新型冠状病毒肺炎精准防控体系构建与效果评价

Research on accurate prevention and control strategy and implementation effect of coronavirus disease 2019 in Shenzhen

新型冠状病毒肺炎(以下简称新冠)流行引起了重大公共卫生安全问题。深圳作为人口密度高,人群流动性大的超大城市,存在着新冠输入性传播及广泛社区暴发性流行的风险,给公共卫生防控工作带来巨大挑战。深圳市通过分析本地新冠肺炎病例的流行病学特征和传播特征,积极探索流行规律与防控重点,确立了“重点人群筛查+病例隔离治疗+接触者隔离医学观察+追踪随访管理”为核心的精准防控策略,辅以佩戴口罩、延迟复工复学、保持社交距离和社区管控的综合策略。在综合策略的实施下,感染者从症状出现至隔离间隔时间缩短,广泛追踪筛查及隔离管理策略促进了病例的早发现、早隔离,有效降低社区传播风险。此外,通过建立输入风险数学模型,评估输入风险以及城市防控承受能力研判,适时调整针对性策略。对出院复阳患者开展监测随访,评估其传播风险,制订复阳人员的随访管理方案和工作指引。“筛查发现-隔离管理-广泛追踪”的称新冠疫情精准防控策略和措施的落实,使得深圳在新冠疫情流行后40d内得到有效控制,为全世界特别是大城市精准有效控制新发传染病流行提供了可借鉴的成功经验。

The COVID-19 epidemic raises major public health security issues.As a metropolis with high population density and great population mobility,Shenzhen has great challenges in public health prevention and control because of the risk of imported transmission,which might lead to widespread community explosive epidemics.By analyzing local COVID-19 epidemiological characteristics and transmission,and actively exploring epidemic rules and key points of prevention and control,Shenzhen established"key population screening+case isolation treatment+contact isolation medical observation,follow-up management"as the core of accurate prevention and control strategy,supplemented by wearing masks,delayed resume work resumption,maintain social distance and schooling community control as the integrated strategy.In confirmed cases of COVID-19,screening and management of close contacts has shown that the time from symptom onset to isolation has been shortened.Extensive follow-up screening and isolation management strategies have promoted early detection and isolation of cases and effectively reduced the risk of community transmission.We established a mathematical model of importation risk,evaluated the importation risk of our city and study and judged the city's tolerance for prevention and control,therefore we could timely adjust targeted strategies.We carried out monitoring and follow-up for discharged patients with recurrent positive of SARS-CoV-2 RNA,and assessed their risk of transmission,which helped us formulate a follow-up management plan and work guidelines.The implementation of the accurate prevention and control strategy and measures of"screening,detection,isolation,management and extensive tracking"has effectively controlled the COVID-19 epidemic in Shenzhen within 40 days after the epidemic spread,which has provided successful experience for the accurate and effective control of the COVID-19 epidemic around the world,especially in a megacity.