Estimating the impact of lock-down, quarantine and sensitization in a COVID-19 outbreak: lessons from the COVID-19 outbreak in China

The methodologies to assess the effectiveness of non-pharmaceutical interventions during COVID-19: a systematic review

Non-pharmaceutical interventions, such as school closures and stay-at-home orders, have been implemented around the world to control the spread of SARS-CoV-2. Their effectiveness in improving health-related outcomes has been the subject of numerous empirical studies. However, these studies show fairly large variation among methodologies in use, reflecting the absence of an established methodological framework. On the one hand, variation in methodologies may be desirable to assess the robustness of results; on the other hand, a lack of common standards can impede comparability among studies. To establish a comprehensive overview over the methodologies in use, we conducted a systematic review of studies assessing the effectiveness of non-pharmaceutical interventions between January 1, 2020 and January 12, 2021 (n = 248). We identified substantial variation in methodologies with respect to study setting, outcome, intervention, methodological approach, and effectiveness assessment. On this basis, we point to shortcomings of existing studies and make recommendations for the design of future studies.

The Impact of Lockdown, Patient Classification, and the Large-Scale Case Screening on the Spread of the Coronavirus Disease 2019 (COVID-19) in Hubei

The coronavirus disease (COVID-19) which emerged in Wuhan, China, in December 2019, is widely controlled now in China. However, the global epidemic is still severe. To study and comment on Hubei's approaches for responding to the disease, the paper considered some factors such as suspected cases (part of them are influenza patients or common pneumonia patients, etc.), quarantine, patient classification (three types), clinically diagnosed cases, and lockdown of Wuhan and Hubei. After that, the paper established an SELIHR model based on the surveillance data of Hubei published by the Hubei Health Commission from 10 January 2020 to 30 April 2020 and used the fminsearch optimization method to estimate the optimal parameters of the model. We obtained the basic reproduction number ℛ₀ = 3.1571 from 10 to 22 January. ℛ₀ was calculated as 2.0471 from 23 to 27 January. From 28 January to 30 April, ℛ₀ = 1.5014. Through analysis, it is not hard to find that the patients without classification during the period of confirmed cases will result in the cumulative number of cases in Hubei to increase. In addition, regarding the lockdown measures implemented by Hubei during the epidemic, our simulations also show that if the lockdown time of either Hubei or Wuhan is advanced, it will effectively curb the spread of the epidemic. If the lockdown measures are not taken, the total cumulative number of cases will increase substantially. From the results of the study, it can be concluded that the lockdown, patient classification, and the large-scale case screening are essential to slow the spread of COVID-19, which can provide references for other countries or regions.

Estimating the Effects of the COVID-19 Outbreak on the Reductions in Tuberculosis Cases and the Epidemiological Trends in China: A Causal Impact Analysis

Objective

COVID-19 may have a demonstrable influence on disease patterns. However, it remained unknown how tuberculosis (TB) epidemics are impacted by the COVID-19 outbreak. The purposes of this study are to evaluate the impacts of the COVID-19 outbreak on the decreases in the TB case notifications and to forecast the epidemiological trends in China.

Methods

The monthly TB incidents from January 2005 to December 2020 were taken. Then, we investigated the causal impacts of the COVID-19 pandemic on the TB case reductions using intervention analysis under the Bayesian structural time series (BSTS) method. Next, we split the observed values into different training and testing horizons to validate the forecasting performance of the BSTS method.

Results

The TB incidence was falling during 2005–2020, with an average annual percentage change of −3.186 (95% confidence interval [CI] −4.083 to −2.281), and showed a peak in March–April and a trough in January–February per year. The BSTS method assessed a monthly average reduction of 14% (95% CI 3.8% to 24%) in the TB case notifications from January–December 2020 owing to COVID-19 (probability of causal effect=99.684%, P=0.003), and this method generated a highly accurate forecast for all the testing horizons considering the small forecasting error rates and estimated a continued downward trend from 2021 to 2035 (annual percentage change =−2.869, 95% CI −3.056 to −2.681).

Conclusion

COVID-19 can cause medium- and longer-term consequences for the TB epidemics and the BSTS model has the potential to forecast the epidemiological trends of the TB incidence, which can be recommended as an automated application for public health policymaking in China. Considering the slow downward trend in the TB incidence, additional measures are required to accelerate the progress of the End TB Strategy.