The epidemiology of COVID-19 cases and the successful containment strategy in Hong Kong-January to May 2020

Int J Infect Dis. 2020 Sep;98:51-58. doi: 10.1016/j.ijid.2020.06.057. Epub 2020 Jun 21.

Abstract

Background: Hong Kong, a Special Administrative Region of China, recorded its first confirmed coronavirus disease 2019 (COVID-19) case on 23 January 2020. We reviewed the case epidemiology and the various public health measures implemented from January to May 2020.

Methods: The epidemiological and clinical characteristics of the cases recorded in different phases of the epidemic were described and compared, and the effectiveness of the public health measures implemented were reviewed using the changes in the daily number of confirmed cases and the interval from symptom onset to hospital admission.

Results: Between January and May 2020, 1084 confirmed COVID-19 cases were reported, about 70% of which had a history of travel during the incubation period. The case fatality ratio was 0.4%. The local epidemic progressed through four phases: (1) preparedness and imported infection from mainland China, (2) local transmission, (3) imported infection from overseas countries associated with local transmission, and (4) controlled imported infection with limited local transmission, with an eventual reduction of the daily case number and minimization of the onset-to-admission interval. Various public health measures, including enhanced surveillance, border control, and social distancing, were introduced in phases in response to the prevailing local and global situations.

Discussion: The overall containment strategy in Hong Kong led to a stabilization of the number of cases and the absence of a community-wide outbreak during the 4.5 m after the first case was reported. This strategy of containment might serve as an example for future planning of preparedness and response against novel infectious agents.

Keywords: COVID-19; Contact tracing; Enhanced surveillance; Hong Kong; Novel coronavirus; Public health intervention; Quarantine; SARS-CoV-2.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Betacoronavirus*
  • Child
  • Child, Preschool
  • Communicable Diseases, Imported
  • Coronavirus Infections / epidemiology*
  • Disease Outbreaks / prevention & control
  • Female
  • Hong Kong / epidemiology
  • Hospitalization
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Public Health
  • Travel
  • Travel-Related Illness
  • Young Adult

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2