About: Effect of changing case definitions for COVID-19 on the epidemic curve and transmission parameters in mainland China: a modelling study

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About: Effect of changing case definitions for COVID-19 on the epidemic curve and transmission parameters in mainland China: a modelling study Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Effect of changing case definitions for COVID-19 on the epidemic curve and transmission parameters in mainland China: a modelling study
Creator	Wu, Peng Leung, Gabriel Lin, Yun Cowling, Benjamin Cowling, B Lau, Y Leung, G Tsang, Tim Bm, Lin Phd, Wu Tsang, T
Source	Elsevier; Medline; PMC
abstract	BACKGROUND: When a new infectious disease emerges, appropriate case definitions are important for clinical diagnosis and for public health surveillance. Tracking case numbers over time is important to establish the speed of spread and the effectiveness of interventions. We aimed to assess whether changes in case definitions affected inferences on the transmission dynamics of coronavirus disease 2019 (COVID-19) in China. METHODS: We examined changes in the case definition for COVID-19 in mainland China during the first epidemic wave. We used exponential growth models to estimate how changes in the case definitions affected the number of cases reported each day. We then inferred how the epidemic curve would have appeared if the same case definition had been used throughout the epidemic. FINDINGS: From Jan 15 to March 3, 2020, seven versions of the case definition for COVID-19 were issued by the National Health Commission in China. We estimated that when the case definitions were changed, the proportion of infections being detected as cases increased by 7·1 times (95% credible interval [CrI] 4·8–10·9) from version 1 to 2, 2·8 times (1·9–4·2) from version 2 to 4, and 4·2 times (2·6–7·3) from version 4 to 5. If the fifth version of the case definition had been applied throughout the outbreak with sufficient testing capacity, we estimated that by Feb 20, 2020, there would have been 232 000 (95% CrI 161 000–359 000) confirmed cases in China as opposed to the 55 508 confirmed cases reported. INTERPRETATION: The case definition was initially narrow and was gradually broadened to allow detection of more cases as knowledge increased, particularly milder cases and those without epidemiological links to Wuhan, China, or other known cases. These changes should be taken into account when making inferences on epidemic growth rates and doubling times, and therefore on the reproductive number, to avoid bias. FUNDING: Health and Medical Research Fund, Hong Kong.
has issue date	2020-04-21(xsd:dateTime)
bibo:doi	10.1016/s2468-2667(20)30089-x
bibo:pmid	32330458
has license	no-cc
sha1sum (hex)	c9c8a7665e8651a96fc4db11d3a608493c423fb1
schema:url	https://doi.org/10.1016/s2468-2667%2820%2930089-x
resource representing a document's title	Effect of changing case definitions for COVID-19 on the epidemic curve and transmission parameters in mainland China: a modelling study
has PubMed Central identifier	PMC7173814
has PubMed identifier	32330458
schema:publication	Lancet Public Health
resource representing a document's body	covid:c9c8a7665e8651a96fc4db11d3a608493c423fb1#body_text
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