Hydroxychloroquine and azithromycin treatment in 80 COVID-19 patients: short-term outcomes
Australia reported over 6,500 confirmed COVID-19 cases by April 18, 2020, with 67 case fatalities. However, the disease curve has been flattening since late March 2020, with fewer infections being reported each day.
The investigators say, "Our analysis suggests that Australia's combined strategy of early, targeted management of the risk of importation, case targeted interventions, and broad-scale social distancing measures applied prior to the onset of detected widespread community transmission has substantially mitigated the first wave of COVID-19. " Falling Reproduction Number
Researchers used a reproduction number - the number of people whom an infected COVID-19 patient infects, in the presence of public health measures and normal susceptibility to the virus. If the reproduction number was below 1 in a certain area, researchers could safely assume that there would be a drop in the infection rate. This also meant that hospitals and intensive care units would not be overwhelmed by a high number of simultaneous infections.
"We estimate that the effective reproduction number was likely below 1 (the threshold value for control) in each Australian state since mid-March and forecast that hospital ward and intensive care unit occupancy will remain below capacity thresholds over the next two weeks," researchers said.
A worst-case scenario was avoided, researchers add, where daily demand for ICU beds would have been 35,000 ICU beds at the most by May 2020, much like other countries that failed to contain the outbreak. This would have far overwhelmed Australia's health system capacity of approximately 2,200 ICU beds. Cautious Relaxations To Keep The Curve Flat
The team warned against premature relaxation of containment measures, especially in places where localized transmission has already been reported, as well as high-risk areas like nursing homes for elderly patients, which have reported a high global fatality rate.
While the case detection rate among symptomatic patients is above 77% in Australia, the number of asymptomatic, mild, and undiagnosed infections remains largely unknown, the researchers added. The presence of a high number of asymptomatic cases has been a thorn in the flesh for many countries grappling with the epidemic.
Even if there were a large number of such cases, the Australian population would still be extremely vulnerable to infection because of the low prevalence of COVID-19 so far. However, the time Australia has bought with its early action may empower it to be more prepared when the wave hits, the researchers conclude.
As of today, May 4, 2020, Australia has reported 6,801 cases and 95 deaths. 5,817 cases are reported as recovered. Over 633,000 tests for COVID-19 have been conducted to date.
"For now, Australia is one of the few countries fortunate enough to be able to plan the next steps from a position of relative calm as opposed to crisis," concludes the report. *Important Notice
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information. Journal reference: Price, D. J. et al. (2020). Early Analysis Of The Australian COVID-19 Epidemic. medRxiv preprint doi: https://doi.org/10.1101/2020.04.25.20080127 . https://www.medrxiv.org/content/10.1101/2020.04.25.20080127v1
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