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[BMJ发表论文]:物理距离措施与新冠肺炎发病率
2020年09月06日 时讯速递, 进展交流 暂无评论

Research

Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries

Nazrul Islam, Stephen J Sharp, Gerardo Chowell, et al 

BMJ 2020; 370: m2743 doi: https://doi.org/10.1136/bmj.m2743 (Published 15 July 2020)

Abstract

Objective 目的

To evaluate the association between physical distancing interventions and incidence of coronavirus disease 2019 (covid-19) globally.

评价物理距离措施与全球新冠肺炎(COVID-19)发病率的相关性。

Design 设计

Natural experiment using interrupted time series analysis, with results synthesised using meta-analysis.

采用中断时间序列分析进行的自然试验,并通过meta分析合成数据结果。

Setting 场景

149 countries or regions, with data on daily reported cases of covid-19 from the European Centre for Disease Prevention and Control and data on the physical distancing policies from the Oxford covid-19 Government Response Tracker.

欧洲CDC报告的149个国家或地区每日COVID-19病例,以及牛津COVID-19政府应对追踪项目报告的物理距离政策数据。

Participants 研究对象

Individual countries or regions that implemented one of the five physical distancing interventions (closures of schools, workplaces, and public transport, restrictions on mass gatherings and public events, and restrictions on movement (lockdowns)) between 1 January and 30 May 2020.

2020年1月1日至5月30日之间,实施以下5种物理距离措施之一(关闭学校,关闭工厂,公交停运,限制聚集性活动,以及限制所有活动(封城))的各个国家或地区。

Main outcome measure 主要预后指标

Incidence rate ratios (IRRs) of covid-19 before and after implementation of physical distancing interventions, estimated using data to 30 May 2020 or 30 days post-intervention, whichever occurred first. IRRs were synthesised across countries using random effects meta-analysis.

根据2020年5月30日或采取措施后30天的数据,评估实施物理距离措施前后COVID-19发病率比值(IRR)。采用随机效应meta分析综合各个国家和地区间的IRR。

Results 结果

On average, implementation of any physical distancing intervention was associated with an overall reduction in covid-19 incidence of 13% (IRR 0.87, 95% confidence interval 0.85 to 0.89; n=149 countries). Closure of public transport was not associated with any additional reduction in covid-19 incidence when the other four physical distancing interventions were in place (pooled IRR with and without public transport closure was 0.85, 0.82 to 0.88; n=72, and 0.87, 0.84 to 0.91; n=32, respectively). Data from 11 countries also suggested similar overall effectiveness (pooled IRR 0.85, 0.81 to 0.89) when school closures, workplace closures, and restrictions on mass gatherings were in place. In terms of sequence of interventions, earlier implementation of lockdown was associated with a larger reduction in covid-19 incidence (pooled IRR 0.86, 0.84 to 0.89; n=105) compared with a delayed implementation of lockdown after other physical distancing interventions were in place (pooled IRR 0.90, 0.87 to 0.94; n=41).

实施任何物理距离措施伴随COVID-19发病率下降13%(IRR 0.87, 95% CI 0.85 to 0.89; n=149 个国家)。如果实施其他4种物理距离措施,公交停运并不额外降低COVID-19发病率(伴或不伴公交停运的综合IRR分别为 0.85, 0.82 to 0.88; n=72, 和 0.87, 0.84 to 0.91; n=32)。来自11个国家的数据表明,当采取措施关闭学校,关闭工厂并限制聚众集会时,也得到相似结果(综合 IRR 0.85, 0.81 to 0.89)。在上述措施实施顺序方面,更早封城伴随COVID-19发病率降低最多(综合IRR 0.86, 0.84 to 0.89; n=105),在其他物理距离措施实施后延迟封城(综合IRR 0.90, 0.87 to 0.94; n=41)效果稍差。

Conclusions 结论

Physical distancing interventions were associated with reductions in the incidence of covid-19 globally. No evidence was found of an additional effect of public transport closure when the other four physical distancing measures were in place. Earlier implementation of lockdown was associated with a larger reduction in the incidence of covid-19. These findings might support policy decisions as countries prepare to impose or lift physical distancing measures in current or future epidemic waves.

物理距离措施伴随全球COVID-19发病率降低。实施其他四种物理距离措施后,没有证据显示公交停运具有额外效果。早期封城伴随COVID-19发病率大幅度降低。在当前或今后的流行过程中,这些结果可能为准备实施物理距离措施的国家进行政策决策提供支持。

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