Opinion review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2020; 8(13): 2674-2678
Published online Jul 6, 2020. doi: 10.12998/wjcc.v8.i13.2674
Minimizing the risk of community spread of COVID-19 via institutional quarantine of high-risk travelers with serial viral RNA testing: A successful experience from Macao SAR, China
Chon Fu Lio, Hou Hon Cheong, Chin Ion Lei, Iek Long Lo, Chong Lam, Iek Hou Leong
Chon Fu Lio, Hou Hon Cheong, Macao Academy of Medicine, Health Bureau, Macao SAR, China
Chin Ion Lei, Department of Internal Medicine, Centro Hospitalar Conde de São Januário, Health Bureau, Macao SAR, China
Iek Long Lo, Department of Respiratory Medicine, Centro Hospitalar Conde de São Januário, Health Bureau, Macao SAR, China
Chong Lam, Iek Hou Leong, Center for Disease Control and Prevention, Health Bureau, Macao SAR, China
Author contributions: Lei CI, Lo IL, Lio CF and Cheong HH conceived the theme and plot of the opinion review; Lio CF and Cheong HH wrote the main manuscript text and prepared figure; Lei CI, Lo IL, Lam C and Leong IH analyzed and provided comments; all authors reviewed the manuscript and contributed to the preparation of the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Chin Ion Lei, MBBS, MSc, Chief Doctor, Department of Internal Medicine, Centro Hospitalar Conde de São Januário, Health Bureau, Estrada do Visconde de S. Januário, Macao SAR, China. cilei@ssm.gov.mo
Received: May 19, 2020
Peer-review started: May 19, 2020
First decision: June 9, 2020
Revised: June 9, 2020
Accepted: June 29, 2020
Article in press: June 29, 2020
Published online: July 6, 2020
Abstract

Macao, a special administrative region (SAR) of the People’s Republic of China, is located in southern China and shares the border with mainland China. It is the most densely populated region in the world, with a population of 667400 and a total land area of 32.9 square kilometers in 2019. Since the first case diagnosed on January 22, 2020, there was a total of 45 laboratory-confirmed coronavirus disease 2019 (COVID-19) cases in Macao, of which 43 patients (96%) were imported cases. To date, all patients had been discharged successfully from Centro Hospitalar Conde de São Januário, a designated hospital to manage all COVID-19 patients in Macao. Eventually, no patient died, and no local community outbreak was noted. This opinion review describes the underlying factors that could have contributed to the successful experience in Macao SAR, China, which include the following: (1) Early implementation of containment measures; (2) Large-scale quarantine using hotel rooms to reduce the risk of a local outbreak; and (3) Multidisciplinary co-operation and transparency of information to the public. Although the successful experience in Macao SAR, China, may not be generalized to other regions, it should not be unreasonable to be well prepared with sufficient logistic support to conduct timely containment and early detection of episodic cases to prevent the backsliding of COVID-19 outbreak.

Keywords: COVID-19, Macao, RNA test, Containment, Quarantine, Outbreak

Core tip: In this article, we elaborated on some reasons behind the successful quarantine policy to curb the local outbreak in Macao. To sum up, that would be the early implementation of combined containment approach, expansion of institutional quarantine capacity with serial viral RNA tests, latest information transparently delivered to the public to ensure sufficient communication between the government and the public, and an efficient authority coordinating different parties in the society to respond to the outbreak.