key: cord-1023518-12xdtllc authors: Kong, Xiang Sha; Liu, Feng; Wang, Hai Bo; Yang, Rui Feng; Chen, Dong Bo; Wang, Xiao Xiao; Lu, Feng Min; Rao, Hui Ying; Chen, Hong Song title: Epidemic prevention and control measures in China significantly curbed the epidemic of COVID-19 and influenza date: 2020-04-14 journal: nan DOI: 10.1101/2020.04.09.20058859 sha: 4cd95855677c018e98b04f0282e3d3f4ec65c6c0 doc_id: 1023518 cord_uid: 12xdtllc At the end of 2019, an outbreak of unknown pathogen pneumonia occurred in China, then it was named corona virus disease 2019 (COVID-19). With the rapid spread of COVID-19, a series of strict prevention and control measures were implemented to cut the spread of the epidemic. Influenza as a respiratory tract infection disease as COVID-19 might also be controlled. To assess the effects, we used the total passenger numbers sent in mainland China from 2018 to 2020 and the daily number of railway passenger (DNRP) flow in 2020 during Spring Festival travel rush to reflect the population movement and further to analyze newly and cumulative confirmed COVID-19 and influenza. We found that with implementing the series measures on COVID-19, not only COVID-19, but also influenza mitigated in China. The prevention and control measures for COVID-19 might be used in controlling respiratory tract diseases, and reducing the national health economic burden. When other countries issue measures on COVID-19 and influenza, they should consider adopting more aggressive epidemic prevention and control strategies. . CC-BY-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. Table 1 ). Among them, to strictly limit population flow is a key measure to mitigate the spread of virus, the epidemic overlaps with the peak period of Spring Festival travel rush; therefore, reducing population movement might help to prevent the spread of COVID-19. Just like COVID-19，influenza is also a respiratory infectious disease, it could cause estimated 3-5 million cases with severe respiratory infection-related illness and 0.29-0.65 million deaths worldwide annual year 6, 7 . And Influenza virus is easy to mutate and highly contagious, and could cause seasonal epidemic every year, mostly . CC-BY-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.09.20058859 doi: medRxiv preprint 5 in winter and spring 8 . At the end and beginning of each year is influenza prevalence season. This study mainly analyzes the influence of national first-level prevention and control measures on the epidemic of COVID-19 and influenza, and hope to provide some insights in curbing the COVID-19, influenza and other respiratory infectious diseases for other countries. Population flow dropping significantly since launching first-level response for the The Spring Festival travel rush period is a national transportation peak arranged by the Ministry of transport and the Civil Aviation Administration. Centering on the Spring Festival, it lasts 40 days, from the 15th of the 12th lunar month to the 25th of the first lunar month of the next year. It was from 10 January to 18 February in 2020 (25 January is the Spring Festival), from 21 January to 1 March in 2019, from 1 February to 12 March in 2018, respectively. In general, the Spring Festival travel rush period refers to intercity transportation in mainland China, including national railways, highway, waterways and civil aviation, and among them, national railways and highway are mainly transportation. We employ the daily number of railway passengers (DNRP) flow in mainland China to reflect the population movement and the speed and effectiveness of the first-level response to the epidemic. During Spring Festival travel rush period in 2020, the total 1.48 billion passengers . CC-BY-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.09.20058859 doi: medRxiv preprint had been sent by railways, highway, waterway and civil aviation, decreased 50.5% and 50.3% compared to the same period in 2019 and 2018 respectively (Table 1) . Among them, 210 million passengers sent by railway in 2020, which were 48.4% lower than the same period in 2019 and 45.0% lower than in 2018. On 10 January, 2020, the DNRP in China had reached more than 10 million, at a high level from 10·49 to 12·44 million. According to previous data, the railway passenger flow showed a rapid downward trend two days before new year during 2018 to 2020 ( Figure 1a ). On 23 January, 2020, the DNRP flow was 9.85 million, higher than that of the same period in 2019 (6.0%) and 2018 (11.5%) respectively. At the same day, Wuhan was locked down and government launched a first-level response for the COVID-19. Therefore, on 24 January (the first day of lock down), the flow dropped After the first-level response prevention and control measures launched, the newly . CC-BY-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.09.20058859 doi: medRxiv preprint confirmed cases of COVID-19 still had an upward trend in other provinces and cities in China except Hubei province, then peaked on 3 February (Figure 1b ). This temporary rise may be related with COVID-19 patients have traveled from Wuhan to other provinces and cities. Therefore, the outbreak has continued to spread geographically, with mounting numbers of cases and deaths. After 3 February, the number of newly confirmed cases in other provinces in China except Hubei province began to drop eventually. Until to 21 February, the number of newly confirmed cases was less than 50. According to the epidemic data of influenza released by the Chinese National One week before the first-level response on 23 January of 2020 (1/13-1/19), the . CC-BY-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. CC-BY-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.09.20058859 doi: medRxiv preprint confirmed cases were less than 50 cases per day since 21 February. Meanwhile, the prevalence of influenza also showed a significantly decline, with the positive rate dropping from 47.7% to 2.1% during the period from Jan 1 to March 1 of 2020 ( Figure 1d ). COVID-19 broke out first in Wuhan, Hubei province in China and then quickly spread across the country. The first-level response was launched to control the spread of COVID-19. Coincidentally, it was just the Spring Festival travel rush in 2020. According to Chinese tradition, people will go back to home to celebrate new year coming. Huge population long distance mobility will extremely enhance virus rapid transmission. In this study, we focus on the measure-restriction of population flow, and analysis its relationship with COVID-19 and influenza. The DNRP flow is used to reflect the population flow and indirectly evaluate the speed and effectiveness of the first-level response to the epidemic. During first-level response period, it was just the Spring Festival travel rush in 2020, with total 1.48 billion passengers sent by railways, highways, waterways and civil aviation, The NHC is responsible for influenza epidemic monitoring throughout the country, which refer to the national influenza surveillance plan (2017 version) 24 . There are 554 National Sentinel Hospital and Influenza Surveillance Network Laboratories. . CC-BY-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.09.20058859 doi: medRxiv preprint 2 1 . CC-BY-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.09.20058859 doi: medRxiv preprint 2 2 Table 2 . *The percentages in brackets represent the ratio of the number after the boundary point to before the boundary point. 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