Wjst Matthias
Institut für Lungenbiologie (iLBD), Helmholtz-Zentrum München, German Research Center for Environmental Health (GmbH), München-Neuherberg.
Institut für Medizinische Informatik, Statistik und Epidemiologie, Klinikum rechts der Isar, München.
Dtsch Med Wochenschr. 2021 Jan;146(1):e1-e9. doi: 10.1055/a-1286-0212. Epub 2020 Nov 27.
The effect of non pharmacological interventions (NPIs) during an epidemic disease outbreak is well accepted dating back to historical events. NPIs involve numerous measurements like hygiene rules or contact restriction that are applied during given situations, while so far only limited quantitative data exist to rate the overall effectiveness.
Using the official counts of Robert Koch Institute in Berlin/Germany, press reports and Twitter messages, the early phase of the current COVID-19/Sars-CoV2 in Bavaria is being reconstructed.
The first cases have been observed in Munich by the end of January 2020. While the initial outbreak could be sufficiently covered using isolation and quarantine measurements, the consecutive early spreading falls into three phases, starting with winter school holidays at the end of February, a number of beer festivals in the following week, and general elections on March, 15. The disaster plan on March, 16 indicates the end of the early phase. Using the official case counts, a rather coherent picture evolves although representative epidemiological studies are still missing. The epidemic started with a few cases during the winter holidays, increased exponentially afterwards including significant more cases by beer festivals and another significant excess of cases following the election that occurred in Bavaria only. Compared to other German countries, Bavaria reached the highest prevalence which could not be reversed by even the most restrictive containment measurements.
To be effective, NPIs need to applied early, if possible even before the beginning of the exponential phase.
传染病爆发期间非药物干预措施(NPIs)的效果可追溯至历史事件,已被广泛认可。非药物干预措施涉及众多措施,如在特定情况下实施的卫生规则或接触限制,然而到目前为止,仅有有限的定量数据可用于评估其总体有效性。
利用德国柏林罗伯特·科赫研究所的官方统计数据、新闻报道和推特信息,对巴伐利亚州当前新冠病毒/严重急性呼吸综合征冠状病毒2(COVID-19/Sars-CoV2)的早期阶段进行重构。
2020年1月底在慕尼黑发现了首例病例。虽然最初的疫情爆发可以通过隔离和检疫措施得到充分控制,但随后的早期传播分为三个阶段,始于2月底的寒假、接下来一周的多个啤酒节以及3月15日的大选。3月16日的灾难预案标志着早期阶段的结束。尽管仍缺乏代表性的流行病学研究,但利用官方病例统计数据可呈现出一幅较为连贯的画面。疫情始于寒假期间的少数病例,之后呈指数级增长,啤酒节期间病例显著增加,仅在巴伐利亚州举行的选举后病例又大幅增多。与德国其他州相比,巴伐利亚州的患病率最高,即使采取最严格地防控措施也无法扭转这一局面。
为有效发挥作用,非药物干预措施需要尽早实施,若可能的话,甚至要在指数增长阶段开始之前实施。