Wuhan and Hubei COVID-19 mortality analysis reveals the critical role of timely supply of medical resources
Identifieur interne : 000479 ( Pmc/Corpus ); précédent : 000478; suivant : 000480Wuhan and Hubei COVID-19 mortality analysis reveals the critical role of timely supply of medical resources
Auteurs : Zuqin Zhang ; Wei Yao ; Yan Wang ; Cheng Long ; Xinmiao FuSource :
- The Journal of Infection [ 0163-4453 ] ; 2020.
Abstract
COVID-19 mortality rates in Wuhan and Hubei decay exponentially. COVID-19 mortality rates outside Hubei and Wuhan are nearly constant. COVID-19 recovery rates in Wuhan and Hubei grow exponentially. Over 40,000 aided health workers help Hubei to effectively treat patients. Newly supplied beds allow over 38,000 patients in Wuhan to be treated in hospitals.
Url:
DOI: 10.1016/j.jinf.2020.03.018
PubMed: 32209384
PubMed Central: 7163181
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Wuhan and Hubei COVID-19 mortality analysis reveals the critical role of timely supply of medical resources</title><author><name sortKey="Zhang, Zuqin" sort="Zhang, Zuqin" uniqKey="Zhang Z" first="Zuqin" last="Zhang">Zuqin Zhang</name><affiliation><nlm:aff id="aff0001">Provincial University Key Laboratory of Cellular Stress Response and Metabolic Regulation, College of Life Sciences, Fujian Normal University, Fuzhou, Fujian 350117, China</nlm:aff></affiliation></author><author><name sortKey="Yao, Wei" sort="Yao, Wei" uniqKey="Yao W" first="Wei" last="Yao">Wei Yao</name><affiliation><nlm:aff id="aff0001">Provincial University Key Laboratory of Cellular Stress Response and Metabolic Regulation, College of Life Sciences, Fujian Normal University, Fuzhou, Fujian 350117, China</nlm:aff></affiliation></author><author><name sortKey="Wang, Yan" sort="Wang, Yan" uniqKey="Wang Y" first="Yan" last="Wang">Yan Wang</name><affiliation><nlm:aff id="aff0001">Provincial University Key Laboratory of Cellular Stress Response and Metabolic Regulation, College of Life Sciences, Fujian Normal University, Fuzhou, Fujian 350117, China</nlm:aff></affiliation></author><author><name sortKey="Long, Cheng" sort="Long, Cheng" uniqKey="Long C" first="Cheng" last="Long">Cheng Long</name><affiliation><nlm:aff id="aff0002">Department of Orthopaedic, Sichuan University West China Hospital, Chengdu, Sichuan, China</nlm:aff></affiliation></author><author><name sortKey="Fu, Xinmiao" sort="Fu, Xinmiao" uniqKey="Fu X" first="Xinmiao" last="Fu">Xinmiao Fu</name><affiliation><nlm:aff id="aff0001">Provincial University Key Laboratory of Cellular Stress Response and Metabolic Regulation, College of Life Sciences, Fujian Normal University, Fuzhou, Fujian 350117, China</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32209384</idno><idno type="pmc">7163181</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163181</idno><idno type="RBID">PMC:7163181</idno><idno type="doi">10.1016/j.jinf.2020.03.018</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000479</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000479</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Wuhan and Hubei COVID-19 mortality analysis reveals the critical role of timely supply of medical resources</title><author><name sortKey="Zhang, Zuqin" sort="Zhang, Zuqin" uniqKey="Zhang Z" first="Zuqin" last="Zhang">Zuqin Zhang</name><affiliation><nlm:aff id="aff0001">Provincial University Key Laboratory of Cellular Stress Response and Metabolic Regulation, College of Life Sciences, Fujian Normal University, Fuzhou, Fujian 350117, China</nlm:aff></affiliation></author><author><name sortKey="Yao, Wei" sort="Yao, Wei" uniqKey="Yao W" first="Wei" last="Yao">Wei Yao</name><affiliation><nlm:aff id="aff0001">Provincial University Key Laboratory of Cellular Stress Response and Metabolic Regulation, College of Life Sciences, Fujian Normal University, Fuzhou, Fujian 350117, China</nlm:aff></affiliation></author><author><name sortKey="Wang, Yan" sort="Wang, Yan" uniqKey="Wang Y" first="Yan" last="Wang">Yan Wang</name><affiliation><nlm:aff id="aff0001">Provincial University Key Laboratory of Cellular Stress Response and Metabolic Regulation, College of Life Sciences, Fujian Normal University, Fuzhou, Fujian 350117, China</nlm:aff></affiliation></author><author><name sortKey="Long, Cheng" sort="Long, Cheng" uniqKey="Long C" first="Cheng" last="Long">Cheng Long</name><affiliation><nlm:aff id="aff0002">Department of Orthopaedic, Sichuan University West China Hospital, Chengdu, Sichuan, China</nlm:aff></affiliation></author><author><name sortKey="Fu, Xinmiao" sort="Fu, Xinmiao" uniqKey="Fu X" first="Xinmiao" last="Fu">Xinmiao Fu</name><affiliation><nlm:aff id="aff0001">Provincial University Key Laboratory of Cellular Stress Response and Metabolic Regulation, College of Life Sciences, Fujian Normal University, Fuzhou, Fujian 350117, China</nlm:aff></affiliation></author></analytic><series><title level="j">The Journal of Infection</title><idno type="ISSN">0163-4453</idno><idno type="eISSN">1532-2742</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Highlights</title><p><list list-type="simple" id="celist0001"><list-item id="celistitem0001"><label>•</label><p id="para0002">COVID-19 mortality rates in Wuhan and Hubei decay exponentially.</p></list-item><list-item id="celistitem0002"><label>•</label><p id="para0003">COVID-19 mortality rates outside Hubei and Wuhan are nearly constant.</p></list-item><list-item id="celistitem0003"><label>•</label><p id="para0004">COVID-19 recovery rates in Wuhan and Hubei grow exponentially.</p></list-item><list-item id="celistitem0004"><label>•</label><p id="para0005">Over 40,000 aided health workers help Hubei to effectively treat patients.</p></list-item><list-item id="celistitem0005"><label>•</label><p id="para0006">Newly supplied beds allow over 38,000 patients in Wuhan to be treated in hospitals.</p></list-item></list></p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Tang, J W" uniqKey="Tang J">J.W. Tang</name></author><author><name sortKey="Tambyah, P A" uniqKey="Tambyah P">P.A. Tambyah</name></author><author><name sortKey="Hui, D S C" uniqKey="Hui D">D.S.C. Hui</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Zhou, P" uniqKey="Zhou P">P. Zhou</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Wang, X S" uniqKey="Wang X">X.S. Wang</name></author><author><name sortKey="Wu, J" uniqKey="Wu J">J. Wu</name></author><author><name sortKey="Yang, Y" uniqKey="Yang Y">Y. Yang</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Yang, X" uniqKey="Yang X">X. Yang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ji, Y" uniqKey="Ji Y">Y. Ji</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="letter"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Infect</journal-id><journal-id journal-id-type="iso-abbrev">J. Infect</journal-id><journal-title-group><journal-title>The Journal of Infection</journal-title></journal-title-group><issn pub-type="ppub">0163-4453</issn><issn pub-type="epub">1532-2742</issn><publisher><publisher-name>The British Infection Association. Published by Elsevier Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32209384</article-id><article-id pub-id-type="pmc">7163181</article-id><article-id pub-id-type="publisher-id">S0163-4453(20)30145-6</article-id><article-id pub-id-type="doi">10.1016/j.jinf.2020.03.018</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Wuhan and Hubei COVID-19 mortality analysis reveals the critical role of timely supply of medical resources</article-title></title-group><contrib-group><contrib contrib-type="author" id="au0001"><name><surname>Zhang</surname><given-names>Zuqin</given-names></name><xref rid="aff0001" ref-type="aff">a</xref><xref rid="fn1" ref-type="fn">1</xref></contrib><contrib contrib-type="author" id="au0002"><name><surname>Yao</surname><given-names>Wei</given-names></name><xref rid="aff0001" ref-type="aff">a</xref><xref rid="fn1" ref-type="fn">1</xref></contrib><contrib contrib-type="author" id="au0003"><name><surname>Wang</surname><given-names>Yan</given-names></name><xref rid="aff0001" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="au0004"><name><surname>Long</surname><given-names>Cheng</given-names></name><email>longchenghx@126.com</email><xref rid="aff0002" ref-type="aff">b</xref><xref rid="cor0001" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author" id="au0005"><name><surname>Fu</surname><given-names>Xinmiao</given-names></name><email>xmfu@fjnu.edu.cn</email><xref rid="aff0001" ref-type="aff">a</xref><xref rid="cor0001" ref-type="corresp">⁎</xref></contrib></contrib-group><aff id="aff0001"><label>a</label>Provincial University Key Laboratory of Cellular Stress Response and Metabolic Regulation, College of Life Sciences, Fujian Normal University, Fuzhou, Fujian 350117, China</aff><aff id="aff0002"><label>b</label>Department of Orthopaedic, Sichuan University West China Hospital, Chengdu, Sichuan, China</aff><author-notes><corresp id="cor0001"><label>⁎</label>Corresponding authors. <email>longchenghx@126.com</email><email>xmfu@fjnu.edu.cn</email></corresp><fn id="fn1"><label>1</label><p id="notep0001">These authors contributed to this work equally.</p></fn></author-notes><pub-date pub-type="pmc-release"><day>21</day><month>3</month><year>2020</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub"><day>21</day><month>3</month><year>2020</year></pub-date><history><date date-type="accepted"><day>14</day><month>3</month><year>2020</year></date></history><permissions><copyright-statement>© 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder></copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract abstract-type="author-highlights" id="abs0001"><title>Highlights</title><p><list list-type="simple" id="celist0001"><list-item id="celistitem0001"><label>•</label><p id="para0002">COVID-19 mortality rates in Wuhan and Hubei decay exponentially.</p></list-item><list-item id="celistitem0002"><label>•</label><p id="para0003">COVID-19 mortality rates outside Hubei and Wuhan are nearly constant.</p></list-item><list-item id="celistitem0003"><label>•</label><p id="para0004">COVID-19 recovery rates in Wuhan and Hubei grow exponentially.</p></list-item><list-item id="celistitem0004"><label>•</label><p id="para0005">Over 40,000 aided health workers help Hubei to effectively treat patients.</p></list-item><list-item id="celistitem0005"><label>•</label><p id="para0006">Newly supplied beds allow over 38,000 patients in Wuhan to be treated in hospitals.</p></list-item></list></p></abstract><abstract abstract-type="graphical" id="abs0002"><title>Graphic abstract</title><p><fig id="fig0002" position="anchor"><alt-text id="alttx001">Image, graphical abstract</alt-text><graphic xlink:href="fx1_lrg"></graphic></fig></p></abstract></article-meta></front><body><p id="para0007">The 2019 novel coronavirus diseases (COVID-19) outbreak caused by SARS-CoV-2 is on-going in China and has hit many countries.<xref rid="bib0001" ref-type="bibr">1</xref>, <xref rid="bib0002" ref-type="bibr">2</xref>, <xref rid="bib0003" ref-type="bibr">3</xref> As of 3 March 2020, there have been 80,270 confirmed cases and 2981 deaths in China, most of which are from the epicenter of the outbreak, Wuhan City, the capital of Hubei Province. New COVID-19 cases have been steadily declining in</p><p id="para0017a">China and more than 60,000 patients have been recovered,<xref rid="bib0004" ref-type="bibr"><sup>4</sup></xref> largely due to the effective implementation of comprehensive control measures in China.<xref rid="bib0005" ref-type="bibr"><sup>5</sup></xref><sup>,</sup><xref rid="bib0006" ref-type="bibr"><sup>6</sup></xref> Here we report that some of these measures, such as a dramatic and timely increase of medical supplies, may play a critical role such that the mortality and recovery rates of COVID-19 in Wuhan follow exponential decay and growth modes, respectively.</p><p id="para0008">We collected data for analysis on the officially released cumulative numbers of confirmed, dead and recovered cases (from 23 Jan to 3 Mar 2020) in five geographic regions, i.e., mainland China, Hubei Province, outside Hubei (in China), Wuhan City and outside Wuhan (in Hubei). As of 3 Mar 2020, crude fatality ratios (CFRs) in the above regions are 0.027±0.006, 0.035±0.007, 0.005±0.002, 0.045±0.012 and 0.021±0.008, respectively, in line with earlier reports.<xref rid="bib0005" ref-type="bibr"><sup>5</sup></xref><sup>,</sup><xref rid="bib0006" ref-type="bibr"><sup>6</sup></xref> While the mortality rates of COVID-19 outside Hubei and outside Wuhan appear constant over time, the mortality rates in Hubei and Wuhan decline continuously (<xref rid="fig0001" ref-type="fig">Fig. 1</xref>(A)). Strikingly, the mortality rates in Hubei and Wuhan are well-fitted with the exponential decay mode (<italic>R<sup>2</sup></italic> being 0.93 and 0.82, respectively; <xref rid="fig0001" ref-type="fig">Fig. 1</xref>(A) and Table S1), and it is the same forth with that in China (<italic>R<sup>2</sup></italic> being 0.86) but not with that outside Hubei and outside Wuhan (<italic>R<sup>2</sup></italic> being 0.39 and 0.32, respectively). Remarkably, we found that the recovery rates of COVID-19 patients in the above regions were all well-fitted with the exponential growth mode (<italic>R<sup>2</sup></italic> being 0.96, 0.95, 0.95, 0.88 and 0.95, respectively; <xref rid="fig0001" ref-type="fig">Fig. 1</xref>(B) and Table S1). Such intriguing pattern for the COVID-19 mortality and recovery rates in Wuhan (or Hubei) somehow contradicts traditional epidemiological models wherein both are assumed as constants.<xref rid="bib0007" ref-type="bibr"><sup>7</sup></xref><fig id="fig0001"><label>Fig. 1</label><caption><p>Fitting the COVID-19 mortality and recovery rates with exponential decay and growth functions, respectively and timely supply of medical resources. (<bold>A, B</bold>) Mortality rate (panel A) and recovery rate (panel B) for COVID-19 in China over time and by location, with exponential decay- and growth-based regression analyses being performed, respectively (as shown by colored solid lines). Parameters from the regression analyses are shown in Table S1, with <italic>R<sup>2</sup></italic> being shown here. (<bold>C</bold>) Numbers of the aided health workers in Hubei over time. Ratio of the aided health workers to patients was also plotted (note: most of the aided health workers are working in Wuhan; refer to Table S3). (<bold>D</bold>) Numbers of the remaining confirmed cases of COVID-19, and acute care beds, makeshift beds from Fangcang hospitals and total beds in Wuhan over time. Ratio of beds to patients was also plotted. Here the data of newly supplied beds in Hubei are not available and thus the data for Wuhan were analyzed.</p></caption><alt-text id="alt0001">Fig 1</alt-text><graphic xlink:href="gr1_lrg"></graphic></fig></p><p id="para0009">The above unique pattern may reflect the fact that COVID-19 patients in Wuhan (or Hubei) have been treated more effectively day by day. Here we focused on two components essential for effective treatments, i.e., the supply of health workers and hospital beds. As a matter of fact, a great number (up to 42,000, as of 1 March 2020) of health workers have been aided by other provinces in China (Table S2) and they are working in different cities of Hubei (Table S3). This extraordinary aid keeps the ratio of the health workers to patients in Hubei at above 0.6 despite the number of remaining confirmed cases has ten-fold increased up to 50,000 on 18 Feb (<xref rid="fig0001" ref-type="fig">Fig. 1</xref>(C)). Results also show that the number of acute care beds from more than 45 designated hospitals plus two newly built ones in Wuhan has been consecutively increasing up to 23,532 (as of Feb 24) under the government-directed re-allocation (<xref rid="fig0001" ref-type="fig">Fig. 1</xref>(D)). This supply thus enabled the severe and critical patients to be treated timely and effectively.<xref rid="bib0006" ref-type="bibr"><sup>6</sup></xref> More importantly, there have been over 10 temporary hospitals (named Fangcang hospitals) reconstructed from gymnasium and exhibition centers, which provide more than 26 000 makeshift beds for mild patients (<xref rid="fig0001" ref-type="fig">Fig. 1</xref>(D)). These combinations guaranteed nearly 100% of COVID-19 patients to be treated in hospitals even if the number of remaining confirmed cases has ten-fold increased up to 38 000 on 18 Feb (<xref rid="fig0001" ref-type="fig">Fig. 1</xref>(D)). In contrast, a lot of patients had to stay at home in the early stage of the outbreak in Wuhan due to the shortage of beds such that many transmissions in households occurred.<xref rid="bib0006" ref-type="bibr"><sup>6</sup></xref></p><p id="para0010">Accordingly, the effective implementation of comprehensive control measures and infection-treatment practices is critical for combatting any new pathogens, not only interrupting the transmissions but also saving the patients. Timely supplied medical resources, including re-allocation of acute care beds, rapid construction of new hospitals and generous aid of health workers by other less-severe areas, apparently help the epicenter of the outbreak Hubei (Wuhan) to accomplish a unique and also encouraging outcome for life-saving such that the mortality and recovery rates of nearly 50,000 COVID-19 patients exponentially decays and grows, respectively. Other crucial factors contributing to this success may include the improved and optimized diagnosis and treatment strategies,<xref rid="bib0008" ref-type="bibr"><sup>8</sup></xref> which are critical for saving severe and critical patients.<xref rid="bib0005" ref-type="bibr"><sup>5</sup></xref><sup>,</sup><xref rid="bib0006" ref-type="bibr"><sup>6</sup></xref><sup>,</sup><xref rid="bib0009" ref-type="bibr"><sup>9</sup></xref> This speculation appears to be supported by the exponential growth of the COVID-19 recovery rate outside Hubei (<xref rid="fig0001" ref-type="fig">Fig. 1</xref>(B)) where medical resources are relatively sufficient over time.<xref rid="bib0010" ref-type="bibr"><sup>10</sup></xref> Collectively, the achievement made in Hubei (or Wuhan) may provide useful guidance for many countries to be better prepared for the potential pandemic<xref rid="bib0002" ref-type="bibr"><sup>2</sup></xref> that may overwhelm local health care systems.</p><sec sec-type="COI-statement"><title>Declaration of Competing Interest</title><p id="p001">The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.</p></sec></body><back><ref-list id="cebibl1"><title>References</title><ref id="bib0001"><label>1</label><element-citation publication-type="journal" id="sbref0001"><person-group person-group-type="author"><name><surname>Tang</surname><given-names>J.W.</given-names></name><name><surname>Tambyah</surname><given-names>P.A.</given-names></name><name><surname>Hui</surname><given-names>D.S.C.</given-names></name></person-group><article-title>Emergence of a novel coronavirus causing respiratory illness from Wuhan, China</article-title><source>J Infect</source><year>2020</year><pub-id pub-id-type="doi">10.1016/j.jinf.2020.01.014</pub-id></element-citation></ref><ref id="bib0002"><label>2</label><mixed-citation publication-type="other" id="othref0001">WHO: Coronavirus disease (COVID-19) outbreak. 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All authors report no conflicts of interest relevant to this article.</p></ack><fn-group><fn id="sec0001" fn-type="supplementary-material"><p id="para0007a">Supplementary material associated with this article can be found, in the online version, at <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/j.jinf.2020.03.018" id="interref0002">doi:10.1016/j.jinf.2020.03.018</ext-link>.</p></fn></fn-group></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:32209384" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a StressCovidV1
| This area was generated with Dilib version V0.6.33. |  |