Early dynamics of transmission and control of 2019-nCoV: a mathematical modelling study
Adam J Kucharski, Timothy W Russell, Charlie Diamond, CMMID nCoV working group, Sebastian Funk, Rosalind M Eggo
medRxiv 2020.01.31.20019901; doi: https://doi.org/10.1101/2020.01.31.20019901
This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.
Abstract
An outbreak of the novel coronavirus 2019-nCoV has led to 7818 cases as of 30th January 2020. Understanding the transmission dynamics of the infection is crucial for evaluating the likely effectiveness of control measures and potential for sustained transmission to occur in new areas. We combined a stochastic transmission model with data on cases 2019-nCoV in Wuhan and exported cases originating in Wuhan to estimate how transmission had varied over time and the likely prevalence of symptomatic cases in the city as of 23rd January 2020. Based on these estimates, we then calculated the probability that newly introduced cases would generate outbreaks in other areas. We estimated that the median reproduction number, R, fluctuated between 1.6-2.9 from mid-December to mid-January 2020. We found that the US, Australia and France had more confirmed cases with travel history to Wuhan than the model predicted, and estimated that there were 29,500 (14,300-85,700) prevalent symptomatic cases in Wuhan on 23rd January 2020, when travel restrictions were introduced. Based on our estimates of R, we calculated that in locations with similar transmission potential as Wuhan, once there are more than three introduced cases, there is a more than 50% chance the infection will establish within that population. Our results show that 2019-nCoV has substantial potential for ongoing human-to-human transmission, and exported cases from Wuhan may have increased prior to travel restrictions being introduced on 23rd January 2020. As more cases arrive in international locations, it is likely many chains of transmission will fail to establish initially, but may still cause new outbreaks eventually.
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