Experts' paper warns of possible epidemic rebound

China needs to prepare for a possible rebound of the novel coronavirus disease (COVID-19) epidemic in the coming weeks and months, said a newly published paper by the Novel Coronavirus Pneumonia Emergency Response Epidemiology Team.

The paper was published on Monday on the website of China CDC Weekly, organized by the Chinese Center for Disease Control and Prevention.

"The epidemic has spread very quickly, taking only 30 days to expand from Hubei to the rest of mainland China," the paper said.

It added that China needs to prepare for a possible resurgence of the epidemic because huge numbers of people will soon be returning to work and school after the extended New Year holiday.

The paper, titled Vital Surveillances: The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) — China, 2020, is about an epidemiological study based on the first 72,314 cases of COVID-19 found on the Chinese mainland from the first recognition of the outbreak on Dec 31 to Feb 11.

The 72,314 patients are confirmed cases, suspected cases, clinically diagnosed cases - only in Hubei province, and asymptomatic cases, it said.

Patient numbers and information are from China's Infectious Disease Information System which records all cases with their national identification numbers. But the study has stripped all personal identifying information during its research.

A main finding of the study is that this novel coronavirus is highly contagious. But, it is fortunate that COVID-19 has been mild for 81 percent of patients and has a very low overall case fatality rate of 2.3 percent, the paper said.

"The massive vigorous actions taken by the Chinese government have slowed down the epidemic in China and curbed spread to the rest of the world, " the paper said.

To date, there is no evidence of a super-spreader event occurring in any of the Chinese health facilities serving the COVID-19 patients. "However, we do not know whether this is due to the nature of the virus itself or whether these events have been successfully prevented."

According to statistics in the paper, as of Feb 11, a total of 44,672 confirmed cases were reported from 1,386 counties of 31 provinces, autonomous regions and municipalities across China. Among them, confirmed cases in Hubei accounted for 74.7 percent.

A total of 1,023 deaths occurred among the 44,672 confirmed cases, thus the overall case fatality rate was 2.3 percent, while the case fatality rate was much higher - 14.8 percent for the group that are 80 years of age or above, which is also the highest.

According to an epidemiological curve in the study, which is the first such description in history, the peak onset of symptoms for all cases overall occurred on Feb 1, after which time onsets of symptoms have declined.

The study showed that 77.8 percent of confirmed cases were aged between 30 to 69 and 74.7 percent of confirmed cases were diagnosed in Hubei.

About 86 percent of confirmed cases had Wuhan-related exposure while 80.9 percent of them were mild cases, it said.

By gender, the case fatality rate for males was 2.8 percent, and 1.7 percent for females.