Evaluating new evidence in the early dynamics of the novel coronavirus COVID-19 outbreak in Wuhan, China with real time domestic traffic and potential asymptomatic transmissions

Can Zhou

It is important to investigate alternative sources of information to understand the disease dynamics due to the inherent issues associated with the time series of the confirmed cases in China. The daily confirmed cases will likely show an increasing trend purely due to the increase in sample processing throughput. Since Jan. 1, 2020, the Chinese CDC has progressively adopted different versions of the case definition, simplified the procedural burden to confirm a case and subsequently increased the throughput of processing virus samples. One study used a hypothesized temporally increasing confirmation rate to estimate R 0 (Zhao et al., 2020) . However, the actual confirmation rate is unknown and the estimated R 0 is highly variable. Another source of uncertainty is the suspected low confirmation rate of this disease. It has been estimated that only 5.1% of infections in Wuhan are identified (Read et al., 2020) . With these concerns, Wu et al. (2020) and Nishiura, Jung, et al. (2020) used an alternative data source, i.e., the number of internationally exported cases between Dec. 31, 2019 and Jan. 28, 2020, to infer the disease dynamics.