An investigation of transmission control measures during the first 50 days of the COVID-19 epidemic in China

• Published in: Science (American Association for the Advancement of Science) Vol. 368; no. 6491; pp. 638 - 642
• Main Authors: Tian, Huaiyu, Liu, Yonghong, Li, Yidan, Wu, Chieh-Hsi, Chen, Bin, Kraemer, Moritz U. G., Li, Bingying, Cai, Jun, Xu, Bo, Yang, Qiqi, Wang, Ben, Yang, Peng, Cui, Yujun, Song, Yimeng, Zheng, Pai, Wang, Quanyi, Bjornstad, Ottar N., Yang, Ruifu, Grenfell, Bryan T., Pybus, Oliver G., Dye, Christopher
• Format: Journal Article
• Language: English
• Published: United States The American Association for the Advancement of Science 08.05.2020; American Association for the Advancement of Science
• Subjects: Betacoronavirus; Case reports; China - epidemiology; Cities; Communicable Disease Control; Coronaviridae; Coronavirus Infections - epidemiology; Coronavirus Infections - prevention & control; Coronavirus Infections - transmission; Coronaviruses; COVID-19; Disease control; Disease transmission; Emergency preparedness; Emergency response; Entertainment; Epidemics; Epidemiology; Health promotion; Human motion; Humans; Impact analysis; Incidence; Medicine; Models, Statistical; Outbreaks; Pandemics - prevention & control; Pneumonia, Viral - epidemiology; Pneumonia, Viral - prevention & control; Pneumonia, Viral - transmission; Public health; Public Health Practice; Public transportation; Regression Analysis; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Shutdowns; Travel; Viral diseases; Viruses; China
• ISSN: 0036-8075; 1095-9203; 1095-9203
• DOI: 10.1126/science.abb6105

By 23 January 2020, China had imposed a national emergency response to restrict travel and impose social distancing measures on its populace in an attempt to inhibit the transmission of severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2). However, which measures were most effective is uncertain. Tian et al. performed a quantitative analysis of the impact of control measures between 31 December 2019 and 19 February 2020, which encompasses the Lunar New Year period when millions of people traveled across China for family visits. Travel restrictions in and out of Wuhan were too late to prevent the spread of the virus to 262 cities within 28 days. However, the epidemic peaked in Hubei province on 4 February 2020, indicating that measures such as closing citywide public transport and entertainment venues and banning public gatherings combined to avert hundreds of thousands of cases of infection. It is unlikely that this decline happened because the supply of susceptible people was exhausted, so relaxing control measures could lead to a resurgence. Science , this issue p. 638 Travel restrictions and the national emergency response delayed the growth and limited the size of the COVID-19 epidemic in China. Responding to an outbreak of a novel coronavirus [agent of coronavirus disease 2019 (COVID-19)] in December 2019, China banned travel to and from Wuhan city on 23 January 2020 and implemented a national emergency response. We investigated the spread and control of COVID-19 using a data set that included case reports, human movement, and public health interventions. The Wuhan shutdown was associated with the delayed arrival of COVID-19 in other cities by 2.91 days. Cities that implemented control measures preemptively reported fewer cases on average (13.0) in the first week of their outbreaks compared with cities that started control later (20.6). Suspending intracity public transport, closing entertainment venues, and banning public gatherings were associated with reductions in case incidence. The national emergency response appears to have delayed the growth and limited the size of the COVID-19 epidemic in China, averting hundreds of thousands of cases by 19 February (day 50).