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      Lockdown contained the spread of 2019 novel coronavirus disease in Huangshi city, China: Early epidemiological findings

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          Abstract

          Background

          To control the spread of 2019 novel coronavirus disease (COVID-19), China sealed Wuhan on Jan 23, 2020 and soon expanded lockdown to other twelve cities in Hubei province. We aimed to describe the epidemiological characteristics in one of the cities and highlight the effect of current implemented lockdown and nonpharmaceutical interventions.

          Methods

          We retrieved data of reported cases in Huangshi and Wuhan from publicly available disease databases. Local epidemiological data on suspected or confirmed cases in Huangshi were collected through field investigation. Epidemic curves were constructed with data on reported and observed cases.

          Results

          The accumulated confirmed COVID-19 cases and fatality in Huangshi were reported to be 1015 and 3.74% respectively, compared with 50006 and 5.08% in Wuhan till Mar 27, 2020. Right after Jan 24, the epidemic curve based on observed cases in Huangshi became flattened. Feb 1, 2020 was identified as the “turning point” as the epidemic in Huangshi faded soon afterwards. COVID-19 epidemic was characterized by mild cases in Huangshi, accounting for 82.66% of total cases. Moreover, 50 asymptomatic infections were identified in adults and children. Besides, we found confirmed cases in 19 familial clusters and 21 health care workers, supporting inter-human transmission.

          Conclusions

          Our study reported the temporal dynamics and characteristics of the COVID-19 epidemic in Huangshi city, China, across the unprecedented intervention. Such new epidemiological inference might provide further guidance on current lockdown measures in high-risk cities and, subsequently, help improve public health intervention strategies against the pandemic on the country and global levels.

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          Most cited references12

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          The psychological effects of quarantining a city

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            Transmission dynamics and control of severe acute respiratory syndrome.

            Severe acute respiratory syndrome (SARS) is a recently described illness of humans that has spread widely over the past 6 months. With the use of detailed epidemiologic data from Singapore and epidemic curves from other settings, we estimated the reproductive number for SARS in the absence of interventions and in the presence of control efforts. We estimate that a single infectious case of SARS will infect about three secondary cases in a population that has not yet instituted control measures. Public-health efforts to reduce transmission are expected to have a substantial impact on reducing the size of the epidemic.
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              Public health interventions and epidemic intensity during the 1918 influenza pandemic.

              Nonpharmaceutical interventions (NPIs) intended to reduce infectious contacts between persons form an integral part of plans to mitigate the impact of the next influenza pandemic. Although the potential benefits of NPIs are supported by mathematical models, the historical evidence for the impact of such interventions in past pandemics has not been systematically examined. We obtained data on the timing of 19 classes of NPI in 17 U.S. cities during the 1918 pandemic and tested the hypothesis that early implementation of multiple interventions was associated with reduced disease transmission. Consistent with this hypothesis, cities in which multiple interventions were implemented at an early phase of the epidemic had peak death rates approximately 50% lower than those that did not and had less-steep epidemic curves. Cities in which multiple interventions were implemented at an early phase of the epidemic also showed a trend toward lower cumulative excess mortality, but the difference was smaller (approximately 20%) and less statistically significant than that for peak death rates. This finding was not unexpected, given that few cities maintained NPIs longer than 6 weeks in 1918. Early implementation of certain interventions, including closure of schools, churches, and theaters, was associated with lower peak death rates, but no single intervention showed an association with improved aggregate outcomes for the 1918 phase of the pandemic. These findings support the hypothesis that rapid implementation of multiple NPIs can significantly reduce influenza transmission, but that viral spread will be renewed upon relaxation of such measures.
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                Author and article information

                Journal
                Clin Infect Dis
                Clin. Infect. Dis
                cid
                Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
                Oxford University Press (US )
                1058-4838
                1537-6591
                07 April 2020
                07 April 2020
                : ciaa390
                Affiliations
                [1 ] Department of Internal Medicine, Huangshi Youse Hospital affiliated to College of Arts & Science of Jianghan University , Huangshi, China
                [2 ] Huangshi Center for Disease Control and Prevention , Huangshi, China
                [3 ] Department of Obstetrics and Gynaecology, Huangshi Maternity and Children’s Health Hospital , Huangshi, China
                [4 ] Department of Internal Medicine, Medical School, Nantong University , Nantong, China
                [5 ] Department of Epidemiology and Biostatistics, School of Public Health, Nantong University , Nantong, China
                Author notes
                Correspondence: Gang Qin, Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, 9 Seyuan Road, Nantong, 226019, China ( tonygqin@ 123456ntu.edu.cn )

                Tuo Ji and Hai-Lian Chen contributed equally to this work.

                Article
                ciaa390
                10.1093/cid/ciaa390
                7184509
                32255183
                72acc911-5c9a-4fd1-a2c4-c1cf342b6ad7
                © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

                This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                History
                : 24 February 2020
                Categories
                Major Article
                AcademicSubjects/MED00290
                Custom metadata
                PAP
                accepted-manuscript

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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