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 Modelling the Effectiveness of Epidemic Control Measures in Preventing the Transmission of COVID-19 in Malaysia

2020 ◽  
Vol 17 (15) ◽  
pp. 5509 ◽  
Author(s):  
Balvinder Singh Gill ◽  
Vivek Jason Jayaraj ◽  
Sarbhan Singh ◽  
Sumarni Mohd Ghazali ◽  
Yoon Ling Cheong ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Model Calibration ◽  
Reproduction Number ◽  
Close Contact ◽  
Movement Control ◽  
Control Measures ◽  
Seir Model ◽  
Epidemic Curve ◽  
Reproduction Numbers ◽  
Control Order

Malaysia is currently facing an outbreak of COVID-19. We aim to present the first study in Malaysia to report the reproduction numbers and develop a mathematical model forecasting COVID-19 transmission by including isolation, quarantine, and movement control measures. We utilized a susceptible, exposed, infectious, and recovered (SEIR) model by incorporating isolation, quarantine, and movement control order (MCO) taken in Malaysia. The simulations were fitted into the Malaysian COVID-19 active case numbers, allowing approximation of parameters consisting of probability of transmission per contact (β), average number of contacts per day per case (ζ), and proportion of close-contact traced per day (q). The effective reproduction number (Rt) was also determined through this model. Our model calibration estimated that (β), (ζ), and (q) were 0.052, 25 persons, and 0.23, respectively. The (Rt) was estimated to be 1.68. MCO measures reduce the peak number of active COVID-19 cases by 99.1% and reduce (ζ) from 25 (pre-MCO) to 7 (during MCO). The flattening of the epidemic curve was also observed with the implementation of these control measures. We conclude that isolation, quarantine, and MCO measures are essential to break the transmission of COVID-19 in Malaysia.

scholarly journals Malaysia Healthcare Early Response in Combatting COVID-19 Pandemic in 2020

2021 ◽  
Vol 42 (6) ◽  
pp. 425-437
Author(s):  
Safiya Amaran ◽  
Ahmad Zulfahmi Mohd Kamaruzaman ◽  
Nurul Yaqeen Mohd Esa ◽  
Zaharah Sulaiman
Keyword(s):  
Public Health ◽  
Healthcare System ◽  
Large Scale ◽  
Movement Control ◽  
Early Response ◽  
Contact Tracing ◽  
Early Disease Detection ◽  
Laboratory Services ◽  
Control Order ◽  
Novel Coronavirus

The year 2020 saw the emergence of a novel coronavirus—the severe acute respiratory syndrome coronavirus 2— which has led to an unprecedented pandemic that has shaken the entire world. The pandemic has been a new experience for Malaysia, especially during the implementation of large-scale public health and social measures called the Movement Control Order (MCO). This paper seeks to describe the experiences of the Malaysian healthcare system thus far in combatting the pandemic. The Malaysian healthcare system comprises two main arms: public health and medicine. The public health arm focuses on early disease detection, contact tracing, quarantines, the MCO, and risk stratification strategies in the community. The medical arm focuses on the clinical management of coronavirus disease 2019 (COVID-19) patients; it encompasses laboratory services, the devising of clinical setting adjustments, and hospital management for COVID-19 and non-COVID-19 patients. Malaysia experienced intense emotions at the beginning of the pandemic, with great uncertainty regarding the pandemic’s outcome, as the world saw a frighteningly high COVID-19 mortality. As of writing (May 30, 2020), Malaysia has passed the peak of its second wave of infections. The experience thus far has helped in preparing the country’s healthcare system to be vigilant and more prepared for future COVID-19 waves. To date, the pandemic has changed many aspects of Malaysia’s life, and people are still learning to adapt to new norms in their lives.

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.

scholarly journals Estimating the proportion of asymptomatic COVID-19 cases in an Italian region with intermediate incidence during the first pandemic wave: an observational retrospective study

2021 ◽  
Author(s):  
Domenico Martinelli ◽  
Francesca Fortunato ◽  
Sara Mazzilli ◽  
Lucia Bisceglia ◽  
Pier Luigi Lopalco ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Signs ◽  
Virus Transmission ◽  
Contact Tracing ◽  
The Public ◽  
Health Community ◽  
Important Challenge ◽  
Asymptomatic Infections ◽  
Public Health Strategies

Abstract Early in the COVID-19 pandemic, asymptomatic transmission represented an important challenge for controlling the spread of SARS-CoV-2 through the traditional public health strategies. Further understanding of the contribution of asymptomatic infections to SARS-CoV-2 transmission has been of crucial importance for pandemic control. We conducted a retrospective epidemiological study to characterize asymptomatic COVID-19 cases occurred in the Apulia region, Italy, during the first epidemic wave of COVID-19 outbreak (February 29 - July 7, 2020). We analyzed data collected in a regional platform developed to manage surveillance activities, namely investigation and follow-up of cases and contacts, contact tracing, laboratory and clinical data collection. We included all asymptomatic cases that were laboratory-confirmed during the appropriate follow-up, defined as persons infected with SARS-CoV-2 who did not develop symptoms/clinical signs of the disease. Between February 29 and July 7, 2020, a total of 4,536 cases were diagnosed with COVID-19 among 193,757 tests performed. The group of persons with asymptomatic SARS-CoV-2 infection consisted of 903 cases; the asymptomatic proportion was 19.9% (95%CI: 18.8-21.1%); this decreased with increasing age (OR: 0.89, 95%CI: 0.83-0.96; p=0.001), in individuals with underlying comorbidities (OR: 0.55, 95%CI: 0.41-0.73; p<0.001), and in males (OR: 0.69, 95%CI: 0.54-0.87; p=0.002). The median asymptomatic SARS-CoV-2 RNA positive period was 19 days (IQR: 14-31) and the cumulative proportion of persons with resolution of infection 14 days after the first positive PCR test was 74%. As the public health community is debating the question of whether asymptomatic and late spreaders could sustain virus transmission in the communities, such cases present unique opportunities to gain insight into SARS-CoV-2 adaptation to human host. This has important implications for future COVID-19 surveillance and prevention.

scholarly journals Epidemiology of COVID-19 and effect of public health interventions, Chennai, India, March - October 2020

2021 ◽  
Author(s):  
M Jagadeesan ◽  
Parasuraman Ganeshkumar ◽  
Prabhdeep Kaur ◽  
Hemalatha Masanam Sriramulu ◽  
Manikandanesan Sakthivel ◽  
...  
Keyword(s):  
Public Health ◽  
Case Fatality ◽  
Contact Tracing ◽  
Severe Illness ◽  
List Type ◽  
Rt Pcr ◽  
Case Fatality Ratio ◽  
Metropolitan City ◽  
Lessons Learnt ◽  
Public Health Strategies

AbstractObjectivesTo describe the public health strategies and their effect in controlling the COVID-19 pandemic from March to October 2020 in Chennai, India.SettingChennai, a densely populated metropolitan city in Southern India, was one of the five cities which contributed to more than half of the COVID-19 cases in India.ParticipantsWe collected the de-identified line list of all the 192,450 COVID-19 case-patients reported from 17 March to 31 October 2020 in Chennai and their contacts for the analysis. We defined a COVID-19 case-patient based on the RT-PCR positive test in one of the Government approved labs.Outcome measuresThe primary outcomes of interest were incidence of COVID-19 per million population, case fatality ratio, deaths per million and the effective reproduction number (Rt). We also analysed the indicators for surveillance, testing, contact tracing and isolation.ResultsOf the 192,450 RT-PCR confirmed COVID-19 case-patients reported in Chennai from 17 March-31 October 2020, 114,889 (60%) were males. The highest incidence was 41,064 per million population among the 61-80 years. The incidence peaked during June 2020 at 5239 per million and declined to 3,627 per million in October 2020. The city reported 3,543 deaths, with a case fatality ratio (CFR) of 1.8% and the crude death rate was 431 per million. When lockdown began, Rt was high (4.2) in March and fluctuated from April to June 2020. The Rt dropped below one by the first week of July and remained so until October 2020, even with the relaxation of restrictionsConclusionThe combination of public health strategies controlled the COVID-19 epidemic in a large, densely populated city in India. We recommend continuing the interventions to prevent resurgence, even as vaccination is being rolled out.StrengthsWe did a comprehensive analysis of COVID-19 strategies and outcome in a large, densely populated metropolitan city in India.We documented that the community-centric public health strategies were feasible and effective in controlling the COVID-19 outbreak even in a large, thickly populated cityThe lessons learnt are relevant to similar settings in low-and middle-income countries. Given the ongoing multiple waves of COVID-19 and the difficulty in controlling the transmission, our experience and lessons learnt will be valuable for policymakers and scientific advisors globallyLimitationsWe analysed the data available from the GCC database and not from the hospitals where patients with moderate to severe illness were admitted. Hence, we could not report the severity of illness among admitted patients.Second, the COVID-19 incidence might have been underestimated while testing was low during the early phase of the epidemic

scholarly journals A QR Code–Based Contact Tracing Framework for Sustainable Containment of COVID-19: Evaluation of an Approach to Assist the Return to Normal Activity (Preprint)

2020 ◽  
Author(s):  
Ichiro Nakamoto ◽  
Sheng Wang ◽  
Yan Guo ◽  
Weiqing Zhuang
Keyword(s):  
Public Health ◽  
Health Status ◽  
Public Transportation ◽  
Normal Activity ◽  
Transportation Systems ◽  
Control Measures ◽  
Contact Tracing ◽  
Qr Code ◽  
Qr Codes ◽  
Health Crisis

UNSTRUCTURED We discuss a pandemic management framework using symptom-based quick response (QR) codes to contain the spread of COVID-19. In this approach, symptom-based QR health codes are issued by public health authorities. The codes do not retrieve the location data of the users; instead, two different colors are displayed to differentiate the health status of individuals. The QR codes are officially regarded as electronic certificates of individuals’ health status, and can be used for contact tracing, exposure risk self-triage, self-update of health status, health care appointments, and contact-free psychiatric consultations. This approach can be effectively deployed as a uniform platform interconnecting a variety of responders (eg, individuals, institutions, and public authorities) who are affected by the pandemic, which minimizes the errors of manual operation and the costs of fragmented coordination. At the same time, this approach enhances the promptness, interoperability, credibility, and traceability of containment measures. The proposed approach not only provides a supplemental mechanism for manual control measures but also addresses the partial failures of pandemic management tools in the abovementioned facets. The QR tool has been formally deployed in Fujian, a province located in southeast China that has a population of nearly 40 million people. All individuals aged ≥3 years were officially requested to present their QR code during daily public activities, such as when using public transportation systems, working at institutions, and entering or exiting schools. The deployment of this approach has achieved sizeable containment effects and played remarkable roles in shifting the negative gross domestic product (–6.8%) to a positive value by July 2020. The number of cumulative patients with COVID-19 in this setting was confined to 363, of whom 361 had recovered (recovery rate 99.4%) as of July 12, 2020. A simulation showed that if only partial measures of the framework were followed, the number of cumulative cases of COVID-19 could potentially increase ten-fold. This approach can serve as a reliable solution to counteract the emergency of a public health crisis; as a routine tool to enhance the level of public health; to accelerate the recovery of social activities; to assist decision making for policy makers; and as a sustainable measure that enables scalability.

scholarly journals Intrinsic and realized generation intervals in infectious-disease transmission

2015 ◽  
Vol 282 (1821) ◽  
pp. 20152026 ◽  
Author(s):  
David Champredon ◽  
Jonathan Dushoff
Keyword(s):  
Public Health ◽  
Mathematical Models ◽  
Disease Transmission ◽  
Interval Data ◽  
Contact Tracing ◽  
Reproductive Number ◽  
Infectious Disease Transmission ◽  
Generation Interval ◽  
Public Health Strategies ◽  
The Relationship

The generation interval is the interval between the time when an individual is infected by an infector and the time when this infector was infected. Its distribution underpins estimates of the reproductive number and hence informs public health strategies. Empirical generation-interval distributions are often derived from contact-tracing data. But linking observed generation intervals to the underlying generation interval required for modelling purposes is surprisingly not straightforward, and misspecifications can lead to incorrect estimates of the reproductive number, with the potential to misguide interventions to stop or slow an epidemic. Here, we clarify the theoretical framework for three conceptually different generation-interval distributions: the ‘intrinsic’ one typically used in mathematical models and the ‘forward’ and ‘backward’ ones typically observed from contact-tracing data, looking, respectively, forward or backward in time. We explain how the relationship between these distributions changes as an epidemic progresses and discuss how empirical generation-interval data can be used to correctly inform mathematical models.

Use of Masks as a Preventative Public Health Strategy to Limit the Spread of COVID-19

2021 ◽  
pp. 1-5
Author(s):  
Wally Bartfay ◽  
Wally Bartfay ◽  
Marina Ali
Keyword(s):  
Public Health ◽  
Single Layer ◽  
Global Perspective ◽  
Contact Tracing ◽  
Global Pandemic ◽  
Health Strategy ◽  
Preventative Strategy ◽  
Viral Dose ◽  
Public Health Strategies ◽  
Health Experts

SARS-CoV-2 coronavirus (COVID-19) is a respiratory infectious disease that has caused a global pandemic of unprecedented proportions. There has been a lot of discussion and debate in social media and by public health experts about the effectiveness of masks as a preventative strategy to decrease transmission of this virus. There are two modes in which mask may be beneficial: i) To serve as a physical barrier against the virus entering or leaving the oral-nasal passages of mask wearers, and ii) to decrease the risk that the person wearing the mask might pass the virus on to someone else (e.g., via coughing). The focus of this review is on the efficacy of different masks-types, and their demonstrated effectiveness in mitigating transmission from a global perspective. Our findings reveal that the use of commercially manufactured mask greatly decreases the distribution of COVID-19, whereas single layer homemade masks also provide protection by decreasing the viral dose of exposure and limit outward aerosol particle emissions. We argue that masks are a critical component in the arsenal of public health strategies to decrease transmission of viruses, including handwashing, maintaining social distancing (2 meters), limiting large gatherings of people, isolation of suspected cases, screening, and contact tracing.

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