Reduction in effective reproduction number of COVID-19 is higher in countries employing active case detection with prompt isolation

Wilasang, Chaiwat; Sararat, Chayanin; Jitsuk, Natcha C.; Yolai, Noppamas; Thammawijaya, Panithee; Auewarakul, Prasert; Modchang, Charin

doi:10.1093/jtm/taaa095

Cited by 47 publications

(48 citation statements)

References 5 publications

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“…These suggest that effective test, isolate, and trace approaches were able to control the epidemic with moderate levels of physical distancing. 27 This finding corroborates the experience of other countries. In Hong Kong, case isolation and contact tracing were combined with other physical distancing measures (but no lockdown), which resulted in an estimated effective reproduction number near 1 for 8 weeks.…”

Section: Discussionsupporting

confidence: 87%

Epidemiological Investigation of the First 135 COVID-19 Cases in Brunei: Implications for Surveillance, Control, and Travel Restrictions

Wong

Chaw

Koh

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Studies on the early introduction of SARS-CoV-2 in a naive population have important epidemic control implications. We report findings from the epidemiological investigation of the initial 135 COVID-19 cases in Brunei and describe the impact of control measures and travel restrictions. Epidemiological and clinical information was obtained for all confirmed COVID-19 cases, whose symptom onset was from March 9 to April 5, 2020. The basic reproduction number (R0), incubation period, and serial interval (SI) were calculated. Time-varying R was estimated to assess the effectiveness of control measures. Of the 135 cases detected, 53 (39.3%) were imported. The median age was 36 (range = 0.5-72) years. Forty-one (30.4%) and 13 (9.6%) were presymptomatic and asymptomatic cases, respectively. The median incubation period was 5 days (interquartile range [IQR] = 5, range = 1-11), and the mean SI was 5.4 days (SD = 4.5; 95% CI: 4.3, 6.5). The reproduction number was between 3.9 and 6.0, and the doubling time was 1.3 days. The time-varying reproduction number (Rt) was below one (Rt = 0.91; 95% credible interval: 0.62, 1.32) by the 13th day of the epidemic. Epidemic control was achieved through a combination of public health measures, with emphasis on a test-isolate-trace approach supplemented by travel restrictions and moderate physical distancing measures but no actual lockdown. Regular and ongoing testing of high-risk groups to supplement the existing surveillance program and a phased easing of physical distancing measures has helped maintain suppression of the COVID-19 outbreak in Brunei, as evidenced by the identification of only six additional cases from April 5 to August 5, 2020.

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Section: Discussionsupporting

confidence: 87%

Epidemiological Investigation of the First 135 COVID-19 Cases in Brunei: Implications for Surveillance, Control, and Travel Restrictions

Wong

Chaw

Koh

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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“…Coronavirus disease 2019 (COVID‐19) is an acute respiratory infectious disease caused by severe and highly contagious acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2; the Coronaviridae family). Although previous studies suggested that the basic reproduction number (R0) of SARS‐CoV‐2 was between 2 and 3, the countries with prompt isolation were successful in reducing the reproduction number 1 . Extensive research has shown that the total mortality rate is 5.6%, lower than SARS (13%) and MERS (35%) 2 .…”

Section: Introductionmentioning

confidence: 97%

Predictive criteria of severe cases in COVID‐19 patients of early stage: A retrospective observational study

Gao

Huang

et al. 2020

Clinical Laboratory Analysis

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Background Patients with coronavirus disease 2019 (COVID‐19) often suffer sudden deterioration of disease around 1‐2 weeks after onset. Once the disease progressed to severe phase, clinical prognosis of patients will significantly deteriorate. Methods This was a multicenter retrospective study on patients of all adult inpatients (≥18 years old) from Tianyou Hospital (Wuhan, China) and the Fourth Affiliated Hospital, Zhejiang University School of Medicine. All 139 patients had laboratory‐confirmed COVID‐19 in their early stage, which is defined as within 7 days of clinical symptoms. Univariate and multivariate logistic regression models were used to determine the predictive factors in the early detection of patients who may subsequently develop into severe cases. Results Multivariable logistic regression analysis showed that the higher level of hypersensitivity C‐reactive protein (OR = 4.77, 95% CI:1.92‐11.87, P = .001), elevated alanine aminotransferase (OR = 6.87, 95%CI:1.56‐30.21, P = .011), and chronic comorbidities (OR = 11.48, 95% CI:4.44‐29.66, P < .001) are the determining risk factors for the progression into severe pneumonia in COVID‐19 patients. Conclusion Early COVID‐19 patients with chronic comorbidities, elevated hs‐CRP or elevated ALT are significantly more likely to develop severe pneumonia as the disease progresses. These risk factors may facilitate the early diagnosis of critical patients in clinical practice.

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“…No approved com mercial tests were available when the pandemic emerged, so the gov ernment has decided "to provide first-generation in-house assays for public health laboratories as an interim measure and for gradual migration to a commercial alternative." 3 We urge the government to reconsider this commitment to unspecified commercial contracts that cannot supply the 10 million tests per day needed for weekly testing in the UK. Rapid tests administered by a trained person, although essential in airports and various other public venues, are not suitable for weekly whole-population screening.…”

Section: Unnecessary Obstacles To Covid-19 Mass Testingmentioning

confidence: 99%

“…These countries employed isolation of all cases, even mild ones, often using isolation shelters, hospitals, or other institutions such as hotels. 3,4 Careful study of the sequential mounting of public health responses in Wuhan, China, to combat their explosive outbreak in January and February, 2020, showed five distinct phases. Only in the fourth and fifth phases, when isolation shelters for all cases (even mild cases) were instituted, did the epidemic curve not only flatten but show a rapid decline in daily new cases, down to zero within a matter of weeks.…”

mentioning

confidence: 99%

Institutional versus home isolation to curb the COVID-19 outbreak – Authors' reply

2020

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Reduction in effective reproduction number of COVID-19 is higher in countries employing active case detection with prompt isolation

Abstract: Highlight Countries that implemented liberal testing with active case finding and prompt isolation, combined with contact tracing and quarantine, were more successful in reducing the reproduction number compared to countries that primarily relied on social distancing and lockdown measures.

Cited by 47 publications

References 5 publications

Epidemiological Investigation of the First 135 COVID-19 Cases in Brunei: Implications for Surveillance, Control, and Travel Restrictions

Epidemiological Investigation of the First 135 COVID-19 Cases in Brunei: Implications for Surveillance, Control, and Travel Restrictions

Predictive criteria of severe cases in COVID‐19 patients of early stage: A retrospective observational study

Institutional versus home isolation to curb the COVID-19 outbreak – Authors' reply

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