Desjardins M R, Hohl A, Delmelle E M
Department of Epidemiology & Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
Department of Geography, The University of Utah, Salt Lake City, UT, 84112, USA.
Appl Geogr. 2020 May;118:102202. doi: 10.1016/j.apgeog.2020.102202. Epub 2020 Apr 8.
Coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China in December 2019, and is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 is a pandemic with an estimated death rate between 1% and 5%; and an estimated between 2.2 and 6.7 according to various sources. As of March 28th, 2020, there were over 649,000 confirmed cases and 30,249 total deaths, globally. In the United States, there were over 115,500 cases and 1891 deaths and this number is likely to increase rapidly. It is critical to detect clusters of COVID-19 to better allocate resources and improve decision-making as the outbreaks continue to grow. Using daily case data at the county level provided by Johns Hopkins University, we conducted a prospective spatial-temporal analysis with SaTScan. We detect statistically significant space-time clusters of COVID-19 at the county level in the U.S. between January 22nd-March 9th, 2020, and January 22nd-March 27th, 2020. The space-time prospective scan statistic detected "active" and emerging clusters that are present at the end of our study periods - notably, 18 more clusters were detected when adding the updated case data. These timely results can inform public health officials and decision makers about where to improve the allocation of resources, testing sites; also, where to implement stricter quarantines and travel bans. As more data becomes available, the statistic can be rerun to support timely surveillance of COVID-19, demonstrated here. Our research is the first geographic study that utilizes space-time statistics to monitor COVID-19 in the U.S.
2019年冠状病毒病(COVID-19)于2019年12月在中国武汉首次被发现,由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起。COVID-19是一场大流行病,估计死亡率在1%至5%之间;根据不同来源,估计感染率在2.2至6.7之间。截至2020年3月28日,全球确诊病例超过64.9万例,死亡总数达30249例。在美国,有超过11.55万例病例和1891例死亡,且这一数字可能会迅速上升。随着疫情持续蔓延,检测COVID-19聚集性病例对于更好地分配资源和改善决策至关重要。利用约翰·霍普金斯大学提供的县级每日病例数据,我们使用时空扫描统计软件进行了前瞻性时空分析。我们在美国县级层面检测到了2020年1月22日至3月9日以及2020年1月22日至3月27日期间具有统计学意义的COVID-19时空聚集性病例。时空前瞻性扫描统计检测到了在我们研究期末存在的“活跃”和新出现的聚集性病例——值得注意的是,添加更新后的病例数据后又检测到了18个以上的聚集性病例。这些及时的结果可以告知公共卫生官员和决策者在哪些地方改善资源分配、检测地点;此外,还能告知在哪些地方实施更严格的隔离和旅行禁令。随着更多数据可用,可以重新运行该统计分析以支持对COVID-19的及时监测,正如在此所展示的。我们的研究是美国第一项利用时空统计来监测COVID-19的地理研究。