Underdetection of cases of COVID-19 in France threatens epidemic control.

Abstract:

:As countries in Europe gradually relaxed lockdown restrictions after the first wave, test-trace-isolate strategies became critical to maintain the incidence of coronavirus disease 2019 (COVID-19) at low levels1,2. Reviewing their shortcomings can provide elements to consider in light of the second wave that is currently underway in Europe. Here we estimate the rate of detection of symptomatic cases of COVID-19 in France after lockdown through the use of virological3 and participatory syndromic4 surveillance data coupled with mathematical transmission models calibrated to regional hospitalizations2. Our findings indicate that around 90,000 symptomatic infections, corresponding to 9 out 10 cases, were not ascertained by the surveillance system in the first 7 weeks after lockdown from 11 May to 28 June 2020, although the test positivity rate did not exceed the 5% recommendation of the World Health Organization (WHO)5. The median detection rate increased from 7% (95% confidence interval, 6-8%) to 38% (35-44%) over time, with large regional variations, owing to a strengthening of the system as well as a decrease in epidemic activity. According to participatory surveillance data, only 31% of individuals with COVID-19-like symptoms consulted a doctor in the study period. This suggests that large numbers of symptomatic cases of COVID-19 did not seek medical advice despite recommendations, as confirmed by serological studies6,7. Encouraging awareness and same-day healthcare-seeking behaviour of suspected cases of COVID-19 is critical to improve detection. However, the capacity of the system remained insufficient even at the low epidemic activity achieved after lockdown, and was predicted to deteriorate rapidly with increasing incidence of COVID-19 cases. Substantially more aggressive, targeted and efficient testing with easier access is required to act as a tool to control the COVID-19 pandemic. The testing strategy will be critical to enable partial lifting of the current restrictive measures in Europe and to avoid a third wave.

journal_name

Nature

journal_title

Nature

authors

Pullano G,Di Domenico L,Sabbatini CE,Valdano E,Turbelin C,Debin M,Guerrisi C,Kengne-Kuetche C,Souty C,Hanslik T,Blanchon T,Boëlle PY,Figoni J,Vaux S,Campèse C,Bernard-Stoecklin S,Colizza V

doi

10.1038/s41586-020-03095-6

subject

Has Abstract

pub_date

2020-12-21 00:00:00

eissn

0028-0836

issn

1476-4687

pii

10.1038/s41586-020-03095-6

pub_type

杂志文章

相关文献

NATURE文献大全
  • RecA acts in trans to allow replication of damaged DNA by DNA polymerase V.

    abstract::The DNA polymerase V (pol V) and RecA proteins are essential components of a mutagenic translesion synthesis pathway in Escherichia coli designed to cope with DNA damage. Previously, it has been assumed that RecA binds to the DNA template strand being copied. Here we show, however, that pol-V-catalysed translesion syn...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/nature05042

    authors: Schlacher K,Cox MM,Woodgate R,Goodman MF

    更新日期:2006-08-24 00:00:00

  • Retinoblastoma protein represses transcription by recruiting a histone deacetylase.

    abstract::The retinoblastoma tumour-suppressor protein Rb inhibits cell proliferation by repressing a subset of genes that are controlled by the E2F family of transcription factors and which are involved in progression from the G1 to the S phase of the cell cycle. Rb, which is recruited to target promoters by E2F1, represses tr...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/35410

    authors: Magnaghi-Jaulin L,Groisman R,Naguibneva I,Robin P,Lorain S,Le Villain JP,Troalen F,Trouche D,Harel-Bellan A

    更新日期:1998-02-05 00:00:00

  • Mutations in Cu/Zn superoxide dismutase gene are associated with familial amyotrophic lateral sclerosis.

    abstract::Amyotrophic lateral sclerosis (ALS) is a degenerative disorder of motor neurons in the cortex, brainstem and spinal cord. Its cause is unknown and it is uniformly fatal, typically within five years. About 10% of cases are inherited as an autosomal dominant trait, with high penetrance after the sixth decade. In most in...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/362059a0

    authors: Rosen DR,Siddique T,Patterson D,Figlewicz DA,Sapp P,Hentati A,Donaldson D,Goto J,O'Regan JP,Deng HX

    更新日期:1993-03-04 00:00:00

  • Fluctuating valence in a correlated solid and the anomalous properties of delta-plutonium.

    abstract::Although the nuclear properties of the late actinides (plutonium, americium and curium) are fully understood and widely applied to energy generation, their solid-state properties do not fit within standard models and are the subject of active research. Plutonium displays phases with enormous volume differences, and bo...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/nature05647

    authors: Shim JH,Haule K,Kotliar G

    更新日期:2007-03-29 00:00:00

  • S-nitrosylation of NADPH oxidase regulates cell death in plant immunity.

    abstract::Changes in redox status are a conspicuous feature of immune responses in a variety of eukaryotes, but the associated signalling mechanisms are not well understood. In plants, attempted microbial infection triggers the rapid synthesis of nitric oxide and a parallel accumulation of reactive oxygen intermediates, the lat...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/nature10427

    authors: Yun BW,Feechan A,Yin M,Saidi NB,Le Bihan T,Yu M,Moore JW,Kang JG,Kwon E,Spoel SH,Pallas JA,Loake GJ

    更新日期:2011-10-13 00:00:00

  • Isolation of a replication-defective murine leukaemia virus from cultured AKR leukaemia cells.

    abstract::Mice of the AKR strain are characterised by a high incidence of spontaneous thymic lymphomas. AKR chromosomes contain the genomes of ecotropic murine leukaemia virus (MuLV) at two loci, termed Akv-1 and Akv-2 (refs 2-6). Shortly after birth, the normal tissues of AKR mice begin to produce high levels of this XC-positi...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/282753a0

    authors: Rein A,Athan E,Benjers BM,Bassin RH,Gerwin BI,Slocum DR

    更新日期:1979-12-13 00:00:00

  • Role of spectral detail in sound-source localization.

    abstract::Sounds heard over headphones are typically perceived inside the head (internalized), unlike real sound sources which are perceived outside the head (externalized). If the acoustical waveforms from a real sound source are reproduced precisely using headphones, auditory images are appropriately externalized and localize...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/25526

    authors: Kulkarni A,Colburn HS

    更新日期:1998-12-24 00:00:00

  • Phylogenomics reveals deep molluscan relationships.

    abstract::Evolutionary relationships among the eight major lineages of Mollusca have remained unresolved despite their diversity and importance. Previous investigations of molluscan phylogeny, based primarily on nuclear ribosomal gene sequences or morphological data, have been unsuccessful at elucidating these relationships. Re...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/nature10382

    authors: Kocot KM,Cannon JT,Todt C,Citarella MR,Kohn AB,Meyer A,Santos SR,Schander C,Moroz LL,Lieb B,Halanych KM

    更新日期:2011-09-04 00:00:00

  • Earliest sensory nerve fibres are guided to peripheral targets by attractants other than nerve growth factor.

    abstract::Recent studies have shown that developing nerve fibres grow directly to their targets and are guided by specific cues, but the nature of these cues and the mechanism of guidance remain unknown. The growth of sympathetic axons towards an artificial source of nerve growth factor (NGF) in vivo and of sensory neurites up ...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/306786a0

    authors: Lumsden AG,Davies AM

    更新日期:1983-12-22 00:00:00

  • Metal-ion coordination by U6 small nuclear RNA contributes to catalysis in the spliceosome.

    abstract::Introns are removed from nuclear messenger RNA precursors through two sequential phospho-transesterification reactions in a dynamic RNA-protein complex called the spliceosome. But whether splicing is catalysed by small nuclear RNAs in the spliceosome is unresolved. As the spliceosome is a metalloenzyme, it is importan...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/35048617

    authors: Yean SL,Wuenschell G,Termini J,Lin RJ

    更新日期:2000-12-14 00:00:00

  • Molecular mechanics of calcium-myristoyl switches.

    abstract::Many eukaryotic cellular and viral proteins have a covalently attached myristoyl group at the amino terminus. One such protein is recoverin, a calcium sensor in retinal rod cells, which controls the lifetime of photoexcited rhodopsin by inhibiting rhodopsin kinase. Recoverin has a relative molecular mass of 23,000 (M[...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/38310

    authors: Ames JB,Ishima R,Tanaka T,Gordon JI,Stryer L,Ikura M

    更新日期:1997-09-11 00:00:00

  • Driven coherent oscillations of a single electron spin in a quantum dot.

    abstract::The ability to control the quantum state of a single electron spin in a quantum dot is at the heart of recent developments towards a scalable spin-based quantum computer. In combination with the recently demonstrated controlled exchange gate between two neighbouring spins, driven coherent single spin rotations would p...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/nature05065

    authors: Koppens FH,Buizert C,Tielrooij KJ,Vink IT,Nowack KC,Meunier T,Kouwenhoven LP,Vandersypen LM

    更新日期:2006-08-17 00:00:00

  • Met-enkephalin-Arg6-Phe7, present in high amounts in brain of rat, cattle and man, is an opioid agonist.

    abstract::The enkephalins Met-enkephalin and Leu-enkephalin were first isolated from porcine brain by Hughes and co-workers. We have recently isolated from bovine adrenals another enkephalin with the structure Tyr-Gly-Gly-Phe-Met-Arg-Phe, or Met-enkephalin-Arg6-Phe7 (ref. 2). We report here that this new heptapeptide is found i...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/288088a0

    authors: Rossier J,Audigier Y,Ling N,Cros J,Udenfriend S

    更新日期:1980-11-06 00:00:00

  • The rhythm of microbial adaptation.

    abstract::The evolutionary biologist "studies the steps by which the miraculous adaptations so characteristic of every aspect of the organic world have evolved". But the general nature of such adaptive steps is still unclear. Evolution is often thought to be random and dependent on unpredictable events. In this light, one might...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/35095046

    authors: Gerrish P

    更新日期:2001-09-20 00:00:00

  • Conversion of lytic to persistent alphavirus infection by the bcl-2 cellular oncogene.

    abstract::Little is known about virus-host cell interactions that regulate the lytic potential of viruses during productive replication. Sindbis virus (SV), a single-stranded positive-sense RNA virus in the alphavirus genus (family Togaviridae), results in lytic infection in most vertebrate cell lines, but persistent productive...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/361739a0

    authors: Levine B,Huang Q,Isaacs JT,Reed JC,Griffin DE,Hardwick JM

    更新日期:1993-02-25 00:00:00

  • Functional V region formation during in vitro culture of a murine immature B precursor cell line.

    abstract::B lymphocytes originate from pluripotential haematopoietic stem cells and differentiate into immunoglobulin (Ig)-producing cells. B-cell lineage differentiation is accompanied by two types of immunoglobulin gene rearrangements--rearrangement of V, D and J gene segments to create a functional V gene and rearrangement o...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/303812a0

    authors: Sugiyama H,Akira S,Kikutani H,Kishimoto S,Yamamura Y,Kishimoto T

    更新日期:1983-06-30 00:00:00

  • Guided hierarchical co-assembly of soft patchy nanoparticles.

    abstract::The concept of hierarchical bottom-up structuring commonly encountered in natural materials provides inspiration for the design of complex artificial materials with advanced functionalities. Natural processes have achieved the orchestration of multicomponent systems across many length scales with very high precision, ...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/nature12610

    authors: Gröschel AH,Walther A,Löbling TI,Schacher FH,Schmalz H,Müller AH

    更新日期:2013-11-14 00:00:00

  • Roles of PPARs in health and disease.

    abstract::In developed societies, chronic diseases such as diabetes, obesity, atherosclerosis and cancer are responsible for most deaths. These ailments have complex causes involving genetic, environmental and nutritional factors. There is evidence that a group of closely related nuclear receptors, called peroxisome proliferato...

    journal_title:Nature

    pub_type: 杂志文章,评审

    doi:10.1038/35013000

    authors: Kersten S,Desvergne B,Wahli W

    更新日期:2000-05-25 00:00:00

  • Cell biology: nondisjunction, aneuploidy and tetraploidy.

    abstract::One simple, widely accepted mechanism for generating an aberrant chromosome number, or aneuploidy, is through nondisjunction--a chromosome distribution error that occurs during mitosis when both copies of a duplicated chromosome are deposited into one daughter cell and none into the other. Shi and King challenge this ...

    journal_title:Nature

    pub_type: 评论,杂志文章

    doi:10.1038/nature05139

    authors: Weaver BA,Silk AD,Cleveland DW

    更新日期:2006-08-17 00:00:00

  • Cell type-specific activation of actin genes in the early amphibian embryo.

    abstract::Muscle actin genes are the earliest yet described to show cell type-specific activation in amphibian embryos. Gene-specific probes show that alpha-skeletal and alpha-cardiac actin genes start to be transcribed simultaneously at the end of gastrulation, but only in those regions of the mesoderm that subsequently form e...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/311716a0

    authors: Mohun TJ,Brennan S,Dathan N,Fairman S,Gurdon JB

    更新日期:1984-10-25 00:00:00

  • A human osteosarcoma cell line secretes a growth factor structurally related to a homodimer of PDGF A-chains.

    abstract::Platelet-derived growth factor (PDGF), as purified from fresh human platelets, is a protein of relative molecular mass (Mr) 30,000 composed of two disulphide-linked subunit chains of similar size, named A and B (ref. 1). The dimer structure of PDGRF seems to be important for its biological effects, as reduction irreve...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/319511a0

    authors: Heldin CH,Johnsson A,Wennergren S,Wernstedt C,Betsholtz C,Westermark B

    更新日期:1986-02-06 00:00:00

  • The TLR4 antagonist Eritoran protects mice from lethal influenza infection.

    abstract::There is a pressing need to develop alternatives to annual influenza vaccines and antiviral agents licensed for mitigating influenza infection. Previous studies reported that acute lung injury caused by chemical or microbial insults is secondary to the generation of host-derived, oxidized phospholipid that potently st...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/nature12118

    authors: Shirey KA,Lai W,Scott AJ,Lipsky M,Mistry P,Pletneva LM,Karp CL,McAlees J,Gioannini TL,Weiss J,Chen WH,Ernst RK,Rossignol DP,Gusovsky F,Blanco JC,Vogel SN

    更新日期:2013-05-23 00:00:00

  • Extreme oxygen isotope ratios in the early Solar System.

    abstract::The origins of the building blocks of the Solar System can be studied using the isotopic composition of early planetary and meteoritic material. Oxygen isotopes in planetary materials show variations at the per cent level that are not related to the mass of the isotopes; rather, they result from the mixture of compone...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/nature03947

    authors: Aléon J,Robert F,Duprat J,Derenne S

    更新日期:2005-09-15 00:00:00

  • Solving a Higgs optimization problem with quantum annealing for machine learning.

    abstract::The discovery of Higgs-boson decays in a background of standard-model processes was assisted by machine learning methods. The classifiers used to separate signals such as these from background are trained using highly unerring but not completely perfect simulations of the physical processes involved, often resulting i...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/nature24047

    authors: Mott A,Job J,Vlimant JR,Lidar D,Spiropulu M

    更新日期:2017-10-18 00:00:00

  • Physiology: postprandial cardiac hypertrophy in pythons.

    abstract::Oxygen consumption by carnivorous reptiles increases enormously after they have eaten a large meal in order to meet metabolic demands, and this places an extra load on the cardiovascular system. Here we show that there is an extraordinarily rapid 40% increase in ventricular muscle mass in Burmese pythons (Python molur...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/434037a

    authors: Andersen JB,Rourke BC,Caiozzo VJ,Bennett AF,Hicks JW

    更新日期:2005-03-03 00:00:00

  • Calcium entry through stretch-inactivated ion channels in mdx myotubes.

    abstract::Recent advances in understanding the molecular basis of human X-linked muscular dystrophies have come from the identification of dystrophin, a cytoskeletal protein associated with the surface membrane. Although there is little or virtually no dystrophin in affected individuals, it is not known how this causes muscle d...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/344670a0

    authors: Franco A Jr,Lansman JB

    更新日期:1990-04-12 00:00:00

  • The C5a chemoattractant receptor mediates mucosal defence to infection.

    abstract::A family of G-protein-coupled chemoattractant receptors is known to mediate the transport and activation of neutrophils and macrophages This family includes receptors for chemokines, such as interleukin-8, bacterial formylated peptides, platelet-activating factor, leukotriene B4, and the complement anaphylatoxins. The...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/383086a0

    authors: Höpken UE,Lu B,Gerard NP,Gerard C

    更新日期:1996-09-05 00:00:00

  • Acceleration of Greenland ice mass loss in spring 2004.

    abstract::In 2001 the Intergovernmental Panel on Climate Change projected the contribution to sea level rise from the Greenland ice sheet to be between -0.02 and +0.09 m from 1990 to 2100 (ref. 1). However, recent work has suggested that the ice sheet responds more quickly to climate perturbations than previously thought, parti...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/nature05168

    authors: Velicogna I,Wahr J

    更新日期:2006-09-21 00:00:00

  • Gut intraepithelial T cells calibrate metabolism and accelerate cardiovascular disease.

    abstract::The biochemical response to food intake must be precisely regulated. Because ingested sugars and fats can feed into many anabolic and catabolic pathways1, how our bodies handle nutrients depends on strategically positioned metabolic sensors that link the intrinsic nutritional value of a meal with intermediary metaboli...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/s41586-018-0849-9

    authors: He S,Kahles F,Rattik S,Nairz M,McAlpine CS,Anzai A,Selgrade D,Fenn AM,Chan CT,Mindur JE,Valet C,Poller WC,Halle L,Rotllan N,Iwamoto Y,Wojtkiewicz GR,Weissleder R,Libby P,Fernández-Hernando C,Drucker DJ,Nahrendorf

    更新日期:2019-02-01 00:00:00

  • A 17-gene stemness score for rapid determination of risk in acute leukaemia.

    abstract::Refractoriness to induction chemotherapy and relapse after achievement of remission are the main obstacles to cure in acute myeloid leukaemia (AML). After standard induction chemotherapy, patients are assigned to different post-remission strategies on the basis of cytogenetic and molecular abnormalities that broadly d...

    journal_title:Nature

    pub_type: 杂志文章

    doi:10.1038/nature20598

    authors: Ng SW,Mitchell A,Kennedy JA,Chen WC,McLeod J,Ibrahimova N,Arruda A,Popescu A,Gupta V,Schimmer AD,Schuh AC,Yee KW,Bullinger L,Herold T,Görlich D,Büchner T,Hiddemann W,Berdel WE,Wörmann B,Cheok M,Preudhomme C,Domb

    更新日期:2016-12-15 00:00:00