Abstract:
The paper discusses the implementation of Hong Kong\'s tailor-made sewage surveillance programme led by the Government, which has demonstrated how an efficient and well-organized sewage surveillance system can complement conventional epidemiological surveillance to facilitate the planning of intervention strategies and actions for combating COVID-19 pandemic in real-time. This included the setting up of a comprehensive sewerage network-based SARS-CoV-2 virus surveillance programme with 154 stationary sites covering 6 million people (or 80 % of the total population), and employing an intensive monitoring programme to take samples from each stationary site every 2 days. From 1 January to 22 May 2022, the daily confirmed case count started with 17 cases per day on 1 January to a maximum of 76,991 cases on 3 March and dropped to 237 cases on 22 May. During this period, a total of 270 \"Restriction-Testing Declaration\" (RTD) operations at high-risk residential areas were conducted based on the sewage virus testing results, where over 26,500 confirmed cases were detected with a majority being asymptomatic. In addition, Compulsory Testing Notices (CTN) were issued to residents, and the distribution of Rapid Antigen Test kits was adopted as alternatives to RTD operations in areas of moderate risk. These measures formulated a tiered and cost-effective approach to combat the disease in the local setting. Some ongoing and future enhancement efforts to improve efficacy are discussed from the perspective of wastewater-based epidemiology. Forecast models on case counts based on sewage virus testing results were also developed with R2 of 0.9669-0.9775, which estimated that up to 22 May 2022, around 2,000,000 people (~67 % higher than the total number of 1,200,000 reported to the health authority, due to various constraints or limitations) had potentially contracted the disease, which is believed to be reflecting the real situation occurring in a highly urbanized metropolis like Hong Kong.
摘要:
文件讨论由政府主导的香港度身订造污水监察计划的实施,这证明了一个高效和组织良好的污水监测系统如何可以补充传统的流行病学监测,以促进实时防治COVID-19大流行的干预战略和行动的规划。这包括建立一个全面的基于污水处理网络的SARS-CoV-2病毒监测计划,该计划有154个固定地点,覆盖600万人(占总人口的80%),并采用密集监测方案,每两天从每个固定地点取样。从2022年1月1日至5月22日,每日确诊病例数从1月1日每天17例开始,到3月3日最多76,991例,5月22日降至237例。在此期间,根据污水病毒检测结果,在高风险住宅区共进行了270次"限制测试申报"(RTD)行动,其中超过26500例确诊病例被发现,其中大多数是无症状的。此外,向居民发出强制性测试通知书(CTN),在中等风险地区采用快速抗原检测试剂盒作为RTD操作的替代品。这些措施制定了一种分层且具有成本效益的方法,以在当地环境中与该疾病作斗争。从基于废水的流行病学的角度讨论了一些正在进行的和未来的增强努力,以提高效率。还开发了基于污水病毒检测结果的病例数预测模型,R2为0.9669-0.9775,估计到2022年5月22日,约有2000,000人(比向卫生当局报告的1,200,000人的总数高出约67%,由于各种限制或限制)可能感染了这种疾病,这被认为反映了像香港这样高度城市化的大都市的真实情况。