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      Social media WeChat infers the development trend of COVID-19

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          Abstract

          Dear editor, Corona Virus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) broke out in Wuhan city, Hubei province, China in December 2019. 1 , 2 As of March 24, 2020, there were a total of 81,773 confirmed cases in China. In most parts of China, the pandemic has been under control, while the number of cases outside China is on the rise. 3 , 4 The official infectious diseases surveillance system in China is run by the Chinese Center for Disease Control and Prevention. However, its lag makes it difficult to timely catch the outbreak of epidemics. With the popularity of the Internet and smartphones, the focus of social media is often a sign of these major epidemic diseases. 5 Information and discussions on COVID-19 spread rapidly on social media, so the use of big data allows more people to pay attention to these situations earlier. WeChat is the largest social media in China, and the number of monthly active accounts has reached to 1.165 billion. The WeChat Index is an official WeChat mobile index based on the analysis of WeChat big data. It reflects the popularity of words in the past 7 days, 30 days, and even 90 days. It is often used to capture current hot events and monitor the trends of public opinion. Here, through the keyword query in the WeChat index, we analyzed the public attention and demand for the COVID-19 pandemic. We have classified keywords from late December of 2019 to the present according to their relevance. These word groups have generated a high degree of popularity in social media at some stages. Since these hot spots are in a good correlation with the occurrence and progress of some major events in China, we capture these hot events and follow their tracks. First of all, the hottest words in the pandemic are "Wuhan", "novel coronavirus" and "pneumonia" (Fig. 1 A). Their rising and downward trends were similar. The heat of these words began to increase sharply on January 19, 2020. Among them, the heat of the word "pneumonia" reached 268,350,505 seven days later, about 35 times that of seven days ago, while the heat of the word "Wuhan" reached its peak on January 25. About 16 times what it was six days ago. The heat of "novel coronavirus" remained above 150 M from January 25th to February 16th. Thus, during the period from the end of January to the beginning of February, the public attention focused on those words. Fig. 1 WeChat Index of six groups of popular words (from Dec 24, 2019 to March 22, 2020). A. WeChat Index of COVID-19 outbreak place and the name of the disease/virus. B. WeChat Index of famous doctors and whistler. C. WeChat Index of potential hosts. D. WeChat Index of potential symptoms. E. WeChat Index of disease control terms. F. WeChat Index of back to school and back to work. Fig. 1 Secondly, we looked at some key figures appeared during the epidemic and regarded as national heroes (Fig. 1B). From the comparison chart of WeChat index, the heat of these heroes increased on January 20, 2020. Zhong Nanshan for the first time declared a human-to-human transmission phenomenon in COVID-19. At the same time, a large number of medical experts rushed to the front line of Wuhan. The "whistler" Dr. Li Wenliang died on February 7, and his index reached an astonishing 179,575,130 on that day (Fig. 1B). We also looked at the potential sources and hosts of this outbreak: "bushmeat", "bat", "pangolin" and "masked palm civet" (Fig. 1C). Those words began to increase on January 20, and the heat lasted until mid-February. During this period, scientists worked hard to find clues about the source of SARS-CoV-2. In the end, bats had the highest heat because they were identified as the original source of the SARS-CoV-2. 6 COVID-19′s symptoms are public concern, and we found that "fever" is the most concerned one (Fig. 1D). Studies have shown that COVID-19 caused a variety of symptoms, and fever is not a necessary factor for diagnosis. However, because of the understanding of conventional pneumonia symptoms and fever symptoms are more obvious, the public are still concerned about fever. In addition, we paid attention to some daily words related to people's livelihood (Fig. 1E). The popularity of the word "mask" began to increase on January 19, peaked on February 6 and 7, and has remained at a high level ever since. We suspect that the highest popularity of masks is due to the fact that most people cannot buy masks, so the online booking system for the purchase of masks has been opened in many places throughout the country. Relief supplies from various countries and medical materials purchased domestically are in place in large quantities, providing strong support to front-line medical staff. The words "isolation" and "disinfection" are almost inseparable, so their trends are very consistent. "Vaccine" reached a small peak on January 26th, February 12th, February 25th and March 18th, respectively, because both researchers have announced the start of vaccine development or clinical trials of vaccines. We also found that the entries for "starting school" and "resuming work" have been very hot since the beginning of February (Fig. 1F). This is probably due to the impact of the epidemic. Many enterprises have delayed returning to work, and students who were supposed to go to school have also begun to take classes online. In February, when the epidemic is more serious, the policy of reducing crowds and allowing people to be isolated at home has aroused extensive discussion. By analyzing the hot words in WeChat, we found that there is a certain pattern in the development of COVID-19. At first, people will focus on which kind of pathogen the disease comes from, where the outbreak is located, what symptoms will appear. Then the public will begin to focus on the source of pathogens, the actions and self-protection of medical workers, as well as the needs of daily life. On the other hand, people will pay more attention to the epidemic situation in other places and the local control results. Through analysis of public concerns, we review the development trend of COVID-19, which will set up an example for future outbreaks of epidemic diseases. It is believed that public health authorities will rely more on these social medias in the future for monitoring the development of the epidemic or pandemic. Declaration of Completing Interest The authors declare that there are no conflicts of interest.

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          A pneumonia outbreak associated with a new coronavirus of probable bat origin

          Since the outbreak of severe acute respiratory syndrome (SARS) 18 years ago, a large number of SARS-related coronaviruses (SARSr-CoVs) have been discovered in their natural reservoir host, bats 1–4 . Previous studies have shown that some bat SARSr-CoVs have the potential to infect humans 5–7 . Here we report the identification and characterization of a new coronavirus (2019-nCoV), which caused an epidemic of acute respiratory syndrome in humans in Wuhan, China. The epidemic, which started on 12 December 2019, had caused 2,794 laboratory-confirmed infections including 80 deaths by 26 January 2020. Full-length genome sequences were obtained from five patients at an early stage of the outbreak. The sequences are almost identical and share 79.6% sequence identity to SARS-CoV. Furthermore, we show that 2019-nCoV is 96% identical at the whole-genome level to a bat coronavirus. Pairwise protein sequence analysis of seven conserved non-structural proteins domains show that this virus belongs to the species of SARSr-CoV. In addition, 2019-nCoV virus isolated from the bronchoalveolar lavage fluid of a critically ill patient could be neutralized by sera from several patients. Notably, we confirmed that 2019-nCoV uses the same cell entry receptor—angiotensin converting enzyme II (ACE2)—as SARS-CoV.
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            Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

            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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              The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health — The latest 2019 novel coronavirus outbreak in Wuhan, China

              The city of Wuhan in China is the focus of global attention due to an outbreak of a febrile respiratory illness due to a coronavirus 2019-nCoV. In December 2019, there was an outbreak of pneumonia of unknown cause in Wuhan, Hubei province in China, with an epidemiological link to the Huanan Seafood Wholesale Market where there was also sale of live animals. Notification of the WHO on 31 Dec 2019 by the Chinese Health Authorities has prompted health authorities in Hong Kong, Macau, and Taiwan to step up border surveillance, and generated concern and fears that it could mark the emergence of a novel and serious threat to public health (WHO, 2020a, Parr, 2020). The Chinese health authorities have taken prompt public health measures including intensive surveillance, epidemiological investigations, and closure of the market on 1 Jan 2020. SARS-CoV, MERS-CoV, avian influenza, influenza and other common respiratory viruses were ruled out. The Chinese scientists were able to isolate a 2019-nCoV from a patient within a short time on 7 Jan 2020 and perform genome sequencing of the 2019-nCoV. The genetic sequence of the 2019-nCoV has become available to the WHO on 12 Jan 2020 and this has facilitated the laboratories in different countries to produce specific diagnostic PCR tests for detecting the novel infection (WHO, 2020b). The 2019-nCoV is a β CoV of group 2B with at least 70% similarity in genetic sequence to SARS-CoV and has been named 2019-nCoV by the WHO. SARS is a zoonosis caused by SARS-CoV, which first emerged in China in 2002 before spreading to 29 countries/regions in 2003 through a travel-related global outbreak with 8,098 cases with a case fatality rate of 9.6%. Nosocomial transmission of SARS-CoV was common while the primary reservoir was putatively bats, although unproven as the actual source and the intermediary source was civet cats in the wet markets in Guangdong (Hui and Zumla, 2019). MERS is a novel lethal zoonotic disease of humans endemic to the Middle East, caused by MERS-CoV. Humans are thought to acquire MERS-CoV infection though contact with camels or camel products with a case fatality rate close to 35% while nosocomial transmission is also a hallmark (Azhar et al., 2019). The recent outbreak of clusters of viral pneumonia due to a 2019-nCoV in the Wuhan market poses significant threats to international health and may be related to sale of bush meat derived from wild or captive sources at the seafood market. As of 10 Jan 2020, 41 patients have been diagnosed to have infection by the 2019-nCoV animals. The onset of illness of the 41 cases ranges from 8 December 2019 to 2 January 2020. Symptoms include fever (>90% cases), malaise, dry cough (80%), shortness of breath (20%) and respiratory distress (15%). The vital signs were stable in most of the cases while leucopenia and lymphopenia were common. Among the 41 cases, six patients have been discharged, seven patients are in critical care and one died, while the remaining patients are in stable condition. The fatal case involved a 61 year-old man with an abdominal tumour and cirrhosis who was admitted to a hospital due to respiratory failure and severe pneumonia. The diagnoses included severe pneumonia, acute respiratory distress syndrome, septic shock and multi-organ failure. The 2019-nCoV infection in Wuhan appears clinically milder than SARS or MERS overall in terms of severity, case fatality rate and transmissibility, which increases the risk of cases remaining undetected. There is currently no clear evidence of human to human transmission. At present, 739 close contacts including 419 healthcare workers are being quarantined and monitored for any development of symptoms (WHO, 2020b, Center for Health Protection and HKSAR, 2020). No new cases have been detected in Wuhan since 3 January 2020. However the first case outside China was reported on 13th January 2020 in a Chinese tourist in Thailand with no epidemiological linkage to the Huanan Seafood Wholesale Market. The Chinese Health Authorities have carried out very appropriate and prompt response measures including active case finding, and retrospective investigations of the current cluster of patients which have been completed; The Huanan Seafood Wholesale Market has been temporarily closed to carry out investigation, environmental sanitation and disinfection; Public risk communication activities have been carried out to improve public awareness and adoption of self-protection measures. Technical guidance on novel coronavirus has been developed and will continue to be updated as additional information becomes available. However, many questions about the new coronavirus remain. While it appears to be transmitted to humans via animals, the specific animals and other reservoirs need to be identified, the transmission route, the incubation period and characteristics of the susceptible population and survival rates. At present, there is however very limited clinical information of the 2019-nCoV infection and data are missing in regard to the age range, animal source of the virus, incubation period, epidemic curve, viral kinetics, transmission route, pathogenesis, autopsy findings and any treatment response to antivirals among the severe cases. Once there is any clue to the source of animals being responsible for this outbreak, global public health authorities should examine the trading route and source of movement of animals or products taken from the wild or captive conditions from other parts to Wuhan and consider appropriate trading restrictions or other control measures to limit. The rapid identification and containment of a novel coronavirus virus in a short period of time is a re-assuring and a commendable achievement by China’s public health authorities and reflects the increasing global capacity to detect, identify, define and contain new outbreaks. The latest analysis show that the Wuhan CoV cluster with the SARS CoV.10 (Novel coronavirus - China (01): (HU) WHO, phylogenetic tree Archive Number: 20200112.6885385). This outbreak brings back memories of the novel coronavirus outbreak in China, the severe acute respiratory syndrome (SARS) in China in 2003, caused by a novel SARS-CoV-coronavirus (World Health Organization, 2019a). SARS-CoV rapidly spread from southern China in 2003 and infected more than 3000 people, killing 774 by 2004, and then disappeared – never to be seen again. However, The Middle East Respiratory Syndrome (MERS) Coronavirus (MERS-CoV) (World Health Organization, 2019b), a lethal zoonotic pathogen that was first identified in humans in the Kingdom of Saudi Arabia (KSA) in 2012 continues to emerge and re-emerge through intermittent sporadic cases, community clusters and nosocomial outbreaks. Between 2012 and December 2019, a total of 2465 laboratory-confirmed cases of MERS-CoV infection, including 850 deaths (34.4% mortality) were reported from 27 countries to WHO, the majority of which were reported by KSA (2073 cases, 772 deaths. Whilst several important aspects of MERS-CoV epidemiology, virology, mode of transmission, pathogenesis, diagnosis, clinical features, have been defined, there remain many unanswered questions, including source, transmission and epidemic potential. The Wuhan outbreak is a stark reminder of the continuing threat of zoonotic diseases to global health security. More significant and better targeted investments are required for a more concerted and collaborative global effort, learning from experiences from all geographical regions, through a ‘ONE-HUMAN-ENIVRONMENTAL-ANIMAL-HEALTH’ global consortium to reduce the global threat of zoonotic diseases (Zumla et al., 2016). Sharing experience and learning from all geographical regions and across disciplines will be key to sustaining and further developing the progress being made. Author declarations All authors have a specialist interest in emerging and re-emerging pathogens. FN, RK, OD, GI, TDMc, CD and AZ are members of the Pan-African Network on Emerging and Re-emerging Infections (PANDORA-ID-NET) funded by the European and Developing Countries Clinical Trials Partnership the EU Horizon 2020 Framework Programme for Research and Innovation. AZ is a National Institutes of Health Research senior investigator. All authors declare no conflicts of interest.
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                Author and article information

                Contributors
                Journal
                J Infect
                J. Infect
                The Journal of Infection
                The British Infection Association. Published by Elsevier Ltd.
                0163-4453
                1532-2742
                10 April 2020
                10 April 2020
                Affiliations
                [a ]School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan 250200, Shandong, China
                [b ]Institute of Basic Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250062, Shandong, China
                Author notes
                [* ]Corresponding author. armzhang@ 123456hotmail.com
                Article
                S0163-4453(20)30176-6
                10.1016/j.jinf.2020.03.050
                7194510
                32283142
                faa8e7cd-a91e-4335-9697-193fd33e9536
                © 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 26 March 2020
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                Infectious disease & Microbiology
                Infectious disease & Microbiology

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