Post-lockdown SARS-CoV-2 nucleic acid screening in nearly ten million residents of Wuhan, China

  1. Shiyi Cao
  2. Yong Gan
  3. Chao Wang
  4. Max Bachmann
  5. Shanbo Wei
  6. Jie Gong
  7. Yuchai Huang
  8. Tiantian Wang
  9. Liqing Li
  10. Kai Lu
  11. Heng Jiang
  12. Yanhong Gong
  13. Hongbin Xu
  14. Xin Shen
  15. Qingfeng Tian
  16. Chuanzhu Lv
  17. Fujian Song
  18. Xiaoxv Yin
  19. Zuxun Lu

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Abstract

Stringent COVID-19 control measures were imposed in Wuhan between January 23 and April 8, 2020. Estimates of the prevalence of infection following the release of restrictions could inform post-lockdown pandemic management. Here, we describe a city-wide SARS-CoV-2 nucleic acid screening programme between May 14 and June 1, 2020 in Wuhan. All city residents aged six years or older were eligible and 9,899,828 (92.9%) participated. No new symptomatic cases and 300 asymptomatic cases (detection rate 0.303/10,000, 95% CI 0.270–0.339/10,000) were identified. There were no positive tests amongst 1,174 close contacts of asymptomatic cases. 107 of 34,424 previously recovered COVID-19 patients tested positive again (re-positive rate 0.31%, 95% CI 0.423–0.574%). The prevalence of SARS-CoV-2 infection in Wuhan was therefore very low five to eight weeks after the end of lockdown.

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  1. Version published to 10.1038/s41467-020-19802-w
  2. ScreenIT

    SciScore for 10.1101/2020.06.29.20142554: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    However, some limitations of this study need be pointed out. First, this was a cross-sectional screening programme, and we are unable to assess the changes over time, including changes in the prevalence of asymptomatic infected persons, mental health of residents, and social and economic development. Second, large scale citywide screening required a certain financial support and it may not be feasible in less-developed countries and regions. Third, the implementation of the citywide screening requires the involvement of all residents. Residents need to have good health literacy, awareness of prevention and control measures, and willingness of participation. Finally, although a positive result of nucleic acid testing certainly reveals the existence of the viral DNA, the possibility of false negative results could not be completely ruled out, in particular due to low level of virus loads or inadequate collection of samples.13 However, even if test sensitivity was as low as 50%, then the actual prevalence would be twice as high as reported in this study, but would still be very low. In summary, the citywide nucleic acid screening of SARS-CoV-2infection in post-lockdown Wuhan shows the determination and perseverance of the government and residents. The detection rate of asymptomatic cases was very low (0.303/10,000), and there was no evidence that the identified asymptomatic cases were infectious. It helps resolve concerns about the post-lockdown risk of the COVID-19 epidemic and...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.06.29.20142554v1 on medRxiv