Using predicted imports of 2019-nCoV cases to determine locations that may not be identifying all imported cases

Munoz, Pablo Martinez de Salazar; Niehus, René; Taylor, Aimee R; Buckee, Caroline O.; Lipsitch, Marc

doi:10.1101/2020.02.04.20020495

Cited by 74 publications

(84 citation statements)

References 3 publications

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“…Therefore our estimates should be viewed as a lower bound on the number of imported infections, given possible mild and asymptomatic infections. Even given this, we estimate that Indonesiawhich has reported 0 cases to date-would be expected to have more cases than this, in line with estimates from Lipsitch et al 6 . In addition, in places that have identified some cases-such as Thailand, Japan, South Korea, Taiwan and Hong Kong, the US and Malaysia-we estimate that the imported number of cases from Wuhan is even higher than those reported.…”

Section: Discussionsupporting

confidence: 89%

“…Previous work has estimated significant under reporting of COVID-19 cases in a number of countries such as Indonesia, Cambodia and Thailand. 6 A detailed understanding of the geographical distribution of case importation will help to guide resources to places with currently limited capacity to test, and provide support to perform control measures and support for clinical care.…”

Section: Introductionmentioning

confidence: 99%

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Estimating number of global importations of COVID-19 from Wuhan, risk of transmission outside mainland China and COVID-19 introduction index between countries outside mainland China

Sun

Dickens

Chen

et al. 2020

Preprint

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Estimating number of global importations of COVID-19 from Wuhan, risk of transmission outside mainland China and COVID-19 introduction index between countries outside mainland China

Sun

Dickens

Chen

et al. 2020

Preprint

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“…While we know of no reason to doubt specificity of detection, we tested the assumption of perfect sensitivity. Based on our previous estimates 5 we assumed Singapore has the highest capacity of surveillance with respect to COVID-19. We regressed the cumulative cases against Wuhan-to-location air travel volume considering Singapore to have the greatest detection capacity and estimating the relative underdetection compared to Singapore in the remaining 190 locations classified according to the GHS 2 index 9 .…”

Section: Resultsmentioning

confidence: 99%

Quantifying bias of COVID-19 prevalence and severity estimates in Wuhan, China that depend on reported cases in international travelers

Niehus

Munoz

Taylor

et al. 2020

Preprint

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Risk of COVID-19 infection in Wuhan has been estimated using imported case counts of international travelers, often under the assumption that all cases in travelers are ascertained. Recent work indicates variation among countries in detection capacity for imported cases. Singapore has historically had very strong epidemiological surveillance and contact-tracing capacity and has shown in the COVID-19 epidemic evidence of a high sensitivity of case detection. We therefore used a Bayesian modeling approach to estimate the relative imported case detection capacity for other countries compared to that of Singapore.We estimate that the global ability to detect imported cases is 38% (95% HPDI 22% -64%) of Singapore's capacity. Equivalently, an estimate of 2.8 (95% HPDI 1.5 -4.4) times the current number of imported cases, could have been detected, if all countries had had the same detection capacity as Singapore. Using the second component of the Global Health Security index to stratify likely case-detection capacities, we found that the ability to detect imported cases relative to Singapore among high surveillance locations is 40% (95% HPDI 22% -67%), among intermediate surveillance locations it is 37% (95% HPDI 18% -68%), and among low surveillance locations it is 11% (95% HPDI 0% -42%). Using a simple mathematical model, we further find that treating all travelers as if they were residents (rather than accounting for the brief stay of some of these travelers in Wuhan) can modestly contribute to underestimation of prevalence as well. We conclude that estimates of case counts in Wuhan based on assumptions of perfect detection in travelers . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. : medRxiv preprintterm can be well approximated as We plot this approximation of V given doubling times . V ≈ 1 − e −(r+γ)d aligned with 4 , a range of durations of detectable infection and a range of lengths of stay 2 ( Figure 2 ). Results:We estimate that the global ability to detect imported cases is 38% (95% HPDI 22% -64%) of Singapore's capacity. Equivalently, an estimate of 2.8 (95% HPDI 1.5 -4.4) times the current number of imported cases, could have been detected, if all countries had had the same detection capacity as Singapore, which leads to 1.8 (95% CI 0.5 -3.4) undetected cases per detected case. The ability to detect imported cases among high surveillance countries is 40% (95% HPDI 22% -67%), among intermediate surveillance countries it is 37% (95% HPDI 18% -68%), and among low surveillance countries it is 11% (95% HPDI 0% -42%). : medRxiv preprint 7In this paper, we have aimed to test two assumptions underlying the estimation of incidence at the epicentre of the SARS-Cov2 outbreak. The first of these is that the capacity for detection of international imported cases is 100% sensitive and specific across locations. While we know of no reason to doubt specificity of detection, we tested the assumption of perfec...

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“…[12] consider the task of forecasting international and domestic spread of COVID-19 and employ Official Airline Group (OAG) data for determining air traffic to various countries. [6] fit a generalized linear model for observed number of cases in various countries as a function of air traffic volume obtained from OAG data (authors refer to [12]) to determine countries with potential risk of under-detection. [7] provide Africa-specific case-study of vulnerability and preparedness using data from Civil Aviation Administration of China.…”

Section: Related Workmentioning

confidence: 99%

Evaluating the impact of international airline suspensions on the early global spread of COVID-19

Adiga

Venkatramanan

Schlitt

et al. 2020

Preprint

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Global airline networks play a key role in the global importation of emerging infectious diseases. Detailed information on air traffic between international airports has been demonstrated to be useful in retrospectively validating and prospectively predicting case emergence in other countries. In this paper, we use a well-established metric known as effective distance on the global air traffic data from IATA to quantify risk of emergence for different countries as a consequence of direct importation from China, and compare it against arrival times for the first 24 countries. Using this model trained on official first reports from WHO, we estimate time of arrival (ToA) for all other countries. We then incorporate data on airline suspensions to recompute the effective distance and assess the effect of such cancellations in delaying the estimated arrival time for all other countries. Finally we use the infectious disease vulnerability indices to explain some of the estimated reporting delays.

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Using predicted imports of 2019-nCoV cases to determine locations that may not be identifying all imported cases

Abstract: Cases from the ongoing outbreak of atypical pneumonia caused by the 2019 novel coronavirus (2019-nCoV) exported from mainland China can lead to self-sustained outbreaks in other populations.

Cited by 74 publications

References 3 publications

Estimating number of global importations of COVID-19 from Wuhan, risk of transmission outside mainland China and COVID-19 introduction index between countries outside mainland China

Estimating number of global importations of COVID-19 from Wuhan, risk of transmission outside mainland China and COVID-19 introduction index between countries outside mainland China

Quantifying bias of COVID-19 prevalence and severity estimates in Wuhan, China that depend on reported cases in international travelers

Evaluating the impact of international airline suspensions on the early global spread of COVID-19

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