key: cord-0979220-7ljl46n4
authors: Fu, Jiye; Jiang, Chu; Wang, Juguang; Li, Yulian; Ying, Huaqing
title: To halt the spread of imported coronavirus disease 2019 cases in China: action and challenges
date: 2020-11-07
journal: Travel Med Infect Dis
DOI: 10.1016/j.tmaid.2020.101913
sha: 4ee2546c14595fe5df73fe056ea234721cd66ff8
doc_id: 979220
cord_uid: 7ljl46n4

nan

The ongoing pandemic of coronavirus disease 2019 has expanded rapidly to more than 200 5 countries, resulting in 5,934,936 cases and at least 367,166 deaths as of May 31, 2020 1 . By implementing 6 combined non-pharmacological interventions, China has brought the outbreak under control. However, 7

with locally-infected cases decreased substantially, the growing number of imported cases has raised major 8 concern. Since released first on March 4, this number has risen to 1756 as of May 31 2 , covering 28 9 provincial jurisdictions in mainland China (Figure panel A and B) and peaking on April 12 before declining 10 substantially. Of those reported before April, 618 (76.7%) were from Iran, Italy, Spain, United Kingdom, 11

France, and United States (Figure panel C) , where the number of cases promptly increased during the same 12

Foreign guest workers, residents, and Chinese tourists and international students returning from overseas 14 Third, health screening, quarantine, and testing. In response to imported cases, each provincial authority 30 has converted hotels into quarantine centers to house individuals back from abroad. Since March 3, 31 international travelers entering mainland China, initially from the severely-affected countries, were 32 required to receive temperature and respiratory symptoms screening upon arrival at airport checkpoint. 33

From March 20, these measures expanded to all entering individuals. Persons screening positive will be 34 transferred to designated hospitals and assessed, and those negative will proceed a 14-day quarantine at 35 collective points. Since March 25, in addition to be quarantined, individuals should also receive testing for 36 the virus at the third and fifth day during quarantine and those who have fever, symptoms, or tested positive 37 would receive further evaluation. Additionally, enhanced surveillance has been implemented in fever 38 clinics nationwide. When patients with fever or respiratory symptoms seek medical care, they will be 39 sampled and under epidemiological investigation. Sixth, prevention measures at the individual level, such as mask wearing, social distancing, hand hygiene, 53 and following the guidance of authority, have been strictly implemented since the declaration of the 54 COVID-19 outbreak in January, 2020. 55

Finally, the laws and regulations guaranteeing the response activities implemented. On January 20, the 56 COVID-19 was brought by the State Council into the national notifiable diseases items as level B, which comply strictly with the interventions in place, such as isolation, quarantine, treatment, and medical 59 observation measures; violators face fines and jail terms. 60

Despite continued efforts in China to control the imported COVID-19 cases, three challenges still remain. 61

First, more research is needed to closely monitor the evolution of SARS-CoV-2, particularly isolated from 62 samples of imported cases, including pathogenicity, virulence, and transmissibility. Second, accelerate 63 research, development, and trial of COVID-19 vaccine. Although six vaccines are in development in China, 64 even some enter phase III clinical trial 5 , more well-designed trials are needed to evaluate efficacy of the 65 vaccine in those ≥65 years who are at increased risk for severe illness. Finally, all individuals should 66 constantly follow the government's order and advice from the public health authorities, until the pandemic 67 is under control. 68

With extensive measures implemented and whole society engagement, China together with other countries 69 and international partners will make sustainable efforts to draw ultimately the pandemic to the end in the This work did not receive any specific grant from funding agencies in the public, commercial, or 96 not-for-profit sectors. 97

WHO coronavirus disease 2019 (COVID-19) Situation Report-132

We declare no competing interests. 100