#Estimation of the #Transmission #Risk of 2019 new #Coronavirus and Its #Implication for #PublicHealth Interventions (SSRN, abstract)

[Source: SSRN, full page: (LINK). Abstract, edited.]

Estimation of the Transmission Risk of 2019-nCov and Its Implication for Public Health Interventions

20 Pages Posted: 27 Jan 2020

Biao Tang, Xi’an Jiaotong University (XJTU) – The Interdisplinary Research Center for Mathematics and Life Sciences; York University – Department of Mathematics and Statistics; Xia Wang, Shaanxi Normal University – School of Mathematics and Information Science; Qian Li, Xi’an Jiaotong University (XJTU) – School of Mathematics and Statistics; York University – Laboratory for Industrial and Applied Mathematics; Nicola Luigi Bragazzi, York University – Laboratory for Industrial and Applied Mathematics; Sanyi Tang, Shaanxi Normal University – School of Mathematics and Information Science; Yanni Xiao, Xi’an Jiaotong University (XJTU) – The Interdisplinary Research Center for Mathematics and Life Sciences; Xi’an Jiaotong University (XJTU) – School of Mathematics and Statistics; Jianhong Wu, Xi’an Jiaotong University (XJTU) – The Interdisplinary Research Center for Mathematics and Life Sciences; York University – Laboratory for Industrial and Applied Mathematics; York University – Laboratory for Industrial and Applied Mathematics

Date Written: January 24, 2020

 

Abstract

Background:

Since the emergence of the first pneumonia cases in Wuhan, China, the novel coronavirus (2019-nCov) infection has been quickly spreading out to other provinces and neighbouring countries. Estimation of the basic reproduction number by means of mathematical modelling can be helpful for determining the potential and severity of an outbreak, and providing critical information for identifying the type of disease interventions and intensity.

Methods:

A deterministic compartmental model was devised based on the clinical progression of the disease, epidemiological status of the individuals, and the intervention measures.

Findings:

The estimation results based on likelihood and model analysis reveal that the control reproduction number may be as high as 6.47 (95% CI 5.71-7.23). Sensitivity analyses reveal that interventions, such as intensive contact tracing followed by quarantine and isolation, can effectively reduce the control reproduction number and transmission risk, with the effect of travel restriction of Wuhan on 2019-nCov infection in Beijing being almost equivalent to increasing quarantine by 100-thousand baseline value.

Interpretation:

It is essential to assess how the expensive, resource-intensive measures implemented by the Chinese authorities can contribute to the prevention and control of the 2019-nCov infection, and how long should be maintained. Under the most restrictive measures, the outbreak is expected to peak within two weeks (since January 23rd 2020) with significant low peak value. With travel restriction (no imported exposed individuals to Beijing), the number of infected individuals in 7 days will decrease by 91.14% in Beijing, compared with the scenario of no travel restriction.

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Keywords: coronavirus, infection management and control, travel restriction, mathematical model, SEIR model

JEL Classification: C02

Suggested Citation: Tang, Biao and Wang, Xia and Li, Qian and Bragazzi, Nicola Luigi and Tang, Sanyi and Xiao, Yanni and Wu, Jianhong, Estimation of the Transmission Risk of 2019-nCov and Its Implication for Public Health Interventions (January 24, 2020). Available at SSRN: https://ssrn.com/abstract=3525558 or http://dx.doi.org/10.2139/ssrn.3525558

Keywords: 2019-nCoV; Quarantine measures; Mathematical models; China.

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#Importation and #H2H #Transmission of a Novel #Coronavirus in #Vietnam (N Engl J Med., summary)

[Source: The New England Journal of Medicine, full page: (LINK). Summary, edited.]

Importation and Human-to-Human Transmission of a Novel Coronavirus in Vietnam

 

TO THE EDITOR:

The emergence and spread of a novel coronavirus (2019-nCoV) from Wuhan, China, has become a global health concern.1 Since the detection of the coronavirus in late December 2019, several countries have reported sporadic imported cases among travelers returning from China.2 We report one family cluster of 2019-nCoV originating from a Chinese man.

On January 22, 2020, a 65-year-old man with a history of hypertension, type 2 diabetes, coronary heart disease for which a stent had been implanted, and lung cancer was admitted to the emergency department of Cho Ray Hospital, the referral hospital in Ho Chi Minh City, for low-grade fever and fatigue. He had become ill with fever on January 17, a total of 4 days after he and his wife had flown to Hanoi from the Wuchang district in Wuhan, where outbreaks of 2019-nCoV were occurring. He reported that he had not been exposed to a “wet market”(a market where dead and live animals are sold) in Wuhan.

(…)

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Lan T. Phan, Ph.D., Thuong V. Nguyen, M.D., Ph.D., Quang C. Luong, M.D., Thinh V. Nguyen, M.D., Hieu T. Nguyen, B.Sc., Pasteur Institute Ho Chi Minh City, Ho Chi Minh City, Vietnam – nguyenthuong@yahoo.com; Hung Q. Le, M.D., Ph.D., Thuc T. Nguyen, M.D., Cho Ray Hospital, Ho Chi Minh City, Vietnam; Thang M. Cao, Pharm.D., Quang D. Pham, M.D., Ph.D., Pasteur Institut Ho Chi Minh City, Ho Chi Minh City, Vietnam

Disclosure forms provided by the authors are available with the full text of this letter at NEJM.org.

This letter was published on January 28, 2020, at NEJM.org.

Keywords: 2019-nCoV; Vietnam; China.

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#Potential for #global #spread of a novel #coronavirus from #China (J Trav Med., summary)

[Source: Journal of Travel Medicine, full page: (LINK). Summary, edited.]

Rapid Communication

Potential for global spread of a novel coronavirus from China

Authors: Isaac I. Bogoch, MD1,2 Alexander Watts, PhD3,4 Andrea Thomas-Bachli, PhD3,4
Carmen Huber, MSA3,4 Moritz U.G. Kraemer, DPhil5,6 Kamran Khan, MD, MPH1,3,4

Affiliations: 1. Department of Medicine, University of Toronto, Toronto, Canada; 2. Divisions of General Internal Medicine and Infectious Diseases, University Health
Network, Toronto, Canada; 3. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada; 4. BlueDot, Toronto, Canada; 5. Department of Zoology, University of Oxford, Oxford, UK; 6. Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK

*Correspondence: Isaac I. Bogoch, Divisions of General Internal Medicine and Infectious
Diseases, Toronto General Hospital, 14EN 209, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4. E-mail: isaac.bogoch@uhn.ca; Kamran Khan, St. Michael’s Hospital, 30 Bond Street, Toronto, Ontario, Canada, M5B 1W8. Email: khank@smh.ca.

Keywords: SARS; Travel; Coronavirus; Pneumonia; Outbreak; Zoonosis; Wuhan

Highlight: An epidemic of a novel coronavirus emerged from Wuhan, China, in late December 2019 and has since spread to several large Chinese cities. Should a scenario arise where this coronavirus spreads more broadly across China, we evaluate how patterns of international disease transmission could change.

Downloaded from https://academic.oup.com/jtm/advance-article-abstract/doi/10.1093/jtm/taaa011/5716260 by guest on 28 January 2020

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A novel coronavirus emerging from Wuhan, China in late December 2019 is currently spreading to other provinces in mainland China and international destinations across East Asia. At the time of writing, cases have been confirmed in Beijing, Shanghai, Hong Kong, Macau, and multiple cities in Guangdong province, with more than 500 cases confirmed across China.1 Furthermore, several cases have spread internationally via air travel2 to Japan, South Korea, Taiwan, Thailand, and the United States. A recent modelling study concluded that for these international exportations to be observed, the outbreak in China should be substantially larger than is reflected by confirmed case counts.3 Currently, many public health interventions are based on scenarios where Wuhan is the primary source of new cases.4 While there are currently no documented
transmission chains outside of the Wuhan region, should a scenario arise where this novel coronavirus spreads more broadly to and within other Chinese cities, we evaluated how global patterns of disease dispersion might change.

(…)

Keywords: 2019-nCoV; Travel medicine; China.

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A Novel #Coronavirus from #Patients with #Pneumonia in #China, 2019 (N Engl J Med., abstract)

[Source: The New England Journal of Medicine, full page: (LINK). Abstract, edited.]

A Novel Coronavirus from Patients with Pneumonia in China, 2019

List of authors:

Na Zhu, Ph.D., Dingyu Zhang, M.D., Wenling Wang, Ph.D., Xinwang Li, M.D., Bo Yang, M.S., Jingdong Song, Ph.D., Xiang Zhao, Ph.D., Baoying Huang, Ph.D., Weifeng Shi, Ph.D., Roujian Lu, M.D., Peihua Niu, Ph.D., Faxian Zhan, Ph.D., et al., for the China Novel Coronavirus Investigating and Research Team

 

Summary

In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed another clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)

Keywords: 2019-NCoV; China.

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#Data #sharing and #outbreaks: best practice exemplified (Lancet, summary)

[Source: Lancet, full page: (LINK). Summary, edited.]

Data sharing and outbreaks: best practice exemplified

David L Heymann

Published: January 24, 2020 / DOI: https://doi.org/10.1016/S0140-6736(20)30184-7

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The current outbreak of the 2019 novel coronavirus (2019-nCoV) is yet another example of the importance of infections at the animal–human interface, and the concerns that arise from the emergence of a newly identified organism as it spreads through human populations and across national and international borders.

(…)

Keywords: 2019-nCoV.

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#Clinical #features of #patients infected with 2019 novel #coronavirus in #Wuhan, #China (Lancet, abstract)

[Source: The Lancet, full page: (LINK). Abstract, edited.]

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Prof Chaolin Huang, MD *, Yeming Wang, MD *, Prof Xingwang Li, MD *, Prof Lili Ren, PhD *, Prof Jianping Zhao, MD *, Yi Hu, MD *, Prof Li Zhang, MD, Guohui Fan, MS, Jiuyang Xu, MDc, Xiaoying Gu, PhD, Prof Zhenshun Cheng, MD, Ting Yu, MD, Jiaan Xia, MD, Yuan Wei, MD, Prof Wenjuan Wu, MD, Prof Xuelei Xie, MD, Wen Yin, MD, Hui Li, MD, Min Liu, MD, Yan Xiao, MS, Prof Hong Gao, PhD, Prof Li Guo, PhD, Prof Jungang Xie, MD, Prof Guangfa Wang, MD, Prof Rongmeng Jiang, MD, Prof Zhancheng Gao, MD, Qi Jin, PhD, Prof Jianwei Wang, PhD  †, Prof Bin Cao, MD  †

Published: January 24, 2020 / DOI: https://doi.org/10.1016/S0140-6736(20)30183-5

 

Summary

Background

A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients.

Methods

All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not.

Findings

By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα.

Interpretation

The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies.

Funding

Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.

Keywords: 2019-nCoV; ARDS; China.

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A #familial #cluster of #pneumonia associated with the 2019 novel #coronavirus indicating person-to-person transmission: a study of a family cluster (Lancet, abstract)

[Source: The Lancet, full page: (LINK). Abstract, edited.]

A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster

Jasper Fuk-Woo Chan, MD *, Shuofeng Yuan, PhD *, Kin-Hang Kok, PhD *, Kelvin Kai-Wang To, MD *, Hin Chu, PhD *, Jin Yang, MD, Fanfan Xing, MD, Jieling Liu, BNurs, Cyril Chik-Yan Yip, PhD, Rosana Wing-Shan Poon, PhD, Hoi-Wah Tsoi, MPhil, Simon Kam-Fai Lo, MPhil, Kwok-Hung Chan, PhD, Vincent Kwok-Man Poon, MPhil, Wan-Mui Chan, PhD, Jonathan Daniel Ip, MSc, Jian-Piao Cai, BSc, Vincent Chi-Chung Cheng, MD, Prof Honglin Chen, PhD, Christopher Kim-Ming Hui, MD, Prof Kwok-Yung Yuen, MD

Published: January 24, 2020 / DOI: https://doi.org/10.1016/S0140-6736(20)30154-9

 

Summary

Background

An ongoing outbreak of pneumonia associated with a novel coronavirus was reported in Wuhan city, Hubei province, China. Affected patients were geographically linked with a local wet market as a potential source. No data on person-to-person or nosocomial transmission have been published to date.

Methods

In this study, we report the epidemiological, clinical, laboratory, radiological, and microbiological findings of five patients in a family cluster who presented with unexplained pneumonia after returning to Shenzhen, Guangdong province, China, after a visit to Wuhan, and an additional family member who did not travel to Wuhan. Phylogenetic analysis of genetic sequences from these patients were done.

Findings

From Jan 10, 2020, we enrolled a family of six patients who travelled to Wuhan from Shenzhen between Dec 29, 2019 and Jan 4, 2020. Of six family members who travelled to Wuhan, five were identified as infected with the novel coronavirus. Additionally, one family member, who did not travel to Wuhan, became infected with the virus after several days of contact with four of the family members. None of the family members had contacts with Wuhan markets or animals, although two had visited a Wuhan hospital. Five family members (aged 36–66 years) presented with fever, upper or lower respiratory tract symptoms, or diarrhoea, or a combination of these 3–6 days after exposure. They presented to our hospital (The University of Hong Kong-Shenzhen Hospital, Shenzhen) 6–10 days after symptom onset. They and one asymptomatic child (aged 10 years) had radiological ground-glass lung opacities. Older patients (aged >60 years) had more systemic symptoms, extensive radiological ground-glass lung changes, lymphopenia, thrombocytopenia, and increased C-reactive protein and lactate dehydrogenase levels. The nasopharyngeal or throat swabs of these six patients were negative for known respiratory microbes by point-of-care multiplex RT-PCR, but five patients (four adults and the child) were RT-PCR positive for genes encoding the internal RNA-dependent RNA polymerase and surface Spike protein of this novel coronavirus, which were confirmed by Sanger sequencing. Phylogenetic analysis of these five patients’ RT-PCR amplicons and two full genomes by next-generation sequencing showed that this is a novel coronavirus, which is closest to the bat severe acute respiatory syndrome (SARS)-related coronaviruses found in Chinese horseshoe bats.

Interpretation

Our findings are consistent with person-to-person transmission of this novel coronavirus in hospital and family settings, and the reports of infected travellers in other geographical regions.

Funding

The Shaw Foundation Hong Kong, Michael Seak-Kan Tong, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, Sanming Project of Medicine (Shenzhen), and High Level-Hospital Program (Guangdong Health Commission).

Keywords: 2019-nCoV; China.

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