Commonwealth Healthcare Corporation, Saipan, Commonwealth of the Northern Mariana Islands, United States of America.
Pacific Island Health Officers Association, Honolulu, HI, United States of America.
Western Pac Surveill Response J. 2023 Jan 25;14(1):1-10. doi: 10.5365/wpsar.2023.14.1.965. eCollection 2023 Jan-Mar.
The Commonwealth of the Northern Mariana Islands (CNMI) is a remote Pacific island territory with a population of 47 329 that successfully prevented the significant introduction of coronavirus disease (COVID-19) until late 2021. This study documents how the response to the introduction of COVID-19 in CNMI in 2021 was conducted with limited resources without overwhelming local clinical capacity or compromising health service delivery for the population.
Data from COVID-19 case investigations, contact tracing, the Commonwealth's immunization registry and whole genome sequencing were collated and analysed as part of this study.
Between 26 March 2020 and 31 December 2021, 3281 cases and 14 deaths due to COVID-19 were reported in CNMI (case fatality rate, 0.4%). While notification rates were highest among younger age groups, hospitalization and mortality rates were disproportionately greater among those aged > 50 years and among the unvaccinated. The first widespread community transmission in CNMI was detected in October 2021, with genomic epidemiology and contact tracing data indicating a single introduction event involving the AY.25 lineage and subsequent rapid community spread. Vaccination coverage was high before widespread transmission occurred in October 2021 and increased further over the study period.
Robust preparedness and strong leadership generated resilience within the public health sector such that COVID-19 did not overwhelm CNMI's health system as it did in other jurisdictions and countries around the world. At no point was hospital capacity exceeded, and all patients received adequate care without the need for health-care rationing.
北马里亚纳群岛联邦（CNMI）是一个位于太平洋偏远地区的岛屿领土，人口 47329 人，直到 2021 年底才成功阻止了新冠病毒疾病（COVID-19）的大规模传入。本研究记录了 2021 年 CNMI 对 COVID-19 引入的反应是如何在资源有限的情况下进行的，没有使当地临床能力不堪重负，也没有损害为民众提供的医疗服务。
本研究将 COVID-19 病例调查、接触者追踪、联邦免疫登记处和全基因组测序的数据进行了整理和分析。
在 2020 年 3 月 26 日至 2021 年 12 月 31 日期间，CNMI 报告了 3281 例 COVID-19 病例和 14 例死亡（病死率为 0.4%）。虽然通知率在年轻人群中最高，但住院和死亡率在>50 岁人群和未接种疫苗人群中不成比例地更高。2021 年 10 月在 CNMI 首次发现广泛的社区传播，基因组流行病学和接触者追踪数据表明，单次引入事件涉及 AY.25 谱系，随后迅速在社区传播。在 2021 年 10 月广泛传播之前，疫苗接种覆盖率很高，并且在研究期间进一步增加。
强大的准备和强有力的领导使公共卫生部门具有弹性，因此 COVID-19 没有像在其他司法管辖区和世界各地的其他国家那样使 CNMI 的卫生系统不堪重负。在任何时候都没有超过医院的容量，所有患者都得到了充分的治疗，而无需进行医疗资源配给。
