Вопросы вирусологии. 2020; 65: 203-211
Закономерности эпидемического распространения SARS-CoV-2 в условиях мегаполиса
https://doi.org/10.36233/0507-4088-2020-65-4-203-211Аннотация
Цель исследования - изучить закономерности, свойственные эпидемическому процессу COVID-19, в условиях мегаполиса, в фазах подъёма, стабилизации и снижения заболеваемости, а также оценить эффективность противоэпидемических мероприятий.
Материал и методы. Проведено комплексное изучение распространения SARS-CoV-2 в Москве с использованием эпидемиологического, молекулярно-генетического и статистического методов исследования в период пандемии COVID-19.
Результаты и обсуждение. Показано, что применение максимально жёстких организационно-ограничительных мер в масштабах Москвы, обеспечивающих разрыв механизма передачи SARS-CoV-2, и высокая дисциплина населения по исполнению режима самоизоляции позволили не допустить экспоненциального роста заболеваемости COVID-19. Анализ динамики выявления новых случаев COVID-19 показал, что эффект от применения мер по разобщению и режима самоизоляции в условиях мегаполиса наступает через временной промежуток, равный 3,5 инкубационного периода, при его максимальной длительности 14 дней. Установлено, что показатель частоты определения РНК SARS-CoV-2 среди условно здорового населения и его динамика - важные параметры мониторинга, особенно на фазах роста и стабилизации заболеваемости COVID-19, позволяющие в перспективе 1-2 инкубационных периодов (14-28 дней) прогнозировать развитие эпидемиологической ситуации. Общий коэффициент летальности, рассчитанный за период наблюдения (06.03.2020-23.06.2020) в Москве, составил 1,73%.
Заключение. В результате проведённого эпидемиологического анализа ситуации с COVID-19 в Москве определены некоторые закономерности распространения SARS-CoV-2 и оценена эффективность противоэпидемических мероприятий, направленных на разрыв механизма передачи возбудителя.
Список литературы
1. Lu R., Zhao X., Li J., Niu P., Yang B., Wu H., et al. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020; 395(10224): 565-74. DOI: http://doi.org/10.1016/S0140-6736(20)30251-8
2. Romagnani P., Gnone G., Guzzi F., Negrini S., Guastalla A., Annun-ziato F., et al. The COVID-19 infection: lessons from the Italian experience. J. Public Health Policy. 2020; 41(3): 238-44. DOI: http://doi.org/10.1057/s41271-020-00229-y
3. Sebastiani G., Massa M., Riboli E. Covid-19 epidemic in Italy: evolution, projections and impact of government measures. Eur. J. Epidemiol. 2020; 35(4): 341-5. DOI: http://doi.org/10.1007/s10654-020-00631-6
4. Rothe C., Schunk M., Sothmann P., Bretzel G., Froeschl G., Wallrauch C., at al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N. Engl. J. Med. 2020; 382(10): 970-1. DOI: http://doi.org/10.1056/NEJMc200146
5. Holshue M.L., DeBolt C., Lindquist S., Lofy K.H., Wiesman J., Bruce H., et al. First case of 2019 novel coronavirus in the United States. N. Engl. J. Med. 2020; 382(10): 929-36. DOI: http://doi.org/10.1056/NEJMoa2001191
6. WHO. Coronavirus disease 2019 (COVID-19) Situation Report - 51. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf
7. Беляков В.Д., Дегтярев А.А., Иванников Ю.Г. Качество и эффективность противоэпидемических мероприятий. Л.: Медицина; 1981.
8. Акимкин В.Г., Кузин С.Н., Шипулина О.Ю., Яцышина С.Б., Ти-ванова Е.В., Каленская А.В. и др. Эпидемиологическое значение определения РНК SARS-CoV-2 среди различных групп населения Москвы и Московской области в период эпидемии COVID-19. Журнал микробиологии, эпидемиологии и иммунобиологии. 2020; 97(3): 197-201. DOI: http://doi.org/10.36233/0372-9311-2020-97-3-197-201
9. Lauer S.A., Grantz K.H., Bi Q., Jones F.K., Zheng Q., Meredith H.R., et al. The incubation period of coronavirus disease 2019 (Covid-19) from publicly reported confirmed cases: estimation and application. Ann. Intern. Med. 2020; 172(9): 577-82. DOI: http://doi.org/10.7326/ M20-0504
10. Backer J.A., Klinkenberg D., Wallinga J. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travelers from Wuhan, China, 20-28 January 2020. Euro Surveill. 2020; 25(5) : 2000062. DOI: http://doi.org/10.2807/1560-7917.ES.2020.25.5.2000062
11. Liu T., Hu J., Kang M., Lin L., Zhong H., Xiao J., et al. Transmission dynamics of 2019 novel coronavirus (2019-nCoV). J. Med. Virol. 2020; 92(5): 501-11. DOI: http://doi.org/10.1101/2020.01.25.919787
12. Read J.M., Bridgen J.R.E., Cummings D.A.T., Ho A., Jewell C.P. Novel coronavirus 2019-nCoV: early estimation of epidemiological parameters and epidemic predictions. medRxiv. 2020. DOI: http://doi.org/10.1101/2020.01.23.20018549
13. Riou J., Althaus C.L. Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020. Euro Surveill. 2020; 25(4): 2000058. DOI: http://doi.org/10.2807/1560-7917.ES.2020.25A2000058.
14. Shen M., Peng Z., Xiao Y., Zhang L. Modelling the epidemic trend of the 2019 novel coronavirus outbreak in China. bioRxiv. 2020. DOI: http://doi.org/10.1101/2020.01.23.916726
15. Wu J.T., Leung K., Leung G.M. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet. 2020; 395(10225): 689-97. DOI: http://doi.org/10.1016/S0140-6736(20)30260-9
16. Randolph H.E., Barreiro L.B. Herd Immunity: Understanding COVID-19. Immunity. 2020; 52(5): 737-41. DOI: http://doi.org/10.1016/j.immuni.2020.04.012
17. Verity R., Okell L.C., Dorigatti I., Winskill P., Whittaker C., Imai N., et al. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect. Dis. 2020; 20(6): 669-77. DOI: http://doi.org/10.1016/S1473
18. Wu J.T., Leung K., Bushman M., Kishore N., Niehus R., de Salazar P.M., et al. Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nat. Med. 2020; 26(4): 506-10. DOI: http://doi.org/10.1038/s41591-020-0822-7-3099(20)30243-7
19. Puca E., Civljak R., Arapovic J., Popescu C., Christova I., Raka L., et al. Short epidemiological overview of the current situation on Covid-19 pandemic in Southeast European (SEE) countries. J. Infect. Dev. Ctries. 2020; 14(5): 433-7. DOI: http://doi.org/10.3855/jidc.12814
20. Abdollahi E., Champredon D., Langley J.M., Galvani A.P., Moghadas S.M. Temporal estimates of case-fatality rate for COVID-19 outbreaks in Canada and the United States. CMAJ. 2020; 192(25): E666-70. DOI: http://doi.org/10.1503/cmaj.200711
21. Xu S., Li Y. Beware of the second wave of COVID-19. Lancet. 2020; 395(10233): 1321-2. DOI: http://doi.org/10.1016/S0140-6736(20)30845-X
22. de Brouwer R., van Veldhuisen D.J., de Boer R.A. Surviving the first COVID-19 wave and learning lessons for the second. Eur. J. Heart Fail. 2020; 22(6): 975-7. DOI: http://doi.org/10.1002/ejhf.1938
23. Vogel L. Is Canada ready for the second wave of COVID-19? CMAJ. 2020; 192(24): E664-5. DOI: http://doi.org/10.1503/cmaj.1095875
24. Ceylan Z. Estimation of COVID-19 Prevalence in Italy, Spain, and France. Sci. Total Environ. 2020; 729: 138817. DOI: http://doi.org/10.1016/j.scitotenv.2020.138817
25. Li Q., Guan X., Wu P., Wang X., Zhou L., Tong Y., et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N. Engl. J. Med. 2020; 382(13): 1199-207. DOI: http://doi.org/10.1056/NEJMoa2001316
26. Chatterjee A., Gerdes M.W., Martinez S.G. Statistical Explorations and Univariate timeseries analysis on COVID-19 datasets to understand the trend of disease spreading and death. Sensors (Basel). 2020; 20(11): 3089. DOI: http://doi.org/10.3390/s20113089
27. Abdollahi E., Champredon D., Langley J.M., Galvani A.P., Moghadas S.M. Temporal estimates of case-fatality rate for COVID-19 outbreaks in Canada and the United States. CMAJ. 2020; 192(25): E666-70. DOI: http://doi.org/10.1503/cmaj.200711
28. Львов Д.К., Альховский С.В. Истоки пандемии COVID-19: экология и генетика коронавирусов (Betacoronavirus: Coronaviridae) SARS-CoV, SARS-CoV-2 (подрод Sarbecovirus), MERS-CoV (подрод Merbecovirus). Вопросы вирусологии. 2020; 65(2): 62-70. DOI: http://doi.org/10.36233/0507-4088-2020-65-2-62-70
Problems of Virology. 2020; 65: 203-211
Patterns of the SARS-CoV-2 epidemic spread in a megacity
https://doi.org/10.36233/0507-4088-2020-65-4-203-211Abstract
The purpose of the study is to analyze patterns demonstrated by the COVID-19 epidemic process in a megacity during the increase, stabilization and reduction in the incidence, and to evaluate the effectiveness of the epidemic prevention measures.
Materials and methods. The comprehensive study incorporating epidemiological, molecular genetic and statistical research methods was conducted to analyze the spread of SARS-CoV-2 in Moscow during the COVID- 19 pandemic.
Results and discussion. It was found that the exponential growth in COVID-19 cases was prevented due to the most stringent control and restrictive measures deployed in Moscow to break the chains of SARS-CoV-2 transmission and due to people who were very disciplined in complying with the self-isolation rules. The analysis of the dynamics in detection of new COVID-19 cases showed that in a megacity, the impact of social distancing and self-isolation would become apparent only after 3.5 incubation periods, where the maximum length of the period is 14 days. It was discovered that the detection frequency of SARS-CoV-2 RNA in relatively healthy population and its dynamics are important monitoring parameters, especially during the increase and stabilization in the COVID-19 incidence, and are instrumental in predicting the development of the epidemic situation within a range of 1–2 incubation periods (14–28 days). In Moscow, the case fatality rate was 1.73% over the observation period (6/3/2020–23/6/2020).
Conclusion. The epidemiological analysis of the COVID-19 situation in Moscow showed certain patterns of the SARS-CoV-2 spread and helped evaluate the effectiveness of the epidemic prevention measures aimed at breaking the routes of transmission of the pathogen.
References
1. Lu R., Zhao X., Li J., Niu P., Yang B., Wu H., et al. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020; 395(10224): 565-74. DOI: http://doi.org/10.1016/S0140-6736(20)30251-8
2. Romagnani P., Gnone G., Guzzi F., Negrini S., Guastalla A., Annun-ziato F., et al. The COVID-19 infection: lessons from the Italian experience. J. Public Health Policy. 2020; 41(3): 238-44. DOI: http://doi.org/10.1057/s41271-020-00229-y
3. Sebastiani G., Massa M., Riboli E. Covid-19 epidemic in Italy: evolution, projections and impact of government measures. Eur. J. Epidemiol. 2020; 35(4): 341-5. DOI: http://doi.org/10.1007/s10654-020-00631-6
4. Rothe C., Schunk M., Sothmann P., Bretzel G., Froeschl G., Wallrauch C., at al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N. Engl. J. Med. 2020; 382(10): 970-1. DOI: http://doi.org/10.1056/NEJMc200146
5. Holshue M.L., DeBolt C., Lindquist S., Lofy K.H., Wiesman J., Bruce H., et al. First case of 2019 novel coronavirus in the United States. N. Engl. J. Med. 2020; 382(10): 929-36. DOI: http://doi.org/10.1056/NEJMoa2001191
6. WHO. Coronavirus disease 2019 (COVID-19) Situation Report - 51. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf
7. Belyakov V.D., Degtyarev A.A., Ivannikov Yu.G. Kachestvo i effektivnost' protivoepidemicheskikh meropriyatii. L.: Meditsina; 1981.
8. Akimkin V.G., Kuzin S.N., Shipulina O.Yu., Yatsyshina S.B., Ti-vanova E.V., Kalenskaya A.V. i dr. Epidemiologicheskoe znachenie opredeleniya RNK SARS-CoV-2 sredi razlichnykh grupp naseleniya Moskvy i Moskovskoi oblasti v period epidemii COVID-19. Zhurnal mikrobiologii, epidemiologii i immunobiologii. 2020; 97(3): 197-201. DOI: http://doi.org/10.36233/0372-9311-2020-97-3-197-201
9. Lauer S.A., Grantz K.H., Bi Q., Jones F.K., Zheng Q., Meredith H.R., et al. The incubation period of coronavirus disease 2019 (Covid-19) from publicly reported confirmed cases: estimation and application. Ann. Intern. Med. 2020; 172(9): 577-82. DOI: http://doi.org/10.7326/ M20-0504
10. Backer J.A., Klinkenberg D., Wallinga J. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travelers from Wuhan, China, 20-28 January 2020. Euro Surveill. 2020; 25(5) : 2000062. DOI: http://doi.org/10.2807/1560-7917.ES.2020.25.5.2000062
11. Liu T., Hu J., Kang M., Lin L., Zhong H., Xiao J., et al. Transmission dynamics of 2019 novel coronavirus (2019-nCoV). J. Med. Virol. 2020; 92(5): 501-11. DOI: http://doi.org/10.1101/2020.01.25.919787
12. Read J.M., Bridgen J.R.E., Cummings D.A.T., Ho A., Jewell C.P. Novel coronavirus 2019-nCoV: early estimation of epidemiological parameters and epidemic predictions. medRxiv. 2020. DOI: http://doi.org/10.1101/2020.01.23.20018549
13. Riou J., Althaus C.L. Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020. Euro Surveill. 2020; 25(4): 2000058. DOI: http://doi.org/10.2807/1560-7917.ES.2020.25A2000058.
14. Shen M., Peng Z., Xiao Y., Zhang L. Modelling the epidemic trend of the 2019 novel coronavirus outbreak in China. bioRxiv. 2020. DOI: http://doi.org/10.1101/2020.01.23.916726
15. Wu J.T., Leung K., Leung G.M. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet. 2020; 395(10225): 689-97. DOI: http://doi.org/10.1016/S0140-6736(20)30260-9
16. Randolph H.E., Barreiro L.B. Herd Immunity: Understanding COVID-19. Immunity. 2020; 52(5): 737-41. DOI: http://doi.org/10.1016/j.immuni.2020.04.012
17. Verity R., Okell L.C., Dorigatti I., Winskill P., Whittaker C., Imai N., et al. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect. Dis. 2020; 20(6): 669-77. DOI: http://doi.org/10.1016/S1473
18. Wu J.T., Leung K., Bushman M., Kishore N., Niehus R., de Salazar P.M., et al. Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nat. Med. 2020; 26(4): 506-10. DOI: http://doi.org/10.1038/s41591-020-0822-7-3099(20)30243-7
19. Puca E., Civljak R., Arapovic J., Popescu C., Christova I., Raka L., et al. Short epidemiological overview of the current situation on Covid-19 pandemic in Southeast European (SEE) countries. J. Infect. Dev. Ctries. 2020; 14(5): 433-7. DOI: http://doi.org/10.3855/jidc.12814
20. Abdollahi E., Champredon D., Langley J.M., Galvani A.P., Moghadas S.M. Temporal estimates of case-fatality rate for COVID-19 outbreaks in Canada and the United States. CMAJ. 2020; 192(25): E666-70. DOI: http://doi.org/10.1503/cmaj.200711
21. Xu S., Li Y. Beware of the second wave of COVID-19. Lancet. 2020; 395(10233): 1321-2. DOI: http://doi.org/10.1016/S0140-6736(20)30845-X
22. de Brouwer R., van Veldhuisen D.J., de Boer R.A. Surviving the first COVID-19 wave and learning lessons for the second. Eur. J. Heart Fail. 2020; 22(6): 975-7. DOI: http://doi.org/10.1002/ejhf.1938
23. Vogel L. Is Canada ready for the second wave of COVID-19? CMAJ. 2020; 192(24): E664-5. DOI: http://doi.org/10.1503/cmaj.1095875
24. Ceylan Z. Estimation of COVID-19 Prevalence in Italy, Spain, and France. Sci. Total Environ. 2020; 729: 138817. DOI: http://doi.org/10.1016/j.scitotenv.2020.138817
25. Li Q., Guan X., Wu P., Wang X., Zhou L., Tong Y., et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N. Engl. J. Med. 2020; 382(13): 1199-207. DOI: http://doi.org/10.1056/NEJMoa2001316
26. Chatterjee A., Gerdes M.W., Martinez S.G. Statistical Explorations and Univariate timeseries analysis on COVID-19 datasets to understand the trend of disease spreading and death. Sensors (Basel). 2020; 20(11): 3089. DOI: http://doi.org/10.3390/s20113089
27. Abdollahi E., Champredon D., Langley J.M., Galvani A.P., Moghadas S.M. Temporal estimates of case-fatality rate for COVID-19 outbreaks in Canada and the United States. CMAJ. 2020; 192(25): E666-70. DOI: http://doi.org/10.1503/cmaj.200711
28. L'vov D.K., Al'khovskii S.V. Istoki pandemii COVID-19: ekologiya i genetika koronavirusov (Betacoronavirus: Coronaviridae) SARS-CoV, SARS-CoV-2 (podrod Sarbecovirus), MERS-CoV (podrod Merbecovirus). Voprosy virusologii. 2020; 65(2): 62-70. DOI: http://doi.org/10.36233/0507-4088-2020-65-2-62-70
