Assessing spread risk of Wuhan novel coronavirus within and beyond China, January-April 2020: a travel network-based modelling study
Shengjie Lai, Isaac Bogoch, Nick Ruktanonchai, Alexander Watts, Yu Li, Jianzing Yu, Xin Lv, Weizhong Yang, Hongjie Yu, Kamran Khan, Zhongjie Li, Andrew J Tatem
doi: https://doi.org/10.1101/2020.02.04.20020479
Abstract
Objective: To estimate the potential risk and geographic range of Wuhan novel coronavirus (2019-nCoV) spread within and beyond China from January through to April, 2020. Design: Travel network-based modelling study. Setting and participants: General population travelling from Wuhan and other high-risk cities in China. Main outcome measures: Based on de-identified and aggregated mobile phone data, air passenger itinerary data, and case reports, we defined the relative importation risk and internal and international destinations of 2019-nCoV from Wuhan and other high-risk cities in China. Results: The cordon sanitaire of Wuhan is likely to have occurred during the latter stages of peak population numbers leaving the city before Lunar New Year (LNY), with travellers departing into neighbouring cities and other megacities in China, and a high proportion of cases likely travelled with symptoms at the early stage of the outbreak. Should secondary outbreaks occur in 17 high-risk secondary cities, they could contribute to seeding the virus in other highly connected cities within and beyond China after the LNY holiday. We estimated that 59,912 air passengers, of which 834 (95% UI: 478 - 1349) had 2019-nCoV infection, travelled from Wuhan to 382 cities outside of mainland China during the two weeks prior to the lockdown of Wuhan. The majority of these cities were in Asia, but major hubs in Europe, the US and Australia were also prominent, with strong correlation seen between predicted importation risks and reported cases seen. Because significant spread has already occurred, a large number of airline travellers (3.3 million under the scenario of 75% travel reduction from normal volumes) may be required to be screened at origin high-risk cities in China and destinations across the globe for the following three months of February to April, 2020 to effectively limit spread beyond its current extent. Conclusion: Further spread of 2019-nCoV within China and international exportation is likely to occur. All countries, especially vulnerable regions, should be prepared for efforts to contain the 2019-nCoV infection.
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