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Article: Comparison of control and transmission of COVID-19 across epidemic waves in Hong Kong: an observational study

TitleComparison of control and transmission of COVID-19 across epidemic waves in Hong Kong: an observational study
Authors
KeywordsControl
COVID-19
Disease burden
Impact
Interventions
Pandemic preparedness
Pandemic responses
Public health
SARS-CoV-2
Issue Date1-Feb-2024
PublisherElsevier
Citation
The Lancet Regional Health - Western Pacific, 2024, v. 43 How to Cite?
Abstract

Background

Hong Kong contained COVID-19 for two years but experienced a large epidemic of Omicron BA.2 in early 2022 and endemic transmission of Omicron subvariants thereafter. We reflected on pandemic preparedness and responses by assessing COVID-19 transmission and associated disease burden in the context of implementation of various public health and social measures (PHSMs).

Methods

We examined the use and impact of pandemic controls in Hong Kong by analysing data on more than 1.7 million confirmed COVID-19 cases and characterizing the temporal changes non-pharmaceutical and pharmaceutical interventions implemented from January 2020 through to 30 December 2022. We estimated the daily effective reproductive number (Rt) to track changes in transmissibility and effectiveness of community-based measures against infection over time. We examined the temporal changes of pharmaceutical interventions, mortality rate and case-fatality risks (CFRs), particularly among older adults.

Findings

Hong Kong experienced four local epidemic waves predominated by the ancestral strain in 2020 and early 2021 and prevented multiple SARS-CoV-2 variants from spreading in the community before 2022. Strict travel-related, case-based, and community-based measures were increasingly tightened in Hong Kong over the first two years of the pandemic. However, even very stringent measures were unable to contain the spread of Omicron BA.2 in Hong Kong. Despite high overall vaccination uptake (>70% with at least two doses), high mortality was observed during the Omicron BA.2 wave due to lower vaccine coverage (42%) among adults ≥65 years of age. Increases in antiviral usage and vaccination uptake over time through 2022 was associated with decreased case fatality risks.

Interpretation

Integrated strict measures were able to reduce importation risks and interrupt local transmission to contain COVID-19 transmission and disease burden while awaiting vaccine development and rollout. Increasing coverage of pharmaceutical interventions among high-risk groups reduced infection-related mortality and mitigated the adverse health impact of the pandemic.


Persistent Identifierhttp://hdl.handle.net/10722/340672
ISSN
2023 Impact Factor: 7.6
2023 SCImago Journal Rankings: 2.197
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYang, Bingyi-
dc.contributor.authorLin, Yun-
dc.contributor.authorXiong, Weijia-
dc.contributor.authorLiu, Chang-
dc.contributor.authorGao, Huizhi-
dc.contributor.authorHo, Faith-
dc.contributor.authorZhou, Jiayi-
dc.contributor.authorZhang, Ru-
dc.contributor.authorWong, Jessica Y-
dc.contributor.authorCheung, Justin K-
dc.contributor.authorLau, Eric HY-
dc.contributor.authorTsang, Tim K-
dc.contributor.authorXiao, Jingyi-
dc.contributor.authorWong, Irene OL-
dc.contributor.authorMartín-Sánchez, Mario-
dc.contributor.authorLeung, Gabriel M-
dc.contributor.authorCowling, Benjamin J-
dc.contributor.authorWu, Peng-
dc.date.accessioned2024-03-11T10:46:18Z-
dc.date.available2024-03-11T10:46:18Z-
dc.date.issued2024-02-01-
dc.identifier.citationThe Lancet Regional Health - Western Pacific, 2024, v. 43-
dc.identifier.issn2666-6065-
dc.identifier.urihttp://hdl.handle.net/10722/340672-
dc.description.abstract<h3>Background</h3><p>Hong Kong contained COVID-19 for two years but experienced a large epidemic of Omicron BA.2 in early 2022 and endemic transmission of Omicron subvariants thereafter. We reflected on pandemic preparedness and responses by assessing COVID-19 transmission and associated disease burden in the context of implementation of various public health and social measures (PHSMs).</p><h3>Methods</h3><p>We examined the use and impact of pandemic controls in Hong Kong by analysing data on more than 1.7 million confirmed COVID-19 cases and characterizing the temporal changes non-pharmaceutical and pharmaceutical interventions implemented from January 2020 through to 30 December 2022. We estimated the daily effective reproductive number (<em>R</em><sub>t</sub>) to track changes in transmissibility and effectiveness of community-based measures against infection over time. We examined the temporal changes of pharmaceutical interventions, mortality rate and case-fatality risks (CFRs), particularly among older adults.</p><h3>Findings</h3><p>Hong Kong experienced four local epidemic waves predominated by the ancestral strain in 2020 and early 2021 and prevented multiple SARS-CoV-2 variants from spreading in the community before 2022. Strict travel-related, case-based, and community-based measures were increasingly tightened in Hong Kong over the first two years of the pandemic. However, even very stringent measures were unable to contain the spread of Omicron BA.2 in Hong Kong. Despite high overall vaccination uptake (>70% with at least two doses), high mortality was observed during the Omicron BA.2 wave due to lower vaccine coverage (42%) among adults ≥65 years of age. Increases in antiviral usage and vaccination uptake over time through 2022 was associated with decreased case fatality risks.</p><h3>Interpretation</h3><p>Integrated strict measures were able to reduce importation risks and interrupt local transmission to contain COVID-19 transmission and disease burden while awaiting vaccine development and rollout. Increasing coverage of pharmaceutical interventions among high-risk groups reduced infection-related mortality and mitigated the adverse health impact of the pandemic.</p>-
dc.languageeng-
dc.publisherElsevier-
dc.relation.ispartofThe Lancet Regional Health - Western Pacific-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectControl-
dc.subjectCOVID-19-
dc.subjectDisease burden-
dc.subjectImpact-
dc.subjectInterventions-
dc.subjectPandemic preparedness-
dc.subjectPandemic responses-
dc.subjectPublic health-
dc.subjectSARS-CoV-2-
dc.titleComparison of control and transmission of COVID-19 across epidemic waves in Hong Kong: an observational study-
dc.typeArticle-
dc.identifier.doi10.1016/j.lanwpc.2023.100969-
dc.identifier.scopuseid_2-s2.0-85177782103-
dc.identifier.volume43-
dc.identifier.isiWOS:001123353400001-
dc.identifier.issnl2666-6065-

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