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Epidemiological characteristics of the first 100 cases of coronavirus disease 2019 (COVID-19) in Hong Kong Special Administrative Region, China, a city with a stringent containment policy.
Int J Epidemiol. 2020 Aug 01; 49(4):1096-1105.IJ

Abstract

BACKGROUND

Hong Kong (HK) is a densely populated city near the epicentre of the coronavirus disease 2019 (COVID-19) outbreak. Stringent border control together with aggressive case finding, contact tracing, social distancing and quarantine measures were implemented to halt the importation and spread of the virus.

METHODS

We performed an epidemiological study using government information covering the first 100 confirmed cases to examine the epidemic curve, incidence, clusters, reproduction number (Rt), incubation period and time to containment.

RESULTS

A total of 93 of the 100 cases were HK residents (6 infected in Mainland China, 10 on the Diamond Princess Cruise). Seven were visitors infected in Mainland China before entering HK. The majority (76%) were aged ≥45 years, and the incidence increased with age (P < 0.001). Escalation of border control measures correlated with a decrease in the proportion (62.5% to 0%) of cases imported from Mainland China, and a reduction in Rt (1.07 to 0.75). The median incubation period was 4.2 days [95% confidence interval (CI), 4.0-4.5; 5th and 95th percentiles: 1.3 and 14.0). Most clusters with identifiable epidemiological links were households involving 2-4 people. Three medium-spreading events were identified: two from New Year gatherings (6-11 people), and another from environmental contamination of a worship hall (12 people). Despite intensified contact tracing, containment was delayed in 78.9% of cases (mean = 5.96 days, range = 0-24 days). An unusual transmission in a multi-storey building via faulty toilet plumbing was suspected with >100 residents evacuated overnight. Our analysis indicated that faulty plumbing was unlikely to be the source of this transmission.

CONCLUSION

Timely stringent containment policies minimized the importation and transmission of COVID-19 in HK.

Authors+Show Affiliations

Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. Centre for Health System and Policy Research, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32601677

Citation

Lai, Christopher K C., et al. "Epidemiological Characteristics of the First 100 Cases of Coronavirus Disease 2019 (COVID-19) in Hong Kong Special Administrative Region, China, a City With a Stringent Containment Policy." International Journal of Epidemiology, vol. 49, no. 4, 2020, pp. 1096-1105.
Lai CKC, Ng RWY, Wong MCS, et al. Epidemiological characteristics of the first 100 cases of coronavirus disease 2019 (COVID-19) in Hong Kong Special Administrative Region, China, a city with a stringent containment policy. Int J Epidemiol. 2020;49(4):1096-1105.
Lai, C. K. C., Ng, R. W. Y., Wong, M. C. S., Chong, K. C., Yeoh, Y. K., Chen, Z., & Chan, P. K. S. (2020). Epidemiological characteristics of the first 100 cases of coronavirus disease 2019 (COVID-19) in Hong Kong Special Administrative Region, China, a city with a stringent containment policy. International Journal of Epidemiology, 49(4), 1096-1105. https://doi.org/10.1093/ije/dyaa106
Lai CKC, et al. Epidemiological Characteristics of the First 100 Cases of Coronavirus Disease 2019 (COVID-19) in Hong Kong Special Administrative Region, China, a City With a Stringent Containment Policy. Int J Epidemiol. 2020 Aug 1;49(4):1096-1105. PubMed PMID: 32601677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiological characteristics of the first 100 cases of coronavirus disease 2019 (COVID-19) in Hong Kong Special Administrative Region, China, a city with a stringent containment policy. AU - Lai,Christopher K C, AU - Ng,Rita W Y, AU - Wong,Martin C S, AU - Chong,Ka Chun, AU - Yeoh,Yun Kit, AU - Chen,Zigui, AU - Chan,Paul K S, PY - 2020/5/19/received PY - 2020/5/20/accepted PY - 2020/7/1/pubmed PY - 2020/11/25/medline PY - 2020/7/1/entrez KW - COVID-19 KW - containment policy KW - epidemic curve KW - novel coronavirus KW - social distancing measures SP - 1096 EP - 1105 JF - International journal of epidemiology JO - Int J Epidemiol VL - 49 IS - 4 N2 - BACKGROUND: Hong Kong (HK) is a densely populated city near the epicentre of the coronavirus disease 2019 (COVID-19) outbreak. Stringent border control together with aggressive case finding, contact tracing, social distancing and quarantine measures were implemented to halt the importation and spread of the virus. METHODS: We performed an epidemiological study using government information covering the first 100 confirmed cases to examine the epidemic curve, incidence, clusters, reproduction number (Rt), incubation period and time to containment. RESULTS: A total of 93 of the 100 cases were HK residents (6 infected in Mainland China, 10 on the Diamond Princess Cruise). Seven were visitors infected in Mainland China before entering HK. The majority (76%) were aged ≥45 years, and the incidence increased with age (P < 0.001). Escalation of border control measures correlated with a decrease in the proportion (62.5% to 0%) of cases imported from Mainland China, and a reduction in Rt (1.07 to 0.75). The median incubation period was 4.2 days [95% confidence interval (CI), 4.0-4.5; 5th and 95th percentiles: 1.3 and 14.0). Most clusters with identifiable epidemiological links were households involving 2-4 people. Three medium-spreading events were identified: two from New Year gatherings (6-11 people), and another from environmental contamination of a worship hall (12 people). Despite intensified contact tracing, containment was delayed in 78.9% of cases (mean = 5.96 days, range = 0-24 days). An unusual transmission in a multi-storey building via faulty toilet plumbing was suspected with >100 residents evacuated overnight. Our analysis indicated that faulty plumbing was unlikely to be the source of this transmission. CONCLUSION: Timely stringent containment policies minimized the importation and transmission of COVID-19 in HK. SN - 1464-3685 UR - https://www.unboundmedicine.com/medline/citation/32601677/Epidemiological_characteristics_of_the_first_100_cases_of_coronavirus_disease_2019__COVID_19__in_Hong_Kong_Special_Administrative_Region_China_a_city_with_a_stringent_containment_policy_ DB - PRIME DP - Unbound Medicine ER -