Absence of nosocomial transmission of coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in the pre-pandemic phase in Hong Kong

Cheng, Vincent C.C.; Wong, Shuk-Ching; Chuang, Vivien W.M.; So, Simon Y.C.; Chen, Jonathan H.K.; Sridhar, Siddharth; To, Kelvin K.W.; Chan, Jasper F.W.; Hung, Ivan F.N.; Ho, Pak-Leung; Yuen, Kwok-Yung

BACKGROUND: To describe the infection control strategy to achieve zero nosocomial transmission of symptomatic coronavirus disease (COVID-19) due to SARS-CoV-2 during the pre-pandemic phase (the first 72 days after announcement of pneumonia cases in Wuhan) in Hong Kong. METHODS: Administrative support with the aim of zero nosocomial transmission by reducing elective clinical services, decanting wards, mobilizing isolation facilities, providing adequate personal protective equipment, coordinating laboratory network for rapid molecular diagnosis under 4-tier active surveillance for hospitalized- and out-patients, and organizing staff forum and training was implemented under the framework of preparedness plan in Hospital Authority. The trend of SARS-CoV-2 in the first 72 days was compared with that of SARS-CoV 2003. RESULTS: Up to day 72 of the epidemic, 130 (0.40%) of 32,443 patients being screened confirmed to have SARS-CoV-2 by RT-PCR. Compared with SARS outbreak in 2003, the SARS-CoV-2 case load constituted 8.9% (130 SARS-CoV-2/1458 SARS-CoV) of SARS-CoV infected cases at day 72 of the outbreak. The incidences of nosocomial acquisition of SARS-CoV per-1,000-SARS-patient-day and per-100-SARS-patient-admission were 7.9 and 16.9 respectively, which were significantly higher than the corresponding incidences of SARS-CoV-2 (zero infection, p<0.001). CONCLUSION: Administrative support to infection control could minimize the risk of nosocomial transmission of SARS-CoV-2.