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Transmission Dynamics of COVID-19 in Mainland China: Impact of Public Health Control Measures

28 Pages Posted: 24 Mar 2020

See all articles by Lin Zhao

Lin Zhao

Shandong University - Institute of EcoHealth

Yun-Xia Liu

Shandong University - Institute of EcoHealth

Jia-Te Wei

Shandong University - Institute of EcoHealth

Yu-Chen Zhu

Shandong University - Institute of EcoHealth

Jie Qian

Chinese Academy of Medical Sciences - School of Public Health

Run-Ze Ye

Shandong University - Institute of EcoHealth

Chun-Yu Li

Shandong University - Institute for Medical Dataology

Xiao-Kang Ji

Shandong University - Institute for Medical Dataology

Hong-Kai Li

Shandong University - Institute for Medical Dataology

Chang Qi

Shandong University - Institute for Medical Dataology

Ying Wang

Shandong University - Institute for Medical Dataology

Fan Yang

Shandong University - Institute for Medical Dataology

Yu-Hao Zhou

Shandong University

Ran Yan

Shandong University - Institute for Medical Dataology

Xiao-Ming Cui

Academy of Military Sciences - State Key Laboratory of Pathogen and Biosecurity

Yuanli Liu

Chinese Academy of Medical Sciences - School of Public Health

Shi-Xue Li

Shandong University - Institute of EcoHealth

Xiu-Jun Li

Shandong University - Institute of EcoHealth

Fuzhong Xue

Shandong University - Institute of EcoHealth

Wu-Chun Cao

Shandong University - Institute of EcoHealth

Cheeloo EcoHealth Consortium (CLEC) Group

More...

Abstract

Background: The ongoing outbreak of COVID-19 is challenging the Chinese public health response system. We aim to understand the epidemic dynamics and underlying mechanisms, and quantify impact of interventions.

Methods: We estimated attack rate (AR) at county level, mapped spatiotemporal dynamics, and identified risk factors involved in the transmission. We then characterized the epidemic range using boundary analysis, and tracked the effective reproduction number Rt in relation to important events and control measures.  

Findings: The ARs were negatively correlated with the distances between affected counties and the epicenter Wuhan. The counties being intersected by railways, freeways, or national highways had significantly higher risk for COVID-19. The number of boundaries, within which active transmission was occurring, rapidly increased up to 698 on Jan 29, 2020. Then, the number dropped and maintained around 300, although the number of cases per boundary consistently increased. The overall Rt waved from 2·7 to 4·0 at the early stage before Dec 31, 2019, when the Wuhan Health Committee announced the outbreak. Thereafter, Rt fluctuated around 3·0 and persisted till Jan 26, when the Chinese authorities took full control of all activities to combat the outbreak. Within a two-week period, the Rt consistently fell to below one on Feb 9. The Rts among different provinces were classified into four clusters.  

Interpretation: The strong political commitment and centrally coordinated response are playing the most important role in containing COVID-19 in mainland China.  

Funding Statement: This work is supported by the Natural Science Foundation of China (81621005 and 81673238) and National Key Research and Development Program of China (2019YFC1200505).

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: The authors stated that as this study constituted data analysis rather than research in human beings, ethical approval from institutional review boards was not required.

Keywords: COVID-19; China; Transmission dynamics; attack rate; effective reproduction number Rt; public health control measures

Suggested Citation

Zhao, Lin and Liu, Yun-Xia and Wei, Jia-Te and Zhu, Yu-Chen and Qian, Jie and Ye, Run-Ze and Li, Chun-Yu and Ji, Xiao-Kang and Li, Hong-Kai and Qi, Chang and Wang, Ying and Yang, Fan and Zhou, Yu-Hao and Yan, Ran and Cui, Xiao-Ming and Liu, Yuanli and Li, Shi-Xue and Li, Xiu-Jun and Xue, Fuzhong and Cao, Wu-Chun and Group, Cheeloo EcoHealth Consortium (CLEC), Transmission Dynamics of COVID-19 in Mainland China: Impact of Public Health Control Measures (3/9/2020). Available at SSRN: https://ssrn.com/abstract=3552826 or http://dx.doi.org/10.2139/ssrn.3552826

Lin Zhao

Shandong University - Institute of EcoHealth

China

Yun-Xia Liu

Shandong University - Institute of EcoHealth

China

Jia-Te Wei

Shandong University - Institute of EcoHealth

China

Yu-Chen Zhu

Shandong University - Institute of EcoHealth

China

Jie Qian

Chinese Academy of Medical Sciences - School of Public Health

Beijing
China

Run-Ze Ye

Shandong University - Institute of EcoHealth

China

Chun-Yu Li

Shandong University - Institute for Medical Dataology

Jinan
China

Xiao-Kang Ji

Shandong University - Institute for Medical Dataology

Jinan
China

Hong-Kai Li

Shandong University - Institute for Medical Dataology

Jinan
China

Chang Qi

Shandong University - Institute for Medical Dataology

Jinan
China

Ying Wang

Shandong University - Institute for Medical Dataology

Jinan
China

Fan Yang

Shandong University - Institute for Medical Dataology

Jinan
China

Yu-Hao Zhou

Shandong University

27 Shanda Nanlu
South Rd.
Jinan, Shandong 250100
China

Ran Yan

Shandong University - Institute for Medical Dataology

Jinan
China

Xiao-Ming Cui

Academy of Military Sciences - State Key Laboratory of Pathogen and Biosecurity

Beijing, 100071
China

Yuanli Liu

Chinese Academy of Medical Sciences - School of Public Health ( email )

Beijing
China

Shi-Xue Li

Shandong University - Institute of EcoHealth ( email )

China

Xiu-Jun Li

Shandong University - Institute of EcoHealth

China

Fuzhong Xue

Shandong University - Institute of EcoHealth ( email )

China

Wu-Chun Cao (Contact Author)

Shandong University - Institute of EcoHealth ( email )

China

No contact information is available for Cheeloo EcoHealth Consortium (CLEC) Group

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