Residential Clustering of Coronavirus Disease 2019 Cases and Efficiency of Building-Wide Compulsory Testing Notices as a Transmission Control Measure in Hong Kong
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Updated: Aug 1, 2025

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Published on: June 23, 2022
Benjamin R Young1, Bingyi Yang1, Peng Wu1,2
1World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Insights
Compulsory testing for coronavirus disease 2019 (COVID-19) in Hong Kong identified 13% of daily cases. While useful early on, this strategy showed limited efficiency against widespread community transmission.
Area of Science:
- Epidemiology
- Public Health
Background:
- Hong Kong implemented compulsory testing during the COVID-19 pandemic.
- Understanding the effectiveness of these measures is crucial for public health strategies.
Purpose of the Study:
- To evaluate the frequency of residential clusters of COVID-19 cases.
- To assess the efficiency of compulsory testing in identifying new COVID-19 cases in Hong Kong.
Main Methods:
- Analysis of buildings with COVID-19 cases targeted by compulsory testing.
- Matching of identified cases with locally infected individuals residing in the same buildings.
- Calculation of the percentage of daily cases detected through compulsory testing.
Main Results:
- Over 55% of buildings with COVID-19 cases reported only a single case.
- Compulsory testing detected approximately 13% of daily reported COVID-19 cases.
- The strategy was less efficient in sustained community transmission scenarios.
Conclusions:
- Residential case clusters were common, with most buildings having only one reported case.
- Compulsory testing played a role in early epidemic containment but showed diminishing returns during sustained transmission.
- The findings suggest a need for adaptive testing strategies based on transmission levels.
Abstract:
We described the frequency of residential case clusters and the efficiency of compulsory testing in identifying cases using buildings targeted in compulsory testing and locally infected coronavirus disease 2019 (COVID-19) cases matched by residence in Hong Kong. Most of the buildings (4246 of 7688, 55.2%) with COVID-19 cases identified had only 1 reported case, and 13% of the daily reported cases were detected through compulsory testing. Compulsory testing notices could be essential in attempting to eliminate infections ("zero COVID") and have an impact early in an epidemic, but they appear to be relatively inefficient in response to sustained community transmission.
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