CORD-19:2bb201255db7f20edb4ee6838cbcae333ed1a1c9 JSONTXT 7 Projects

Potential for global spread of a novel coronavirus from China A novel coronavirus emerging from Wuhan, China in late December 2019 is currently spreading to other provinces in mainland China and international destinations across East Asia. At the time of writing, cases have been confirmed in Beijing, Shanghai, Hong Kong, Macau and multiple cities in Guangdong province, with more than 500 cases confirmed across China. 1 Furthermore, several cases have spread internationally via air travel 2 to Japan, South Korea, Taiwan, Thailand and the USA. A recent modelling study concluded that for these international exportations to be observed, the outbreak in China should be substantially larger than is reflected by confirmed case counts. 3 Currently, many public health interventions are based on scenarios where Wuhan is the primary source of new cases. 4 While there are currently no documented transmission chains outside of the Wuhan region, should a scenario arise where this novel coronavirus spreads more broadly to and within other Chinese cities, we evaluated how global patterns of disease dispersion might change. Using 2019 data from the International Air Transport Association (IATA), we identified all cities in China that received at least 100 000 airline passengers from Wuhan during February through April 2019. In a scenario where these cities might experience local epidemics, we analyzed the volumes of airline passengers to international destinations from February to April 2019. To generate these estimates, we used anonymized, passenger-level flight itinerary data from IATA, comprising both commercial flights and scheduled charter flights. These data account for ∼90% of global air travel volumes, with the remaining volumes modelled using market intelligence. We report the top 50 international destination cities of passengers arriving from nine cities in mainland China, plus Hong Kong, and present the corresponding infectious disease vulnerability index (IDVI) for each receiving country. 5 The IDVI is a validated measure of a country's capacity to manage infectious disease threats, and utilizes multiple indicators including health, political and economic metrics. Scores range from 0 to 1 with higher scores representing a greater capacity to cope with epidemic threats. We analyzed international airline passenger trips from the following 10 cities: Wuhan, Beijing, Shanghai, Kunming, Chengdu, Xiamen, Haikou, Guangzhou, Shenzhen and Hong KK is the founder of BlueDot, a social enterprise that develops digital technologies for public health. KK, AW, ATB and CH are employed at BlueDot. IIB has consulted for BlueDot. MK has no conflicts of interest to declare. IIB, KK and AW conceived the idea. AW, ATB and CH conducted data analysis.