AIR Worldwide Uses Pandemic Model to Determine Countries at Highest Risk

March 3, 2020

AIR Worldwide published an evaluation of potential coronavirus disease 2019 (COVID-19) cases in other countries, using its pandemic model to run hypothetical scenarios, which could reveal those countries at the highest risk for onward infections.

In these scenarios, AIR simulated the spread of disease based on the latest reported number of cases in the countries outside China with the highest number of cases: namely South Korea, Italy and Iran, with 2033, 650 and 245 reported cases, respectively, as of Feb. 28.

“What we observed in these countries was an abrupt rise in the reported number of severe cases, which implies the existence of clusters before public health officials became aware of them,” said the analysis, which was compiled by Dr. Narges Dorratoltaj, senior scientist at Boston-based AIR Worldwide.

The prime assumption in these scenarios is that by the time a country starts to act against the further transmission of diseases, cases have already been exported to other countries, said AIR, explaining that air travel enables large numbers of people to travel internationally quickly.

Based on the daily pattern of travel between airports, AIR developed a list of countries with a higher probability of having imported cases from the source countries of South Korea, Italy and Iran.

AIR’s pointed to the following countries that are at highest risk for onward infections from these secondary outbreaks.

After South Korea’s outbreak, the following countries are at highest risk:

  • Japan
  • United States
  • Vietnam
  • Thailand
  • Philippines
  • Taiwan

For Italy:

  • Germany
  • United Kingdom
  • Spain
  • France
  • Netherlands
  • Belgium
  • United States
  • Romania

For Iran (the country with highest number of reported cases outside China):

  • United Arab Emirates
  • Turkey (There have been no confirmed cases of onward transmission of coronavirus cases from Iran, but they can be expected, said AIR).
  • Iraq
  • Qatar
  • German
  • Kuwait
  • Italy
Pattern of Disease Transmission

While China has imposed drastic containment procedures to limit the spread of the disease in the province of Hubei, where Wuhan is located, outbreaks in Italy and Iran show a type of pattern that can be expected in other countries, explained AIR.

“First is a cluster of severe cases, generally among elderly people, and then as contacts are examined, there is a sharp rise in confirmed cases over the next few days,” said AIR. “This pattern corresponds to the detection of a previously hidden chain of infection in the country, with cases that are largely asymptomatic or mildly symptomatic.”

For each country examined by AIR, its neighboring countries have a higher probability of transmission compared to the rest of the world. Since these countries are in different regions of the world, the probability of direct or indirect transmission of the disease to additional regions is more probable, added AIR.

“We expect to see this pattern of transmission repeat across the globe in coming days. During situations when there are limited resources available, such analyses can help with prioritizing the allocation of resources to regions and prevent the further spread of the disease,” continued the modeling firm.

Source: AIR Worldwide

Photograph: Commuters wear face masks to protect themselves from the new coronavirus at the skytrain station in Bangkok, Thailand, on Feb. 7, 2020. The virus outbreak, which began in China and has spread to more than 20 countries, stretching already-strained public health systems in Asia and beyond. Photo credit: AP Photo/Sakchai Lalit.

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