State heterogeneity of human mobility and COVID-19 epidemics in the European Union

Human mobility was associated with epidemic changes of coronavirus disease 2019 (COVID-19) in China, where strict public health interventions reduced human mobility and COVID-19 epidemics. But its association with COVID-19 epidemics in the European Union (EU) is unclear. In this quasi-experimental study, we modelled the temporal trends in human mobility and epidemics of COVID-19 in the 27 EU states between January 15 and May 9, 2020. COVID-19 and human mobility had 3 trend-segments, including an upward trend in COVID-19 daily incidence and a downward trend in most human mobilities in the middle segment. Compared with the EU states farther from Italy, the state-wide lockdown dates were more likely linked to turning points of human mobilities in the EU states closer to Italy, which were also more likely linked to second turning points of COVID-19 epidemics. Among the examined human mobilities, the second turning points in driving mobility and the first turning points in parks mobility were the best factors that connected lockdown dates and COVID-19 epidemics in the EU states closer to Italy. Our findings highlight the state- and mobility-heterogeneity in the associations of public health interventions and human mobility with changes of COVID-19 epidemics in the EU states.

Associations of stay-at-home order and face-masking recommendation with trends in daily new cases and deaths of laboratory-confirmed COVID-19 in the United States

Background and objectivesPublic health interventions were associated with reduction in coronavirus disease 2019 (COVID-19) transmission in China, but their impacts on COVID-19 epidemiology in other countries are unclear. We examined the associations of stay-at-home order (SAHO) and face-masking recommendation with epidemiology of laboratory-confirmed COVID-19 in the United States. MethodsIn this quasi-experimental study, we modeled the temporal trends in daily new cases and deaths of COVID-19, and COVID-19 time-varying reproduction numbers (Rt) in the United States between March 1 and April 20, 2020, and conducted simulation studies. ResultsThe number and proportion of U.S. residents under SAHO increased between March 19 and April 7, and plateaued at 29,0829,980 and 88.6%, respectively. Trends in COVID-19 daily cases and Rt reduced after March 23 (P<0.001) and further reduced on April 3 (P<0.001), which was associated with implementation of SAHO by 10 states on March 23, and face-masking recommendation on April 3, respectively. The estimates of Rt eventually fell below/around 1.0 on April 13. Similar turning points were identified in the trends of daily deaths with a lag time. Early implementation and early-removal of SAHO would be associated with significantly reduced and increased daily new cases and deaths, respectively. ConclusionsThere were 2 turning points of COVID-19 daily new cases or deaths in the U.S., which appeared to associate with implementation of SAHO and the CDCs face-masking recommendation. These findings may inform decision-making of lifting SAHO and face-masking recommendation.

Trends and prediction in daily incidence and deaths of COVID-19 in the United States: a search-interest based model

Background and ObjectivesThe coronavirus disease 2019 (COVID-19) infected more than 586,000 patients in the U.S. However, its daily incidence and deaths in the U.S. are poorly understood. Internet search interest was found correlated with COVID-19 daily incidence in China, but not yet applied to the U.S. Therefore, we examined the association of internet search-interest with COVID-19 daily incidence and deaths in the U.S. MethodsWe extracted the COVDI-19 daily incidence and death data in the U.S. from two population-based datasets. The search interest of COVID-19 related terms was obtained using Google Trends. Pearson correlation test and general linear model were used to examine correlations and predict future trends, respectively. ResultsThere were 555,245 new cases and 22,019 deaths of COVID-19 reported in the U.S. from March 1 to April 12, 2020. The search interest of COVID, "COVID pneumonia," and "COVID heart" were correlated with COVDI-19 daily incidence with [~]12-day of delay (Pearsons r=0.978, 0.978 and 0.979, respectively) and deaths with 19-day of delay (Pearsons r=0.963, 0.958 and 0.970, respectively). The COVID-19 daily incidence and deaths appeared to both peak on April 10. The 4-day follow-up with prospectively collected data showed moderate to good accuracies for predicting new cases (Pearsons r=-0.641 to -0.833) and poor to good accuracies for daily new deaths (Pearsons r=0.365 to 0.935). ConclusionsSearch terms related to COVID-19 are highly correlated with the trends in COVID-19 daily incidence and deaths in the U.S. The prediction-models based on the search interest trend reached moderate to good accuracies.

Trends and prediction in daily incidence of novel coronavirus infection in China, Hubei Province and Wuhan City: an application of Farr law

BackgroundThe recent outbreak of novel coronavirus (2019-nCoV) has infected tens of thousands of patients in China. Studies have forecasted future trends of the incidence of 2019-nCoV infection, but appeared unsuccessful. Farrs law is a classic epidemiology theory/practice for predicting epidemics. Therefore, we used and validated a model based on Farrs law to predict the daily-incidence of 2019-nCoV infection in China and 2 regions of high-incidence. MethodsWe extracted the 2019-nCoV incidence data of China, Hubei Province and Wuhan City from websites of the Chinese and Hubei health commissions. A model based on Farrs law was developed using the data available on Feb. 8, 2020, and used to predict daily-incidence of 2019-nCoV infection in China, Hubei Province and Wuhan City afterward. ResultsWe observed 50,995 (37001 on or before Feb. 8) incident cases in China from January 16 to February 15, 2020. The daily-incidence has peaked in China, Hubei Providence and Wuhan City, but with different downward slopes. If no major changes occur, our model shows that the daily-incidence of 2019-nCoV will drop to single-digit by February 25 for China and Hubei Province, but by March 8 for Wuhan city. However, predicted 75% confidence intervals of daily-incidence in all 3 regions of interest had an upward trend. The predicted trends overall match the prospectively-collected data, confirming usefulness of these models. ConclusionsThis study shows the daily-incidence of 2019-nCoV in China, Hubei Province and Wuhan City has reached the peak and was decreasing. However, there is a possibility of upward trend.

Offshore training in navy personnel is associated with uninvestigated dyspepsia / 华中科技大学学报（医学）（英德文版）

To investigate the known and new factors associated with uninvestigated dyspepsia (UD), we surveyed 8600 Chinese navy personnel with offshore training shorter than 1 month or longer than 9 months per year. All respondents were required to complete a questionnaire covering demographics, the Chinese version of the Rome III survey, eating habits, life styles, and medical and family history. The response rate was 94.3% (8106/8600) with 4899 respondents qualified for analysis, including 1046 with offshore training and 3853 with onshore training. The prevalence of UD was higher in the offshore group than in the onshore group (12.6% vs. 6.9%, P<0.001), with a general prevalence of 8.1%. The subjects with offshore training were more likely to suffer from UD and postprandial distress syndrome (OR=1.955, 95% CI 1.568-2.439, P<0.001 and OR=1.789, 95% CI 1.403-2.303, P<0.001, respectively). The multivariate logistic regression analysis showed UD was associated with offshore training (OR=1.580, 95% CI 1.179-2.118, P=0.002), family history (OR=1.765, 95% CI 1.186-2.626, P=0.005) and smoking (OR=1.270, 95% CI 1.084-1.488, P=0.003), but not with alcohol drinking. The association between dysentery history and UD was undetermined/borderline (P=0.056-0.069). In conclusion, we identified offshore training as a new factor associated with UD, and also confirmed 2 known associated factors, family history and smoking.

Offshore training in navy personnel is associated with uninvestigated dyspepsia / 华中科技大学学报（医学）（英德文版）

To investigate the known and new factors associated with uninvestigated dyspepsia (UD), we surveyed 8600 Chinese navy personnel with offshore training shorter than 1 month or longer than 9 months per year. All respondents were required to complete a questionnaire covering demographics, the Chinese version of the Rome III survey, eating habits, life styles, and medical and family history. The response rate was 94.3% (8106/8600) with 4899 respondents qualified for analysis, including 1046 with offshore training and 3853 with onshore training. The prevalence of UD was higher in the offshore group than in the onshore group (12.6% vs. 6.9%, P<0.001), with a general prevalence of 8.1%. The subjects with offshore training were more likely to suffer from UD and postprandial distress syndrome (OR=1.955, 95% CI 1.568-2.439, P<0.001 and OR=1.789, 95% CI 1.403-2.303, P<0.001, respectively). The multivariate logistic regression analysis showed UD was associated with offshore training (OR=1.580, 95% CI 1.179-2.118, P=0.002), family history (OR=1.765, 95% CI 1.186-2.626, P=0.005) and smoking (OR=1.270, 95% CI 1.084-1.488, P=0.003), but not with alcohol drinking. The association between dysentery history and UD was undetermined/borderline (P=0.056-0.069). In conclusion, we identified offshore training as a new factor associated with UD, and also confirmed 2 known associated factors, family history and smoking.