Abstract
BackgroundA local coronavirus disease 2019 (COVID-19) case confirmed on June 11, 2020 triggered an outbreak in Beijing, China after 56 consecutive days without a newly confirmed case. Non-pharmaceutical interventions (NPIs) were used to contain the source in Xinfadi (XFD) market. To rapidly control the outbreak, both traditional and newly introduced NPIs including large-scale management of high-risk populations and expanded severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR-based screening in the general population were conducted in Beijing. We aimed to assess the effectiveness of the response to the COVID-19 outbreak in Beijing’s XFD market and inform future response efforts of resurgence across regions.MethodsA modified susceptible–exposed–infectious–recovered (SEIR) model was developed and applied to evaluate a range of different scenarios from the public health perspective. Two outcomes were measured: magnitude of transmission (i.e., number of cases in the outbreak) and endpoint of transmission (i.e., date of containment). The outcomes of scenario evaluations were presented relative to the reality case (i.e., 368 cases in 34 days) with 95% Confidence Interval (CI).ResultsOur results indicated that a 3 to 14 day delay in the identification of XFD as the infection source and initiation of NPIs would have caused a 3 to 28-fold increase in total case number (31–77 day delay in containment). A failure to implement the quarantine scheme employed in the XFD outbreak for defined key population would have caused a fivefold greater number of cases (73 day delay in containment). Similarly, failure to implement the quarantine plan executed in the XFD outbreak for close contacts would have caused twofold greater transmission (44 day delay in containment). Finally, failure to implement expanded nucleic acid screening in the general population would have yielded 1.6-fold greater transmission and a 32 day delay to containment.ConclusionsThis study informs new evidence that in form the selection of NPI to use as countermeasures in response to a COVID-19 outbreak and optimal timing of their implementation. The evidence provided by this study should inform responses to future outbreaks of COVID-19 and future infectious disease outbreak preparedness efforts in China and elsewhere.Graphical abstract
Highlights
A local coronavirus disease 2019 (COVID-19) case confirmed on June 11, 2020 triggered an outbreak in Beijing, China after 56 consecutive days without a newly confirmed case
This study informs new evidence that in form the selection of Non-pharmaceutical intervention (NPI) to use as countermeasures in response to a COVID-19 outbreak and optimal timing of their implementation
After the new outbreak was discovered on June 11, the municipal government have adopted a two-pronged approach—re-instating NPIs used during the initial wave in January–March 2020 and introducing new NPIs including: (i) large-scale tracing and management of high-risk populations identified by exposure risk levels, and (ii) expanded SARSCoV-2 nucleic acid screening in the general population in Beijing
Summary
A local coronavirus disease 2019 (COVID-19) case confirmed on June 11, 2020 triggered an outbreak in Beijing, China after 56 consecutive days without a newly confirmed case. We aimed to assess the effectiveness of the response to the COVID-19 outbreak in Beijing’s XFD market and inform future response efforts of resurgence across regions It has been more than 12 months since the first confirmed case of novel coronavirus disease 2019 (COVID-19) was reported, and vaccines have been approved and rolled out in some countries to protect high-risk populations for severe outcomes, for the time being non-pharmaceutical interventions (NPIs) remain primary public health measures to slow the transmission and reduce the healthcare burden before vaccines are widely available and herd immunity can be achieved. It offers an exceptional opportunity to develop a model using real-world data and to quantitatively evaluate the timing and impact of integrated NPIs for containing COVID-19 resurgences The source of this outbreak was identified as the virus spread from XFD market [12], the largest wholesale food market in Asia that has about 3000 workers and 50 000 visitors each day and provides about 80% of Beijing’s food supply. After the new outbreak was discovered on June 11, the municipal government have adopted a two-pronged approach—re-instating NPIs used during the initial wave in January–March 2020 and introducing new NPIs including: (i) large-scale tracing and management of high-risk populations identified by exposure risk levels, and (ii) expanded SARSCoV-2 nucleic acid screening in the general population in Beijing
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