I just finished reading a very informative and enlightening revue of Covid in China outside the Hubei province where Wuhan is located. To emphasize, this was not about the initial infections, etc. in Wuhan, but was rather about the spread into other cities and provinces in China (in 320 municipalities in China). This spread to different parts of China was undoubtedly exacerbated by Chinese New Year (CNY), which in mainland China encompassed 1/24 – 1/30, and the extensive travel associated with CNY.
The purpose of this study was to demonstrate when and how this virus is transmitted. Since I cannot pronounce nor will I attempt to spell the names of these municipalities, most of this info will be in generalities, not related to specific municipalities.
First, some definitions:
A cluster is 3 or more cases linked to some infection venue (e.g. apartment, train, school, plane, car) during a sufficiently close period of time.
An outbreak is a cluster with a common index point. These common index points were divided into six categories (e.g. homes, transport, restaurants, entertainment, shopping, and miscellaneous). [bear with me, as I needed to demonstrate how detailed this study was!]
This paper involved 318 outbreaks and 1245 infections. Of these 318 outbreaks, 129 involved family members, 133 family relatives, and only 53 involved other contacts, both social and non-social. In other words over 80% involved relatives and family members. (Most likely the family relatives were involved in some kind of CNY festivities.)
Of the 318 outbreaks 253 involved apartments with an average of 3.4 people involved in each of the 253. Most families in China have only one child, and the parents often live with them. This implies that again about 80% involved a single apartment with an average of 3.4 people living within the apartment. Only 108 of the 318 outbreaks involved the category of “transportation,” (which included train, private car, bus, plane, taxi, cruise ship) and these involved an average of 3.8 each. The remainder of the cases were related to restaurants, entertainment, shopping, and miscellaneous.
The common denominator in these top two categories seemed to be confinement in a relatively small space. In addition, the most remarkable thing about this comprehensive study is that all outbreaks occurred in indoor environments.
This article did not draw any conclusions except those relating to outdoors and indoors. I hope that governors who had banned just about all activities in outdoor places, (e.g. parks, and are still banning most beach activities) will be cognizant that being outdoors is much safer.
Also the likelihood of transmission by contaminated surfaces although still possible, as people in the same apartment or on the same train or bus all touch similar things, is deemed an infrequent cause of spread.
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