ORIGINAL RESEARCH article

Front. Public Health

Sec. Infectious Diseases: Epidemiology and Prevention

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1516208

This article is part of the Research TopicInnovative Strategies for Urban Public Health Resilience in Crisis SituationsView all 14 articles

Efficiency Evaluation on Case Finding Strategy for COVID-19 Outbreak Control under China's "Dynamic Zero-Case Policy": a Retrospective Field Epidemiology Study

Provisionally accepted
Zhibei  ZhengZhibei Zheng1Wanwan  SunWanwan Sun2Shelan  LiuShelan Liu2Enfu  ChenEnfu Chen2Jinren  PANJinren PAN2*
  • 1Hangzhou Center for Disease Control and Prevention (HZCDC), Hangzhou, Zhejiang Province, China
  • 2Zhejiang Center for Disease Control and Prevention (Zhejiang CDC), Hangzhou, China

The final, formatted version of the article will be published soon.

Objectives: To evaluate the efficiency of case-finding strategy for COVID-19 outbreak control during the "dynamic zero-case policy" period in Zhejiang Province, China, in 2022.A field epidemiological observational study was conducted to describe the proportion and time distribution of all cases identified in the event. Categorical data were expressed as counts/proportions or positive rates. The proportion of control lead-time was developed to evaluate the performance of management in various at-risk populations. Positivity rates were used to evaluate the efficiency of certain case-finding approaches. The Pearson χ² test was used to compare proportions between the groups.Results: Close-contact tracing identified 62.3% of the total cases. Low-risk area resident screening revealed 15.2% of the cases, most of which were ascertained within the first 3 days. All cases found by second-layer contact tracing had a longer control lead-time, but transmission events were believed to occur during the transportation or quarantine period. A higher proportion of positive control leadtime was more effective in curbing SARS-CoV-2 transmission on subsequent days. The proportion of control lead-time between those with and without quarantine status was statistically different (χ² (1) = 248.5, P<0.001). 442 cases (0.571%) were found out of 77 462 close contacts, while 9 cases (0.104%) were found out of 8 683 second-layer contacts (χ² (1) = 32.7, P<0.001). On average, 2.2, 7.4, and 106.5 cases were detected per million tests by low-, medium-, and high-risk area residents, respectively.Conclusions: Rapid and stringent comprehensive public health and social measures can contain the spread of SARS-CoV-2 in a localized area within weeks. Close-contact tracing plays a pivotal role in COVID-19 outbreak control, but contact tracing alone is insufficient to contain the transmission. Mass screening in the early stage and outbreak site exposure person tracing also play an important role for cases finding. It is suggested that in containing severe acute infections with direct transmission route in the future, if stringent social distancing requirements have already being implemented, measures such as tracing second-layer contacts, repeated mass screening for mediumor low-risk residents during the middle and late stages of the event are not recommended.

Keywords: COVID-19, Case finding, public health and social measures, Emergency response, Efficiency of control measures

Received: 24 Oct 2024; Accepted: 28 May 2025.

Copyright: © 2025 Zheng, Sun, Liu, Chen and PAN. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Jinren PAN, Zhejiang Center for Disease Control and Prevention (Zhejiang CDC), Hangzhou, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.