key: cord-0929520-xzfnzbcf authors: Chen, Juan; Feng, Zhan-hui; Ye, Lan; Cheng, Yong-ran; Zhou, Meng-Yun; Li, Yafei; Du, Chong; Wang, Liansheng; Wang, Ming-Wei title: Travel rush during Chinese Spring Festival and the 2019-nCoV date: 2020-04-22 journal: Travel Med Infect Dis DOI: 10.1016/j.tmaid.2020.101686 sha: 9e81a4655515a59792de8c890a960a4fb4c270f9 doc_id: 929520 cord_uid: xzfnzbcf nan Travel Medicine and Infectious Disease journal homepage: www.elsevier.com/locate/tmaid We read with interest the report on 2019-nCov [1] and would like to provide travel rush during Chinese Spring Festival and the 2019-nCoV in China.Chinese Spring Festival Travel rush refers to the massive use of public (and private) transportation around the Spring Festival. It is a huge-scale phenomenon of high pressure transportation that occurs around the Lunar New Year in China. The Travel rush usually begins 15 days before Lunar New Year's Day and lasts for 40 days. A report from the Chinese Ministry of Transportation shows the total number of public transportation trips during this period in 2019 was 2.98 billion, a number equivalent to all Europeans, Oceanians, and Africans collectively travelling once. Therefore, the BBC referred to the Chinese Spring Festival travel rush as "the world's largest population migration every year." The 2020 Spring Festival travelling started on January 10 and will end on February 18, a total of 40 days. Due to the outbreak of 2019-nCoV in Wuhan, China, this year's travel rush is special. The 2019-nCoV outbreak has attracted worldwide attention. Several of the world's most influential magazines rushed to report about the epidemic [ [2] [3] [4] ]. At our institute, we study not only the epidemiological characteristics of the 2019-nCoV epidemic, but also its effects on the actual situation in China. This includes the effects on population mobility during the Chinese Spring Festival, and how this affects changes in the 2019-nCoV-infected population. We used the Baidu's Big Data to obtain five million trips and destinations of people travelling out of Wuhan between January 10 and 22, 2020, ahead of the Chinese Spring Festival. Wuhan was sealed off on January 23, 2020. From that date, people were prohibited from leaving Wuhan and all bus, subway, ferry, and long-distance passenger transportation were suspended. According to the New England Journal of Medicine, the average incubation period for the 2019-nCoV is 5.2 days [5] . We performed correlation analysis based on the data released by the Chinese National Health Commission, and show that incidence rate was higher in the regions receiving the largest number of travelers during this period, further confirming the epidemiological characteristics ( Fig. 1A-C) . Although the measures that Wuhan government took had been implemented, it is Clear that the effect is not satisfactory. Those people who returned to their hometown or travelled for sightseeing had already left Wuhan before its closure. As a result, 2019-nCoV was brought to other provinces across China as well as to other countries around the world, causing worldwide concern. With the progress of the 2019-nCoV epidemic, as of January 31, 2020, a total of 9692 cases were diagnosed and 213 people have died. It is not known what trend the 2019-nCoV epidemic is going to take and when it will reach its peak. We think that the beginning of the Chinese Spring Festival travel rush was an important factor in spreading the 2019-nCoV. If the Chinese government would have implemented the closure of Wuhan before the start of the travel rush, it is possible that the impact of 2019-nCoV would have been considerably lower. We should also pay attention to the fact that the Chinese Spring Festival travel rush is about to enter its second climax towards February 18, 2020, and with it the problems will come again. People who are now closed in Wuhan will start returning to their work places in other parts of China. This "second big migration," when the workers return to work, should be at the focus of our attention. This second migration process might escalate the epidemic as we are about to quell it. The attention of the government is required to minimize the impact of this second wave of migration. We envisage two solutions: First, after the Spring Festival holidays, to let those in Wuhan return to their original places of residence or places of work where they should be isolated immediately and be monitored for two weeks. People outside Wuhan should not be allowed to enter Wuhan for the time being. Second, closure of Wuhan should continue until the 2019-nCoV epidemic has subsided. Only then people would be allowed to go in and out of Wuhan. This approach would take longer. It has to be pointed out that no matter what approach the Chinese government will take, the public should be vigilant and cooperative to ensure that no one is infected again. It is clear to all that the Chinese government has taken strong measures to strengthen the country and control the progress of the 2019-nCoV epidemic. We hope that our suggestion can help China, and contribute to bringing the battle against 2019-nCoV to an early and successful end. The association between domestic train transportation and novel coronavirus outbreak in China, from 2019 to 2020: a data-driven correlational report Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia