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Flattening the curve in 52 days: characterisation of the COVID-19 pandemic in the Principality of Liechtenstein - an observational study.

Identifieur interne : 000057 ( Main/Corpus ); précédent : 000056; suivant : 000058

Flattening the curve in 52 days: characterisation of the COVID-19 pandemic in the Principality of Liechtenstein - an observational study.

Auteurs : Sarah Lucia Thiel ; Myriam Carol Weber ; Lorenz Risch ; Nadia Wohlwend ; Thomas Lung ; Dorothea Hillmann ; Michael Ritzler ; Martin Risch ; Philipp Kohler ; Pietro Vernazza ; Christian R. Kahlert ; Felix Fleisch ; Alexia Cusini ; Tomas V. Karajan ; Sandra Copeland ; Matthias Paprotny

Source :

RBID : pubmed:33105020

English descriptors

Abstract

BACKGROUND

The principality of Liechtenstein had its first COVID-19 case at the beginning of March 2020. After exponential growth, the pandemic’s first wave was contained, with the last case being diagnosed 52 days after the initial occurrence.

AIM

To characterise the COVID-19 pandemic in Liechtenstein.

METHODS

All patients diagnosed in Liechtenstein were followed up until recovery and again 6–8 weeks after symptom onset. They were contacted every 2 days to record their clinical status until the resolution of their symptoms. The diagnosis of COVID-19 was based on clinical symptoms and molecular testing. Household and close workplace contacts were included in the follow-up, which also comprised antibody testing. In addition, public health measures installed during the pandemic in Liechtenstein are summarised.

RESULTS

During the first wave, 5% of the population obtained a reverse transcriptase polymerase chain reaction test. A total of 95 patients (median age 39 years) were diagnosed with COVID-19 (82 who resided in Liechtenstein), resulting in an incidence in Liechtenstein of 0.211%. One patient, aged 94, died (mortality rate 1%). Only 62% of patients could retrospectively identify a potential source of infection. Testing the patients’ household and close workplace contacts (n = 170) with antibody tests revealed that 25% of those tested were additional COVID-19 cases, a quarter of whom were asymptomatic. Those households which adhered to strict isolation measures had a significantly lower rate of affected household members than those who didn’t follow such measures. The national public health measures never restricted free movement of residents. Masks were only mandatory in healthcare settings. The use of home working for the general workforce was promoted. Gatherings were prohibited. Schools, universities, certain public spaces (like sports facilities and playgrounds), childcare facilities, nonessential shops, restaurants and bars were closed. Social distancing, hygienic measures, solidarity and supporting individuals who were at risk were the main pillars of the public health campaigns.

CONCLUSION

The close collaboration of all relevant stakeholders allowed for the complete workup of all COVID-19 patients nationwide. A multitude of factors (e.g., young age of the patients, low-threshold access to testing, close monitoring of cases, high alertness and adherence to public health measures by the population) led to the early containment of the first wave of the pandemic, with a very low rate of serious outcomes. Antibody testing for SARS-CoV-2 revealed a substantial proportion of undiagnosed COVID-19 cases among close contacts of the patients.


DOI: 10.4414/smw.2020.20361
PubMed: 33105020

Links to Exploration step

pubmed:33105020

Le document en format XML

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<name sortKey="Copeland, Sandra" sort="Copeland, Sandra" uniqKey="Copeland S" first="Sandra" last="Copeland">Sandra Copeland</name>
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<term>COVID-19 (MeSH)</term>
<term>COVID-19 Testing (MeSH)</term>
<term>Clinical Laboratory Techniques (methods)</term>
<term>Clinical Laboratory Techniques (statistics & numerical data)</term>
<term>Communicable Disease Control (methods)</term>
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<term>Pneumonia, Viral (epidemiology)</term>
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<front>
<div type="abstract" xml:lang="en">
<p>
<b>BACKGROUND</b>
</p>
<p>The principality of Liechtenstein had its first COVID-19 case at the beginning of March 2020. After exponential growth, the pandemic’s first wave was contained, with the last case being diagnosed 52 days after the initial occurrence.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>AIM</b>
</p>
<p>To characterise the COVID-19 pandemic in Liechtenstein.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>All patients diagnosed in Liechtenstein were followed up until recovery and again 6–8 weeks after symptom onset. They were contacted every 2 days to record their clinical status until the resolution of their symptoms. The diagnosis of COVID-19 was based on clinical symptoms and molecular testing. Household and close workplace contacts were included in the follow-up, which also comprised antibody testing. In addition, public health measures installed during the pandemic in Liechtenstein are summarised.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>During the first wave, 5% of the population obtained a reverse transcriptase polymerase chain reaction test. A total of 95 patients (median age 39 years) were diagnosed with COVID-19 (82 who resided in Liechtenstein), resulting in an incidence in Liechtenstein of 0.211%. One patient, aged 94, died (mortality rate 1%). Only 62% of patients could retrospectively identify a potential source of infection. Testing the patients’ household and close workplace contacts (n = 170) with antibody tests revealed that 25% of those tested were additional COVID-19 cases, a quarter of whom were asymptomatic. Those households which adhered to strict isolation measures had a significantly lower rate of affected household members than those who didn’t follow such measures. The national public health measures never restricted free movement of residents. Masks were only mandatory in healthcare settings. The use of home working for the general workforce was promoted. Gatherings were prohibited. Schools, universities, certain public spaces (like sports facilities and playgrounds), childcare facilities, nonessential shops, restaurants and bars were closed. Social distancing, hygienic measures, solidarity and supporting individuals who were at risk were the main pillars of the public health campaigns.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>The close collaboration of all relevant stakeholders allowed for the complete workup of all COVID-19 patients nationwide. A multitude of factors (e.g., young age of the patients, low-threshold access to testing, close monitoring of cases, high alertness and adherence to public health measures by the population) led to the early containment of the first wave of the pandemic, with a very low rate of serious outcomes. Antibody testing for SARS-CoV-2 revealed a substantial proportion of undiagnosed COVID-19 cases among close contacts of the patients.</p>
</div>
</front>
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<AbstractText Label="BACKGROUND">The principality of Liechtenstein had its first COVID-19 case at the beginning of March 2020. After exponential growth, the pandemic’s first wave was contained, with the last case being diagnosed 52 days after the initial occurrence.</AbstractText>
<AbstractText Label="AIM">To characterise the COVID-19 pandemic in Liechtenstein.</AbstractText>
<AbstractText Label="METHODS">All patients diagnosed in Liechtenstein were followed up until recovery and again 6–8 weeks after symptom onset. They were contacted every 2 days to record their clinical status until the resolution of their symptoms. The diagnosis of COVID-19 was based on clinical symptoms and molecular testing. Household and close workplace contacts were included in the follow-up, which also comprised antibody testing. In addition, public health measures installed during the pandemic in Liechtenstein are summarised.</AbstractText>
<AbstractText Label="RESULTS">During the first wave, 5% of the population obtained a reverse transcriptase polymerase chain reaction test. A total of 95 patients (median age 39 years) were diagnosed with COVID-19 (82 who resided in Liechtenstein), resulting in an incidence in Liechtenstein of 0.211%. One patient, aged 94, died (mortality rate 1%). Only 62% of patients could retrospectively identify a potential source of infection. Testing the patients’ household and close workplace contacts (n = 170) with antibody tests revealed that 25% of those tested were additional COVID-19 cases, a quarter of whom were asymptomatic. Those households which adhered to strict isolation measures had a significantly lower rate of affected household members than those who didn’t follow such measures. The national public health measures never restricted free movement of residents. Masks were only mandatory in healthcare settings. The use of home working for the general workforce was promoted. Gatherings were prohibited. Schools, universities, certain public spaces (like sports facilities and playgrounds), childcare facilities, nonessential shops, restaurants and bars were closed. Social distancing, hygienic measures, solidarity and supporting individuals who were at risk were the main pillars of the public health campaigns.</AbstractText>
<AbstractText Label="CONCLUSION">The close collaboration of all relevant stakeholders allowed for the complete workup of all COVID-19 patients nationwide. A multitude of factors (e.g., young age of the patients, low-threshold access to testing, close monitoring of cases, high alertness and adherence to public health measures by the population) led to the early containment of the first wave of the pandemic, with a very low rate of serious outcomes. Antibody testing for SARS-CoV-2 revealed a substantial proportion of undiagnosed COVID-19 cases among close contacts of the patients.</AbstractText>
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<LastName>Thiel</LastName>
<ForeName>Sarah Lucia</ForeName>
<Initials>SL</Initials>
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<Affiliation>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz, Liechtenstein.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y">
<LastName>Weber</LastName>
<ForeName>Myriam Carol</ForeName>
<Initials>MC</Initials>
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<Affiliation>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz, Liechtenstein.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Risch</LastName>
<ForeName>Lorenz</ForeName>
<Initials>L</Initials>
<AffiliationInfo>
<Affiliation>Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein / Centre of Laboratory Medicine, University Institute of Clinical Chemistry, University of Bern, Switzerland / Private University of the Principality of Liechtenstein, Triesen, Liechtenstein.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Wohlwend</LastName>
<ForeName>Nadia</ForeName>
<Initials>N</Initials>
<AffiliationInfo>
<Affiliation>Private University of the Principality of Liechtenstein, Triesen, Liechtenstein.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Lung</LastName>
<ForeName>Thomas</ForeName>
<Initials>T</Initials>
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<Affiliation>Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein.</Affiliation>
</AffiliationInfo>
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<LastName>Hillmann</LastName>
<ForeName>Dorothea</ForeName>
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<Affiliation>Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
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