Evaluation of Effectiveness of Global COVID-19 Vaccination Campaign.

To model estimated deaths averted by COVID-19 vaccines, we used state-of-the-art mathematical modeling, likelihood-based inference, and reported COVID-19 death and vaccination data. We estimated that >1.5 million deaths were averted in 12 countries. Our model can help assess effectiveness of the vaccination program, which is crucial for curbing the COVID-19 pandemic.

Modelling COVID-19 outbreak on the Diamond Princess ship using the public surveillance data.

The novel coronavirus disease 2019 (COVID-19) outbreak on the Diamond Princess (DP) ship has caused over 634 cases as of February 20, 2020. We model the transmission process on DP ship as a stochastic branching process, and estimate the reproduction number at the innitial phase of 2.9 (95%CrI: 1.7-7.7). The epidemic doubling time is 3.4 days, and thus timely actions on COVID-19 control were crucial. We estimate the COVID-19 transmissibility reduced 34% after the quarantine program on the DP ship which was implemented on February 5. According to the model simulation, relocating the population at risk may sustainably decrease the epidemic size, postpone the timing of epidemic peak, and thus relieve the tensive demands in the healthcare. The lesson learnt on the ship should be considered in other similar settings.

Optimizing COVID-19 vaccination programs during vaccine shortages.

During the ongoing COVID-19 pandemic, vaccine shortages occur due to various types of constraints, including interruptions in production/supply, higher-than-expected demands, and a lack of resources such as healthcare capacity to administer vaccines. Scientifically informed epidemic models have been utilized as pivotal tools to optimize the immunization programs subject to vaccine shortages. The current paper reviews modelling methods to optimize the allocation strategies of vaccines with differential efficacies by using various model-based outcome measures. The models reviewed in this study are expected to be adopted and extended to make contributions on policy development for disease control under the vaccine shortage scenario.

Preliminary estimates of the reproduction number of the Coronavirus disease (COVID-19) outbreak in Republic of Korea and Italy by 5 March 2020

The novel coronavirus disease 2019 (COVID-19) outbreak has caused 6088 cases and 41 deaths in Republic of Korea, and 3144 cases and 107 death in Italy by 5 March 2020, respectively. We modelled the transmission process in the Republic of Korea and Italy with a stochastic model, and estimated the basic reproduction number R0 as 2.6 (95% CI: 2.3-2.9) or 3.2 (95% CI: 2.9-3.5) in the Republic of Korea, under the assumption that the exponential growth starting on 31 January or 5 February 2020, and 2.6 (95% CI: 2.3-2.9) or 3.3 (95% CI: 3.0-3.6) in Italy, under the assumption that the exponential growth starting on 5 February or 10 February 2020, respectively.

Preliminary estimation of the novel Coronavirus disease (COVID-19) cases in Iran: a modelling analysis based on overseas cases and air travel data. (Coronavirus (COVID-19) collection.)

As of March 1, 2020, Iran had reported 987 novel coronavirus disease (COVID-19) cases, including 54 associated deaths. At least six neighboring countries (Bahrain, Iraq, Kuwait, Oman, Afghanistan, and Pakistan) had reported imported COVID-19 cases from Iran. In this study, air travel data and the numbers of cases from Iran imported into other Middle Eastern countries were used to estimate the number of COVID-19 cases in Iran. It was estimated that the total number of cases in Iran was 16 533 (95% confidence interval: 5925-35 538) by February 25, 2020, before the UAE and other Gulf Cooperation Council countries suspended inbound and outbound flights from Iran.

Low dispersion in the infectiousness of COVID-19 cases implies difficulty in control.

The individual infectiousness of coronavirus disease 2019 (COVID-19), quantified by the number of secondary cases of a typical index case, is conventionally modelled by a negative-binomial (NB) distribution. Based on patient data of 9120 confirmed cases in China, we calculated the variation of the individual infectiousness, i.e., the dispersion parameter k of the NB distribution, at 0.70 (95% confidence interval: 0.59, 0.98). This suggests that the dispersion in the individual infectiousness is probably low, thus COVID-19 infection is relatively easy to sustain in the population and more challenging to control. Instead of focusing on the much fewer super spreading events, we also need to focus on almost every case to effectively reduce transmission.

Comparing COVID-19 and the 1918-19 influenza pandemics in the United Kingdom.

We compared the COVID-19 and 1918-19 influenza pandemics in the United Kingdom. We found that the ongoing COVID-19 wave of infection matched the major wave of the 1918-19 influenza pandemic surprisingly well, with both reaching similar magnitudes (in terms of estimated weekly new infections) and spending the same duration with over five cases per 1000 inhabitants over the previous two months. We also discussed the similarities in epidemiological characteristics between these two pandemics.

Quantifying the improvement in confirmation efficiency of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the early phase of outbreak in Hong Kong in 2020

BACKGROUNDS: The emerging virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a large outbreak of coronavirus disease COVID-19 in Wuhan, China since December 2019. The COVID-19 soon spread to other regions of China and overseas. In Hong Kong, local mitigation measures have been implemented since the first imported case was confirmed on January 23, 2020. Here we evaluated the temporal variation of detection delay from symptoms onset to laboratory confirmation of SARS-CoV-2 in Hong Kong. METHODS: A regression model is adopted to quantify the association between the SARS-CoV-2 detection delay and the calendar time. The association is tested and further validated by a Cox proportional hazard model. FINDINGS: The estimated median detection delay was 9.5 days (95%CI: 6.5-11.5) in the second half of January, and reduced to 6.0 days (95%CI: 5.5-9.5) in the first half of February 2020. We estimate that the SARS-CoV-2 detection efficiency improves at a daily rate of 5.40% (95%CI: 2.54-8.33) in Hong Kong. CONCLUSION: The detection efficiency of SARS-CoV-2 was likely being improved substantially in Hong Kong since the first imported case was detected. The sustaining enforcement in timely detection and other effective control measures are recommended to prevent the SARS-CoV-2 infection.

A conceptual model for the coronavirus disease 2019 (COVID-19) outbreak in Wuhan, China with individual reaction and governmental action.

The ongoing coronavirus disease 2019 (COVID-19) outbreak, emerged in Wuhan, China in the end of 2019, has claimed more than 2600 lives as of 24 February 2020 and posed a huge threat to global public health. The Chinese government has implemented control measures including setting up special hospitals and travel restriction to mitigate the spread. We propose conceptual models for the COVID-19 outbreak in Wuhan with the consideration of individual behavioural reaction and governmental actions, e.g., holiday extension, travel restriction, hospitalisation and quarantine. We employe the estimates of these two key components from the 1918 influenza pandemic in London, United Kingdom, incorporated zoonotic introductions and the emigration, and then compute future trends and the reporting ratio. The model is concise in structure, and it successfully captures the course of the COVID-19 outbreak, and thus sheds light on understanding the trends of the outbreak.

Estimating the Unreported Number of Novel Coronavirus (2019-nCoV) Cases in China in the First Half of January 2020: A Data-Driven Modelling Analysis of the Early Outbreak.

BACKGROUND: In December 2019, an outbreak of respiratory illness caused by a novel coronavirus (2019-nCoV) emerged in Wuhan, China and has swiftly spread to other parts of China and a number of foreign countries. The 2019-nCoV cases might have been under-reported roughly from 1 to 15 January 2020, and thus we estimated the number of unreported cases and the basic reproduction number, R0, of 2019-nCoV. METHODS: We modelled the epidemic curve of 2019-nCoV cases, in mainland China from 1 December 2019 to 24 January 2020 through the exponential growth. The number of unreported cases was determined by the maximum likelihood estimation. We used the serial intervals (SI) of infection caused by two other well-known coronaviruses (CoV), Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) CoVs, as approximations of the unknown SI for 2019-nCoV to estimate R0. RESULTS: We confirmed that the initial growth phase followed an exponential growth pattern. The under-reporting was likely to have resulted in 469 (95% CI: 403-540) unreported cases from 1 to 15 January 2020. The reporting rate after 17 January 2020 was likely to have increased 21-fold (95% CI: 18-25) in comparison to the situation from 1 to 17 January 2020 on average. We estimated the R0 of 2019-nCoV at 2.56 (95% CI: 2.49-2.63). CONCLUSION: The under-reporting was likely to have occurred during the first half of January 2020 and should be considered in future investigation.

Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak.

BACKGROUNDS: An ongoing outbreak of a novel coronavirus (2019-nCoV) pneumonia hit a major city in China, Wuhan, December 2019 and subsequently reached other provinces/regions of China and other countries. We present estimates of the basic reproduction number, R0, of 2019-nCoV in the early phase of the outbreak. METHODS: Accounting for the impact of the variations in disease reporting rate, we modelled the epidemic curve of 2019-nCoV cases time series, in mainland China from January 10 to January 24, 2020, through the exponential growth. With the estimated intrinsic growth rate (γ), we estimated R0 by using the serial intervals (SI) of two other well-known coronavirus diseases, MERS and SARS, as approximations for the true unknown SI. FINDINGS: The early outbreak data largely follows the exponential growth. We estimated that the mean R0 ranges from 2.24 (95%CI: 1.96-2.55) to 3.58 (95%CI: 2.89-4.39) associated with 8-fold to 2-fold increase in the reporting rate. We demonstrated that changes in reporting rate substantially affect estimates of R0. CONCLUSION: The mean estimate of R0 for the 2019-nCoV ranges from 2.24 to 3.58, and is significantly larger than 1. Our findings indicate the potential of 2019-nCoV to cause outbreaks.