Fangcang shelter hospitals are a One Health approach for responding to the COVID-19 outbreak in Wuhan, China

• Published in: One health Vol. 10; p. 100167
• Main Authors: Wang, Ke-Wei, Gao, Jie, Song, Xiao-Xiao, Huang, Jiang, Wang, Hua, Wu, Xiao-Long, Yuan, Qin-Fang, Li, Xiao-Shan, Cheng, Feng, Cheng, Yang
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.12.2020; Elsevier
• Subjects: China; COVID-19; COVID-19 infection; environmental health; Epidemiology; Fangcang; health policy; medicine; One Health initiative; psychology; reproduction; Research Paper; SARS-CoV-2; time series analysis; Wuhan; China; COVID-19; SARS-CoV-2; Fangcang; RT-PCR; CI; Wuhan; SARS; Epidemiology; MERS; R(t)
• ISSN: 2352-7714; 2352-7714
• DOI: 10.1016/j.onehlt.2020.100167

In February 2020, the exponential growth of COVID-19 cases in Wuhan city posed a huge economic burden to local medical systems. Consequently, Wuhan established Fangcang Shelter hospitals as a One Health approach for responding to and containing the COVID-19 outbreak by isolating and caring for mild-to-moderate cases. However, it is unclear to what degree the hospitals contained COVID-19. This study performed an interrupted time series analysis to compare the number of new confirmed cases of COVID-19 before and after the operation of Fangcang Shelter hospitals. The initial number of confirmed cases in Wuhan increased significantly by 68.54 cases per day prior to February 4, 2020. Compared with the number of cases noted 20 days before the use of Fangcang Shelter hospitals, a sustained reduction in the number of confirmed cases (trend change, −125.57; P < 0.0001) was noted 41 days after the use of the hospitals. Immediate-level changes were observed for confirmed cases (level change, 725.97; P = 0.025). These changes led to an estimated 5148 fewer confirmed cases (P < 0.0001). According to the mean confirmed cases of 395.71 per day before the intervention, we estimated that Wuhan had advanced the terminal phase of COVID-19 by 13 days. Furthermore, immediately after introduction of Fangcang Shelter Hospitals on February 5, the reproduction number dropped rapidly, from a pre-introduction rate of 4.0 to 2.0. The Fangcang Shelter hospitals most likely to reversed the epidemic trend of COVID-19 while a containment strategy was implemented in Wuhan. In a One Health perspective, Fangcang Shelter hospitals, with their functions of isolation and treatment of confirmed COVID-19 patients, engaging professionals from many disciplines, such as medicine, engineering, architecture, psychology, environmental health, and social sciences. The results of this study provide a valuable reference for health policy makers in other countries. •A sustained reduction and immediate increase in the number of cases were observed in Wuhan city after Fangcang Shelter hospitals were established.•The above changes resulted in an estimated 5148 fewer confirmed cases in Wuhan.•According to the mean confirmed cases of 395.71 per day before the intervention, we estimated that Wuhan had advanced the terminal phase of COVID-19 by 13 days.•Compared to the approximate real-time effective reproduction number [R(t)] of 4.0 in the pre-operation periods of Fangcang Shelter hospitals, the R(t) was less than 2.0 in the post-operation periods.