Temporal relationship between outbound traffic from Wuhan and the 2019 coronavirus disease (COVID-19) incidence in China
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Abstract
Background
The city of Wuhan is the epicenter of the 2019 coronavirus disease (COVID-19) outbreak and a central Chinese hub for transportation and industry. Mass migration prior to the Chinese New Year may have accelerated the spread of COVID-19 across China. This analysis investigated the temporal relationship between daily outbound traffic from Wuhan and the incidence of COVID-19 in 31 Chinese provinces during January-February 2020.
Methods
We collected incidence of confirmed COVID-19 cases from National and Provincial Health Committee reports from January 10 to February 29, 2020. Volume of outbound traffic from Wuhan to other provinces was measured by Baidu Migration Index, a widely used metric that tracks migration based on cellphone location. We used cross-correlation function and autoregressive integrated moving average (ARIMA) model to examine time-lagged association between traffic volume and COVID-19 incidence by province. Contributors to the provincial variation in the temporal associations were investigated. Additionally, we estimated the reduction in cumulative incidence of COVID-19 cases following the travel ban for Wuhan.
Results
Cross-correlation function analyses suggested that the volume of outbound traffic from Wuhan was positively associated with COVID-19 incidence in all provinces, with correlation coefficients between 0.22-0.78 (all P<0.05). Approximately 42% of provinces showed <1 week of lag between traffic volume and COVID-19 incidence, 39% with 1 week, and 19% with 2-3 weeks. Migration had more prolonged impacts in provinces closer to Wuhan and with more passenger influx from Wuhan, but affected economically advantaged provinces to a lesser extent. We further estimated that the travel ban may have prevented approximately 19,768 COVID-19 cases (95% CI: 13,589, 25,946) outside of Wuhan by February 29, 2020.
Conclusions
Outflowing migration from Wuhan facilitated the COVID-19 transmission to other parts of China with varying time-lagged effects dependent on provincial characteristics. The travel ban led to a significant reduction in COVID-19 outside of Wuhan.
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SciScore for 10.1101/2020.03.15.20034199: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:This analysis is subject to limitations. First, changes in diagnostic capacity and criteria for COVID-19 may have contributed to, at least partly, the secular trend of COVID-19 incidence. For example, there were underdiagnoses …
SciScore for 10.1101/2020.03.15.20034199: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:This analysis is subject to limitations. First, changes in diagnostic capacity and criteria for COVID-19 may have contributed to, at least partly, the secular trend of COVID-19 incidence. For example, there were underdiagnoses of COVID-19 during the early stage of the outbreak, and later a surge in COVID-19 cases around February 13 due to broadened diagnostic criteria. These changes were not travel-related and may distort the estimated association to some extent. Second, the temporal association between traffic and COVID-19 could be confounded by other preventive measures, such as increased self-quarantine and widespread use of face mask and hand sanitization. Therefore, the estimated intervention effect associated with the travel ban could be overestimated. Finally, as an ecologic study, our findings may suffer from ecologic fallacy and do not necessarily imply individual-level association between travel history and risk of COVID-19 infection. In conclusion, mass migration out of Wuhan facilitated the COVID-19 outbreak in other parts of China. The outflowing migration from Wuhan had a more prolonged impact on provinces that are closer to Wuhan and have more immigration from Wuhan. Provinces with higher GDP per capita were less impacted by migration. It is estimated that approximately 39% of cases outside of Wuhan have been prevented by the travel ban issued on January 23, 2020. In the absence of cures and immunization for an emerging infectious disease like COVID-19, transpo...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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