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# Risk Assessment of Novel Coronavirus COVID-19 Outbreaks Outside China

Journal of Clinical Medicine

MDPI

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### Abstract

We developed a computational tool to assess the risks of novel coronavirus outbreaks outside of China. We estimate the dependence of the risk of a major outbreak in a country from imported cases on key parameters such as: (i) the evolution of the cumulative number of cases in mainland China outside the closed areas; (ii) the connectivity of the destination country with China, including baseline travel frequencies, the effect of travel restrictions, and the efficacy of entry screening at destination; and (iii) the efficacy of control measures in the destination country (expressed by the local reproduction number $R loc$ ). We found that in countries with low connectivity to China but with relatively high $R loc$ , the most beneficial control measure to reduce the risk of outbreaks is a further reduction in their importation number either by entry screening or travel restrictions. Countries with high connectivity but low $R loc$ benefit the most from policies that further reduce $R loc$ . Countries in the middle should consider a combination of such policies. Risk assessments were illustrated for selected groups of countries from America, Asia, and Europe. We investigated how their risks depend on those parameters, and how the risk is increasing in time as the number of cases in China is growing.

### Most cited references24

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### Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

(2022)
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### The Rate of Underascertainment of Novel Coronavirus (2019-nCoV) Infection: Estimation Using Japanese Passengers Data on Evacuation Flights

(2020)
From 29 to 31 January 2020, a total of 565 Japanese citizens were evacuated from Wuhan, China on three chartered flights. All passengers were screened upon arrival in Japan for symptoms consistent with novel coronavirus (2019-nCoV) infection and tested for presence of the virus. Assuming that the mean detection window of the virus can be informed by the mean serial interval (estimated at 7.5 days), the ascertainment rate of infection was estimated at 9.2% (95% confidence interval: 5.0, 20.0). This indicates that the incidence of infection in Wuhan can be estimated at 20,767 infected individuals, including those with asymptomatic and mildly symptomatic infections. The infection fatality risk (IFR)—the actual risk of death among all infected individuals—is therefore 0.3% to 0.6%, which may be comparable to Asian influenza pandemic of 1957–1958.
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### Early Transmissibility Assessment of a Novel Coronavirus in Wuhan, China

(2020)
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### Author and article information

###### Journal
J Clin Med
J Clin Med
jcm
Journal of Clinical Medicine
MDPI
2077-0383
19 February 2020
February 2020
: 9
: 2
###### Affiliations
Bolyai Institute, University of Szeged, H-6720 Szeged, Hungary; boldogpeter@ 123456gmail.com (P.B.); tekeli.tamas@ 123456gmail.com (T.T.); zsvizi@ 123456math.u-szeged.hu (Z.V.); barfer@ 123456math.u-szeged.hu (F.A.B.); rost@ 123456math.u-szeged.hu (G.R.)
###### Article
jcm-09-00571
10.3390/jcm9020571
7073711
32093043