Estimation of infection density and epidemic size of COVID-19 using the back-calculation algorithm
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Health Information Science and Systems
RESEARCH
Estimation of infection density and epidemic size of COVID‑19 using the back‑calculation algorithm Yukun Liu1*† , Jing Qin2†, Yan Fan3, Yong Zhou4, Dean A. Follmann2 and Chiung‑Yu Huang5
Abstract The novel coronavirus (COVID-19) is continuing its spread across the world, claiming more than 160,000 lives and sick‑ ening more than 2,400,000 people as of April 21, 2020. Early research has reported a basic reproduction number (R0) between 2.2 to 3.6, implying that the majority of the population is at risk of infection if no intervention measures were undertaken. The true size of the COVID-19 epidemic remains unknown, as a significant proportion of infected indi‑ viduals only exhibit mild symptoms or are even asymptomatic. A timely assessment of the evolving epidemic size is crucial for resource allocation and triage decisions. In this article, we modify the back-calculation algorithm to obtain a lower bound estimate of the number of COVID-19 infected persons in China in and outside the Hubei province. We estimate the infection density among infected and show that the drastic control measures enforced throughout China following the lockdown of Wuhan City effectively slowed down the spread of the disease in two weeks. We also investigate the COVID-19 epidemic size in South Korea and find a similar effect of its “test, trace, isolate, and treat” strategy. Our findings are expected to provide guidelines and enlightenment for surveillance and control activities of COVID-19 in other countries around the world. Keywords: Back calculation, COVID-19 epidemic, Incubation period, Infection time Introduction In early December 2019, a cluster of pneumonia cases of unknown etiology was reported in Wuhan, a city of 11 million residents in central China. The Chinese Center for Disease Control and Prevention (China CDC) reported a novel coronavirus as the causative agent of this outbreak on January 9, 2020. To contain the spread of the virus, Wuhan, the epicenter of the coronavirus epidemic, has been placed in lockdown since January 23, 2020. The order was later expanded to the entire Hubei province in the next few days, affecting nearly 56 million people. However, it was estimated that 5 million people already left the central Chinese city, as China’s great Lunar New Year migration has already broken across the nation in the first few weeks of January. Some carried with them *Correspondence: [email protected] † Yukun Liu and Jing Qin have contributed equally. 1 KLATASDS‑MOE, School of Statistics, East China Normal University, Shanghai 200262, China Full list of author information is available at the end of the article © Springer Nature Switzerland AG 2020.
the new virus that has since spread throughout China and to 215 other countries, claiming almost 750,000 lives and sickening more than 20,000,000 people as of April 10, 2020. After characterizing the outbreak a Public Health Emergency of International Concern in late January, the World Health Organization (WHO) eventually decl
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