ABSTRACT
BACKGROUND: In late February 2022, the Omicron epidemic swept through Shanghai, and the Shanghai government responded to it by adhering to a dynamic zero-COVID strategy. In this study, we conducted a retrospective analysis of the Omicron epidemic in Shanghai to explore the timing and performance of control measures based on the eventual size and duration of the outbreak. METHODS: We constructed an age-structured and vaccination-stratified SEPASHRD model by considering populations that had been detected or controlled before symptom onset. In addition, we retrospectively modeled the epidemic in Shanghai from 26 February 2022 to 31 May 2022 across four periods defined by events and interventions, on the basis of officially reported confirmed (58,084) and asymptomatic (591,346) cases. RESULTS: According to our model fitting, there were about 785,123 positive infections, of which about 57,585 positive infections were symptomatic infections. Our counterfactual assessment found that precise control by grid management was not so effective and that citywide static management was still needed. Universal and enforced control by citywide static management contained 87.65% and 96.29% of transmission opportunities, respectively. The number of daily new and cumulative infections could be significantly reduced if we implemented static management in advance. Moreover, if static management was implemented in the first 14 days of the epidemic, the number of daily new infections would be less than 10. CONCLUSIONS: The above research suggests that dynamic zeroing can only be achieved when strict prevention and control measures are implemented as early as possible. In addition, a lot of preparation is still needed if China wants to change its strategy in the future.