The Lancet published a study that revealed the original source of new crown cases outside China

2019-nCoV Special
[International News]     30 Jul 2020
An article published in the journal The Lancet Infectious Diseases (web screenshot), published in the medical journal The Lancet Infectious Diseases, shows that almost two-thirds of the newly diagnosed cases outside the Chinese mainland have traveled to Italy, China or Iran. The study showed that one in four of the first cases originated in Italy and one in five originated in China.
The Lancet published a study that revealed the original source of new crown cases outside China

Published in The Lancet Infectious Diseases (Web screenshot)

A study published in the lancet infectious disease medical journal shows that almost two-thirds of the first confirmed new crown cases outside chinese mainland have traveled to italy, china or iran. The study showed that one in four of the first cases originated in Italy and one in five originated in China.

The term "first cases" is defined as the first 100 cases diagnosed in a country.

The U.S. Centers for Disease Control and Prevention (CDC) co-led the study, Dr. Fatima Daoud (Fatimah Dawood) said, "Our results show that, Before COVID-19 became a pandemic on 11 March 2020, trips from a few countries that have emerged SARS-CoV-2virus mass transmission may trigger a larger epidemic worldwide. "

The study also showed that in early cases, there were many small family transmission clusters, but the transmission clusters were often larger in professional and community settings, which supported the claim that keeping distance between people could slow the spread of new crown disease.

For the first 11 weeks of the outbreak, From 31 December 2019 to 10 March 2020, Coronavirus network monitoring of global communications shows that, Three-quarters of the countries reporting outbreaks outside China reported the first cases in people who recently went to a country where the outbreak occurred, Almost two thirds of the initial cases were related to visits to Italy (27 per cent), China (22 per cent) or Iran (11 per cent), respectively.

Before Coronavirus disease was identified as a pandemic, 101 clusters emerged in 29 countries, 386 cases involved; Three quarters (76/101) of these clusters are family communication, The average number of infections per cluster was 2.6. In contrast, 11 clusters related to community gatherings (i.e. tour groups, religious groups, dinner parties); The average number of infections per cluster is 14.2(1), The 14 clusters were associated with non-medical occupational environments (an average of 4.3 infections per cluster).

Researchers say their research shows that slowing the epidemic requires the cooperation of religious groups. "The four large clusters of our study and the large-scale outbreaks reported elsewhere, linked to the spread of faith-based sites, highlight the need to work with faith-based organizations in designing and implementing community-based epidemic mitigation efforts ," said Dr. Philip Rex (Philip Rick) of the CDC, co-author of the study.

This analysis also highlights the relatively late discovery of new crown disease in Africa. Among the 46 African countries covered by the study, only six (13 per cent) reported cases when the World Health Organization identified Coronavirus disease as a pandemic on 11 March 2020.

This is the first study to use globally publicly available case data to describe travel exposure and case cluster characteristics of early new crown cases in different countries. However, the study authors cautioned that, given that almost all cases in the analysis came from middle- and high-income countries in Asia and Europe (due to the late detection of virus in other regions), they could not fully understand the early global epidemiology of new crown disease.

The authors of the study mentioned some of the major limitations of the study, including that the analysis of case characteristics was limited to 4%(1200/32459) of globally confirmed cases with sufficient information about the age or sex of the cases, and that the integrity of the open data was different, which may lead to some case characteristics not being found. They also pointed out that the first confirmed case in each country may not be the first real case of infection in some countries, given the wide variation in the detection of early cases.

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