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      Distribution of the COVID-19 epidemic and correlation with population emigration from Wuhan, China

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          Abstract

          Background

          The ongoing new coronavirus pneumonia (Corona Virus Disease 2019, COVID-19) outbreak is spreading in China, but it has not yet reached its peak. Five million people emigrated from Wuhan before lockdown, potentially representing a source of virus infection. Determining case distribution and its correlation with population emigration from Wuhan in the early stage of the epidemic is of great importance for early warning and for the prevention of future outbreaks.

          Methods

          The official case report on the COVID-19 epidemic was collected as of January 30, 2020. Time and location information on COVID-19 cases was extracted and analyzed using ArcGIS and WinBUGS software. Data on population migration from Wuhan city and Hubei province were extracted from Baidu Qianxi, and their correlation with the number of cases was analyzed.

          Results

          The COVID-19 confirmed and death cases in Hubei province accounted for 59.91% (5806/9692) and 95.77% (204/213) of the total cases in China, respectively. Hot spot provinces included Sichuan and Yunnan, which are adjacent to Hubei. The time risk of Hubei province on the following day was 1.960 times that on the previous day. The number of cases in some cities was relatively low, but the time risk appeared to be continuously rising. The correlation coefficient between the provincial number of cases and emigration from Wuhan was up to 0.943. The lockdown of 17 cities in Hubei province and the implementation of nationwide control measures efficiently prevented an exponential growth in the number of cases.

          Conclusions

          The population that emigrated from Wuhan was the main infection source in other cities and provinces. Some cities with a low number of cases showed a rapid increase in case load. Owing to the upcoming Spring Festival return wave, understanding the risk trends in different regions is crucial to ensure preparedness at both the individual and organization levels and to prevent new outbreaks.

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          A Novel Coronavirus from Patients with Pneumonia in China, 2019

          Na Zhu, Dingyu Zhang, Wenling Wang … (2020)
          Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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            Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

            Qun Li, Xuhua Guan, Peng Wu … (2020)
            Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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              First Case of 2019 Novel Coronavirus in the United States

              Michelle Holshue, Chas DeBolt, Scott Lindquist … (2020)
              Summary An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient’s initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Chin Med J (Engl)
                Journal ID (iso-abbrev): Chin. Med. J
                Journal ID (publisher-id): CMJ
                Title: Chinese Medical Journal
                Publisher: Wolters Kluwer Health
                ISSN (Print): 0366-6999
                ISSN (Electronic): 2542-5641
                Publication date (Electronic): 28 February 2020
                Electronic Location Identifier: 10.1097/CM9.0000000000000782
                Affiliations
                [1 ]One Health Center, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
                [2 ]Key Laboratory of Livestock Infectious Diseases in Northeast China, Ministry of Education, Shenyang Agricultural University, Shenyang, Liaoning 110866, China
                [3 ]College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang, Liaoning 110866, China
                [4 ]Department of Health Law, Policy and Management, School of Public Health, Boston University, Boston, MA 02215, USA
                [5 ]Animal Experiment Center, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
                [6 ]Department of Biological Science and Technology, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
                [7 ]Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
                Author notes
                Correspondence to: Prof. Jia-Hai Lu, One Health Center, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, ChinaE-Mail: lujiahai@ 123456mail.sysu.edu.cn
                Article
                Publisher ID: CMJ-2020-290
                DOI: 10.1097/CM9.0000000000000782
                PMC ID: 7147281
                PubMed ID: 32118644
                SO-VID: 00892805-caf3-4dce-bfa7-f3db45a32146
                Copyright © Copyright © 2020 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.
                License:

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                History
                Date received : 10 February 2020
                Categories
                Subject: Original Article
                Custom metadata
                OPEN-ACCESS TRUE
                PUBSTATE POST-ACCEPTANCE

                Keywords: corona virus disease 2019,temporal,spatial,distribution,outbreak
                Data availability:
                Keywords: corona virus disease 2019, temporal, spatial, distribution, outbreak

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