Effects of Fang Cang Shelter Hospitals on the Reduction of COVID-19 New Cases in Wuhan: An Interrupted Time Series Analysis

Background: In December 2019, coronavirus disease 2019 (COVID-19) broke out in Wuhan, China and quickly spread to other areas and other countries worldwide. Since then, Wuhan implemented Fang Cang Shelter hospitals to stop the spread of SARS-CoV-2. This study aimed to evaluate the effects of Fang Cang Shelter hospitals on the trend of COVID-19 using an interrupted time series analysis to provide a reference for COVID-19 control in other countries. Methods: To evaluate whether Fang Cang Shelter hospitals change the epidemic trend of COVID-19 in Wuhan, China, an interrupted time series analysis was performed to compare the number of new confirmed cases of COVID-19 before (January 16, 2020–February 4, 2020) and after (February 5, 2020–March 16, 2020) the operation of Fang Cang Shelter hospitals. Our setting included Wuhan, China, where severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) was identified firstly as the cause of coronavirus disease-2019 (COVID-19). The information obtained included numbers of confirmed COVID-19 cases in Wuhan. Findings: The initial number of confirmed cases increased significantly per day prior to February 4, 2020 by 68.54 cases ( P < 0.0001; CI, 36.42–100.67) in Wuhan. Compared with the number of cases noted 20 days before the use of Fang Cang Shelter hospitals , a sustained reduction in the number of confirmed (trend change, −125.57; P < 0.0001 ; CI, −160.44 to − 90.69) cases of COVID-19 in Wuhan was noted 41 days after the use of Fang Cang Shelter hospitals. Immediate-level changes were observed for confirmed cases in Wuhan (level change, 725.97; P = 0.025; CI, 93.34–1358.59). These changes led to an estimated 5148 fewer confirmed cases ( P < 0.0001; CI, −6578.04 to −3718.29 ). Furthermore, according to the mean confirmed cases of 395.71 per day before the intervention, we estimated that Wuhan had advanced the terminal phase of COVID-19 by 13 days. Interpretation: Interrupted time series analysis revealed that Fang Cang Shelter hospitals were likely to reverse the epidemic trend of COVID-19 while containment strategy was implemented in Wuhan. The results provide a valuable reference for health policy makers in countries to which the COVID-19 outbreak has also spread, including Italy, Iran, and Spain.Funding Statement: This work was supported by The National Natural Science Foundation of China (81871681), The National First-class Discipline Programme of Food Science and Technology (JUFSTR20180101), The Fundamental Research Funds for the Central Universities funded by the Ministry of Education of China (JUSRP51710A), and Project of Wuxi Science and Technology Supporting Plan (N2020X004). Declaration of Interests: We declare no competing interests.