Global epidemiology of coronavirus disease 2019 (COVID-19): disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status

Abstract

It has been 2 months since the first case of coronavirus disease 2019 (COVID-19) was reported in Wuhan, China. So far, COVID-19 has affected 85 403 patients in 57 countries/territories and has caused 2924 deaths in 9 countries. However, epidemiological data differ between countries. Although China had higher morbidity and mortality than other sites, the number of new daily cases in China has been lower than outside of China since 26 February 2020. The incidence ranged from 61.44 per 1 000 000 people in the Republic of Korea to 0.0002 per 1 000 000 people in India. The daily cumulative index (DCI) of COVID-19 (cumulative cases/no. of days between the first reported case and 29 February 2020) was greatest in China (1320.85), followed by the Republic of Korea (78.78), Iran (43.11) and Italy (30.62). However, the DCIs in other countries/territories were <10 per day. Several effective measures including restricting travel from China, controlling the distribution of masks, extensive investigation of COVID-19 spread, and once-daily press conferences by the government to inform and educate people were aggressively conducted in Taiwan. This is probably the reason why there was only 39 cases (as of 29 February 2020) with a DCI of 1 case per day in Taiwan, which is much lower than that of nearby countries such as the Republic of Korea and Japan. In addition, the incidence and mortality were correlated with the DCI. However, further study and continued monitoring are needed to better understand the underlying mechanism of COVID-19.

Keywords: COVID-19; Coronavirus disease 2019; Country healthcare resources; Daily cumulative index; Disease incidence; Mortality.

Fig. 1

Daily cumulative case number of patients with coronavirus disease 2019 (COVID-19) in five main geographical regions and the international conveyance (Diamond Princess cruise ship) as of 29 February 2020.

Fig. 2

Daily cumulative case number of patients with coronavirus disease 2019 (COVID-19) in four different categories of countries according to number of reported cases as of 29 February 2020: (A) ≥100 reported cases; (B) 50–99 reported cases; (C) 20–49 reported cases; and (D) 10–19 reported cases. Inverted triangles with different colours denote the date of the first reported case in each indicated country.

Fig. 2

Daily cumulative case number of patients with coronavirus disease 2019 (COVID-19) in four different categories of countries according to number of reported cases as of 29 February 2020: (A) ≥100 reported cases; (B) 50–99 reported cases; (C) 20–49 reported cases; and (D) 10–19 reported cases. Inverted triangles with different colours denote the date of the first reported case in each indicated country.

Fig. 3

(A) Epidemic curve (‘epicurve’) of the 39 patients with coronavirus disease 2019 (COVID-19) and implementation of primary control measures in Taiwan from 21 January to 29 February 2020. (B) Geographical distribution of the 39 patients with COVID-19 and (C) the possible modes of transmission [https://www.cna.com.tw/news/ahel/202003010211.aspx; accessed 2 March 2020]. * Taiwanese businesswoman returning from China who had negative real-time RT-PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the respiratory tract but positive anti-SARS-CoV-2 antibody in the serum.

Fig. 4

Incidence (per 1 000 000 population), mortality rate (%) and deaths per 1 000 000 population of patients with coronavirus disease 2019 (COVID-19) and their association (Spearman's rank-order correlation) with (A) daily cumulative index (DCI), (B) Health Care Index (HCI) and (C) Healthcare Access Quality Index (HAQI) by country.