Flattening the curve in 52 days: characterisation of the COVID-19 pandemic in the Principality of Liechtenstein - an observational study.
Identifieur interne : 000157 ( Main/Exploration ); précédent : 000156; suivant : 000158Flattening the curve in 52 days: characterisation of the COVID-19 pandemic in the Principality of Liechtenstein - an observational study.
Auteurs : Sarah Lucia Thiel [Liechtenstein] ; Myriam Carol Weber [Liechtenstein] ; Lorenz Risch [Liechtenstein] ; Nadia Wohlwend [Liechtenstein] ; Thomas Lung [Liechtenstein] ; Dorothea Hillmann [Liechtenstein] ; Michael Ritzler [Liechtenstein] ; Martin Risch [Suisse] ; Philipp Kohler [Suisse] ; Pietro Vernazza [Suisse] ; Christian R. Kahlert [Suisse] ; Felix Fleisch [Suisse] ; Alexia Cusini [Suisse] ; Tomas V. Karajan [Liechtenstein] ; Sandra Copeland [Liechtenstein] ; Matthias Paprotny [Liechtenstein]Source :
- Swiss medical weekly [ 1424-3997 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Betacoronavirus (isolement et purification), Contrôle des maladies transmissibles (méthodes), Contrôle des maladies transmissibles (organisation et administration), Femelle (MeSH), Humains (MeSH), Incidence (MeSH), Infections à coronavirus (diagnostic), Infections à coronavirus (prévention et contrôle), Infections à coronavirus (thérapie), Infections à coronavirus (épidémiologie), Liechtenstein (épidémiologie), Maladies asymptomatiques (épidémiologie), Monitorage physiologique (méthodes), Mâle (MeSH), Pandémies (prévention et contrôle), Pneumopathie virale (prévention et contrôle), Pneumopathie virale (thérapie), Pneumopathie virale (épidémiologie), Techniques de laboratoire clinique (méthodes), Techniques de laboratoire clinique (statistiques et données numériques), Traçage des contacts (MeSH).
- MESH :
- diagnostic : Infections à coronavirus.
- isolement et purification : Betacoronavirus.
- méthodes : Contrôle des maladies transmissibles, Monitorage physiologique, Techniques de laboratoire clinique.
- organisation et administration : Contrôle des maladies transmissibles.
- prévention et contrôle : Infections à coronavirus, Pandémies, Pneumopathie virale.
- statistiques et données numériques : Techniques de laboratoire clinique.
- thérapie : Infections à coronavirus, Pneumopathie virale.
- épidémiologie : Infections à coronavirus, Liechtenstein, Maladies asymptomatiques, Pneumopathie virale.
- Adulte, Femelle, Humains, Incidence, Mâle, Traçage des contacts.
- Wicri :
- geographic : Liechtenstein.
English descriptors
- KwdEn :
- Adult (MeSH), Asymptomatic Diseases (epidemiology), Betacoronavirus (isolation & purification), COVID-19 (MeSH), COVID-19 Testing (MeSH), Clinical Laboratory Techniques (methods), Clinical Laboratory Techniques (statistics & numerical data), Communicable Disease Control (methods), Communicable Disease Control (organization & administration), Contact Tracing (MeSH), Coronavirus Infections (diagnosis), Coronavirus Infections (epidemiology), Coronavirus Infections (prevention & control), Coronavirus Infections (therapy), Female (MeSH), Humans (MeSH), Incidence (MeSH), Liechtenstein (epidemiology), Male (MeSH), Monitoring, Physiologic (methods), Pandemics (prevention & control), Pneumonia, Viral (epidemiology), Pneumonia, Viral (prevention & control), Pneumonia, Viral (therapy), SARS-CoV-2 (MeSH).
- MESH :
- geographic , epidemiology : Liechtenstein.
- diagnosis : Coronavirus Infections.
- epidemiology : Asymptomatic Diseases, Coronavirus Infections, Pneumonia, Viral.
- isolation & purification : Betacoronavirus.
- methods : Clinical Laboratory Techniques, Communicable Disease Control, Monitoring, Physiologic.
- organization & administration : Communicable Disease Control.
- prevention & control : Coronavirus Infections, Pandemics, Pneumonia, Viral.
- statistics & numerical data : Clinical Laboratory Techniques.
- therapy : Coronavirus Infections, Pneumonia, Viral.
- Adult, COVID-19, COVID-19 Testing, Contact Tracing, Female, Humans, Incidence, Male, SARS-CoV-2.
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
Affiliations:
Links toward previous steps (curation, corpus...)
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Internal Medicine, Landesspital Liechtenstein, Vaduz, Liechtenstein.</nlm:affiliation><country xml:lang="fr">Liechtenstein</country><wicri:regionArea>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz</wicri:regionArea><wicri:noRegion>Vaduz</wicri:noRegion></affiliation></author><author><name sortKey="Risch, Lorenz" sort="Risch, Lorenz" uniqKey="Risch L" first="Lorenz" last="Risch">Lorenz Risch</name><affiliation wicri:level="1"><nlm: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.</nlm:affiliation><country xml:lang="fr">Liechtenstein</country><wicri:regionArea>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</wicri:regionArea><wicri:noRegion>Triesen</wicri:noRegion></affiliation></author><author><name sortKey="Wohlwend, Nadia" sort="Wohlwend, Nadia" uniqKey="Wohlwend N" first="Nadia" last="Wohlwend">Nadia Wohlwend</name><affiliation wicri:level="1"><nlm:affiliation>Private University of the Principality of Liechtenstein, Triesen, Liechtenstein.</nlm:affiliation><country xml:lang="fr">Liechtenstein</country><wicri:regionArea>Private University of the Principality of Liechtenstein, Triesen</wicri:regionArea><wicri:noRegion>Triesen</wicri:noRegion></affiliation></author><author><name sortKey="Lung, Thomas" sort="Lung, Thomas" uniqKey="Lung T" first="Thomas" last="Lung">Thomas Lung</name><affiliation wicri:level="1"><nlm:affiliation>Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein.</nlm:affiliation><country xml:lang="fr">Liechtenstein</country><wicri:regionArea>Labormedizinisches Zentrum Dr Risch, Vaduz</wicri:regionArea><wicri:noRegion>Vaduz</wicri:noRegion></affiliation></author><author><name sortKey="Hillmann, Dorothea" sort="Hillmann, Dorothea" uniqKey="Hillmann D" first="Dorothea" last="Hillmann">Dorothea Hillmann</name><affiliation wicri:level="1"><nlm:affiliation>Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein.</nlm:affiliation><country xml:lang="fr">Liechtenstein</country><wicri:regionArea>Labormedizinisches Zentrum Dr Risch, Vaduz</wicri:regionArea><wicri:noRegion>Vaduz</wicri:noRegion></affiliation></author><author><name sortKey="Ritzler, Michael" sort="Ritzler, Michael" uniqKey="Ritzler M" first="Michael" last="Ritzler">Michael Ritzler</name><affiliation wicri:level="1"><nlm:affiliation>Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein.</nlm:affiliation><country xml:lang="fr">Liechtenstein</country><wicri:regionArea>Labormedizinisches Zentrum Dr Risch, Vaduz</wicri:regionArea><wicri:noRegion>Vaduz</wicri:noRegion></affiliation></author><author><name sortKey="Risch, Martin" sort="Risch, Martin" uniqKey="Risch M" first="Martin" last="Risch">Martin Risch</name><affiliation wicri:level="1"><nlm:affiliation>Central Laboratory, Kantonsspital Graubünden, Chur, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Central Laboratory, Kantonsspital Graubünden, Chur</wicri:regionArea><wicri:noRegion>Chur</wicri:noRegion></affiliation></author><author><name sortKey="Kohler, Philipp" sort="Kohler, Philipp" uniqKey="Kohler P" first="Philipp" last="Kohler">Philipp Kohler</name><affiliation wicri:level="1"><nlm:affiliation>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St Gallen, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St Gallen</wicri:regionArea><wicri:noRegion>Kantonsspital St Gallen</wicri:noRegion></affiliation></author><author><name sortKey="Vernazza, Pietro" sort="Vernazza, Pietro" uniqKey="Vernazza P" first="Pietro" last="Vernazza">Pietro Vernazza</name><affiliation wicri:level="1"><nlm:affiliation>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St Gallen, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St Gallen</wicri:regionArea><wicri:noRegion>Kantonsspital St Gallen</wicri:noRegion></affiliation></author><author><name sortKey="Kahlert, Christian R" sort="Kahlert, Christian R" uniqKey="Kahlert C" first="Christian R" last="Kahlert">Christian R. Kahlert</name><affiliation wicri:level="1"><nlm:affiliation>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St Gallen, Switzerland / Department of Infectious Diseases and Hospital Epidemiology, Children's Hospital of Eastern Switzerland, St Gallen, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St Gallen, Switzerland / Department of Infectious Diseases and Hospital Epidemiology, Children's Hospital of Eastern Switzerland, St Gallen</wicri:regionArea><wicri:noRegion>St Gallen</wicri:noRegion></affiliation></author><author><name sortKey="Fleisch, Felix" sort="Fleisch, Felix" uniqKey="Fleisch F" first="Felix" last="Fleisch">Felix Fleisch</name><affiliation wicri:level="1"><nlm:affiliation>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital Graubünden, Chur, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital Graubünden, Chur</wicri:regionArea><wicri:noRegion>Chur</wicri:noRegion></affiliation></author><author><name sortKey="Cusini, Alexia" sort="Cusini, Alexia" uniqKey="Cusini A" first="Alexia" last="Cusini">Alexia Cusini</name><affiliation wicri:level="1"><nlm:affiliation>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital Graubünden, Chur, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital Graubünden, Chur</wicri:regionArea><wicri:noRegion>Chur</wicri:noRegion></affiliation></author><author><name sortKey="Karajan, Tomas V" sort="Karajan, Tomas V" uniqKey="Karajan T" first="Tomas V" last="Karajan">Tomas V. Karajan</name><affiliation wicri:level="1"><nlm:affiliation>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz, Liechtenstein.</nlm:affiliation><country xml:lang="fr">Liechtenstein</country><wicri:regionArea>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz</wicri:regionArea><wicri:noRegion>Vaduz</wicri:noRegion></affiliation></author><author><name sortKey="Copeland, Sandra" sort="Copeland, Sandra" uniqKey="Copeland S" first="Sandra" last="Copeland">Sandra Copeland</name><affiliation wicri:level="1"><nlm:affiliation>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz, Liechtenstein.</nlm:affiliation><country xml:lang="fr">Liechtenstein</country><wicri:regionArea>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz</wicri:regionArea><wicri:noRegion>Vaduz</wicri:noRegion></affiliation></author><author><name sortKey="Paprotny, Matthias" sort="Paprotny, Matthias" uniqKey="Paprotny M" first="Matthias" last="Paprotny">Matthias Paprotny</name><affiliation wicri:level="1"><nlm:affiliation>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz, Liechtenstein.</nlm:affiliation><country xml:lang="fr">Liechtenstein</country><wicri:regionArea>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz</wicri:regionArea><wicri:noRegion>Vaduz</wicri:noRegion></affiliation></author></analytic><series><title level="j">Swiss medical weekly</title><idno type="eISSN">1424-3997</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Asymptomatic Diseases (epidemiology)</term><term>Betacoronavirus (isolation & purification)</term><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><term>Communicable Disease Control (organization & administration)</term><term>Contact Tracing (MeSH)</term><term>Coronavirus Infections (diagnosis)</term><term>Coronavirus Infections (epidemiology)</term><term>Coronavirus Infections (prevention & control)</term><term>Coronavirus Infections (therapy)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Incidence (MeSH)</term><term>Liechtenstein (epidemiology)</term><term>Male (MeSH)</term><term>Monitoring, Physiologic (methods)</term><term>Pandemics (prevention & control)</term><term>Pneumonia, Viral (epidemiology)</term><term>Pneumonia, Viral (prevention & control)</term><term>Pneumonia, Viral (therapy)</term><term>SARS-CoV-2 (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Betacoronavirus (isolement et purification)</term><term>Contrôle des maladies transmissibles (méthodes)</term><term>Contrôle des maladies transmissibles (organisation et administration)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Incidence (MeSH)</term><term>Infections à coronavirus (diagnostic)</term><term>Infections à coronavirus (prévention et contrôle)</term><term>Infections à coronavirus (thérapie)</term><term>Infections à coronavirus (épidémiologie)</term><term>Liechtenstein (épidémiologie)</term><term>Maladies asymptomatiques (épidémiologie)</term><term>Monitorage physiologique (méthodes)</term><term>Mâle (MeSH)</term><term>Pandémies (prévention et contrôle)</term><term>Pneumopathie virale (prévention et contrôle)</term><term>Pneumopathie virale (thérapie)</term><term>Pneumopathie virale (épidémiologie)</term><term>Techniques de laboratoire clinique (méthodes)</term><term>Techniques de laboratoire clinique (statistiques et données numériques)</term><term>Traçage des contacts (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Liechtenstein</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à coronavirus</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Asymptomatic Diseases</term><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Clinical Laboratory Techniques</term><term>Communicable Disease Control</term><term>Monitoring, Physiologic</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Contrôle des maladies transmissibles</term><term>Monitorage physiologique</term><term>Techniques de laboratoire clinique</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Contrôle des maladies transmissibles</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Communicable Disease Control</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Coronavirus Infections</term><term>Pandemics</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Infections à coronavirus</term><term>Pandémies</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Clinical Laboratory Techniques</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Techniques de laboratoire clinique</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Infections à coronavirus</term><term>Liechtenstein</term><term>Maladies asymptomatiques</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>COVID-19</term><term>COVID-19 Testing</term><term>Contact Tracing</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Male</term><term>SARS-CoV-2</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Mâle</term><term>Traçage des contacts</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Liechtenstein</term></keywords></textClass></profileDesc></teiHeader><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></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33105020</PMID><DateCompleted><Year>2020</Year><Month>11</Month><Day>09</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>10</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1424-3997</ISSN><JournalIssue CitedMedium="Internet"><Volume>150</Volume><PubDate><Year>2020</Year><Month>10</Month><Day>05</Day></PubDate></JournalIssue><Title>Swiss medical weekly</Title><ISOAbbreviation>Swiss Med Wkly</ISOAbbreviation></Journal><ArticleTitle>Flattening the curve in 52 days: characterisation of the COVID-19 pandemic in the Principality of Liechtenstein - an observational study.</ArticleTitle><Pagination><MedlinePgn>w20361</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.4414/smw.2020.20361</ELocationID><ELocationID EIdType="pii" ValidYN="Y">Swiss Med Wkly. 2020;150:w20361</ELocationID><Abstract><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></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Thiel</LastName><ForeName>Sarah Lucia</ForeName><Initials>SL</Initials><AffiliationInfo><Affiliation>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz, Liechtenstein.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weber</LastName><ForeName>Myriam Carol</ForeName><Initials>MC</Initials><AffiliationInfo><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><AffiliationInfo><Affiliation>Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hillmann</LastName><ForeName>Dorothea</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ritzler</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Risch</LastName><ForeName>Martin</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Central Laboratory, Kantonsspital Graubünden, Chur, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kohler</LastName><ForeName>Philipp</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St Gallen, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vernazza</LastName><ForeName>Pietro</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St Gallen, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kahlert</LastName><ForeName>Christian R</ForeName><Initials>CR</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St Gallen, Switzerland / Department of Infectious Diseases and Hospital Epidemiology, Children's Hospital of Eastern Switzerland, St Gallen, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fleisch</LastName><ForeName>Felix</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital Graubünden, Chur, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cusini</LastName><ForeName>Alexia</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital Graubünden, Chur, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Karajan</LastName><ForeName>Tomas V</ForeName><Initials>TV</Initials><AffiliationInfo><Affiliation>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz, Liechtenstein.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Copeland</LastName><ForeName>Sandra</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz, Liechtenstein.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Paprotny</LastName><ForeName>Matthias</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of General Internal Medicine, Landesspital Liechtenstein, Vaduz, Liechtenstein.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>10</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Swiss Med Wkly</MedlineTA><NlmUniqueID>100970884</NlmUniqueID><ISSNLinking>0036-7672</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Protocol" UI="C000657964">COVID-19 diagnostic testing</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058070" MajorTopicYN="N">Asymptomatic Diseases</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086742" MajorTopicYN="N">COVID-19 Testing</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019411" MajorTopicYN="N">Clinical Laboratory Techniques</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003140" MajorTopicYN="Y">Communicable Disease Control</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000458" MajorTopicYN="N">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016358" MajorTopicYN="N">Contact Tracing</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="Y">Coronavirus Infections</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008015" MajorTopicYN="N" Type="Geographic">Liechtenstein</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008991" MajorTopicYN="N">Monitoring, Physiologic</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="Y">Pandemics</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="Y">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>10</Month><Day>26</Day><Hour>17</Hour><Minute>15</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>10</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>11</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33105020</ArticleId><ArticleId IdType="doi">10.4414/smw.2020.20361</ArticleId><ArticleId IdType="pii">Swiss Med Wkly. 2020;150:w20361</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Liechtenstein</li><li>Suisse</li></country></list><tree><country name="Liechtenstein"><noRegion><name sortKey="Thiel, Sarah Lucia" sort="Thiel, Sarah Lucia" uniqKey="Thiel S" first="Sarah Lucia" last="Thiel">Sarah Lucia Thiel</name></noRegion><name sortKey="Copeland, Sandra" sort="Copeland, Sandra" uniqKey="Copeland S" first="Sandra" last="Copeland">Sandra Copeland</name><name sortKey="Hillmann, Dorothea" sort="Hillmann, Dorothea" uniqKey="Hillmann D" first="Dorothea" last="Hillmann">Dorothea Hillmann</name><name sortKey="Karajan, Tomas V" sort="Karajan, Tomas V" uniqKey="Karajan T" first="Tomas V" last="Karajan">Tomas V. Karajan</name><name sortKey="Lung, Thomas" sort="Lung, Thomas" uniqKey="Lung T" first="Thomas" last="Lung">Thomas Lung</name><name sortKey="Paprotny, Matthias" sort="Paprotny, Matthias" uniqKey="Paprotny M" first="Matthias" last="Paprotny">Matthias Paprotny</name><name sortKey="Risch, Lorenz" sort="Risch, Lorenz" uniqKey="Risch L" first="Lorenz" last="Risch">Lorenz Risch</name><name sortKey="Ritzler, Michael" sort="Ritzler, Michael" uniqKey="Ritzler M" first="Michael" last="Ritzler">Michael Ritzler</name><name sortKey="Weber, Myriam Carol" sort="Weber, Myriam Carol" uniqKey="Weber M" first="Myriam Carol" last="Weber">Myriam Carol Weber</name><name sortKey="Wohlwend, Nadia" sort="Wohlwend, Nadia" uniqKey="Wohlwend N" first="Nadia" last="Wohlwend">Nadia Wohlwend</name></country><country name="Suisse"><noRegion><name sortKey="Risch, Martin" sort="Risch, Martin" uniqKey="Risch M" first="Martin" last="Risch">Martin Risch</name></noRegion><name sortKey="Cusini, Alexia" sort="Cusini, Alexia" uniqKey="Cusini A" first="Alexia" last="Cusini">Alexia Cusini</name><name sortKey="Fleisch, Felix" sort="Fleisch, Felix" uniqKey="Fleisch F" first="Felix" last="Fleisch">Felix Fleisch</name><name sortKey="Kahlert, Christian R" sort="Kahlert, Christian R" uniqKey="Kahlert C" first="Christian R" last="Kahlert">Christian R. Kahlert</name><name sortKey="Kohler, Philipp" sort="Kohler, Philipp" uniqKey="Kohler P" first="Philipp" last="Kohler">Philipp Kohler</name><name sortKey="Vernazza, Pietro" sort="Vernazza, Pietro" uniqKey="Vernazza P" first="Pietro" last="Vernazza">Pietro Vernazza</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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