University Hospital of Clermont-Ferrand, Public Health Department, Clermont Auvergne University, National Center for Scientific Research, SIGMA Clermont, Pascal Institute, 63000 Clermont-Ferrand, France.
Emergency Department of Diaconat Fonderie Hospital, 68100 Mulhouse, France.
Int J Environ Res Public Health. 2020 Sep 30;17(19):7175. doi: 10.3390/ijerph17197175.
Understanding SARS-CoV-2 dynamics and transmission is a serious issue. Its propagation needs to be modeled and controlled. The Alsace region in the East of France has been among the first French COVID-19 clusters in 2020.
We confront evidence from three independent and retrospective sources: a population-based survey through internet, an analysis of the medical records from hospital emergency care services, and a review of medical biology laboratory data. We also check the role played in virus propagation by a large religious meeting that gathered over 2000 participants from all over France mid-February in Mulhouse.
Our results suggest that SARS-CoV-2 was circulating several weeks before the first officially recognized case in Alsace on 26 February 2020 and the sanitary alert on 3 March 2020. The religious gathering seems to have played a role for secondary dissemination of the epidemic in France, but not in creating the local outbreak.
Our results illustrate how the integration of data coming from multiple sources could help trigger an early alarm in the context of an emerging disease. Good information data systems, able to produce earlier alerts, could have avoided a general lockdown in France.
了解 SARS-CoV-2 的动态和传播是一个严重的问题。需要对其传播进行建模和控制。法国东部的阿尔萨斯地区是 2020 年法国首批 COVID-19 集群之一。
我们从三个独立的回溯性来源来面对证据：通过互联网进行的基于人群的调查、对医院急诊服务的医疗记录进行的分析，以及对医学生物学实验室数据的审查。我们还检查了 2 月中旬在米卢斯聚集了来自法国各地的 2000 多名参与者的大型宗教集会在病毒传播中所起的作用。
我们的结果表明，SARS-CoV-2 在 2020 年 2 月 26 日阿尔萨斯首次正式确认病例和 2020 年 3 月 3 日发出卫生警报之前已经传播了数周。宗教集会似乎在法国的疫情二次传播中发挥了作用，但没有在当地引发疫情爆发。
我们的结果说明了如何整合来自多个来源的数据可以帮助在新出现的疾病背景下提前发出警报。能够更早地发出警报的良好信息数据系统本可以避免法国的全面封锁。
