Despite vaccination, China needs non-pharmaceutical interventions to prevent widespread outbreaks of COVID-19 in 2021

  1. Juan Yang
  2. Valentina Marziano
  3. Xiaowei Deng
  4. Giorgio Guzzetta
  5. Juanjuan Zhang
  6. Filippo Trentini
  7. Jun Cai
  8. Piero Poletti
  9. Wen Zheng
  10. Wei Wang
  11. Qianhui Wu
  12. Zeyao Zhao
  13. Kaige Dong
  14. Guangjie Zhong
  15. Cécile Viboud
  16. Stefano Merler
  17. Marco Ajelli
  18. Hongjie Yu

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Abstract

COVID-19 vaccination is being conducted in over 200 countries and regions to control SARS-CoV-2 transmission and return to a pre-pandemic lifestyle. However, understanding when non-pharmaceutical interventions (NPIs) can be lifted as immunity builds up remains a key question for policy makers. To address this, we built a data-driven model of SARS-CoV-2 transmission for China. We estimated that, to prevent the escalation of local outbreaks to widespread epidemics, stringent NPIs need to remain in place at least one year after the start of vaccination. Should NPIs alone be capable of keeping the reproduction number ( R t ) around 1.3, the synergetic effect of NPIs and vaccination could reduce the COVID-19 burden by up to 99% and bring R t below the epidemic threshold in about 9 months. Maintaining strict NPIs throughout 2021 is of paramount importance to reduce COVID-19 burden while vaccines are distributed to the population, especially in large populations with little natural immunity.

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  3. Version published to 10.1038/s41562-021-01155-z
  4. Version published to 10.1101/2021.02.03.21251108v2 on medRxiv
  5. ScreenIT

    SciScore for 10.1101/2021.02.03.21251108: (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:
    Our study has a number of limitations. First, we integrated the impact of NPIs through a simple reduction in the value of Rt at the beginning of the outbreak, homogeneously across age groups. However, our analysis does not suggest which combination of NPIs should be adopted to lower Rt to a certain level, and how this would affect transmission rates in different age groups. Li, et al, estimated that individual NPIs, including school closure, workplace closure, and public events bans, were associated with reductions in Rt of 13–24% on day 28 after their introduction (28). Further studies are needed to pinpoint the specific NPIs to be adopted in parallel with the vaccination campaign. Second, our study uses a static allocation strategy, which means a constant coverage is assumed for all subgroups, and vaccination starts from one group and remains in the group until target coverage achieved, and then moves to the next group in sequence. Such allocation process may not generate the maximum health benefit for a vaccination program (29). Further studies could be designed to identify the optimal dynamic allocation strategy (e.g., different coverage required in subgroups, where vaccination could start from one group, move to the next and then return) to minimize COVID-19 burden, especially in the context of limited doses. Third, in China, vaccines have not been licensed for older adults and children, so we assume a 50% lower or equivalent VE for them compared to other adults. Althoug...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).

    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.

  6. Version published to 10.1101/2021.02.03.21251108v1 on medRxiv