Marginal effects of public health measures and COVID-19 disease burden in China: A large-scale modelling study

PLoS Comput Biol. 2023 Sep 18;19(9):e1011492. doi: 10.1371/journal.pcbi.1011492. eCollection 2023 Sep.

Abstract

China had conducted some of the most stringent public health measures to control the spread of successive SARS-CoV-2 variants. However, the effectiveness of these measures and their impacts on the associated disease burden have rarely been quantitatively assessed at the national level. To address this gap, we developed a stochastic age-stratified metapopulation model that incorporates testing, contact tracing and isolation, based on 419 million travel movements among 366 Chinese cities. The study period for this model began from September 2022. The COVID-19 disease burden was evaluated, considering 8 types of underlying health conditions in the Chinese population. We identified the marginal effects between the testing speed and reduction in the epidemic duration. The findings suggest that assuming a vaccine coverage of 89%, the Omicron-like wave could be suppressed by 3-day interval population-level testing (PLT), while it would become endemic with 4-day interval PLT, and without testing, it would result in an epidemic. PLT conducted every 3 days would not only eliminate infections but also keep hospital bed occupancy at less than 29.46% (95% CI, 22.73-38.68%) of capacity for respiratory illness and ICU bed occupancy at less than 58.94% (95% CI, 45.70-76.90%) during an outbreak. Furthermore, the underlying health conditions would lead to an extra 2.35 (95% CI, 1.89-2.92) million hospital admissions and 0.16 (95% CI, 0.13-0.2) million ICU admissions. Our study provides insights into health preparedness to balance the disease burden and sustainability for a country with a population of billions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • China / epidemiology
  • Epidemics* / prevention & control
  • Humans
  • Public Health
  • SARS-CoV-2

Supplementary concepts

  • SARS-CoV-2 variants

Grants and funding

This research was supported by a grant from the Scientific and Technological Innovation 2030 - Major Project of New Generation Artificial Intelligence (2021ZD0111201), which supported ZW; a grant from the National Natural Science Foundation of China (82204160) that supported ZW; a grant from the National Natural Science Foundation of China (82073616) that partially supported ZW; a grant from the National Key Research and Development Program of China (2022YFC2303803, 2021YFC0863400) that partially supported ZW; a grant from the Beijing Science and Technology Planning Project (Z201100005420010) that partially supported ZW; a grant from the Beijing Natural Science Foundation (JQ18025) that partially supported ZW; a grant from the Beijing Advanced Innovation Program for Land Surface Science (110631111) that partially supported ZW; a grant from the Fundamental Research Funds for the Central Universities (2021NTST17) that supported ZW; a grant from the Research on Key Technologies of Plague Prevention and Control in Inner Mongolia Autonomous Region (2021ZD0006) that partially supported ZW; a grant from Research Council of Finland (321890) that supported ML. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.