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. 2021 Jul;75(7):e14174.
doi: 10.1111/ijcp.14174. Epub 2021 Apr 1.

Development and application of a new framework for infectious disease management at the early stage of new epidemics: Taking COVID-19 outbreak in China as an example

Ziyi Li  1 , Cheng Li  2 , Xinyin Wu  3 , Guanming Li  1 , Guowei Li  1   4 , Junzhang Tian  1
Affiliations

Development and application of a new framework for infectious disease management at the early stage of new epidemics: Taking COVID-19 outbreak in China as an example

Ziyi Li et al. Int J Clin Pract. 2021 Jul.

Abstract

Background: The outbreak of coronavirus disease 2019 (COVID-19) rapidly spread across worldwide, posing a significant challenge to public health. Several shortcomings in the existing infectious disease management system were exposed during the pandemic, which hindered the control of the disease globally. To cope with this issue, we propose a window-period framework to reveal the general rule of the progression of management of infectious diseases and to help with decision making at the early stage of epidemics with a focus on healthcare provisions.

Methods: The framework has two significant periods (dark-window period and bright-window period). Outbreak of COVID-19 in China was used as an example for the application of the framework.

Results: The framework could reflect the progression of the epidemic objectively. The spread increased slowly in the dark-window period, but rocketed up in the bright-window period. The beginning of the bright-window period was the time when healthcare personnel were exposed to a substantially high risk of nosocomial infection. Additionally, proper and prompt preventive actions during the dark-window and bright-window periods were substantially important to reduce the future spreading of the disease.

Conclusions: It was recommended that when possible healthcare provisions should upgrade to the highest level of alert for the control of an unknown epidemic in the dark-window period, while countermeasures in the bright-window period could be accordingly adjusted with full exploration and considerations. The framework may provide some insights into how to accelerate the control of future epidemics promptly and effectively.

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Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
Proposed window‐period framework
FIGURE 2
FIGURE 2
Daily increased numbers of COVID‐19 cases for overall population and healthcare personnel in China (note–A, The number of diagnosed patients quickly increased in the bright‐window period. Eight days after the window‐period ends, the confirmed case started to decrease; B, Peak of diagnosis of healthcare personnel was in the middle of bright‐window periods. Considering the incubation period of 2‐7 days, they were supposed to be infected at the beginning of the bright‐window period.)
FIGURE 3
FIGURE 3
Time‐dependent reproduction number (Rt) stratified by the four periods for COVID‐19 in China
See this image and copyright information in PMC

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