Cited by 349COVID-19 epidemiological studiesCOVID-19 Prevention and ImpactCOVID-19 Clinical Research Studies

COVID-19 in New Zealand and the impact of the national response: a descriptive epidemiological study

Open access
Jefferies, Sarah, French, Nigel, Gilkison, Charlotte, Graham, Giles, Hope, Virginia, Marshall, Jonathan, McElnay, Caroline, McNeill, Andrea +7 more·2020·The Lancet Public Health

Abstract

BACKGROUND: In early 2020, during the COVID-19 pandemic, New Zealand implemented graduated, risk-informed national COVID-19 suppression measures aimed at disease elimination. We investigated their impacts on the epidemiology of the first wave of COVID-19 in the country and response performance measures. METHODS: We did a descriptive epidemiological study of all laboratory-confirmed and probable cases of COVID-19 and all patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in New Zealand from Feb 2 to May 13, 2020, after which time community transmission ceased. We extracted data from the national notifiable diseases database and the national SARS-CoV-2 test results repository. Demographic features and disease outcomes, transmission patterns (source of infection, outbreaks, household transmission), time-to-event intervals, and testing coverage were described over five phases of the response, capturing different levels of non-pharmaceutical interventions. Risk factors for severe outcomes (hospitalisation or death) were examined with multivariable logistic regression and time-to-event intervals were analysed by fitting parametric distributions using maximum likelihood estimation. FINDINGS: 1503 cases were detected over the study period, including 95 (6·3%) hospital admissions and 22 (1·5%) COVID-19 deaths. The estimated case infection rate per million people per day peaked at 8·5 (95% CI 7·6-9·4) during the 10-day period of rapid response escalation, declining to 3·2 (2·8-3·7) in the start of lockdown and progressively thereafter. 1034 (69%) cases were imported or import related, tending to be younger adults, of European ethnicity, and of higher socioeconomic status. 702 (47%) cases were linked to 34 outbreaks. Severe outcomes were associated with locally acquired infection (crude odds ratio [OR] 2·32 [95% CI 1·40-3·82] compared with imported), older age (adjusted OR ranging from 2·72 [1·40-5·30] for 50-64 year olds to 8·25 [2·59-26·31] for people aged ≥80 years compared with 20-34 year olds), aged residential care residency (adjusted OR 3·86 [1·59-9·35]), and Pacific peoples (adjusted OR 2·76 [1·14-6·68]) and Asian (2·15 [1·10-4·20]) ethnicities relative to European or other. Times from illness onset to notification and isolation progressively decreased and testing increased over the study period, with few disparities and increasing coverage of females, Māori, Pacific peoples, and lower socioeconomic groups. INTERPRETATION: New Zealand's response resulted in low relative burden of disease, low levels of population disease disparities, and the initial achievement of COVID-19 elimination. FUNDING: Ministry of Business Innovation and Employment Strategic Scientific Investment Fund, and Ministry of Health, New Zealand.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/s2468-2667(20)30225-5

Cites

23 of 23 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

2 of the 25 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Authors
Jefferies, S., French, N., Gilkison, C., Graham, G., Hope, V., Marshall, J., McElnay, C., McNeill, A., Muellner, P., Paine, S., Prasad, N., Scott, J., Sherwood, J., Yang, L., & Priest, P.
Affiliations
  • New Zealand Institute for Public Health and Forensic Science (NZ)
  • Massey University (NZ)
  • Ministry of Health (NZ)
  • University of Otago (NZ)
Corresponding author
Jefferies, Sarah
Venue
The Lancet Public Health
Publisher
Elsevier BV
Published
2020-11
Volume
5
Issue
11
Pages
e612-e623
ISSN
2468-2667 (ISSN-L)
OpenAlex
W3093036788
Cited by
349
References
25
Citations by year
2026: 7 · 2025: 23 · 2024: 31 · 2023: 45 · 2022: 62 · 2021: 174 · 2020: 7
FWCI
11.45
Type
journal article
Language
en
Open access
Locations
  • The Lancet Public Health (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Ministry of Health, New Zealand
Topics
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
  • Social Sciences › Sociology and Political Science › COVID-19 Prevention and Impact
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Keywords
COVID-19 pandemic, SARS-CoV-2, New Zealand, non-pharmaceutical interventions, lockdown, imported infections, household transmission, community outbreak, severe outcomes, hospitalization, mortality, risk factors, residential care, Pacific Islanders, socioeconomic status, test coverage, infection rate, response performance, first wave, survival analysis
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, COVID-19 Testing, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Infant, Male, Middle Aged, New Zealand, Pneumonia, Viral, Risk Factors, Epidemiologic Studies, Coronavirus Infections, Clinical Laboratory Techniques, Young Adult, Pandemics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review