TropicalMed, Vol. 10, Pages 170: Epidemiological Analysis of the COVID-19 Clusters in the Early Stages of the Epidemic in Shanghai, China: Pandemic-to-Epidemic Response Shift

Tropical Medicine and Infectious Disease doi: 10.3390/tropicalmed10060170

Authors:
Dechuan Kong
Qiwen Fang
Jian Chen
Linjie Hu
Yihan Lu
Yaxu Zheng
Yiyi Zhu
Bihong Jin
Wenjia Xiao
Shenghua Mao
Chenyan Jiang
Xiaohuan Gong
Sheng Lin
Ruobing Han
Xiao Yu
Qi Qiu
Xiaodong Sun
Hao Pan
Huanyu Wu

As COVID-19 transitions from pandemic to endemic, our prevention and control policies have shifted from broad, strict community interventions to focusing on the prevention of cluster outbreaks. Currently, information on the characteristics of cluster outbreaks remains limited. This study describes the features of COVID-19 clusters in Shanghai. It aims to provide valuable insights for managing localized outbreaks. We conducted a retrospective analysis of clusters of confirmed COVID-19 cases. Epidemiological descriptions, the transmission characteristics of clusters, and individual risk factors for contagiousness were analyzed. A total of 381 cases of COVID-19 were confirmed and 67 clusters were identified. Most clusters (58.21%, 39/67) only had two cases, with a declining proportion held by clusters of more cases. Familial transmission was predominant, accounting for 79.10% (53/67) of clusters. Although other types of cluster outbreaks, such as those in workplaces (1.49%, 1/67), occur less frequently compared to household clusters, they tend to involve larger scales and more cases. Workplaces and similar venues are more likely to experience large-scale cluster outbreaks. Contagiousness was higher among cases with runny nose (risk ratio [RR]: 4.8, 95% CI: 1.40–16.44, p-value = 0.01) and those with diabetes (RR: 3.8, 95% CI: 1.01–14.60, p-value = 0.05). In conclusion, household cluster outbreaks, in particular, are both a key priority and a foundational issue. Establishing an indicator system based on the transmissibility of cases holds significant practical value for infectious disease prevention and control. By enhancing household hygiene and developing a case classification and management system based on transmissibility, it is possible to better prevent and control regional COVID-19 outbreaks.

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Dechuan Kong www.mdpi.com