Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

Abstract

We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. RESULTSAmong the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). CONCLUSIONSOn the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.) a bs tr ac t Early Transmission Dynamics

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“…On the basis of the initial investigation, the shared history of exposure to the Wuhan Seafood Wholesale Market highly suggested that wild animals sold in the market such as bamboo rats, raccoons, and snakes would be the original source of the novel virus. 16 Soon afterwards, the traceability analysis supported that the 2019-nCoV would be from Rhinolophus. This is with the phylogenetic analysis results that the 2019-nCoV was most related to BatCoV RaTG13 from the bat.…”

“…10 , 18 , 19 Importantly, the people who are primary, asymptomatic and in incubation period are the main sources of infection, which is of critical significance to the epidemic prevention and control. 16 Up to now, respiratory droplets is the major route of transmission. Besides, the fecal-oral route of transmission is considered but unconfirmed because 2019-nCoV nucleic acids could be detected in the stool samples of pneumonia patients with abdominal symptoms.…”

Understanding the emerging coronavirus: what it means for health security and infection prevention

“…SARS-CoV-2 seems to mostly be spread by droplets, and not through air. Nosocomial transmission have been described, 49 and superspreading events in hospital settings may occur. SARS-CoV-2 is possibly spreading indirectly through contaminated surfaces and hand contamination as well, but the lack of aerosol transmission will make the spread less efficient.…”

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“…The virus-specific nucleic acid sequences have been detected in lung fluid, throat, oropharyngeal and nasopharyngeal swab samples [3]. Due to lack of sufficient awareness of the COVID-19 in the early stages of the epidemic, some healthcare workers (HCWs) have been infected [4,5]. Patients with symptoms of VOVID-19 may present to Ear Nose and Throat ENT Departments.…”

“…To decrease the density of patients, the ENT department separated the waiting area from the treatment area, reduced the number of appointments, scheduled appointments at different times, and increased online consulting services. In addition, taking account of the facts that the median age of COVID-19 patients was 59 years and that morbidity and mortality is greater in the elderly [4], HCWs older than 65 years of age were suspended from outpatient activities. Further, our escalation plan is that if the number of COVID-19 cases continues to rise, only emergency services will be maintained.…”