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 language | English |
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Pages (from-to) | 95-113 |
Number of pages | 19 |
Journal | Epidemiologia |
Volume | 2 |
Issue number | 1 |
DOIs | |
State | Published - 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