Tag Archives: China

Preprint: “Considerable countermeasures have effectively controlled the Covid-19 outbreak in Wuhan.”

Chaolong Wang, Li Liu, Xingjie Hao, Huan Guo, Qi Wang, Jiao Huang, Na He, Hongjie Yu, Xihong Lin, An Pan, Sheng Wei, Tangchun Wu. Evolving Epidemiology and Impact of Non-pharmaceutical Interventions on the Outbreak of Coronavirus Disease 2019 in Wuhan, China doi: https://doi.org/10.1101/2020.03.03.20030593

BACKGROUND

We described the epidemiological features of the coronavirus disease 2019 (Covid-19) outbreak, and evaluated the impact of non-pharmaceutical interventions on the epidemic in Wuhan, China.

METHODS

Individual-level data on 25,961 laboratory-confirmed Covid-19 cases reported through February 18, 2020 were extracted from the municipal Notifiable Disease Report System. Based on key events and interventions, we divided the epidemic into four periods: before January 11, January 11-22, January 23 – February 1, and February 2-18. We compared epidemiological characteristics across periods and different demographic groups. We developed a susceptible-exposed-infectious-recovered model to study the epidemic and evaluate the impact of interventions.

RESULTS

The median age of the cases was 57 years and 50.3% were women. The attack rate peaked in the third period and substantially declined afterwards across geographic regions, sex and age groups, except for children (age <20) whose attack rate continued to increase. Healthcare workers and elderly people had higher attack rates and severity risk increased with age. The effective reproductive number dropped from 3.86 (95% credible interval 3.74 to 3.97) before interventions to 0.32 (0.28 to 0.37) post interventions. The interventions were estimated to prevent 94.5% (93.7 to 95.2%) infections till February 18. We found that at least 59% of infected cases were unascertained in Wuhan, potentially including asymptomatic and mild-symptomatic cases.

CONCLUSIONS

Considerable countermeasures have effectively controlled the Covid-19 outbreak in Wuhan. Special efforts are needed to protect vulnerable populations, including healthcare workers, elderly and children. Estimation of unascertained cases has important implications on continuing surveillance and interventions.

Wuhan, China Coronavirus cases under-reported

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click here 

Daily confirmed coronavirus cases in Singapore, Hong Kong, Taiwan, South Korea, Japan Thailand, and USA

jodi-feb-22

click here for the source of the above figure.

 

 

Temperature data homogenization leads to overestimated warming, Beijing

Lei Zhang, Guo-Yu Ren, Yu-Yu Ren, Ai-Ying Zhang, Zi-Ying Chu, Ya-Qing Zhou. Effect of data homogenization on estimate of temperature trend: a case of Huairou station in Beijing Municipality. Theoretical and Applied Climatology, February 2014, Volume 115, Issue 3-4, pp 365-373

Daily minimum temperature (Tmin) and maximum temperature (Tmax) data of Huairou station in Beijing from 1960 to 2008 are examined and adjusted for inhomogeneities by applying the data of two nearby reference stations. Urban effects on the linear trends of the original and adjusted temperature series are estimated and compared. Results show that relocations of station cause obvious discontinuities in the data series, and one of the discontinuities for Tmin are highly significant when the station was moved from downtown to suburb in 1996. The daily Tmin and Tmax data are adjusted for the inhomogeneities. The mean annual Tmin and Tmax at Huairou station drop by 1.377°C and 0.271°C respectively after homogenization. The adjustments for Tmin are larger than those for Tmax, especially in winter, and the seasonal differences of the adjustments are generally more obvious for Tmin than for Tmax. Urban effects on annual mean Tmin and Tmax trends are −0.004°C/10 year and −0.035°C/10 year respectively for the original data, but they increase to 0.388°C/10 year and 0.096°C/10 year respectively for the adjusted data. The increase is more significant for the annual mean Tmin series. Urban contributions to the overall trends of annual mean Tmin and Tmax reach 100% and 28.8% respectively for the adjusted data. Our analysis shows that data homogenization for the stations moved from downtowns to suburbs can lead to a significant overestimate of rising trends of surface air temperature, and this necessitates a careful evaluation and adjustment for urban biases before the data are applied in analyses of local and regional climate change.

WHO situation report on COVID-19

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Source: WHO

Novel Coronavirus incubation period is 14 days; Breathing trouble 5 days later

“The illness appears to be less severe outside China, but a new study reports that this virus often looks benign to start with. It begins with a mix of mild symptoms that can look like the common cold, or resemble gastro. But some patients go on to develop breathing trouble five days later, and may need the ICU (Intensive Care Unit) by day 8. Sometimes people get released from medical care, but then have to return the next week. So not only must we wait 14 days for the incubation period, there may be another 8 days (or more) before we know how many will need emergency life support and we can begin to calculate the fatality rate.” click here

Clinical characteristics of people infected by the 2019 novel coronavirus, Wuhan, China

Dawei Wang, MD; Bo Hu, MD; Chang Hu, MD; et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. Published online February 7, 2020. doi:10.1001/jama.2020.1585

Key Points

Question  What are the clinical characteristics of hospitalized patients with 2019 novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) in Wuhan, China?

Findings  In this single-center case series involving 138 patients with NCIP, 26% of patients required admission to the intensive care unit and 4.3% died. Presumed human-to-human hospital-associated transmission of 2019-nCoV was suspected in 41% of patients.

Meaning  In this case series in Wuhan, China, NCIP was frequently associated with presumed hospital-related transmission, 26% of patients required intensive care unit treatment, and mortality was 4.3%.

Abstract

Importance  In December 2019, novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.

Objective  To describe the epidemiological and clinical characteristics of NCIP.

Design, Setting, and Participants  Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up was February 3, 2020.

Exposures  Documented NCIP.

Main Outcomes and Measures  Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked.

Results  Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men. Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 [29%]) and hospitalized patients (17 [12.3%]). Common symptoms included fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]). Lymphopenia (lymphocyte count, 0.8 × 109/L [interquartile range {IQR}, 0.6-1.1]) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients (39.9%). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Most patients received antiviral therapy (oseltamivir, 124 [89.9%]), and many received antibacterial therapy (moxifloxacin, 89 [64.4%]; ceftriaxone, 34 [24.6%]; azithromycin, 25 [18.1%]) and glucocorticoid therapy (62 [44.9%]). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 [61.1%]), arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%] vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]). Of the 36 cases in the ICU, 4 (11.1%) received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17 (47.2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). As of February 3, 47 patients (34.1%) were discharged and 6 died (overall mortality, 4.3%), but the remaining patients are still hospitalized. Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7.0-14.0).

Conclusions and Relevance  In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%.