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. 2020 Jul 6;9(1):83.
doi: 10.1186/s40249-020-00709-z.

Transmission patterns of COVID-19 in the mainland of China and the efficacy of different control strategies: a data- and model-driven study

Jian Zu  1 , Miao-Lei Li  2 , Zong-Fang Li  3   4 , Ming-Wang Shen  5 , Yan-Ni Xiao  2 , Fan-Pu Ji  6   7   8
Affiliations

Transmission patterns of COVID-19 in the mainland of China and the efficacy of different control strategies: a data- and model-driven study

Jian Zu et al. Infect Dis Poverty. .

Abstract

Background: The coronavirus disease 2019 (COVID-19) outbreak has seriously endangered the health and lives of Chinese people. In this study, we predicted the COVID-19 epidemic trend and estimated the efficacy of several intervention strategies in the mainland of China.

Methods: According to the COVID-19 epidemic status, we constructed a compartmental model. Based on reported data from the National Health Commission of People's Republic of China during January 10-February 17, 2020, we estimated the model parameters. We then predicted the epidemic trend and transmission risk of COVID-19. Using a sensitivity analysis method, we estimated the efficacy of several intervention strategies.

Results: The cumulative number of confirmed cases in the mainland of China will be 86 763 (95% CI: 86 067-87 460) on May 2, 2020. Up until March 15, 2020, the case fatality rate increased to 6.42% (95% CI: 6.16-6.68%). On February 23, 2020, the existing confirmed cases reached its peak, with 60 890 cases (95% CI: 60 350-61 431). On January 23, 2020, the effective reproduction number was 2.620 (95% CI: 2.567-2.676) and had dropped below 1.0 since February 5, 2020. Due to governmental intervention, the total number of confirmed cases was reduced by 99.85% on May 2, 2020. Had the isolation been relaxed from February 24, 2020, there might have been a second peak of infection. However, relaxing the isolation after March 16, 2020 greatly reduced the number of existing confirmed cases and deaths. The total number of confirmed cases and deaths would increase by 8.72 and 9.44%, respectively, due to a 1-day delayed diagnosis in non-isolated infected patients. Moreover, if the coverage of close contact tracing was increased to 100%, the cumulative number of confirmed cases would be decreased by 88.26% on May 2, 2020.

Conclusions: The quarantine measures adopted by the Chinese government since January 23, 2020 were necessary and effective. Postponing the relaxation of isolation, early diagnosis, patient isolation, broad close-contact tracing, and strict monitoring of infected persons could effectively control the COVID-19 epidemic. April 1, 2020 would be a reasonable date to lift quarantine in Hubei and Wuhan.

Keywords: COVID-19; Effective reproduction number; Intervention strategy; Prevalence; SARS-CoV-2; Transmission dynamics.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of COVID-19 transmission model
Fig. 2
Fig. 2
COVID-19 epidemic trends in the mainland of China for cumulative cases over time. a Confirmed cases. b Deaths. CI: confidence interval; COVID-19: Corona virus disease 2019
Fig. 3
Fig. 3
COVID-19 epidemic trends in the mainland of China for existing confirmed cases and effective reproduction number over time. a Number of existing confirmed cases in the mainland of China. b Estimated effective reproduction number. CI: confidence interval; COVID-19: Corona virus disease 2019
Fig. 4
Fig. 4
COVID-19 epidemic trends in the mainland of China over time without any control measures from January 10, 2020. a Number of existing confirmed cases. b Cumulative number of confirmed cases. c Cumulative number of deaths. d Estimated effective reproduction number without any control measures from January 10, 2020. CI: confidence interval; COVID-19: Corona virus disease 2019
Fig. 5
Fig. 5
Impact of relaxing isolation at different times on COVID-19 epidemic trends in the mainland of China. a Number of existing confirmed cases when c = 4.394. b Number of existing confirmed cases when c = 4.334. c Cumulative number of confirmed cases when c = 4.334. d Cumulative number of deaths when c = 4.334. COVID-19: Corona virus disease 2019
Fig. 6
Fig. 6
Effect of delayed diagnosis in non-isolated infectious individuals on COVID-19 epidemic trends. a Number of existing confirmed cases. b Cumulative number of confirmed cases. c Cumulative number of deaths. COVID-19: Corona virus disease 2019
Fig. 7
Fig. 7
Impact of external input of infected persons and increasing qua rantine rate. Impact of external input of free infected persons on January 23rd on (a) existing and (b) cumulative confirmed cases, and (c) cumulative death numbers. Impact of increasing quarantine rate (q) on (d) existing and (e) cumulative confirmed cases, and (f) cumulative death numbers
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References

    1. Special Expert Group for Control of the Epidemic of Novel Coronavirus Pneumonia of the Chinese Preventive Medicine Association An update on the epidemiological characteristics of novel coronavirus pneumonia (COVID-19) Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41:139–144. - PubMed
    1. Backer JA, Klinkenberg D, Wallinga J. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20-28 January 2020. Euro Surveill. 2020;25:2000062. doi: 10.2807/1560-7917.ES.2020.25.5.2000062. - DOI - PMC - PubMed
    1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. doi: 10.1016/S0140-6736(20)30183-5. - DOI - PMC - PubMed
    1. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395:565–574. doi: 10.1016/S0140-6736(20)30251-8. - DOI - PMC - PubMed
    1. Chan JFW, Yuan S, Kok KH, To KK, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395:514–523. doi: 10.1016/S0140-6736(20)30154-9. - DOI - PMC - PubMed

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