Real-time tentative assessment of the epidemiological characteristics of novel coronavirus infections in Wuhan, China, as at 22 January 2020

Peng Wu, Xinxin Hao, Eric H Y Lau, Jessica Y Wong, Kathy S M Leung, Joseph T Wu, Benjamin J Cowling, Gabriel M Leung, Peng Wu, Xinxin Hao, Eric H Y Lau, Jessica Y Wong, Kathy S M Leung, Joseph T Wu, Benjamin J Cowling, Gabriel M Leung

Abstract

A novel coronavirus (2019-nCoV) causing severe acute respiratory disease emerged recently in Wuhan, China. Information on reported cases strongly indicates human-to-human spread, and the most recent information is increasingly indicative of sustained human-to-human transmission. While the overall severity profile among cases may change as more mild cases are identified, we estimate a risk of fatality among hospitalised cases at 14% (95% confidence interval: 3.9-32%).

Keywords: Coronavirus; public health.

Conflict of interest statement

Conflict of interest: BJC reports honoraria from Sanofi Pasteur and Roche not related to this work. The authors report no other potential conflicts of interest.

Figures

Figure 1
Figure 1
Increase in laboratory-confirmed cases of 2019-nCoV infection over time, as at 21 January 2020
Figure 2
Figure 2
Temporal changes in estimated risk of death among laboratory-confirmed cases of 2019-nCoV admitted to hospitala, Wuhan, China, as at 21 January 2020

References

    1. Su S, Wong G, Shi W, Liu J, Lai ACK, Zhou J, et al. Epidemiology, Genetic Recombination, and Pathogenesis of Coronaviruses. Trends Microbiol. 2016;24(6):490-502. 10.1016/j.tim.2016.03.003
    1. Fan Y, Zhao K, Shi ZL, Zhou P. Bat Coronaviruses in China. Viruses. 2019;11(3):E210. 10.3390/v11030210
    1. Hui DS. Epidemic and Emerging Coronaviruses (Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome). Clin Chest Med. 2017;38(1):71-86. 10.1016/j.ccm.2016.11.007
    1. Guan Y, Peiris JS, Zheng B, Poon LL, Chan KH, Zeng FY, et al. Molecular epidemiology of the novel coronavirus that causes severe acute respiratory syndrome. Lancet. 2004;363(9403):99-104. 10.1016/S0140-6736(03)15259-2
    1. World Health Organization Regional Office for the (WHO/Eastern Mediterranean). MERS Situation Update. Cairo: WHO/Eastern Mediterranean; Nov2019. [Accessed 11 Jan 2020]. Available from:
    1. Cowling BJ, Park M, Fang VJ, Wu P, Leung GM, Wu JT. Preliminary epidemiological assessment of MERS-CoV outbreak in South Korea, May to June 2015. Euro Surveill. 2015;20(25):7-13. 10.2807/1560-7917.ES2015.20.25.21163
    1. Kim KH, Tandi TE, Choi JW, Moon JM, Kim MS. Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, 2015: epidemiology, characteristics and public health implications. J Hosp Infect. 2017;95(2):207-13. 10.1016/j.jhin.2016.10.008
    1. Wong G, Liu W, Liu Y, Zhou B, Bi Y, Gao GF. MERS, SARS, and Ebola: The Role of Super-Spreaders in Infectious Disease. Cell Host Microbe. 2015;18(4):398-401. 10.1016/j.chom.2015.09.013
    1. Kucharski AJ, Althaus CL. The role of superspreading in Middle East respiratory syndrome coronavirus (MERS-CoV) transmission. Euro Surveill. 2015;20(25):14-8. 10.2807/1560-7917.ES2015.20.25.21167
    1. Amer H, Alqahtani AS, Alzoman H, Aljerian N, Memish ZA. Unusual presentation of Middle East respiratory syndrome coronavirus leading to a large outbreak in Riyadh during 2017. Am J Infect Control. 2018;46(9):1022-5. 10.1016/j.ajic.2018.02.023
    1. World Health Organization (WHO). WHO Statement Regarding Cluster of Pneumonia Cases in Wuhan, China. Beijing: WHO; 9 Jan 2020. [Accessed 11 Jan 2020].
    1. Wuhan Municipal Health Commission. [Update on outbreak of pneumonia cases in Wuhan]. 31 Dec 2019. [Accessed 13 Jan 2020]. Chinese. Available from:
    1. Beijing News. [Southern China Seafood Market linked to unexplained pneumonia outbreak]. 2 Jan 2020. [Accessed 13 Jan 2020]. Chinese. Available from:
    1. Wuhan Municipal Health Commission. [Report on unexplained viral pneumonia]. 5 Jan 2020. [Accessed 21 Jan 2020]. Chinese. Available from:
    1. Wuhan Municipal Health Commission. [Report on unexplained viral pneumonia]. 11 Jan 2020. [Accessed 21 Jan 2020]. Chinese. Available from:
    1. Cheung J. Ill husband and wife add to Wuhan riddle. Hong Kong; The Standard; 16 Jan 2020. [Accessed 20 Jan 2020]. Available from:
    1. Cauchemez S, Epperson S, Biggerstaff M, Swerdlow D, Finelli L, Ferguson NM. Using routine surveillance data to estimate the epidemic potential of emerging zoonoses: application to the emergence of US swine origin influenza A H3N2v virus. PLoS Med. 2013;10(3):e1001399. 10.1371/journal.pmed.1001399
    1. Wuhan Municipal Health Commission. [Questions and answers on pneumonia due to novel coronavirus infection]. 14 Jan 2020. [Accessed 20 Jan 2020]. Chinese. Available from:
    1. Cauchemez S, Van Kerkhove MD, Riley S, Donnelly CA, Fraser C, Ferguson NM. Transmission scenarios for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and how to tell them apart. Euro Surveill. 2013;18(24):20503.
    1. World Health Organization Regional Office for the Western Pacific (WHO/Pacific). World Health Organization Western Pacific Twitter Feed. Manila: WHO/Pacific; 8:35 PM 20 Jan 2020. Available from:
    1. Yu H, Cowling BJ, Feng L, Lau EH, Liao Q, Tsang TK, et al. Human infection with avian influenza A H7N9 virus: an assessment of clinical severity. Lancet. 2013;382(9887):138-45. 10.1016/S0140-6736(13)61207-6
    1. Ghani AC, Donnelly CA, Cox DR, Griffin JT, Fraser C, Lam TH, et al. Methods for estimating the case fatality ratio for a novel, emerging infectious disease. Am J Epidemiol. 2005;162(5):479-86. 10.1093/aje/kwi230
    1. Cowling BJ, Muller MP, Wong IO, Ho LM, Lo SV, Tsang T, et al. Clinical prognostic rules for severe acute respiratory syndrome in low- and high-resource settings. Arch Intern Med. 2006;166(14):1505-11. 10.1001/archinte.166.14.1505
    1. Lau EH, Hsiung CA, Cowling BJ, Chen CH, Ho LM, Tsang T, et al. A comparative epidemiologic analysis of SARS in Hong Kong, Beijing and Taiwan. BMC Infect Dis. 2010;10(1):50. 10.1186/1471-2334-10-50
    1. Hui DS, Azhar EI, Kim YJ, Memish ZA, Oh MD, Zumla A. Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission. Lancet Infect Dis. 2018;18(8):e217-27. 10.1016/S1473-3099(18)30127-0
    1. Leung GM, Hedley AJ, Ho LM, Chau P, Wong IO, Thach TQ, et al. The epidemiology of severe acute respiratory syndrome in the 2003 Hong Kong epidemic: an analysis of all 1755 patients. Ann Intern Med. 2004;141(9):662-73. 10.7326/0003-4819-141-9-200411020-00006
    1. Jewell NP, Lei X, Ghani AC, Donnelly CA, Leung GM, Ho LM, et al. Non-parametric estimation of the case fatality ratio with competing risks data: an application to Severe Acute Respiratory Syndrome (SARS). Stat Med. 2007;26(9):1982-98. 10.1002/sim.2691
    1. Chinese National Health Commission (NHC). [Experts answer reporters' questions on pneumonia outbreak of new coronavirus infection]. Beijing: NHC; 20 Jan 2020. [Accessed 20 Jan 2020]. Chinese
    1. Chinese National Health Commission (NHC). [Press conference in response to the outbreak of pneumonia caused by 2019-nCoV]. Beijing: NHC; 21 Jan 2020. [Accessed 21 Jan 2020]. Chinese. Available from:
    1. World Health Organization (WHO). Novel Coronavirus – Thailand (ex-China). Geneva: WHO: 14 Jan 2020. Available from:
    1. World Health Organization (WHO). Novel Coronavirus – Japan (ex-China). Geneva: WHO; 16 Jan 2020. Available from:
    1. Centers for Disease Control and Prevention (CDC). First Travel-related Case of 2019 Novel Coronavirus Detected in United States. Atlanta: CDC; 21 Jan 2020. Available from:
    1. Taiwan Centers for Disease Control (CDC). Taiwan timely identifies first imported case of severe special infectious pneumonia from Wuhan, China through onboard quarantine; Central Epidemic Command Center (CECC) raises travel notice level for Wuhan, China to Level 3: Warning. Taipei City: CDC; 21 Jan 2020. Available from: https://

Source: PubMed

3
Abonnere