Evidence of initial success for China exiting COVID-19 social distancing policy after achieving containment

Neil M. Ferguson*, Kylie E.C. Ainslie, Caroline E. Walters, Han Fu, Sangeeta Bhatia, Haowei Wang, Xiaoyue Xi, Marc Baguelin, Samir Bhatt, Adhiratha Boonyasiri, Olivia Boyd, Lorenzo Cattarino, Constanze Ciavarella, Zulma Cucunuba, Gina Cuomo-Dannenburg, Amy Dighe, Ilaria Dorigatti, Sabine L. van Elsland, Rich FitzJohn, Katy GaythorpeAzra C. Ghani, Will Green, Arran Hamlet, Wes Hinsley, Natsuko Imai, David Jorgensen, Edward Knock, Daniel Laydon, Gemma Nedjati-Gilani, Lucy C. Okell, Igor Siveroni, Hayley A. Thompson, H. Juliette T. Unwin, Robert Verity, Michaela Vollmer, Patrick G.T. Walker, Yuanrong Wang, Oliver J. Watson, Charles Whittaker, Peter Winskill, Christl A. Donnelly, Steven Riley

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)

Abstract

Background: The COVID-19 epidemic was declared a Global Pandemic by WHO on 11 March 2020. By 24 March 2020, over 440,000 cases and almost 20,000 deaths had been reported worldwide. In response to the fast-growing epidemic, which began in the Chinese city of Wuhan, Hubei, China imposed strict social distancing in Wuhan on 23 January 2020 followed closely by similar measures in other provinces. These interventions have impacted economic productivity in China, and the ability of the Chinese economy to resume without restarting the epidemic was not clear. Methods: Using daily reported cases from mainland China and Hong Kong SAR, we estimated transmissibility over time and compared it to daily within-city movement, as a proxy for economic activity. Results: Initially, within-city movement and transmission were very strongly correlated in the five mainland provinces most affected by the epidemic and Beijing. However, that correlation decreased rapidly after the initial sharp fall in transmissibility. In general, towards the end of the study period, the correlation was no longer apparent, despite substantial increases in within-city movement. A similar analysis for Hong Kong shows that intermediate levels of local activity were maintained while avoiding a large outbreak. At the very end of the study period, when China began to experience the re-introduction of a small number of cases from Europe and the United States, there is an apparent up-tick in transmission. Conclusions: Although these results do not preclude future substantial increases in incidence, they suggest that after very intense social distancing (which resulted in containment), China successfully exited its lockdown to some degree. Elsewhere, movement data are being used as proxies for economic activity to assess the impact of interventions. The results presented here illustrate how the eventual decorrelation between transmission and movement is likely a key feature of successful COVID-19 exit strategies.

Original languageEnglish
Article number81
JournalWellcome Open Research
Volume5
DOIs
Publication statusPublished - 2020
Externally publishedYes

Bibliographical note

Funding Information:
Grant information: This work was supported by the Wellcome Trust through a Wellcome Trust Investigator Award [200861; KA, CW, SR], a Wellcome Trust Collaborator Award [200187; SR], and a Wellcome Trust Sir Henry Dale Fellowship [213494; ID]. This work was also supported by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement, also part of the EDCTP2 programme supported by the European Union [UK, Centre MR/R015600/1]; and the National Institute for Health Research (UK, for Health Protection Research Unit funding) (SR).

Publisher Copyright:
© 2020 Ainslie KEC et al.

Keywords

  • COVID-19
  • Exit strategy
  • Social distancing
  • Transmission

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