October 12, 2020
First-wave COVID-19 transmissibility and severity in China
As of March 18, 2020, 13 415 confirmed cases and 120 deaths
related to coronavirus disease 2019 (COVID-19) in mainland China,
outside Hubei province—the epicentre of the outbreak—had been reported.
Since late January, massive public health interventions have been
implemented nationwide to contain the outbreak. We provide an impact
assessment of the transmissibility and severity of COVID-19 during the
first wave in mainland Chinese locations outside Hubei.To get more China
news about shanghai coronavirus cases, you can visit shine news official website.
We
estimated the instantaneous reproduction number (Rt) of COVID-19 in
Beijing, Shanghai, Shenzhen, Wenzhou, and the ten Chinese provinces that
had the highest number of confirmed COVID-19 cases; and the confirmed
case-fatality risk (cCFR) in Beijing, Shanghai, Shenzhen, and Wenzhou,
and all 31 Chinese provinces.
We used a
susceptible–infectious–recovered model to show the potential effects of
relaxing containment measures after the first wave of infection, in
anticipation of a possible second wave.FindingsIn all selected cities
and provinces, the Rt decreased substantially since Jan 23, when control
measures were implemented, and have since remained below 1. The cCFR
outside Hubei was 0·98% (95% CI 0·82–1·16), which was almost five times
lower than that in Hubei (5·91%, 5·73–6·09). Relaxing the interventions
(resulting in Rt >1) when the epidemic size was still small would
increase the cumulative case count exponentially as a function of
relaxation duration, even if aggressive interventions could subsequently
push disease prevalence back to the baseline level.InterpretationThe
first wave of COVID-19 outside of Hubei has abated because of aggressive
non-pharmaceutical interventions.
However, given the
substantial risk of viral reintroduction, particularly from overseas
importation, close monitoring of Rt and cCFR is needed to inform
strategies against a potential second wave to achieve an optimal balance
between health and economic protection.Since the third week of January,
2020, massive public health interventions have been implemented across
China to contain the spread of coronavirus disease 2019 (COVID-19;
figure 1). Wuhan, the epicentre of the outbreak, has been locked down
since Jan 23, with 16 of its neighbouring cities in Hubei province
included behind the cordon sanitaire shortly thereafter.
The
national Spring Festival holiday was extended by 8 days to Feb 7, and
most schools have remained closed to date. As the Spring Festival
holiday ended, stringent social distancing measures and mobility
restrictions were coordinated and implemented by the central and local
governments in many Chinese megacities (ie, the largest and wealthiest;
figure 1), including Beijing (north of Wuhan), Guangzhou and Shenzhen
(south), Shanghai and Hangzhou (east), and Chengdu (west). For example,
only residents were allowed to enter residential communities, face
mask-wearing was made compulsory, and non-essential community services
were shut down. Although the aggressive countermeasures appear to have
reduced the number of reported cases, the absence of herd immunity
against COVID-19 suggests that counts could easily resurge when these
interventions are relaxed, as business, factory operations, and schools
resume.
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