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Assessment of Coronavirus Disease 2019 Community Containment Strategies in Shenzhen, China

Educational Objective
To understand how to assess the community containment strategies practiced in Shenzhen, China
1 Credit CME
Key Points

Question  Which community preventive measures were implemented in a Chinese city to address the coronavirus disease 2019 (COVID-19) pandemic, and were they associated with limited community transmission?

Findings  This retrospective case series included 7 imported COVID-19 cases and 800 individuals at high risk. After the implementation of community measures, no locally acquired case of COVID-19 with indirect links to confirmed cases was identified in the community.

Meaning  The findings of this study suggest that the implementation of community containment strategies by a multidisciplinary team may limit the community transmission of COVID-19.


Importance  A new outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus 2 in Wuhan, China, is spreading rapidly around the globe. Limited information on control in community settings is available.

Objective  To detail measures enacted within a community to prevent the spread of coronavirus disease 2019 (COVID-19) and to evaluate the spread of COVID-19 associated with implementation of the program.

Design, Setting, and Participants  This case series study details the implementation of prevention measures in a specific community setting among community-dwelling individuals exposed to or at risk of COVID-19 in Haiyu, Shenzhen, China, from January 23 to April 10, 2020.

Exposures  Community containment strategies for tracking, quarantine, and management were strictly, cooperatively, and effectively implemented by a team that included a general practitioner, a community manager, and public safety bureau officials.

Main Outcomes and Measures  Number of locally acquired cases with indirect links to confirmed COVID-19 cases. Diagnosis with COVID-19 was confirmed when throat swab samples tested positive for severe acute respiratory syndrome coronavirus 2 on reverse transcription–polymerase chain reaction.

Results  Approximately 34 686 individuals live in Haiyu, including 2382 residents aged 65 years or older. Seven individuals with COVID-19 acquired outside the community (age, 20-70 years; 3 [42%] women) were moved from quarantine to a hospital for standard isolation treatment. A total of 20 people who were asymptomatic and who had had direct contact with these individuals were closely observed by health care workers at a nearby hotel. Additionally, 800 individuals considered to be at higher risk were moved from quarantine to home isolation for 14 days. There were no locally acquired cases of COVID-19 with indirect links reported in the Haiyu community from the time that the study began on January 23, 2020, to April 10, 2020.

Conclusions and Relevance  These findings suggest that cooperation among the authorities of multiple sectors allowed for the implementation of preventive measures that were associated with limited community transmission.

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Article Information

Accepted for Publication: May 16, 2020.

Published: June 22, 2020. doi:10.1001/jamanetworkopen.2020.12934

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Zhang X-M et al. JAMA Network Open.

Corresponding Author: Wen-Wu Zhang, BMed (1149646884@qq.com) and Qing-Li Dou, PHD (zhangmuxi0310@163.com), Department of Emergency, Affiliated Baoan Hospital of Southern Medical University, The People’s Hospital of Baoan Shenzhen, No. 118, Second road Longjing, Baoan District, Shenzhen 518101, China.

Author Contributions: Drs X.-M. Zhang and Dou had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: W.-W. Zhang, Dou, Cheng.

Acquisition, analysis, or interpretation of data: X.-M. Zhang, Zhou, Li, Wei, Hu, Liu.

Drafting of the manuscript: X.-M. Zhang, Zhou, Liu.

Critical revision of the manuscript for important intellectual content: Zhou, W.-W. Zhang, Dou, Li, Wei, Hu, Cheng.

Statistical analysis: Zhou, Liu.

Administrative, technical, or material support: Dou, Li, Cheng.

Supervision: W.-W. Zhang, Cheng.

Other: Wei.

Conflict of Interest Disclosures: None reported.

Zhu  N , Zhang  D , Wang  W ,  et al; China Novel Coronavirus Investigating and Research Team.  A novel coronavirus from patients with pneumonia in China, 2019.   N Engl J Med. 2020;382(8):727-733. doi:10.1056/NEJMoa2001017 PubMedGoogle ScholarCrossref
Li  Q , Guan  X , Wu  P ,  et al.  Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia.   N Engl J Med. 2020;382(13):1199-1207. doi:10.1056/NEJMoa2001316 PubMedGoogle ScholarCrossref
Guarner  J .  Three emerging coronaviruses in two decades.   Am J Clin Pathol. 2020;153(4):420-421. doi:10.1093/ajcp/aqaa029PubMedGoogle ScholarCrossref
Linton  NM , Kobayashi  T , Yang  Y ,  et al.  Incubation period and other epidemiological characteristics of 2019 novel coronavirus infections with right truncation: a statistical analysis of publicly available case data.   J Clin Med. 2020;9(2):E538. doi:10.3390/jcm9020538PubMedGoogle Scholar
Lauer  SA , Grantz  KH , Bi  Q ,  et al.  The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application.   Ann Intern Med. 2020;172(9):577-582. doi:10.7326/M20-0504PubMedGoogle ScholarCrossref
Phelan  AL , Katz  R , Gostin  LO .  The novel coronavirus originating in Wuhan, China: Challenges for Global Health Governance.   JAMA. 2020;323(8):709-710. doi:10.1001/jama.2020.1097 PubMedGoogle ScholarCrossref
Johns Hopkins University and Medicine. COVID-19 map. Accessed May 29, 2020. https://coronavirus.jhu.edu/map.html
SARS Investigation Team from DMERI; SGH.  Strategies adopted and lessons learnt during the severe acute respiratory syndrome crisis in Singapore.   Rev Med Virol. 2005;15(1):57-70. doi:10.1002/rmv.458 PubMedGoogle ScholarCrossref
Huang  C , Wang  Y , Li  X ,  et al.  Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.   Lancet. 2020;395(10223):497-506. doi:10.1016/S0140-6736(20)30183-5 PubMedGoogle ScholarCrossref
Zhao  S , Musa  SS , Lin  Q ,  et al.  Estimating the unreported number of novel coronavirus (2019-nCoV) cases in China in the first half of January 2020: a data-driven modelling analysis of the early outbreak.   J Clin Med. 2020;9(2):E388. doi:10.3390/jcm9020388 PubMedGoogle Scholar
Wu  JT , Leung  K , Leung  GM .  Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study.   Lancet. 2020;395(10225):689-697. doi:10.1016/S0140-6736(20)30260-9 PubMedGoogle ScholarCrossref
Güner  R , Hasanoğlu  I , Aktaş  F .  COVID-19: prevention and control measures in community.   Turk J Med Sci. 2020;50(SI-1):571-577. doi:10.3906/sag-2004-146 PubMedGoogle ScholarCrossref
Meo  SA , Alhowikan  AM , Al-Khlaiwi  T ,  et al.  Novel coronavirus 2019-nCoV: prevalence, biological and clinical characteristics comparison with SARS-CoV and MERS-CoV.   Eur Rev Med Pharmacol Sci. 2020;24(4):2012-2019. doi:10.26355/eurrev_202002_20379PubMedGoogle Scholar
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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