Early characteristics of the COVID-19 outbreak predict the subsequent epidemic scope

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Zhang, L; Tao, Y; Wang, J; Ong, JJ; Tang, W; Zou, M; Bai, L; Ding, M; Shen, M; Zhuang, G; ...Date
2020-08-01Source Title
International Journal of Infectious DiseasesPublisher
ELSEVIER SCI LTDAffiliation
University GeneralMedical Education
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Journal ArticleCitations
Zhang, L., Tao, Y., Wang, J., Ong, J. J., Tang, W., Zou, M., Bai, L., Ding, M., Shen, M., Zhuang, G. & Fairley, C. K. (2020). Early characteristics of the COVID-19 outbreak predict the subsequent epidemic scope. INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, 97, pp.219-224. https://doi.org/10.1016/j.ijid.2020.05.122.Access Status
Open AccessAbstract
OBJECTIVES: The mostly-resolved first wave of the COVID-19 epidemic in China provided a unique opportunity to investigate how the initial characteristics of the COVID-19 outbreak predict its subsequent magnitude. METHODS: We collected publicly available COVID-19 epidemiological data from 436 Chinese cities from 16th January-15th March 2020. Based on 45 cities that reported >100 confirmed cases, we examined the correlation between early-stage epidemic characteristics and subsequent epidemic magnitude. RESULTS: We identified a transition point from a slow- to a fast-growing phase for COVID-19 at 5.5 (95% CI, 4.6-6.4) days after the first report, and 30 confirmed cases marked a critical threshold for this transition. The average time for the number of confirmed cases to increase from 30 to 100 (time from 30-to-100) was 6.6 (5.3-7.9) days, and the average case-fatality rate in the first 100 confirmed cases (CFR-100) was 0.8% (0.2-1.4%). The subsequent epidemic size per million population was significantly associated with both of these indicators. We predicted a ranking of epidemic size in the cities based on these two indicators and found it highly correlated with the actual classification of epidemic size. CONCLUSIONS: Early epidemic characteristics are important indicators for the size of the entire epidemic.
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