) and the second one in early March (week 9 to 10). The Rt increased to approximately 2 95% credible interval (CI): 0.3-3.3) and approximately 1 (95%CI: 0.2-1.7), respectively, following these importations; it decreased to below 1 afterwards from weeks 11 to 13, which coincided with the implementation, modification and intensification of different control measures. Compared to local cases, imported cases were younger (mean age: 52 years among local cases vs 35 years among imported cases), had a lower proportion of underlying disease (9% vs 5%) and severe outcome (13% vs 5%). Cases were recorded in all districts but the incidence was highest in those in the Hong Kong Island region. Conclusions: Stringent and sustained public health measures at population level could contain the COVID-19 disease at a relatively low level.

scholarly journals The Use of Digital Tools to Mitigate the COVID-19 Pandemic: Comparative Retrospective Study of Six Countries

10.2196/24598 ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. e24598
Author(s):  
Kylie Zeng ◽  
Stephanie N Bernardo ◽  
Weldon E Havins
Keyword(s):  
United States ◽  
South Korea ◽  
Transmission Rate ◽  
The United States ◽  
Control Measures ◽  
Digital Tools ◽  
Contact Tracing ◽  
Border Control ◽  
Significant Difference ◽  
Containment Measures

Background Since the COVID-19 outbreak began in Wuhan, China, countries worldwide have been forced to take unprecedented measures to combat it. While some countries are still grappling with the COVID-19 pandemic, others have fared better and have re-established relative normalcy quickly. The rapid transmission rate of the virus has shown a greater need for efficient and technologically modern containment measures. The use of digital tools to facilitate strict containment measures in countries that have fared well against the COVID-19 pandemic has sparked both interest and controversy. Objective In this study, we compare the precautions taken against the spread of COVID-19 in the United States, Spain, and Italy, with Taiwan, South Korea, and Singapore, particularly related to the use of digital tools for contact tracing, and propose policies that could be used in the United States for future COVID-19 waves or pandemics. Methods COVID-19 death rate data were obtained from the European Center for Disease Prevention and Control (ECDC), accessed through the Our World in Data database, and were evaluated based on population size per 100,000 people from December 31, 2019, to September 6, 2020. All policies and measures enacted were obtained from their respective governmental websites. Results We found a strong association between lower death rates per capita and countries that implemented early mask use and strict border control measures that included mandatory quarantine using digital tools. There is a significant difference in the number of deaths per 100,000 when comparing Taiwan, South Korea, and Singapore with the United States, Spain, and Italy. Conclusions Based on our research, it is evident that early intervention with the use of digital tools had a strong correlation with the successful containment of COVID-19. Infection rates and subsequent deaths in Italy, Spain, and the United States could have been much lower with early mask use and, more importantly, timely border control measures using modern digital tools. Thus, we propose that the United States execute the following national policies should a public health emergency be declared: (1) immediately establish a National Command responsible for enacting strict mandatory guidelines enforced by federal and state governments, including national mask use; (2) mandate civilian cooperation with health officials in contact tracing and quarantine orders; and (3) require incoming travelers to the United States and those quarantined to download a contact tracing app. We acknowledge the countries we studied differ in their cultures, political systems, and reporting criteria for COVID-19 deaths. Further research may need to be conducted to address these limitations; however, we believe that the proposed policies could protect the American public.

scholarly journals Containing the Spread of Coronavirus Disease 2019 (COVID-19): Meteorological Factors and Control Strategies

2020 ◽  
Author(s):  
Jun Lin ◽  
Weihao Huang ◽  
Muchen Wen ◽  
Shuyi Ma ◽  
Jiawen Hua ◽  
...  
Keyword(s):  
Relative Humidity ◽  
Meteorological Factors ◽  
Control Strategies ◽  
Mainland China ◽  
Control Measures ◽  
Contact Tracing ◽  
Effect Of Temperature ◽  
Individual Level ◽  
Novel Coronavirus ◽  
And Control

AbstractThe novel coronavirus disease 2019 (COVID-19) has spread globally and the meteorological factors vary greatly across the world. Understanding the effect of meteorological factors and control strategies on COVID-19 transmission is critical to contain the epidemic. Using individual-level data in mainland China, Hong Kong, and Singapore, and the number of confirmed cases in other regions, we explore the effect of temperature, relative humidity, and control measures on the spread of COVID-19. We found that high temperature mitigates the transmission of the disease. High relative humidity promotes COVID-19 transmission when temperature is low, but tends to reduce transmission when temperature is high. Implementing classical control measures can dramatically slow the spread of the disease. However, due to the occurrence of pre-symptomatic infections, the effect of the measures to shorten onset-to-isolation time is markedly reduced and the importance of contact tracing and quarantine and social distancing increases. The analytic results also highlight the importance of early intervention to contain the spread of COVID-19.

scholarly journals Analysis of Imported Cases of COVID-19 in Taiwan: A Nationwide Study

2020 ◽  
Vol 17 (9) ◽  
pp. 3311 ◽  
Author(s):  
Jui-Yao Liu ◽  
Tzeng-Ji Chen ◽  
Shinn-Jang Hwang
Keyword(s):  
Control Measures ◽  
Contact Tracing ◽  
Border Control ◽  
Symptom Presentation ◽  
Symptom Screening ◽  
Imported Cases ◽  
Infection Source ◽  
Community Transmission ◽  
Strict Enforcement ◽  
Novel Coronavirus

In the early stages of the 2019 novel coronavirus disease (COVID-19) pandemic, containment of disease importation from epidemic areas was essential for outbreak control. This study is based on publicly accessible data on confirmed COVID-19 cases in Taiwan extracted from the Taiwan Centers for Disease Control website. We analysed the characteristics, infection source, symptom presentation, and route of identification of the 321 imported cases that were identified from 21 January to 6 April 2020. They were mostly returned Taiwanese citizens who had travelled to one or more of 37 countries for tourism, business, work, or study. Half of these cases developed symptoms before arrival, most of the remainder developed symptoms 1–13 days (mean 4.0 days) after arrival, and 3.4% never developed symptoms. Three-quarters of the cases had respiratory symptoms, 44.9% had fever, 13.1% lost smell or taste, and 7.2% had diarrhoea. Body temperature and symptom screening at airports identified 32.7% of the cases. Of the remainder, 27.7% were identified during home quarantining, 16.2% were identified via contact tracing, and 23.4% were reported by hospitals. Under the strict enforcement of these measures, the incidence of locally acquired COVID-19 cases in Taiwan remains sporadic. In conclusion, proactive border control measures are effective for preventing community transmission of this disease.

scholarly journals Impact of international travel and border control measures on the global spread of the novel 2019 coronavirus outbreak

2020 ◽  
Vol 117 (13) ◽  
pp. 7504-7509 ◽  
Author(s):  
Chad R. Wells ◽  
Pratha Sah ◽  
Seyed M. Moghadas ◽  
Abhishek Pandey ◽  
Affan Shoukat ◽  
...  
Keyword(s):  
Mainland China ◽  
International Travel ◽  
Control Measures ◽  
Chinese Government ◽  
Border Control ◽  
The Novel ◽  
Public Health Response ◽  
Global Spread ◽  
Travel Restrictions ◽  
The Impact

The novel coronavirus outbreak (COVID-19) in mainland China has rapidly spread across the globe. Within 2 mo since the outbreak was first reported on December 31, 2019, a total of 566 Severe Acute Respiratory Syndrome (SARS CoV-2) cases have been confirmed in 26 other countries. Travel restrictions and border control measures have been enforced in China and other countries to limit the spread of the outbreak. We estimate the impact of these control measures and investigate the role of the airport travel network on the global spread of the COVID-19 outbreak. Our results show that the daily risk of exporting at least a single SARS CoV-2 case from mainland China via international travel exceeded 95% on January 13, 2020. We found that 779 cases (95% CI: 632 to 967) would have been exported by February 15, 2020 without any border or travel restrictions and that the travel lockdowns enforced by the Chinese government averted 70.5% (95% CI: 68.8 to 72.0%) of these cases. In addition, during the first three and a half weeks of implementation, the travel restrictions decreased the daily rate of exportation by 81.3% (95% CI: 80.5 to 82.1%), on average. At this early stage of the epidemic, reduction in the rate of exportation could delay the importation of cases into cities unaffected by the COVID-19 outbreak, buying time to coordinate an appropriate public health response.

scholarly journals Public perception of ethical issues related to COVID-19 control measures in Singapore, Hong Kong, and Malaysia: A cross-sectional survey

2021 ◽  
Author(s):  
Teck Chuan Voo ◽  
Angela Ballantyne ◽  
Ng Chirk Jenn ◽  
Benjamin J. Cowling ◽  
Jingyi Xiao ◽  
...  
Keyword(s):  
Hong Kong ◽  
Public Perception ◽  
Ethical Issues ◽  
Public Attitudes ◽  
Public Support ◽  
Control Measures ◽  
Contact Tracing ◽  
Cross Sectional ◽  
Travel Restrictions ◽  
Monitoring Devices

AbstractBackgroundSeveral countries have implemented control measures to limit SARS-CoV-2 spread, including digital contact tracing, digital monitoring of quarantined individuals and testing of travelers. These raise ethical issues around privacy, personal freedoms and equity. However, little is known regarding public acceptability of these measures.MethodsIn December 2020, we conducted surveys among 3635 respondents in Singapore, Hong Kong and Malaysia to understand public perceptions on the ethical acceptability of COVID-19 control measures.FindingsHong Kong respondents were much less supportive of digital contact tracing and monitoring devices than those in Malaysia and Singapore. Around three-quarters of Hong Kong respondents perceived digital contact tracing as an unreasonable restriction of individual freedom; <20% trusted that there were adequate local provisions preventing these data being used for other purposes. This was the opposite in Singapore, where nearly three-quarters of respondents agreed that there were adequate data protection rules locally. In contrast, only a minority of Hong Kong respondents viewed mandatory testing and vaccination for travelers as unreasonable infringements of privacy or freedom. Less than two-thirds of respondents in all territories were willing to be vaccinated against COVID-19, with a quarter of respondents undecided. However, support for differential travel restrictions for vaccinated and unvaccinated individuals was high in all settings.InterpretationOur findings highlight the importance of socio-political context in public perception of public health measures and emphasize the need to continually monitor public attitudes towards such measures to inform implementation and communication strategies.FundingThis work was funded by the World Health Organization.Research in contextEvidence before this studyWe searched PubMed and Google Scholar for research articles published between 29 February 2020 to 20 January 2021 to identify empirical studies on public perception of restrictive and control measures imposed during COVID-19. We used the following terms: “COVID-19”, “SARS-COV-2”, “pandemic”, “public”, “population”, “survey”, “cross-sectional”, “national”, “international”, “perception”, “attitudes”, “opinions”, “views”, “acceptance”, “acceptability”, “support”, “ethics”, “restrictive measures”, “restrictions”, “control measures”, travel”, “contact tracing”, “testing”, “tests”, “quarantine”, “monitoring”, “vaccines” “vaccination”, “immunity”, “certificates”, “passports”, “digital”, “applications”, “apps”, “mandatory” and “compulsory”. We found 4 peer-reviewed publications: three population surveys on public acceptance of and ethical issues in digital contact tracing in France, Jordan, and Ireland, and one population survey on perceptions of immunity and vaccination certificates in Geneva, Switzerland. We found no studies that studied the relative acceptance of different types of control measures.Added valueThere is a paucity of literature on public perception of the ethics of control measures that have been or may be implemented in response to the COVID-19 pandemic. In this study, we found differing levels of public support in Singapore, Hong Kong, and Malaysia for digital contact tracing, wearable quarantine monitoring devices, and mandatory testing and vaccination for travelers. Hong Kong respondents sharply differed from Singapore and Malaysia respondents on perceptions of risks and benefits, the extent of intrusion into individual freedom, and assurance of privacy and data protection related to use of digital contact tracing and monitoring devices. These differences are likely to be substantially influenced by socio-political climate and governmental trust. Although less than two-thirds of respondents in all territories expressed a willingness to be vaccinated against COVID-19, we found high support for differential travel restrictions for vaccinated and unvaccinated individuals in all settings.Implications of all the available evidenceOur survey provides evidence of strong public support of vaccination requirements for travelers within an Asian context, and differential restrictions for vaccinated and non-vaccinated travelers. It highlights the importance of wider socio-political influences on public perception and ethical issues related to control measures and emphasizes the need to continually monitor public attitudes towards such measures to inform implementation and communication strategies.

scholarly journals Use of movement restrictions during an outbreak of COVID-19 in Selangor, Malaysia

2021 ◽  
Vol 12 (2) ◽  
pp. 51-56
Author(s):  
Anita Suleiman ◽  
Shaari Ngadiman ◽  
Mazliza Ramly ◽  
Ahmad Faudzi Yusoff ◽  
Mohamed Paid Yusof
Keyword(s):  
Public Health ◽  
Movement Control ◽  
Health Department ◽  
Control Measures ◽  
Contact Tracing ◽  
Epidemic Curve ◽  
Imported Cases ◽  
Control Order ◽  
Control Orders ◽  
Public Health Strategies

Objective: Various public health and social measures have been used during the COVID-19 outbreak, including lockdowns, contact-tracing, isolation and quarantine. The objective of this manuscript is to describe outbreaks of COVID-19 in Selangor, Malaysia, the public health strategies used and the observed impact of the measures on the epidemic curve. Methods: Information on all confirmed COVID-19 cases in Selangor between 25 January and 28 April 2020 was obtained. Clusters were identified, and cases were disaggregated into linked, unlinked and imported cases. Epidemic curves were constructed, and the timing of movement control orders was compared with the numbers of cases reported. Results: During the study period, 1395 confirmed COVID-19 cases were reported to the Selangor Health Department, of which 15.8% were imported, 79.5% were linked and 4.7% were unlinked cases. For two main clusters, the number of cases decreased after control measures were instituted, by contact-tracing followed by isolation and home quarantine for the first cluster (n = 126), and with the addition of the movement control order for the second, much larger cluster (n = 559). Discussion: The findings suggest that appropriate, timely public health interventions and movement control measures have a synergistic effect on controlling COVID-19 outbreaks.

scholarly journals Risk estimation and prediction by modeling the transmission of the novel coronavirus (COVID-19) in mainland China excluding Hubei province

2020 ◽  
Author(s):  
Hui Wan ◽  
Jing-an Cui ◽  
Guo-jing Yang
Keyword(s):  
Mainland China ◽  
Hubei Province ◽  
Control Measures ◽  
Contact Tracing ◽  
Published Data ◽  
Chinese Government ◽  
Personal Protection ◽  
Protection Measures ◽  
Reproduction Ratio ◽  
Self Protection

AbstractBackgroundIn December 2019, an outbreak of coronavirus disease (COVID-19) was identified in Wuhan, China and, later on, detected in other parts of China. Our aim is to evaluate the effectiveness of the evolution of interventions and self-protection measures, estimate the risk of partial lifting control measures and predict the epidemic trend of the virus in mainland China excluding Hubei province based on the published data and a novel mathematical model.MethodsA novel COVID-19 transmission dynamic model incorporating the intervention measures implemented in China is proposed. COVID-19 daily data of mainland China excluding Hubei province, including the cumulative confirmed cases, the cumulative deaths, newly confirmed cases and the cumulative recovered cases for the period January 20th-March 3rd, 2020, were archived from the National Health Commission of China (NHCC). We parameterize the model by using the Markov Chain Monte Carlo (MCMC) method and estimate the control reproduction number Rc, as well as the effective daily reproduction ratio Re(t), of the disease transmission in mainland China excluding Hubei province.ResultsThe estimation outcomes indicate that Rc is 3.36 (95% CI 3.20-3.64) and Re(t) has dropped below 1 since January 31st, 2020, which implies that the containment strategies implemented by the Chinese government in mainland China excluding Hubei province are indeed effective and magnificently suppressed COVID-19 transmission. Moreover, our results show that relieving personal protection too early may lead to the spread of disease for a longer time and more people would be infected, and may even cause epidemic or outbreak again. By calculating the effective reproduction ratio, we prove that the contact rate should be kept at least less than 30% of the normal level by April, 2020.ConclusionsTo ensure the epidemic ending rapidly, it is necessary to maintain the current integrated restrict interventions and self-protection measures, including travel restriction, quarantine of entry, contact tracing followed by quarantine and isolation and reduction of contact, like wearing masks, etc. People should be fully aware of the real-time epidemic situation and keep sufficient personal protection until April. If all the above conditions are met, the outbreak is expected to be ended by April in mainland China apart from Hubei province.

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