Quarantine Methods and Prevention of Secondary Outbreak of Pandemic (H1N1) 2009

Chu, Chenyi; Li, Chengyi; Zhang, Hui; Wang, Yong; Huo, Dong Hui; Wen, Liang; Yin, Zhi-Tao; Li, Feng; Song, Hongbin

doi:10.3201/eid1608.091787

Cited by 15 publications

(17 citation statements)

References 2 publications

(2 reference statements)

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“…At present, the quarantining of family and close contacts of confirmed cases is crucial, as shown by the substantial increase in infection rates among individuals who shared living spaces and bathrooms during the 2009 H1N1 influenza pandemic in China, despite the regular disinfection of these areas. 35 The protocols in place at present, including the use of specialist ambulances, negative pressure isolation rooms, and ultraviolet disinfection, will assist in isolating the infection and preventing transmission events at health-care facilities, as was seen during the 2003 SARS outbreak. 21 Since at least 15 medical staff in Wuhan have contracted the virus, 3 Singapore has provided full personal protective equipment for health-care workers; however, the results of our study suggest that community transmission will substantially contribute to transmission should local containment fail despite these measures.…”

Section: Discussionmentioning

confidence: 99%

Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study

Koo

Cook

Park

et al. 2020

The Lancet Infectious Diseases

729

683

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Background Since the coronavirus disease 2019 outbreak began in the Chinese city of Wuhan on Dec 31, 2019, 68 imported cases and 175 locally acquired infections have been reported in Singapore. We aimed to investigate options for early intervention in Singapore should local containment (eg, preventing disease spread through contact tracing efforts) be unsuccessful. MethodsWe adapted an influenza epidemic simulation model to estimate the likelihood of human-to-human transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a simulated Singaporean population. Using this model, we estimated the cumulative number of SARS-CoV-2 infections at 80 days, after detection of 100 cases of community transmission, under three infectivity scenarios (basic reproduction number [R 0 ] of 1•5, 2•0, or 2•5) and assuming 7·5% of infections are asymptomatic. We first ran the model assuming no intervention was in place (baseline scenario), and then assessed the effect of four intervention scenarios compared with a baseline scenario on the size and progression of the outbreak for each R 0 value. These scenarios included isolation measures for infected individuals and quarantining of family members (hereafter referred to as quarantine); quarantine plus school closure; quarantine plus workplace distancing; and quarantine, school closure, and workplace distancing (hereafter referred to as the combined intervention). We also did sensitivity analyses by altering the asymptomatic fraction of infections (22·7%, 30·0%, 40·0%, and 50·0%) to compare outbreak sizes under the same control measures.Findings For the baseline scenario, when R 0 was 1·5, the median cumulative number of infections at day 80 was 279 000 (IQR 245 000-320 000), corresponding to 7•4% (IQR 6·5-8·5) of the resident population of Singapore. The median number of infections increased with higher infectivity: 727 000 cases (670 000-776 000) when R 0 was 2·0, corresponding to 19•3% (17•8-20•6) of the Singaporean population, and 1 207 000 cases (1 164 000-1 249 000) when R 0 was 2·5, corresponding to 32% (30•9-33•1) of the Singaporean population. Compared with the baseline scenario, the combined intervention was the most effective, reducing the estimated median number of infections by 99•3% (IQR 92•6-99•9) when R 0 was 1·5, by 93·0% (81•5-99•7) when R 0 was 2·0, and by 78•2% (59·0 -94•4) when R 0 was 2·5. Assuming increasing asymptomatic fractions up to 50·0%, up to 277 000 infections were estimated to occur at day 80 with the combined intervention relative to 1800 for the baseline at R 0 of 1·5.Interpretation Implementing the combined intervention of quarantining infected individuals and their family members, workplace distancing, and school closure once community transmission has been detected could substantially reduce the number of SARS-CoV-2 infections. We therefore recommend immediate deployment of this strategy if local secondary transmission is confirmed within Singapore. However, quarantine and workplace distancing should be prioritised over school cl...

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Section: Discussionmentioning

confidence: 99%

Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study

Koo

Cook

Park

et al. 2020

The Lancet Infectious Diseases

729

683

View full text Add to dashboard Cite

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“…Among the excluded articles, 19 were identified as not being RCT, however met other inclusion criteria . The level of evidence types consisted of seven level III‐2 studies (prospective/retrospective cohort, case control and quasi‐experimental) with the remaining studies being level III‐3 (retrospective cross‐sectional, cross‐sectional, historical observational).…”

Section: Resultsmentioning

confidence: 99%

“…Among the excluded articles, 19 were identified as not being RCT, however met other inclusion criteria. 5,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] The level of evidence types consisted of seven level III-2 studies (prospective/retrospective cohort, case control and quasi-experimental) with the remaining studies being level III-3 (retrospective cross-sectional, cross-sectional, historical observational). The overall quality of these excluded studies was poor, with only a small number representing a low risk of bias.…”

Section: Excluded Studiesmentioning

confidence: 99%

Use of non‐pharmaceutical interventions to reduce the transmission of influenza in adults: A systematic review

et al. 2015

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During seasonal influenza epidemics and pandemics, virus transmission causes significant public health concern. Reduction of viral transmission by non-pharmaceutical interventions (NPI) has a significant appeal and is often recommended. However, the efficacy of such interventions is unclear. A systematic literature review was undertaken to identify and evaluate the published literature on NPI efficacy to prevent human transmission of influenza virus in adults. Reviewers assessed the quality of eligible studies utilizing the Critical Appraisal Skills Programme for bias and the Scottish Intercollegiate Guidelines Network for methodological quality. Studies were assessed for risk of bias domains of random sequence generation, allocation concealment, attribution bias, selective reporting and blinding. Relevant citations of 2247 were reduced to 100 for full-text evaluation. Only seven met all selection criteria and pooled analysis was not feasible. Of the seven studies, two were randomized controlled trials (RCT) and five were cluster RCT. The main NPI studied were disinfection and hygiene; barriers; and combined NPI. However, these seven RCT had significant design flaws. Only two studies used laboratory confirmed influenza and poor statistical power was a major problem. Positive significant interventions included professional oral hygiene intervention in the elderly and hand washing. Despite the potential for NPI in preventing influenza transmission, there is very limited data available. Hand washing and dental hygiene may be useful, but other interventions have not been fully assessed. Properly designed studies evaluating large populations including ‘at risk’ patients and in a variety of communities are needed.

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“…Current plans should be reviewed and revised based on lessons learned during the pH1N1 pandemic. 6,7,[17][18][19][20][21][22] However, as that experience illustrated, we can never conceive of all possible scenarios ahead of time, will always want additional information, and need a flexible framework for making and communicating decisions. Despite advances in vaccine production and distribution, it is unlikely that a well-matched vaccine will be available at the onset of the next pandemic.…”

Section: Discussionmentioning

confidence: 99%

Selecting Nonpharmaceutical Strategies to Minimize Influenza Spread: The 2009 Influenza A (H1N1) Pandemic and beyond

et al. 2012

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Shortly after the influenza A (H1N1) 2009 pandemic began, the U.S. government provided guidance to state and local authorities to assist decision-making for the use of nonpharmaceutical strategies to minimize influenza spread. This guidance included recommendations for flexible decision-making based on outbreak severity, and it allowed for uncertainty and course correction as the pandemic progressed. These recommendations build on a foundation of local, collaborative planning and posit a series of questions regarding epidemiology, the impact on the health-care system, and locally determined feasibility and acceptability of nonpharmaceutical strategies. This article describes recommendations and key questions for decision makers.

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Quarantine Methods and Prevention of Secondary Outbreak of Pandemic (H1N1) 2009

Abstract: Quarantine Methods and Secondary Outbreak Prevention

Cited by 15 publications

References 2 publications

Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study

Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study

Use of non‐pharmaceutical interventions to reduce the transmission of influenza in adults: A systematic review

Selecting Nonpharmaceutical Strategies to Minimize Influenza Spread: The 2009 Influenza A (H1N1) Pandemic and beyond

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