COVID-19 in New Zealand and the impact of the national response: a descriptive epidemiological study
Fecha
2020Autor
Jefferies, Sarah
French, Nigel
Gilkison, Charlotte
Graham, Giles
Hope, Virginia
Marshall, Jonathan
McElnay, Caroline
McNeill, Andrea
Muellne, Petra
Paine, Shevaun
Prasad, Namrata
Scott, Julia
Sherwood, Jillian
Yang, Liang
Priest, Patricia
Resumen
Background In early 2020, during the COVID-19 pandemic, New Zealand implemented graduated, risk-informed
national COVID-19 suppression measures aimed at disease elimination. We investigated their impacts on the
epidemiology of the first wave of COVID-19 in the country and response performance measures.
Methods We did a descriptive epidemiological study of all laboratory-confirmed and probable cases of COVID-19 and
all patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in New Zealand from Feb 2 to
May 13, 2020, after which time community transmission ceased. We extracted data from the national notifiable diseases
database and the national SARS-CoV-2 test results repository. Demographic features and disease outcomes,
transmission patterns (source of infection, outbreaks, household transmission), time-to-event intervals, and testing
coverage were described over five phases of the response, capturing different levels of non-pharmaceutical interventions.
Risk factors for severe outcomes (hospitalisation or death) were examined with multivariable logistic regression and
time-to-event intervals were analysed by fitting parametric distributions using maximum likelihood estimation.
Findings 1503 cases were detected over the study period, including 95 (6·3%) hospital admissions and
22 (1·5%) COVID-19 deaths. The estimated case infection rate per million people per day peaked at 8·5 (95% CI
7·6–9·4) during the 10-day period of rapid response escalation, declining to 3·2 (2·8–3·7) in the start of lockdown and
progressively thereafter. 1034 (69%) cases were imported or import related, tending to be younger adults, of European
ethnicity, and of higher socioeconomic status. 702 (47%) cases were linked to 34 outbreaks. Severe outcomes were
associated with locally acquired infection (crude odds ratio [OR] 2·32 [95% CI 1·40–3·82] compared with imported),
older age (adjusted OR ranging from 2·72 [1·40–5·30] for 50–64 year olds to 8·25 [2·59–26·31] for people aged
≥80 years compared with 20–34 year olds), aged residential care residency (adjusted OR 3·86 [1·59–9·35]), and Pacific
peoples (adjusted OR 2·76 [1·14–6·68]) and Asian (2·15 [1·10–4·20]) ethnicities relative to European or other. Times
from illness onset to notification and isolation progressively decreased and testing increased over the study period,
with few disparities and increasing coverage of females, Māori, Pacific peoples, and lower socioeconomic groups.
Palabras clave
COVID-19; New Zealand; Impact of the national response; Epidemiological studyEnlace al recurso
https://doi.org/10.1016/Colecciones
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