Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak.
TL;DR: Public health measures were decisive in controlling the SARS epidemic in 2003 but whether these measures will be sufficient to control 2019-nCoV depends on addressing some unanswered questions.
Abstract: Public health measures were decisive in controlling the SARS epidemic in 2003. Isolation is the separation of ill persons from non-infected persons. Quarantine is movement restriction, often with fever surveillance, of contacts when it is not evident whether they have been infected but are not yet symptomatic or have not been infected. Community containment includes measures that range from increasing social distancing to community-wide quarantine. Whether these measures will be sufficient to control 2019-nCoV depends on addressing some unanswered questions.
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TL;DR: Hospitalised COVID-19 patients are frequently elderly subjects with co-morbidities receiving polypharmacy, all of which are known risk factors for d
Abstract: Background: Hospitalised COVID-19 patients are frequently elderly subjects with co-morbidities receiving polypharmacy, all of which are known risk factors for d
14,343 citations
TL;DR: Analysis of epidemiological, diagnostic, clinical, and therapeutic aspects, including perspectives of vaccines and preventive measures that have already been globally recommended to counter this pandemic virus, suggest that this novel virus has been transferred from an animal source, such as bats.
Abstract: SUMMARYIn recent decades, several new diseases have emerged in different geographical areas, with pathogens including Ebola virus, Zika virus, Nipah virus, and coronaviruses (CoVs). Recently, a new type of viral infection emerged in Wuhan City, China, and initial genomic sequencing data of this virus do not match with previously sequenced CoVs, suggesting a novel CoV strain (2019-nCoV), which has now been termed severe acute respiratory syndrome CoV-2 (SARS-CoV-2). Although coronavirus disease 2019 (COVID-19) is suspected to originate from an animal host (zoonotic origin) followed by human-to-human transmission, the possibility of other routes should not be ruled out. Compared to diseases caused by previously known human CoVs, COVID-19 shows less severe pathogenesis but higher transmission competence, as is evident from the continuously increasing number of confirmed cases globally. Compared to other emerging viruses, such as Ebola virus, avian H7N9, SARS-CoV, and Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV-2 has shown relatively low pathogenicity and moderate transmissibility. Codon usage studies suggest that this novel virus has been transferred from an animal source, such as bats. Early diagnosis by real-time PCR and next-generation sequencing has facilitated the identification of the pathogen at an early stage. Since no antiviral drug or vaccine exists to treat or prevent SARS-CoV-2, potential therapeutic strategies that are currently being evaluated predominantly stem from previous experience with treating SARS-CoV, MERS-CoV, and other emerging viral diseases. In this review, we address epidemiological, diagnostic, clinical, and therapeutic aspects, including perspectives of vaccines and preventive measures that have already been globally recommended to counter this pandemic virus.
1,011 citations
TL;DR: A significantly decreased growth rate and increased doubling time of cases was observed, which is most likely due to Chinese lockdown measures, which seem to have a potential to slow down the spread of COVID-19.
Abstract: BACKGROUND With its epicenter in Wuhan, China, the COVID-19 outbreak was declared a Public Health Emergency of International Concern by the World Health Organization (WHO). Consequently, many countries have implemented flight restrictions to China. China itself has imposed a lockdown of the population of Wuhan as well as the entire Hubei province. However, whether these two enormous measures have led to significant changes in the spread of COVID-19 cases remains unclear. METHODS We analyzed the available data on the development of confirmed domestic and international COVID-19 cases before and after lockdown measures. We evaluated the correlation of domestic air traffic to the number of confirmed COVID-19 cases and determined the growth curves of COVID-19 cases within China before and after lockdown as well as after changes in COVID-19 diagnostic criteria. RESULTS Our findings indicate a significant increase in doubling time from 2 days (95% CI: 1.9-2.6) to 4 days (95% CI: 3.5-4.3), after imposing lockdown. A further increase is detected after changing diagnostic and testing methodology to 19.3 (95% CI: 15.1-26.3), respectively. Moreover, the correlation between domestic air traffic and COVID-19 spread became weaker following lockdown (before lockdown: r = 0.98, P < 0.05 vs after lockdown: r = 0.91, P = NS). CONCLUSIONS A significantly decreased growth rate and increased doubling time of cases was observed, which is most likely due to Chinese lockdown measures. A more stringent confinement of people in high risk areas seems to have a potential to slow down the spread of COVID-19.
982 citations
Cites background from "Isolation, quarantine, social dista..."
...In a recent study, WilderSmith et al.(5) describe these different concepts in detail, ranging from quarantine of confirmed and possibly infected individuals as implemented in Germany to community containment in northern Italy with travel restriction outside of defined areas, and point out their respective efficacy in virus containment....
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...In a recent study, WilderSmith et al.5 describe these different concepts in detail, ranging from quarantine of confirmed and possibly infected individuals as implemented in Germany to community containment in northern Italy with travel restriction outside of defined areas, and point out their respective efficacy in virus containment....
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TL;DR: Environmental data released by NASA and ESA before and after the coronavirus pandemic is compiled and its impact on environmental quality is discussed.
768 citations
Cites background from "Isolation, quarantine, social dista..."
...Subsequently, Chinese government placed the whole country on lockdown to slow down the spread of infection and ease burden on health facilities (Wilder-Smith and Freedman, 2020)....
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TL;DR: The creation of an interactive platform and dashboard to provide real-time alerts of rumours and concerns about coronavirus spreading globally would enable public health officials and relevant stakeholders to respond rapidly with a proactive and engaging narrative that can mitigate misinformation.
Abstract: We need to rapidly detect and respond to public rumours, perceptions, attitudes and behaviours around COVID-19 and control measures. The creation of an interactive platform and dashboard to provide ...
744 citations
References
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TL;DR: Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily, which is the seventh member of the family of coronaviruses that infect humans.
Abstract: In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.).
21,455 citations
TL;DR: There is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019 and considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere.
Abstract: Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the...
13,101 citations
TL;DR: Investigators in Germany detected the spread of the novel coronavirus (2019-nCoV) from a person who had recently traveled from China and found it to be a novel virus.
Abstract: 2019-nCoV Transmission from Asymptomatic Patient In this report, investigators in Germany detected the spread of the novel coronavirus (2019-nCoV) from a person who had recently traveled from China...
3,492 citations
TL;DR: Human-to-Human Coronavirus Transmission in Vietnam The authors describe transmission of 2019-nCoV from a father, who had flown with his wife from Wuhan to Hanoi, to the son, who met his father and ...
Abstract: Human-to-Human Coronavirus Transmission in Vietnam The authors describe transmission of 2019-nCoV from a father, who had flown with his wife from Wuhan to Hanoi, to the son, who met his father and ...
980 citations
"Isolation, quarantine, social dista..." refers background in this paper
...Preliminary insights from clusters in Vietnam and Germany unveil that even mildly symptomatic persons may contribute to transmission.(11) ,12 If this is indeed more frequent, then old-style public health measures will not be sufficient and we need to await vaccines to halt the epidemic....
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TL;DR: Overall, peak viral loads were reached at 12–14 days of illness when patients were probably in hospital care, which would explain why hospital workers were prone to infection.
303 citations
"Isolation, quarantine, social dista..." refers background in this paper
...Viral loads peaked at 6– 11 days after onset of illness for nasopharyngeal aspirates, and overall, peak viral loads were reached at 12–14 days of illness when patients were usually already in hospital care.(10) Low or absence of viral shedding in the first few days of illness meant that early isolation measures could be effective....
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