Abstract
OBJECTIVESSince the report of the first confirmed case in Daegu on February 18, 2020, local transmission of coronavirus disease 2019 (COVID-19) in Korea has continued. In this study, we aimed to identify the pattern of local transmission of COVID-19 using mathematical modeling and predict the epidemic size and the timing of the end of the spread.METHODSWe modeled the COVID-19 outbreak in Korea by applying a mathematical model of transmission that factors in behavioral changes. We used the Korea Centers for Disease Control and Prevention data of daily confirmed cases in the country to estimate the nationwide and Daegu/Gyeongbuk area-specific transmission rates as well as behavioral change parameters using a least-squares method.RESULTSThe number of transmissions per infected patient was estimated to be about 10 times higher in the Daegu/Gyeongbuk area than the average of nationwide. Using these estimated parameters, our models predicts that about 13,800 cases will occur nationwide and 11,400 cases in the Daegu/Gyeongbuk area until mid-June.CONCLUSIONSWe mathematically demonstrate that the relatively high per-capita rate of transmission and the low rate of changes in behavior have caused a large-scale transmission of COVID-19 in the Daegu/Gyeongbuk area in Korea. Since the outbreak is expected to continue until May, non-pharmaceutical interventions that can be sustained over the long term are required.
Highlights
In December 2019, a case of pneumonia of unknown cause occurred in Wuhan, China and was identified as a novel coronavirus infection in January 2020
Assuming that the period from symptom onset to isolation is identical for the cases in the Daegu/Gyeongbuk area and those occurring nationwide, our model estimates the per-capita rate of transmission (β/N) to be at least 8.9 times higher in the Daegu/ Gyeongbuk area, with 1.3616e-7 per infected patient nationwide and 1.2145e-6 around Daegu/Gyeongbuk
The transmission rate of the behavioral changes implemented in the Daegu/Gyeongbuk area is estimated to be lower than that of the national average
Summary
In December 2019, a case of pneumonia of unknown cause occurred in Wuhan, China and was identified as a novel coronavirus infection in January 2020. Originating from Wuhan, the virus spread to every region in China. 2020, Korean Society of Epidemiology confirmed case outside China in Thailand on January 13, 2020, the virus has been spreading worldwide. According to the WHO situation reports No 48 [2], a total of 53 countries so far, including Korea, Italy, and Japan are showing community transmission; there have been 80,859 confirmed cases in China and 24,727 confirmed cases outside of China as of March 8, 2020. In Korea, after the first confirmed case of coronavirus disease 2019 (COVID-19) on January 20, 2020, the epidemic has continued to spread. Prior to February 18, 2020, most confirmed cases were imported or a result of transmission via close contact with a confirmed patient, but since February 18, 2020, local transmission has led to a spread throughout the entire nation following outbreaks in religious communities and social welfare facilities. On February 23, 2020, the Korea Centers for Disease Control and Prevention (KCDC) raised the infectious disease alert level to Epidemiol Health 2020;42:e2020026
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