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Lancet Public Health. Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observatio

tetano

Editor, Senior Moderator
Lancet Public Health. 2020 Apr 17. pii: S2468-2667(20)30090-6. doi: 10.1016/S2468-2667(20)30090-6. [Epub ahead of print]
Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study.


Cowling BJ[SUP]1[/SUP], Ali ST[SUP]1[/SUP], Ng TWY[SUP]1[/SUP], Tsang TK[SUP]1[/SUP], Li JCM[SUP]1[/SUP], Fong MW[SUP]1[/SUP], Liao Q[SUP]1[/SUP], Kwan MY[SUP]2[/SUP], Lee SL[SUP]3[/SUP], Chiu SS[SUP]3[/SUP], Wu JT[SUP]1[/SUP], Wu P[SUP]4[/SUP], Leung GM[SUP]1[/SUP].

Author information




Abstract

BACKGROUND:

A range of public health measures have been implemented to suppress local transmission of coronavirus disease 2019 (COVID-19) in Hong Kong. We examined the effect of these interventions and behavioural changes of the public on the incidence of COVID-19, as well as on influenza virus infections, which might share some aspects of transmission dynamics with COVID-19.
METHODS:

We analysed data on laboratory-confirmed COVID-19 cases, influenza surveillance data in outpatients of all ages, and influenza hospitalisations in children. We estimated the daily effective reproduction number (R[SUB]t[/SUB]) for COVID-19 and influenza A H1N1 to estimate changes in transmissibility over time. Attitudes towards COVID-19 and changes in population behaviours were reviewed through three telephone surveys done on Jan 20-23, Feb 11-14, and March 10-13, 2020.
FINDINGS:

COVID-19 transmissibility measured by R[SUB]t[/SUB] has remained at approximately 1 for 8 weeks in Hong Kong. Influenza transmission declined substantially after the implementation of social distancing measures and changes in population behaviours in late January, with a 44% (95% CI 34-53%) reduction in transmissibility in the community, from an estimated R[SUB]t[/SUB] of 1?28 (95% CI 1?26-1?30) before the start of the school closures to 0?72 (0?70-0?74) during the closure weeks. Similarly, a 33% (24-43%) reduction in transmissibility was seen based on paediatric hospitalisation rates, from an R[SUB]t[/SUB] of 1?10 (1?06-1?12) before the start of the school closures to 0?73 (0?68-0?77) after school closures. Among respondents to the surveys, 74?5%, 97?5%, and 98?8% reported wearing masks when going out, and 61?3%, 90?2%, and 85?1% reported avoiding crowded places in surveys 1 (n=1008), 2 (n=1000), and 3 (n=1005), respectively.
INTERPRETATION:

Our study shows that non-pharmaceutical interventions (including border restrictions, quarantine and isolation, distancing, and changes in population behaviour) were associated with reduced transmission of COVID-19 in Hong Kong, and are also likely to have substantially reduced influenza transmission in early February, 2020.
FUNDING:

Health and Medical Research Fund, Hong Kong.
Copyright ? 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.



PMID:32311320DOI:10.1016/S2468-2667(20)30090-6
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