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. 2020 May 5;133(9):1044-1050.
doi: 10.1097/CM9.0000000000000782.

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

Ze-Liang Chen  1   2 , Qi Zhang  3 , Yi Lu  4 , Zhong-Min Guo  5 , Xi Zhang  3 , Wen-Jun Zhang  6 , Cheng Guo  7 , Cong-Hui Liao  1 , Qian-Lin Li  1 , Xiao-Hu Han  2 , Jia-Hai Lu  1
Affiliations

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

Ze-Liang Chen et al. Chin Med J (Engl). .

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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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Daily changes of Corona Virus Disease 2019, cases in China. (A) Number of the increased and cumulative cases. (B) Number of death case. (C) Suspected cases. (D) Increase in severe cases. (E) Number of the increased and cumulative cases in Hubei province. (F) Number of the increased and cumulative death case in Hubei province.
Figure 2
Figure 2
Nationwide distribution of Corona Virus Disease 2019, cases and change in trends across provinces in China. (A) Model convergence analysis. (B) Hot spots and cold spots of case distribution. (C) Overall trendline of relative risk with time. (D) Time risk probability of different provinces.
Figure 3
Figure 3
Distribution of Corona Virus Disease 2019, cases and change in trends of cities of Hubei province. (A) Model convergence analysis of case distribution. (B) Hot spots and cold spots of case distribution. (C) Trendline of relative risk with time. (D) Time risk probability of different cities of Hubei province.
Figure 4
Figure 4
Correlation between migration index and the number of cases. (A) Migration index indicating the movement of people to and from Wuhan city and Hubei province during spring festival (Yellow, 2020; Gray, 2019). (B) Emigration and immigration index of people to and from Hubei province. (C) Emigration and immigration index of people to and from Wuhan city and Hubei province from January 10 to 23, 2020. (D) Correlation between the number of cases and emigration index of people from Hubei province. (E) Correlation between the number of cases and emigration index of people from Wuhan city (inter-province migration). (F) Correlation between the number of cases and emigration index of people from Wuhan city (intra-province migration).
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References

    1. Morens DM, Folkers GK, Fauci AS. The challenge of emerging and re-emerging infectious diseases. Nature 2004; 430:242–249. doi: 10.1038/nature02759. - PMC - PubMed
    1. Suwantarat N, Apisarnthanarak A. Risks to healthcare workers with emerging diseases: lessons from MERS-CoV, Ebola, SARS, and avian flu. Curr Opin Infect Dis 2015; 28:349–361. doi: 10.1097/QCO.0000000000000183. - PubMed
    1. Li W, Shi Z, Yu M, Ren W, Smith C, Epstein JH, et al. Bats are natural reservoirs of SARS-like coronaviruses. Science 2005; 310:676–679. doi: 10.1126/science.1118391. - PubMed
    1. Krupovic M, Dolja VV, Koonin EV. Origin of viruses: primordial replicators recruiting capsids from hosts. Nat Rev Microbiol 2019; 17:449–458. doi: 10.1038/s41579-019-0205-6. - PubMed
    1. Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, et al. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020; 382:929–936. doi: 10.1056/NEJMoa2001191. - PMC - PubMed