The impact of temperature and absolute humidity on the coronavirus disease 2019 (COVID-19) outbreak - evidence from China

Abstract
OBJECTIVE: To investigate the impact of temperature and absolute humidity on the coronavirus disease 2019 (COVID-19) outbreak.DESIGN: Ecological study.SETTING: 31 provincial-level regions in mainland China.MAIN OUTCOME MEASURES: Data on COVID-19 incidence and climate between Jan 20 and Feb 29, 2020.RESULTS: The number of new confirm COVID-19 cases in mainland China peaked on Feb 1, 2020. COVID-19 daily incidence were lowest at -10 °C and highest at 10 °C, while the maximum incidence was observed at the absolute humidity of approximately 7 g/m3. COVID-19 incidence changed with temperature as daily incidence decreased when the temperature rose. No significant association between COVID-19 incidence and absolute humidity was observed in distributed lag nonlinear models. Additionally, A modified susceptible-exposed-infectious-recovered (M-SEIR) model confirmed that transmission rate decreased with the increase of temperature, leading to further decrease of infection rate and outbreak scale.CONCLUSION: Temperature is an environmental driver of the COVID-19 outbreak in China. Lower and higher temperatures might be positive to decrease the COVID-19 incidence. M-SEIR models help to better evaluate environmental and social impacts on COVID-19.What is already known on this topic: Many infectious diseases present an environmental pattern in their incidence. Environmental factors, such as climate and weather condition, could drive the space and time correlations of infectious diseases, including influenza. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be transmitted through aerosols, large droplets, or direct contact with secretions (or fomites) as influenza virus can. Little is known about environmental pattern in COVID-19 incidence. What this study adds: The significant association between COVID-19 daily incidence and temperature was confirmed, using 3 methods, based on the data on COVID-19 and weather from 31 provincial-level regions in mainland China. Environmental factors were considered on the basis of SEIR model, and a modified susceptible-exposed-infectious-recovered (M-SEIR) model was developed. Simulations of the COVID-19 outbreak in Wuhan presented similar effects of temperature on incidence as the incidence decrease with the increase of temperature.