2019 novel coronavirus: clinicians report potential treatment as global numbers predicted to jump

  • Wu JT, et al
  • The Lancet
  • 31 Jan 2020

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Independent, sustainable, human-to-human spread of the 2019 novel coronavirus (2019-nCoV) has extended to multiple major Chinese cities, many of them global transportation hubs.
  • Without immediate, substantial public health interventions, further international spread and additional local epidemics are likely. 
  • Thai clinician researchers report favorable patient response to drug "cocktail" comprising oseltamivir combined with lopinavir and ritonavir.

Why this matters

  • WHO has available its Disease Commodity Package for essential prevention, control, and case management guidance.
  • 50% reduced transmission is needed to prevent April disease peak.

Key results

  • Baseline scenario:
    • Basic reproductive number (R0): 2.68 (95% credible interval [CrI]: 2.47-2.86).
    • Epidemic doubling time: 6.4 days (95% CrI: 5.8-7.1).
  • As of January 25 in greater Wuhan: 75,815 infected persons (95% CrI: 37,304-130,330).
  • 461 (95% CrI: 227-805) imported cases, accounting for 53% of all outbound international air travel from China, 69% outside Asia.
  • By city (95% CrI):
    • Beijing: 113 (57-193);
    • Shanghai: 98 (49-168); 
    • Guangzhou: 111 (56-191); and
    • Shenzhen: 80 (40-139).

Study design

  • Modeling study analyzing basic 2019-nCoV reproductive number; probable outbreak size in Wuhan, December 1, 2019-January 25, 2020; cases imported domestically; and forecasted national and global spread.
  • Funding: Hong Kong Special Administrative Region.  

Limitations

  • Assumed travel behavior.
  • Sensitivity.
  • Mobility patterns based on older data.
  • Potential seasonality unaccounted for.