Impact of Mass Screening on the Number of Confirmed Cases, Recovered Cases, and Deaths Due to COVID-19 in Iran: An Interrupted Time Series Analysis

Abstract

Background: Mass screening for the coronavirus disease 2019 (COVID-19) began in Iran on March 23, 2020, with the purpose of improving early detection of patients for their own health and to prevent onward transmission to others. In this study, we evaluated the impact of the change towards mass screening on new cases reported, cases recovered, and deaths due to COVID-19. Methods: This study analyzed the daily reports on the number of new cases confirmed by polymerase chain reaction (PCR) testing, cases recovered, and deaths due to COVID-19 provided to the Ministry of Health and Medical Education of Iran. Changes in trends on these outcomes were evaluated using interrupted time series analysis. Results: From February 19 to May 6, 2020, a total of 519544 COVID-19 tests were done and 101650 diagnoses were made (case/ test ratio 19.6%). For the same period, 6418 deaths due to COVID-19 were reported (case fatality ratio 6.3%). The number of cases detected increased significantly over the period of scale-up of mass screening (P=0.003), as did the number of recovered cases (P=0.001). The number of deaths due to COVID-19 did not change before versus after mass screening. Conclusion: Following the scale-up of mass screening for COVID-19 in Iran, the rate of new cases detected and reported recovered accelerated significantly. Mass screening is likely to have detected many mild and asymptomatic cases that were infectious. Our data support the role that mass screening, coupled with isolation and contract tracing, can have in slowing the COVID-19 epidemic.

Effectiveness of non-pharmaceutical public health interventions against COVID-19: A systematic review and meta-analysis

“…We excluded 74 papers from the systematic review due to using modelling studies/simulation/scenario (n = 56), exploring the irrelevant outcomes (n = 2), theoretical paper (n = 2), a specific small population (n = 1), irrelevant comparison (n = 2), multicounty studies in which there were no country-level data or several countries were considered as a single unit of observation (n = 3), and not being peer-reviewed (n = 8). Additionally, 12 studies were not included in the meta-analysis due to inadequate data for estimating the effect size [24][25][26][27][28][29][30][31][32][33][34][35]. Through the precise and vigorous review of the full texts of the relevant studies, we found that 35 articles qualified to be included in the systematic review based on the previously mentioned eligibility criteria .…”

Dissection of non-pharmaceutical interventions implemented by Iran, South Korea, and Turkey in the fight against COVID-19 pandemic

“…Noticeably, enhancing test capacity has contributed to an increase in COVID-19 incidence rates [ 4 ]. Consistent with this concept, in March 2020, throughout a mass screening by the Iranian government, the number of cases detected increased significantly (P = 0.003), in addition to the number of recovered cases (P = 0.001); although, the number of deaths due to COVID-19 did not change during the same period [ 65 ]. In South Korea and Turkey, specific clusters of suspected people were recognized with contact tracing and screening.…”

“…Even though Turkey and Iran had the same strategy to assess suspected individuals through the whole population, Iran did not invest enough in mass screening, leading to pointless and unfruitful results. On the other side, South Korea has developed different screening strategies by conducting PCR tests for suspected clusters and high-risk individuals recognized by smart tracing and tracking [ 13 , 65 ]. Noticeably, enhancing test capacity has contributed to an increase in COVID-19 incidence rates [ 4 ].…”

Alcohol: A Double-Edged Sword in the Fight Against COVID-19

“…Currently, most countries are facing the coronavirus disease 2019 (COVID-19) pandemic worldwide. The social media and news websites spread information about selfprotecting with alcohol, some of which are mainly beneficial to the individuals, and some are misinformation (1).…”