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Abstract/Summary
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ABSTRACT:
In order to rapidly inform polices in the international response to the ongoing pandemic of coronavirus disease 19 (COVID-19), we summarize in this review current evidence on epidemiological and clinical features of the infection, transmission routes, problems of nucleic-acid testing, the epidemiological trend in China and impact of interventional measures, and some lessons learned. We concluded that the epidemic is containable with traditional nonpharmacological interventions, mainly through social distancing and finding and isolating suspected patients and close contacts. Nonpharmacological interventions are the only effective measures currently accessible and have suppressed some 90% of the infections in China. Close contacts are the major mechanism of transmission, which makes it possible to control this epidemic through nonpharmacological methods. Nucleic-acid testing alone may miss some 50% of infected patients, and other methods such as chest computerized tomography (CT) or serology should be considered to supplement molecular testing. The development of vaccines and drugs is important, but hesitation to make use of nonpharmacological interventions may mean missing golden opportunities for effective actions.
AUTHOR SUMMARY:
In particular, we summarize the origin of the pathogen, epidemiological and clinical features of the infection, transmission routes and transmissibility, problems of nucleic-acid testing and diagnostic criteria, the epidemiological trend in China and its relation to interventional measures, and special issues including infection in doctors and children and the role of vaccines versus traditional nonpharmacological interventions in control of the epidemic. Importantly, evidence clearly suggests the following: The epidemic is containable with traditional nonpharmacological interventions, largely by social distancing and testing and isolation of suspected patients and close contacts.
Nonpharmacological interventions are the most immediately accessible effective measures and have helped suppress some 90% of infections in China.
Close contacts through droplets and fomites are the major mechanism of transmission, and asymptomatic infections and aerosols are unlikely important in spreading the virus. This is a major feature of the virus and explains why it is containable through nonpharmacological methods.
Nucleic-acid testing alone may miss many truly infected patients, and chest CT should always be used if available to supplement molecular testing.
Development of vaccines and drugs are important, but any hesitation to use nonpharmacological interventions may mean missing golden opportunities for useful actions against the epidemic.
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