Key Words: COVID-19, coronavirus, 2019-nCoV, SARS-CoV2, 2019 novel coronavirus, forecasting, quarantine
Abstract
Introduction
The results of mandatory confinement have been detrimental in several respects. Nonetheless, they have resulted in reducing the number of active cases of COVID-19. Chile has begun the de-escalation and needs to know the best time to end the restrictions.
Objective
We discuss the best conditions and guarantees for the end of compulsory confinement.
Methods
This study is based on a trend model with prediction estimation. The data of the variables of interest were subjected to linear regression studies to determine the curve that best explained the data. The coefficient of determination, the standard deviation of y in x, and the confidence interval of the observed curve were estimated. The trend curve was chosen in accordance with the regression estimates.
Outcomes
It was found that all dependent variables tended to decrease over time in a quadratic fashion, except for the new cases variable. In general, the R2 and MAPE estimates are satisfactory, except for the variable number of PCR tests per day.
Conclusions
Gradual and cautious steps should be taken before ending mandatory confinement. In the current de-escalator, daily PCR tests should be increased, maintaining vigilance on indicators of incidence, prevalence, and positivity of PCR tests. Evidence suggests with some degree of confidence that mandatory confinement could be safely lifted as of August 30, 2020. Long-term preparations must be made to contain future waves of new cases.
No English version is available for this article.
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Introducción
Los resultados del confinamiento obligatorio han sido perjudiciales en varios aspectos. No obstante, han surtido efecto en lograr el descenso de casos activos de COVID-19. Chile ha comenzado la desescalada y precisa conocer el mejor momento para poner fin a las restricciones.
Objetivos
Discutir las mejores condiciones y garantías para el fin del confinamiento obligatorio sobre la base de los casos nuevos, casos activos y positividad de exámenes de reacción en cadena de la polimerasa.
Métodos
Estudio basado en un modelo de tendencia con estimación de predicciones. Los datos de las variables de interés fueron sometidas a estudios de regresión lineal, con el objeto de determinar la curva que mejor explicaba los datos. Se estimó el coeficiente de determinación, la desviación estándar de y en x y el intervalo de confianza de la curva observada. Posteriormente, fue escogida la curva de tendencia en concordancia con las estimaciones de regresión.
Resultados
Se encontró que todas las variables dependientes tendían a disminuir con el tiempo de forma cuadrática, con excepción de la variable casos nuevos. En general, las estimaciones de coeficiente de determinación (R2) y error porcentual absoluto medio son satisfactorias, con excepción de la variable: número de exámenes de reacción en cadena de la polimerasa por día.
Conclusiones
Se deben tomar medidas graduales y cautelosas antes de poner fin al confinamiento obligatorio. En la actual desescalada, se deben aumentar los exámenes de reacción en cadena de la polimerasa diarios y mantener vigilancia en los indicadores de incidencia, prevalencia y positividad de dichos exámenes. La evidencia sugiere con cierto grado de confiabilidad que el confinamiento obligatorio podría levantarse de forma segura a contar del día 30 de agosto de 2020. Se deben hacer preparativos a largo plazo en contención de las futuras olas, es decir, una nueva alza de casos nuevos y activos luego del descenso.
Authors:
David San Martín-Roldán[1], Francisca Rojo-Lazo[1], Aracelis Calzadilla-Núñez[2], Pablo San Martín-Roldán[3], Patricia Díaz-Calzadilla[2], Víctor P Díaz-Narváez[4]
Affiliation:
[1] Escuela de Obstetricia y Puericultura, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
[2] Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile
[3] Escuela de Nutrición y Dietética, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
[4] Facultad de Odontología, Universidad Andres Bello, Santiago, Chile
E-mail: francisca.rojo@uv.cl
Author address:
[1] Angamos 655, Reñaca, Viña del Mar
Citation: San Martín-Roldán D, Rojo-Lazo F, Calzadilla-Núñez A, San Martín-Roldán P, Díaz-Calzadilla P, Díaz-Narváez VP. Prediction of end of lockdown post-peak of cases in first wave of the COVID-19 pandemic in Chile. Medwave 2020;20(10):e8057 doi: 10.5867/medwave.2020.10.8057
Submission date: 10/7/2020
Acceptance date: 20/10/2020
Publication date: 9/11/2020
Origin: Not commissioned
Type of review: Externally peer-reviewed by five reviewers, double blind
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Rawson T, Brewer T, Veltcheva D, Huntingford C, Bonsall MB. How and When to End the COVID-19 Lockdown: An Optimization Approach. Front Public Health. 2020 Jun 10;8:262. | CrossRef | PubMed |Adhikari SP, Meng S, Wu YJ, Mao YP, Ye RX, Wang QZ, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty. 2020 Mar 17;9(1):29. | CrossRef | PubMed |Basu D, Salvatore M, Ray D, Kleinsasser M, Purkayastha S, Bhattacharyya R, et al. A Comprehensive Public Health Evaluation of Lockdown as a Non-pharmaceutical Intervention on COVID-19 Spread in India: National Trends Masking State Level Variations. medRxiv [Preprint]. 2020 Jun 14:2020.05.25.20113043. | CrossRef | PubMed |Ng WL. To lockdown? When to peak? Will there be an end? A macroeconomic analysis on COVID-19 epidemic in the United States. J Macroecon. 2020 Sep;65:103230. | CrossRef | PubMed |Johns Hopkins University, Center for Systems Science and Engineering. Cases by Country/Region/Sovereignty. COVID-19 Dashboard by the Center for Systems Science and Engineering [CSSE] at Johns Hopkins University. 2020. [On line]. | Link |Nicola M, Alsafi Z, Sohrabi C, Kerwan A, Al-Jabir A, Iosifidis C, et al. The socio-economic implications of the coronavirus pandemic (COVID-19): A review. Int J Surg. 2020 Jun;78:185-193. | CrossRef | PubMed |Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S, et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr. 2020 Sep-Oct;14(5):779-788. | CrossRef | PubMed |Ministerio de Ciencia, Tecnología, Conocimiento e Innovación de Chile. Base de Datos COVID-19. 2020. [On line]. | Link |Díaz-Narváez V, San-Martín-Roldán D, Calzadilla-Núñez A, San-Martín-Roldán P, Parody-Muñoz A, Robledo-Veloso G. Which curve provides the best explanation of the growth in confirmed COVID-19 cases in Chile? Rev Lat Am Enfermagem. 2020 Jun 26;28:e3346. | CrossRef | PubMed |Veloz T, Martínez A, Ravello C, Ropert S, Barrios A, Mora S, et al. Proyección del impacto de la pandemia de Covid-19 en Chile a través del modelo SEÎRHUD georreferenciado. 2020. [On line]. | Link |Sjödin H, Wilder-Smith A, Osman S, Farooq Z, Rocklöv J. Only strict quarantine measures can curb the coronavirus disease (COVID-19) outbreak in Italy, 2020. Euro Surveill. 2020 Apr;25(13):2000280. | CrossRef | PubMed |University of Oxford, Oxford Martin School, Our World in Data. Policy Responses to the Coronavirus Pandemic. 2020. [On line]. | Link |Robert Koch Institute (RKI). COVID-19: Fallzahlen in Deutschland und weltweit. 2020. [On line]. | Link |National Health Commission of the People's Republic of China. July 6: Daily briefing on novel coronavirus cases in China. 2020. [On line]. | Link |Centro Nacional de Epidemiología. Situación y evolución de la pandemia de COVID-19 en España. España: Ministerio de Sanidad; 2020. [On line]. | Link |Istituto Superiore di Sanità, EpiCentro. Dati della Sorveglianza integrata COVID-19 in Italia. Italia; 2020. [On line]. | Link |Rijksinstituut voor Volksgezondheid en Milieu. Actuele informatie over het nieuwe coronavirus (COVID-19). Nederlans: Ministerie van Volksgezondheid, Welzijn en Sport; 2020. [On line]. | Link |Department of Health of Australia. Coronavirus (COVID-19) at a glance infographic collection. 2020. [On line]. | Link |Social Affairs, Health, Care and Consumer Protection. Official COVID-19 Dashboard – Explanatory Notes. Austria: Federal Ministry; 2020. [On line]. | Link |Ministry of Health Manatū Hauora. COVID-19 (novel coronavirus). New Zealand; 2020. [On line]. | Link |Website of the Republic of Poland. Coronavirus: information and recommendations. 2020. [On line]. | Link |Direção-Geral da Saúde. Disponibilização de Dados. Portugal: Ministério da Saúde; 2020. [On line]. | Link |Garg S, Basu S, Rustagi R, Borle A. Primary Health Care Facility Preparedness for Outpatient Service Provision During the COVID-19 Pandemic in India: Cross-Sectional Study. JMIR Public Health Surveill. 2020 Jun 1;6(2):e19927. | CrossRef | PubMed |Kwok KO, Lai F, Wei WI, Wong SYS, Tang JWT. Herd immunity - estimating the level required to halt the COVID-19 epidemics in affected countries. J Infect. 2020 Jun;80(6):e32-e33. | CrossRef | PubMed |Li Z, Chen Q, Feng L, Rodewald L, Xia Y, Yu H, et al. Active case finding with case management: the key to tackling the COVID-19 pandemic. Lancet. 2020 Jul 4;396(10243):63-70. | CrossRef | PubMed |Saez M, Tobias A, Varga D, Barceló MA. Effectiveness of the measures to flatten the epidemic curve of COVID-19. The case of Spain. Sci Total Environ. 2020 Jul 20;727:138761. | CrossRef | PubMed |Besigye IK, Mulowooza M, Namatovu J. Coronavirus disease-2019 epidemic response in Uganda: The need to strengthen and engage primary healthcare. Afr J Prim Health Care Fam Med. 2020 Jun 4;12(1):e1-e3. | CrossRef | PubMed |Cobianchi L, Pugliese L, Peloso A, Dal Mas F, Angelos P. To a New Normal: Surgery and COVID-19 During the Transition Phase. Ann Surg. 2020 Aug;272(2):e49-e51. | CrossRef | PubMed |Wynants L, Van Calster B, Collins GS, Riley RD, Heinze G, Schuit E, et al. Prediction models for diagnosis and prognosis of covid-19 infection: systematic review and critical appraisal. BMJ. 2020 Apr 7;369:m1328. | CrossRef | PubMed |
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