Earlier Intervention Could Have Improved US Control of COVID-19

As several states in the US approach devastating peaks of COVID-19 cases, researchers published in JAMA what combination of public health interventions were successful at controlling the spread in China.

COVID-19 continues to rapidly spread in the United States with more than 500,000 cases (525,704 as of April 12, 2020) and over 20,000 related deaths (20,486 of April 12, 2020).

“In this study, the epidemiological characteristics of patients with COVID-19 in Wuhan through March 8, 2020, were described, and the rate of confirmed cases and effective reproduction number in different periods according to key events and interventions were compared to evaluate the temporal associations of multiple public health interventions,” explained An Pan, PhD, department of epidemiology and biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

“In Wuhan, vigorous and multifaceted measures of containment, mitigation, and suppression were temporally associated with improved control of the epidemic when there was neither effective drug nor vaccine,” researchers explained.

Building upon a study that measured the severity of the epidemic beginning in Wuhan, China, and another that estimated how the progression was delayed with the institution of a travel ban, the researchers looked at a series of interventions that contributed to slowing down the spread.

“Interventions including cordons sanitaire, traffic restriction, social distancing, home quarantine, centralized quarantine, and universal symptom survey [were] temporally associated with reduced effective reproduction number of SARS-CoV-2 (secondary transmission),” found the researchers, “and [reduced] the number of confirmed cases per day across age groups, sex, and geographic regions.”

Researchers examined daily rate of confirmed cases by patient age, sex, health care occupation, and residential district across multiple periods. Each intervention period was followed by a temporary lull in case increases.

“In a city with 10 million residents, mitigation measures, such as traffic restriction, cancellation of social gatherings, and home quarantine, were associated with a reduction in the degree of transmission,” explained Dr Pan and colleagues.

The researchers noted that increased cases that followed interventions could be attributed to drug shortages, lack of PPE, and diagnosis and treatment delays. 

“A series of multifaceted public health interventions was temporally associated with improved control of the COVID-19 outbreak in Wuhan, China,” concluded Dr Pan and colleagues in the study. “These findings may inform public health policy in other countries and regions to combat the global pandemic of COVID-19.”  —Edan Stanley