Analysis of the Transmissibility Change of 2019-Novel Coronavirus Pneumonia and Its Potential Factors in China from 2019 to 2020.
2019-2020 年中国 2019-传染性新冠肺炎变化及其潜在因素分析.
- 作者列表："Zhao Y","Wang R","Li J","Zhang Y","Yang H","Zhao Y
Background:Recently, a large-scale novel coronavirus pneumonia (NCP) outbreak swept China. As of Feb. 9, 2020, a total of 40,260 patients have been diagnosed with NCP, and 23,589 patients were suspected to have infected by the 2019 novel coronavirus (COVID-19), which puts forward a great challenge for public health and clinical treatment in China. Until now, we are in the high-incidence season of NCP. Thus, the analysis of the transmissibility change of NCP and its potential factors may provide a reliable reference for establishing effective prevention and control strategies. Method:By means of the method of calculating the instantaneous basic reproduction number R0t proposed by Cori et al. (2013), we use R0t to describe the transmissibility change of COVID-19 in China, 2019-2020. In addition, the Baidu Index (BDI) and Baidu Migration Scale (BMS) were selected to measure the public awareness and the effect of Wuhan lockdown (restricted persons in Wuhan outflow from the epidemic area) strategy, respectively. The Granger causality test (GCT) was carried out to explore the association between public awareness, the effect of the Wuhan lockdown strategy, and the transmissibility of COVID-19. Results:The estimated averaged basic reproduction number of NCP in China was 3.44 with 95% CI (2.87, 4.0) during Dec. 8, 2019, to Feb. 9, 2020. The instantaneous basic reproduction numbers (R0t ) have two waves and reaching peaks on Jan. 8 and Jan. 27, respectively. After reaching a peak on Jan. 27, R0t showed a continuous decline trend. On Feb. 9, R0t has fallen to 1.68 (95% CI: 1.66, 1.7), but it is still larger than 1. We find a significantly negative association between public awareness and the transmissibility change of COVID-19, with one unit increase in cumulative BDI leading to a decrease of 0.0295% (95% CI: 0.0077, 0.051) R0t . We also find a significantly negative association between the effect of the Wuhan lockdown strategy and the transmissibility change of COVID-19, and a one unit decrease in BMS may lead to a drop of 2.7% (95% CI: 0.382, 4.97) R0t . Conclusion:The current prevention and control measures have effectively reduced the transmissibility of COVID-19; however, R0t is still larger than the threshold 1. The results show that the government adopting the Wuhan lockdown strategy plays an important role in restricting the potential infected persons in Wuhan outflow from the epidemic area and avoiding a nationwide spread by quickly controlling the potential infection in Wuhan. Meanwhile, since Jan. 18, 2020, the people successively accessed COVID-19-related information via the Internet, which may help to effectively implement the government's prevention and control strategy and contribute to reducing the transmissibility of NCP. Therefore, ongoing travel restriction and public health awareness remain essential to provide a foundation for controlling the outbreak of COVID-19.
背景: 最近，一场大规模的新型冠状病毒肺炎(NCP) 爆发席卷中国。截至 2020 年 2 月 9 日，共有 40,260 名患者被诊断为NCP，23,589 名患者被怀疑感染了 2019 新型冠状病毒 (新型冠状病毒肺炎)，这对我国的公共卫生和临床治疗提出了巨大的挑战。直到现在，我们正处于NCP的高发季节。因此，分析NCP的传染性变化及其潜在因素，可为制定有效的防控策略提供可靠的参考依据。 方法: 采用Cori et al. (2013) 提出的计算瞬时基本再生数R0t的方法，用R0t描述中国传染性的新型冠状病毒肺炎变化，2019-2020。此外，选择百度指数 (BDI) 和百度迁移量表 (BMS) 来衡量公众意识和武汉禁闭 (疫区武汉流出的限制人员) 的效果战略，分别。通过格兰杰因果test (GCT)，探讨了公众意识、武汉封锁战略的效果和传染性的新型冠状病毒肺炎之间的关系。 结果: 2019 年 12 月 8 日至 20 20 0 年 2 月 9 日期间，中国NCP的平均基本繁殖次数为 3.44 次，95% CI (2.87，4.0)。瞬时基本再生数 (R0t) 有两个波，分别在 1 月 8 日和 1 月 27 日达到峰值。在 1 月 27 日达到峰值后，R0t呈持续下降趋势。2 月 9 日，R0t已降至 1。68 (95% CI: 1。66 、 1.7)，但仍大于 1。我们发现公众意识与传染性 1 9 的新型冠状病毒肺炎变化之间存在显著负相关，累积BDI增加一个单位导致 0.0295% 的下降 (95% CI: 0.0077，0.051) R0t。我们还发现武汉禁闭策略的效果与传染性变化新型冠状病毒肺炎显著负相关，BMS减少一个单位可能导致下降 2.7% (95% CI: 0.382，4.97) R0t。 结论: 现行的防治措施有效地降低了传染性的新型冠状病毒肺炎; 而R0t仍大于阈值 1。结果表明，政府采取 “武汉禁闭” 策略，通过快速控制武汉地区的潜在感染者，在控制潜在感染者从疫区流出、避免全国范围内传播等方面发挥了重要作用。武汉。同时，自 2020 年 1 月 18 日以来，人们陆续通过互联网访问COVID-19-related信息，这可能有助于政府防控战略的有效实施，并有助于降低NCP的传染性。因此，持续的旅行限制和公众健康意识仍然是控制新型冠状病毒肺炎爆发的基础。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.