Cultural factors in measures and their compliance
In this country, scientists, business and politics are discussing the right measures to contain the coronavirus pandemic. The epidemic was very successfully contained in the cities of Hong Kong and the neighboring province of Shenzhen without the need for far-reaching measures. Researchers have now examined and evaluated the measures with which the provinces managed to successfully manage SARS-CoV-2 without a complete shutdown.
Hong Kong and Shenzhen, despite their proximity to the origin of the coronavirus pandemic, have surprisingly few COVID-19 sufferers and deaths, even though the local health authorities have not ordered a complete lockdown. Two research teams have now investigated how this was achieved. Her results for Hong Kong were presented in the specialist journal “Lancet Public Health” and those for Shenzhen in the specialist journal “Lancet Infectious Diseases”.
Hong Kong is surely maneuvering through the crisis
Hong Kong had only 715 COVID-19 cases and 4 deaths associated with SARS-CoV-2 at the end of March 2020, according to the Hong Kong University. If you consider that 7.5 million people live here in a small space and that there is a geographical proximity to the Wuhan outbreak, this result is impressive. How did this happen?
The results were achieved without a complete shutdown
As the research team at the University of Hong Kong shows, the successful narrowing down is based on early consistent action and on the good cooperation of the population. The measures included that all persons who entered from countries where COVID-19 cases were known had to go into a 14-day quarantine. In addition, all people suffering from COVID-19 were isolated in hospitals.
In addition, the authorities intensively tracked all contacts of the infected people. People who tested positive immediately had to leave their homes and cure the infection in a quarantine facility – regardless of the severity.
Further measures in Hong Kong
The health authorities called on the population to comply with distance regulations and to wear face masks in public. These measures were followed consistently. In addition, the schools were closed from the end of January and employees were sent to the home office if possible. The rest of public life, however, continued relatively normal under tightened hygiene measures.
Success of the measures
In this way, Hong Kong was able to keep the reproductive number (R) of the coronavirus low from the start. During March, R could be pushed from 1.5 to below 1 without an exponential spread. School closings, according to the University of Hong Kong, resulted in a 33 percent reduction in child transmission. R much in this group from 1.1 to 0.73.
The behavior of the population had a big impact
The researchers attribute the great success of containment to the high willingness of the population to implement the recommendations and to support the measures. According to surveys conducted as part of the study, 85 percent of respondents avoided crowded places and 99 percent wore face masks in public.
Influenza was contained
The measures also had a major impact on the spread of influenza. The number of illnesses fell within the scope of the measures by 44 percent, whereby the flu season ended prematurely. The reproductive number for influenza therefore drops from 1.28 to 0.72.
Similar results in Shenzhen
The success of this approach was also reflected in the neighboring province of Shenzhen, where similar measures were taken. Around 13 million people live in the province. Researchers at the Guangdong Provincial University showed that the number of reproductions here could even be reduced to 0.4.
Six times higher risk of infection in households
Contact tracking and the consequent quarantine of all those infected proved to be particularly effective. The research team found that the probability of transmission in a household is six times higher than in public. The temporary placement of infected people in quarantine facilities has proven to be an effective measure to reduce household transmissions and break the chain of infection.
Early detection through contact tracking
Through contact tracking, many cases of illness could be discovered much earlier. While it took an average of 4.6 days for an infected person to isolate themselves after the onset of symptoms, it was only 2.7 days among the cases uncovered by contact tracking.
Limitations of the study
While the overall package of measures taken there resulted in effective containment, it remains unclear which partial success the individual measures brought about. And cultural factors certainly play a decisive role in success. For example, far less acceptance would be expected when isolating family members in quarantine facilities in Europe. (vb)
Graduate editor (FH) Volker Blasek
- Benjamin J Cowling, Sheikh Taslim Ali, Tiffany W Y Ng, u.a .: Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study; in: Lancet Public Health, 2020, thelancet.com
- Qifang Bi, Yongsheng Wu, Shujiang Mei, et al .: Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study; in: Lancet Infectious Diseases, 2020, thelancet.com
This article contains general information only and should not be used for self-diagnosis or treatment. He can not substitute a visit at the doctor.