Public Health Unit, South Eastern Sydney Local Health District, NSW, Australia; School of Public Health, University of Sydney, NSW, Australia;
Public Health Unit, South Eastern Sydney Local Health District, NSW, Australia; School of Public Health, University of Sydney, NSW, Australia.
Public Health Res Pract. 2021 Sep 8;31(3):3132112. doi: 10.17061/phrp3132112.
To describe local operational aspects of the coronavirus disease 2019 (COVID-19) response during the first three waves of outbreaks in New South Wales (NSW), Australia, which began in January, July and December 2020. Type of program or service: Public health outbreak response.
Narrative with epidemiological linking and genomic testing.
Epidemiological linking and genomic testing found that during the first wave of COVID-19 in NSW, a large number of community transmissions went undetected because of limited testing for the virus and limited contact tracing of cases. The second wave of COVID-19 in NSW emerged following reintroduction from the second wave in Victoria, Australia in July 2020, and the third wave followed undetected introduction from overseas. By the second and third waves, cases could be more effectively detected and isolated through an increased ability to test and contact trace, and to rapidly genomic sequence severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolates, allowing most cases to be identified and epidemiologically linked. This greater certainty in understanding chains of transmission resulted in control of the outbreaks despite less stringent restrictions on the community, by using a refined strategy of targeted shutdown, restrictions on cases, their close contacts, identified hotspots and venues of concern rather than a whole of community lockdown. Risk assessments of potential transmission sites were constantly updated through our evolving experience with transmission events. However, this refined strategy did leave the potential for large point source outbreaks should any cases go undetected. [Addendum] A fourth wave that began in Sydney in June 2021 challenged this strategy due to the more transmissible nature of the Delta variant of SARS-CoV-2.
A wave of COVID-19 infections can develop quickly from one infected person. The community needs to remain vigilant, adhering to physical distancing measures, signing in to venues they visit, and getting tested if they have any symptoms. Signing out of venues on exit allows public health resources to be used more efficiently to respond to outbreaks.
描述 2020 年 1 月、7 月和 12 月澳大利亚新南威尔士州（新州）COVID-19 疫情前 3 波暴发期间的当地应对行动。项目或服务类型：公共卫生疫情应对。
描述性叙述，结合流行病学关联和基因组检测。
流行病学关联和基因组检测发现，在新州 COVID-19 第一波疫情期间，由于病毒检测有限，病例接触者追踪有限，大量社区传播未被发现。新州 2020 年 7 月澳大利亚维多利亚州第二波疫情重新输入后出现第二波疫情，第三波疫情则是在海外输入后出现。到第二波和第三波疫情时，通过增加检测和接触者追踪能力，以及快速对严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）分离株进行基因组测序，能够更有效地发现和隔离病例，从而识别并对大多数病例进行流行病学关联。通过对确诊病例、其密切接触者、确定的热点和关注场所进行有针对性的关闭、限制，而不是对整个社区实施封锁，对传播链有了更明确的认识，从而控制了疫情，尽管对社区的限制较为宽松。通过我们对传播事件的不断了解，对潜在传播地点的风险评估不断更新。然而，由于 SARS-CoV-2 的 Delta 变体传播能力更强，这种精细策略仍有可能导致大规模的点状暴发。[增编]2021 年 6 月悉尼开始的第 4 波疫情对这一策略构成挑战，原因是 SARS-CoV-2 的 Delta 变体传播能力更强。
一波 COVID-19 感染可以迅速由一个感染者引发。社区需要保持警惕，遵守保持社交距离措施，在进入他们访问的场所时签到，并在出现任何症状时接受检测。离开场所时签出可以使公共卫生资源更有效地用于应对疫情。
