Major epidemic response actions taken by the Chinese government are shown in brown boxes. Most other cases that experienced onset of symptoms in December were only discovered when retrospectively investigated. The first few cases of pneumonia of unknown etiology are shown in blue boxes on December 26 (n = 4) and 28-29 (n = 3). The graph's x-axis (dates from December 8, 2019, to February 11, 2020) is also used as a timeline of major milestones in the epidemic response. The difference between the cases by date of symptom onset curve (blue) and the cases by date of diagnosis curve (orange) illustrates lag time between the start of illness and diagnosis of COVID-19 by viral nucleic acid testing. Because, on retrospective investigation, so few cases experienced illness in December, these cases are shown in the inset.
1ĭaily numbers of confirmed cases are plotted by date of onset of symptoms (blue) and by date of diagnosis (orange). Epidemic curves reflect what may be a mixed outbreak pattern, with early cases suggestive of a continuous common source, potentially zoonotic spillover at Huanan Seafood Wholesale Market, and later cases suggestive of a propagated source as the virus began to be transmitted from person to person ( Figure 1). The sheer speed of both the geographical expansion and the sudden increase in numbers of cases surprised and quickly overwhelmed health and public health services in China, particularly in Wuhan City and Hubei Province. 1ĬOVID-19 rapidly spread from a single city to the entire country in just 30 days. Overall, 14.8% of confirmed cases among health workers were classified as severe or critical and 5 deaths were observed. Among the 44 672 cases, a total of 1716 were health workers (3.8%), 1080 of whom were in Wuhan (63%). CFR was elevated among those with preexisting comorbid conditions-10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for hypertension, and 5.6% for cancer. No deaths were reported among mild and severe cases. No deaths occurred in the group aged 9 years and younger, but cases in those aged 70 to 79 years had an 8.0% CFR and cases in those aged 80 years and older had a 14.8% CFR. The overall case-fatality rate (CFR) was 2.3% (1023 deaths among 44 672 confirmed cases). Key Findings From the Chinese Center for Disease Control and Prevention Reportĥ0% within 24 to 48 hours), and 5% were critical (ie, respiratory failure, septic shock, and/or multiple organ dysfunction or failure) ( Box).
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