Assessing Early Heterogeneity in Doubling Times of the COVID-19 Epidemic across Prefectures in Mainland China, January–February, 2020

Isaac Chun Hai Fung, Xiaolu Zhou, Chi Ngai Cheung, Sylvia K. Ofori, Kamalich Muniz-Rodriguez, Chi Hin Cheung, Po Ying Lai, Manyun Liu, Gerardo Chowell

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

To describe the geographical heterogeneity of COVID-19 across prefectures in mainland China, we estimated doubling times from daily time series of the cumulative case count between 24 January and 24 February 2020. We analyzed the prefecture-level COVID-19 case burden using linear regression models and used the local Moran’s I to test for spatial autocorrelation and clustering. Four hundred prefectures (~98% population) had at least one COVID-19 case and 39 prefectures had zero cases by 24 February 2020. Excluding Wuhan and those prefectures where there was only one case or none, 76 (17.3% of 439) prefectures had an arithmetic mean of the epidemic doubling time <2 d. Low-population prefectures had a higher per capita cumulative incidence than high-population prefectures during the study period. An increase in population size was associated with a very small reduction in the mean doubling time (−0.012, 95% CI, −0.017, −0.006) where the cumulative case count doubled ≥3 times. Spatial analysis revealed high case count clusters in Hubei and Heilongjiang and fast epidemic growth in several metropolitan areas by mid-February 2020. Prefectures in Hubei and neighboring provinces and several metropolitan areas in coastal and northeastern China experienced rapid growth with cumulative case count doubling multiple times with a small mean doubling time.

Original languageEnglish
Pages (from-to)95-113
Number of pages19
JournalEpidemiologia
Volume2
Issue number1
DOIs
StatePublished - Mar 2021

Scopus Subject Areas

  • Epidemiology
  • Medicine (miscellaneous)

Keywords

  • COVID-19
  • Hu Line
  • SARS-CoV-2
  • coronavirus
  • doubling time
  • epidemiology
  • geography
  • spatial analysis
  • spatial clustering

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