Evidence map›Paper›PMID 32511601›Full record

ArticlemedRxiv : the preprint server for health sciences2020

Effect of non-pharmaceutical interventions for containing the COVID-19 outbreak in China.

Shengjie Lai, Nick W Ruktanonchai, Liangcai Zhou, Olivia Prosper, Wei Luo, Jessica R Floyd, Amy Wesolowski, Mauricio Santillana, Chi Zhang, Xiangjun Du and 2 more

Open access · greenAbstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 238 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 3 countries.

Shengjie LaiWorldPop, School of Geography and Environmental Science, University of Southampton, UK (S Lai PhD, N W R Ruktanonchai PhD, J R Floyd, Prof A J Tatem PhD); Wuhan Center for Disease Control and Prevention, Wuhan, Hubei Province, China (L Zhou MD); Department of Mathematics, University of Tennessee, Knoxville, TN, USA (O Prosper PhD); Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA (W Luo PhD, M Santillana PhD); Department of Pediatrics, Harvard Medical School, Boston, MA, USA (W Luo, M Santillana); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (A Weolowski PhD); School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China (C Zhang, Prof X Du PhD); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (Prof H Yu PhD, S Lai).
Nick W RuktanonchaiWorldPop, School of Geography and Environmental Science, University of Southampton, UK (S Lai PhD, N W R Ruktanonchai PhD, J R Floyd, Prof A J Tatem PhD); Wuhan Center for Disease Control and Prevention, Wuhan, Hubei Province, China (L Zhou MD); Department of Mathematics, University of Tennessee, Knoxville, TN, USA (O Prosper PhD); Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA (W Luo PhD, M Santillana PhD); Department of Pediatrics, Harvard Medical School, Boston, MA, USA (W Luo, M Santillana); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (A Weolowski PhD); School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China (C Zhang, Prof X Du PhD); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (Prof H Yu PhD, S Lai).
Liangcai ZhouWorldPop, School of Geography and Environmental Science, University of Southampton, UK (S Lai PhD, N W R Ruktanonchai PhD, J R Floyd, Prof A J Tatem PhD); Wuhan Center for Disease Control and Prevention, Wuhan, Hubei Province, China (L Zhou MD); Department of Mathematics, University of Tennessee, Knoxville, TN, USA (O Prosper PhD); Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA (W Luo PhD, M Santillana PhD); Department of Pediatrics, Harvard Medical School, Boston, MA, USA (W Luo, M Santillana); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (A Weolowski PhD); School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China (C Zhang, Prof X Du PhD); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (Prof H Yu PhD, S Lai).
Olivia ProsperWorldPop, School of Geography and Environmental Science, University of Southampton, UK (S Lai PhD, N W R Ruktanonchai PhD, J R Floyd, Prof A J Tatem PhD); Wuhan Center for Disease Control and Prevention, Wuhan, Hubei Province, China (L Zhou MD); Department of Mathematics, University of Tennessee, Knoxville, TN, USA (O Prosper PhD); Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA (W Luo PhD, M Santillana PhD); Department of Pediatrics, Harvard Medical School, Boston, MA, USA (W Luo, M Santillana); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (A Weolowski PhD); School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China (C Zhang, Prof X Du PhD); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (Prof H Yu PhD, S Lai).
Wei LuoWorldPop, School of Geography and Environmental Science, University of Southampton, UK (S Lai PhD, N W R Ruktanonchai PhD, J R Floyd, Prof A J Tatem PhD); Wuhan Center for Disease Control and Prevention, Wuhan, Hubei Province, China (L Zhou MD); Department of Mathematics, University of Tennessee, Knoxville, TN, USA (O Prosper PhD); Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA (W Luo PhD, M Santillana PhD); Department of Pediatrics, Harvard Medical School, Boston, MA, USA (W Luo, M Santillana); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (A Weolowski PhD); School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China (C Zhang, Prof X Du PhD); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (Prof H Yu PhD, S Lai).
Jessica R FloydWorldPop, School of Geography and Environmental Science, University of Southampton, UK (S Lai PhD, N W R Ruktanonchai PhD, J R Floyd, Prof A J Tatem PhD); Wuhan Center for Disease Control and Prevention, Wuhan, Hubei Province, China (L Zhou MD); Department of Mathematics, University of Tennessee, Knoxville, TN, USA (O Prosper PhD); Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA (W Luo PhD, M Santillana PhD); Department of Pediatrics, Harvard Medical School, Boston, MA, USA (W Luo, M Santillana); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (A Weolowski PhD); School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China (C Zhang, Prof X Du PhD); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (Prof H Yu PhD, S Lai).
Amy WesolowskiWorldPop, School of Geography and Environmental Science, University of Southampton, UK (S Lai PhD, N W R Ruktanonchai PhD, J R Floyd, Prof A J Tatem PhD); Wuhan Center for Disease Control and Prevention, Wuhan, Hubei Province, China (L Zhou MD); Department of Mathematics, University of Tennessee, Knoxville, TN, USA (O Prosper PhD); Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA (W Luo PhD, M Santillana PhD); Department of Pediatrics, Harvard Medical School, Boston, MA, USA (W Luo, M Santillana); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (A Weolowski PhD); School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China (C Zhang, Prof X Du PhD); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (Prof H Yu PhD, S Lai).
Mauricio SantillanaWorldPop, School of Geography and Environmental Science, University of Southampton, UK (S Lai PhD, N W R Ruktanonchai PhD, J R Floyd, Prof A J Tatem PhD); Wuhan Center for Disease Control and Prevention, Wuhan, Hubei Province, China (L Zhou MD); Department of Mathematics, University of Tennessee, Knoxville, TN, USA (O Prosper PhD); Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA (W Luo PhD, M Santillana PhD); Department of Pediatrics, Harvard Medical School, Boston, MA, USA (W Luo, M Santillana); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (A Weolowski PhD); School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China (C Zhang, Prof X Du PhD); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (Prof H Yu PhD, S Lai).
Chi ZhangWorldPop, School of Geography and Environmental Science, University of Southampton, UK (S Lai PhD, N W R Ruktanonchai PhD, J R Floyd, Prof A J Tatem PhD); Wuhan Center for Disease Control and Prevention, Wuhan, Hubei Province, China (L Zhou MD); Department of Mathematics, University of Tennessee, Knoxville, TN, USA (O Prosper PhD); Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA (W Luo PhD, M Santillana PhD); Department of Pediatrics, Harvard Medical School, Boston, MA, USA (W Luo, M Santillana); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (A Weolowski PhD); School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China (C Zhang, Prof X Du PhD); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (Prof H Yu PhD, S Lai).
Xiangjun DuWorldPop, School of Geography and Environmental Science, University of Southampton, UK (S Lai PhD, N W R Ruktanonchai PhD, J R Floyd, Prof A J Tatem PhD); Wuhan Center for Disease Control and Prevention, Wuhan, Hubei Province, China (L Zhou MD); Department of Mathematics, University of Tennessee, Knoxville, TN, USA (O Prosper PhD); Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA (W Luo PhD, M Santillana PhD); Department of Pediatrics, Harvard Medical School, Boston, MA, USA (W Luo, M Santillana); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (A Weolowski PhD); School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China (C Zhang, Prof X Du PhD); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (Prof H Yu PhD, S Lai).
Hongjie YuWorldPop, School of Geography and Environmental Science, University of Southampton, UK (S Lai PhD, N W R Ruktanonchai PhD, J R Floyd, Prof A J Tatem PhD); Wuhan Center for Disease Control and Prevention, Wuhan, Hubei Province, China (L Zhou MD); Department of Mathematics, University of Tennessee, Knoxville, TN, USA (O Prosper PhD); Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA (W Luo PhD, M Santillana PhD); Department of Pediatrics, Harvard Medical School, Boston, MA, USA (W Luo, M Santillana); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (A Weolowski PhD); School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China (C Zhang, Prof X Du PhD); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (Prof H Yu PhD, S Lai).
Andrew J TatemWorldPop, School of Geography and Environmental Science, University of Southampton, UK (S Lai PhD, N W R Ruktanonchai PhD, J R Floyd, Prof A J Tatem PhD); Wuhan Center for Disease Control and Prevention, Wuhan, Hubei Province, China (L Zhou MD); Department of Mathematics, University of Tennessee, Knoxville, TN, USA (O Prosper PhD); Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA (W Luo PhD, M Santillana PhD); Department of Pediatrics, Harvard Medical School, Boston, MA, USA (W Luo, M Santillana); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA (A Weolowski PhD); School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China (C Zhang, Prof X Du PhD); School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China (Prof H Yu PhD, S Lai).
Johns Hopkins University · USBoston Children's Hospital · US

Funding

Virology &ImmunologyU19AI051915 · NIAID · NATIONAL CENTER FOR AIDS/STD CONTROL AND PREVENTION · PI HE, WEI · 2002 to 2009
$21.6M
Development of an Open-Source and Data-Driven Modeling Platform to Monitor and Forecast Disease ActivityR01GM130668 · NIGMS · NORTHEASTERN UNIVERSITY · PI SANTILLANA, MAURICIO · 2018 to 2022
$1.9M
NIAID NIH HHS U19 AI051915NIGMS NIH HHS R01 GM130668Wellcome Trust
6 · The paper itself

Abstract

backgroundThe COVID-19 outbreak containment strategies in China based on non-pharmaceutical interventions (NPIs) appear to be effective. Quantitative research is still needed however to assess the efficacy of different candidate NPIs and their timings to guide ongoing and future responses to epidemics of this emerging disease across the World.

methodsWe built a travel network-based susceptible-exposed-infectious-removed (SEIR) model to simulate the outbreak across cities in mainland China. We used epidemiological parameters estimated for the early stage of outbreak in Wuhan to parameterise the transmission before NPIs were implemented. To quantify the relative effect of various NPIs, daily changes of delay from illness onset to the first reported case in each county were used as a proxy for the improvement of case identification and isolation across the outbreak. Historical and near-real time human movement data, obtained from Baidu location-based service, were used to derive the intensity of travel restrictions and contact reductions across China. The model and outputs were validated using daily reported case numbers, with a series of sensitivity analyses conducted.

resultsWe estimated that there were a total of 114,325 COVID-19 cases (interquartile range [IQR] 76,776 - 164,576) in mainland China as of February 29, 2020, and these were highly correlated (p<0.001, R2=0.86) with reported incidence. Without NPIs, the number of COVID-19 cases would likely have shown a 67-fold increase (IQR: 44 - 94), with the effectiveness of different interventions varying. The early detection and isolation of cases was estimated to prevent more infections than travel restrictions and contact reductions, but integrated NPIs would achieve the strongest and most rapid effect. If NPIs could have been conducted one week, two weeks, or three weeks earlier in China, cases could have been reduced by 66%, 86%, and 95%, respectively, together with significantly reducing the number of affected areas. However, if NPIs were conducted one week, two weeks, or three weeks later, the number of cases could have shown a 3-fold, 7-fold, and 18-fold increase across China, respectively. Results also suggest that the social distancing intervention should be continued for the next few months in China to prevent case numbers increasing again after travel restrictions were lifted on February 17, 2020.

conclusionThe NPIs deployed in China appear to be effectively containing the COVID-19 outbreak, but the efficacy of the different interventions varied, with the early case detection and contact reduction being the most effective. Moreover, deploying the NPIs early is also important to prevent further spread. Early and integrated NPI strategies should be prepared, adopted and adjusted to minimize health, social and economic impacts in affected regions around the World.

Identifiers

PMID32511601
PMCPMC7276028
OpenAlexW3009826263

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.