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<?covid-19-tdm?>
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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Int J Public Health</journal-id>
<journal-title>International Journal of Public Health</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Int J Public Health</abbrev-journal-title>
<issn pub-type="epub">1661-8564</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">1605177</article-id>
<article-id pub-id-type="doi">10.3389/ijph.2022.1605177</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Public Health Archive</subject>
<subj-group>
<subject>Original Article</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Transmission Characteristics and Predictive Model for Recent Epidemic Waves of COVID-19 Associated With OMICRON Variant in Major Cities in China</article-title>
<alt-title alt-title-type="left-running-head">Zheng and Wang</alt-title>
<alt-title alt-title-type="right-running-head">OMICRON Transmission Prediction in China</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Zheng</surname>
<given-names>Yangcheng</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Wang</surname>
<given-names>Yunpeng</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/868316/overview"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>State Key Laboratory of Organic Geochemistry</institution>, <institution>Guangzhou Institute of Geochemistry</institution>, <institution>Chinese Academy of Sciences</institution>, <addr-line>Guangzhou</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>University of Chinese Academy of Sciences</institution>, <addr-line>Beijing</addr-line>, <country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/943079/overview">Nino Kuenzli</ext-link>, Swiss Tropical and Public Health Institute (Swiss TPH), Switzerland</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Yunpeng Wang, <email>wangyp@gig.ac.cn</email>
</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>03</day>
<month>11</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="collection">
<year>2022</year>
</pub-date>
<volume>67</volume>
<elocation-id>1605177</elocation-id>
<history>
<date date-type="received">
<day>30</day>
<month>06</month>
<year>2022</year>
</date>
<date date-type="accepted">
<day>24</day>
<month>10</month>
<year>2022</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2022 Zheng and Wang.</copyright-statement>
<copyright-year>2022</copyright-year>
<copyright-holder>Zheng and Wang</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>
<bold>Objectives:</bold> Waves of epidemics associated with Omicron variant of Coronavirus Disease 2019 (COVID-19) in major cities in China this year have been controlled. It is of great importance to study the transmission characteristics of these cases to support further interventions.</p>
<p>
<bold>Methods:</bold> We simulate the transmission trajectory and analyze the intervention influences of waves associated with Omicron variant in major cities in China using the Suspected-Exposed-Infectious-Removed (SEIR) model. In addition, we propose a model using a function between the maximum daily infections and the duration of the epidemic, calibrated with data from Chinese cities.</p>
<p>
<bold>Results:</bold> An infection period of 5&#xa0;days and basic reproduction number R<sub>0</sub> between 2 and 8.72 are most appropriate for most cases in China. Control measures show a significant impact on reducing R<sub>0</sub>, and the earlier control measures are implemented, the shorter the epidemic will last. Our proposed model performs well in predicting the duration of the epidemic with an average error of 2.49&#xa0;days.</p>
<p>
<bold>Conclusion:</bold> Our results show great potential in epidemic model simulation and predicting the end date of the Omicron epidemic effectively and efficiently.</p>
</abstract>
<kwd-group>
<kwd>COVID-19</kwd>
<kwd>China</kwd>
<kwd>SEIR model</kwd>
<kwd>Omicron</kwd>
<kwd>predicting the end of the epidemic</kwd>
</kwd-group>
<contract-num rid="cn001">U1901215 42007205</contract-num>
<contract-sponsor id="cn001">National Natural Science Foundation of China<named-content content-type="fundref-id">10.13039/501100001809</named-content>
</contract-sponsor>
</article-meta>
</front>
<body>
<sec id="s1">
<title>Introduction</title>
<p>On 24 November 2021, the World Health Organization (WHO) confirmed a new variant of the 2019 Coronavirus (COVID-19) reported by South Africa which was named as Omicron [<xref ref-type="bibr" rid="B1">1</xref>]. WHO rated the global risk of Omicron as &#x201c;very high,&#x201d; which could lead to a global pandemic [<xref ref-type="bibr" rid="B2">2</xref>]. Last winter, Omicron swept across the world, with the maximum number of daily infections exceeding 3.8 million, and a significant increasing rate of Omicron variant in confirmed COVID-19 positive cases was found [<xref ref-type="bibr" rid="B3">3</xref>, <xref ref-type="bibr" rid="B4">4</xref>]. Compared to other variants of the SARS-CoV-2 virus, the Omicron variant has very rapid transmission rate that is much more difficult to predict [<xref ref-type="bibr" rid="B1">1</xref>&#x2013;<xref ref-type="bibr" rid="B3">3</xref>].</p>
<p>Since 2022, epidemics of varying severity caused by the Omicron variant have occurred in some major cities in China, with Shanghai and Hong Kong experiencing the most severe outbreaks. Since the Omicron outbreaks, China has continued to insist on the dynamic zero policy of COVID and strategies that have generally proven effective [<xref ref-type="bibr" rid="B5">5</xref>]. As of the writing of this article, most cities have succeeded in achieving the goal of dynamic zero COVID. With sporadic relapses occurring in other cities in China, there is no indication that the epidemic will disappear in a short time. Therefore, it is of great importance to comprehensively evaluate and study the current Omicron outbreaks in China to draw lessons for further epidemic control measures.</p>
<p>In this paper, we simulate the course of transmission and the influences of interventions using the Suspected-Exposed-Infectious-Removed (SEIR) epidemic model and analyze the epidemiology and statistical characteristics. In addition, we propose a model using a concise function between the maximum daily infections and the duration of each outbreak, which can be used to predict the end date of ongoing and potential outbreaks in other cities or countries.</p>
</sec>
<sec sec-type="methods" id="s2">
<title>Methods</title>
<p>Twelve typical cases in major cities or provinces in China that have experienced the Omicron epidemic since 2022 were selected as study cases and their daily infection data before 30 April were collected [<xref ref-type="bibr" rid="B6">6</xref>, <xref ref-type="bibr" rid="B7">7</xref>]. Since asymptomatic cases are also infectious, we combined the symptomatic cases and asymptomatic cases into daily infections [<xref ref-type="bibr" rid="B8">8</xref>, <xref ref-type="bibr" rid="B9">9</xref>]. We mark the date when the number of cases increases and exceeds 1% of the maximum value as the epidemic start date, and the date when the number of cases falls to less than 1% as the epidemic end date. The duration of each outbreak round is defined as the interval between the start and end dates. According to our definition, most selected cases, except Shanghai, experienced one completed outbreak before 30 April, while Shenzhen and Tianjin experienced two completed rounds. The specific start and end dates of each outbreak are shown in <xref ref-type="table" rid="T1">Table 1</xref>.</p>
<table-wrap id="T1" position="float">
<label>TABLE 1</label>
<caption>
<p>Selected cases with Omicron outbreaks (China 2022).</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">City/province</th>
<th align="center">Start date</th>
<th align="center">End date</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Changchun</td>
<td align="left">March 8</td>
<td align="left">30 April</td>
</tr>
<tr>
<td align="left">Jilin</td>
<td align="left">March 5</td>
<td align="left">17 April</td>
</tr>
<tr>
<td align="left">Hangzhou</td>
<td align="left">January 25</td>
<td align="left">2 February</td>
</tr>
<tr>
<td align="left">Shanghai</td>
<td align="left">March 17</td>
<td align="left">N/A</td>
</tr>
<tr>
<td align="left">Guangzhou</td>
<td align="left">April 7</td>
<td align="left">22 April</td>
</tr>
<tr>
<td align="left">Hong Kong</td>
<td align="left">February 4</td>
<td align="left">16 April</td>
</tr>
<tr>
<td align="left">Shenzhen&#x23;1<xref ref-type="table-fn" rid="Tfn1">
<sup>a</sup>
</xref>
</td>
<td align="left">February 19</td>
<td align="left">6 March</td>
</tr>
<tr>
<td align="left">Shenzhen&#x23;2<xref ref-type="table-fn" rid="Tfn1">
<sup>a</sup>
</xref>
</td>
<td align="left">March 8</td>
<td align="left">30 March</td>
</tr>
<tr>
<td align="left">Tianjin&#x23;1<xref ref-type="table-fn" rid="Tfn1">
<sup>a</sup>
</xref>
</td>
<td align="left">March 8</td>
<td align="left">19 March</td>
</tr>
<tr>
<td align="left">Tianjin&#x23;2<xref ref-type="table-fn" rid="Tfn1">
<sup>a</sup>
</xref>
</td>
<td align="left">March 18</td>
<td align="left">14 April</td>
</tr>
<tr>
<td align="left">Harbin</td>
<td align="left">April 13</td>
<td align="left">29 April</td>
</tr>
<tr>
<td align="left">Shaanxi</td>
<td align="left">March 7</td>
<td align="left">23 March</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="Tfn1">
<label>
<sup>a</sup>
</label>
<p>&#x23;1 and &#x23;2 denote the first and second round of epidemic, respectively.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<p>The SEIR model is the most commonly used dynamic epidemic model in COVID-19 studies, which divides the population into suspected population (<italic>S</italic>), exposed population (<italic>E</italic>), infectious population (<italic>I</italic>), and removed population (<italic>R</italic>), whose relationship can be formulated by the following differential equations:<disp-formula id="e1">
<mml:math id="m1">
<mml:mrow>
<mml:mfrac>
<mml:mrow>
<mml:mi>d</mml:mi>
<mml:mi>S</mml:mi>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
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<mml:mrow>
<mml:mi>d</mml:mi>
<mml:mi>t</mml:mi>
</mml:mrow>
</mml:mfrac>
<mml:mo>&#x3d;</mml:mo>
<mml:mo>&#x2212;</mml:mo>
<mml:mfrac>
<mml:mrow>
<mml:mi>&#x3b3;</mml:mi>
<mml:msub>
<mml:mi>R</mml:mi>
<mml:mn>0</mml:mn>
</mml:msub>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mi>N</mml:mi>
</mml:mfrac>
<mml:mi>S</mml:mi>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
<mml:mi>I</mml:mi>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
</mml:math>
<label>(1)</label>
</disp-formula>
<disp-formula id="e2">
<mml:math id="m2">
<mml:mrow>
<mml:mfrac>
<mml:mrow>
<mml:mi>d</mml:mi>
<mml:mi>E</mml:mi>
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<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mrow>
<mml:mi>d</mml:mi>
<mml:mi>t</mml:mi>
</mml:mrow>
</mml:mfrac>
<mml:mo>&#x3d;</mml:mo>
<mml:mfrac>
<mml:mrow>
<mml:mi>&#x3b3;</mml:mi>
<mml:msub>
<mml:mi>R</mml:mi>
<mml:mn>0</mml:mn>
</mml:msub>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mi>N</mml:mi>
</mml:mfrac>
<mml:mi>S</mml:mi>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
<mml:mi>I</mml:mi>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
<mml:mo>&#x2212;</mml:mo>
<mml:mi>&#x3b1;</mml:mi>
<mml:mi>E</mml:mi>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
</mml:math>
<label>(2)</label>
</disp-formula>
<disp-formula id="e3">
<mml:math id="m3">
<mml:mrow>
<mml:mfrac>
<mml:mrow>
<mml:mi>d</mml:mi>
<mml:mi>I</mml:mi>
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<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mrow>
<mml:mi>d</mml:mi>
<mml:mi>t</mml:mi>
</mml:mrow>
</mml:mfrac>
<mml:mo>&#x3d;</mml:mo>
<mml:mi>&#x3b1;</mml:mi>
<mml:mi>E</mml:mi>
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</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
</mml:math>
<label>(3)</label>
</disp-formula>where <italic>N</italic> is the total population, <italic>&#x3b3;</italic>
<sup>&#x2212;1</sup> is the infectious period, <italic>&#x3b1;</italic>
<sup>&#x2212;1</sup> is the incubation period, and the time-varying <italic>R</italic>
<sub>
<italic>0</italic>
</sub>
<italic>(t)</italic> is defined as follows<italic>:</italic>
<disp-formula id="e4">
<mml:math id="m4">
<mml:mrow>
<mml:msub>
<mml:mi>R</mml:mi>
<mml:mn>0</mml:mn>
</mml:msub>
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<mml:mn>0</mml:mn>
</mml:msub>
<mml:mo>&#x2212;</mml:mo>
<mml:msub>
<mml:mi>R</mml:mi>
<mml:mn>1</mml:mn>
</mml:msub>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
<mml:msup>
<mml:mi>e</mml:mi>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
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<mml:mi>q</mml:mi>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>t</mml:mi>
<mml:mo>&#x2212;</mml:mo>
<mml:msub>
<mml:mi>T</mml:mi>
<mml:mi>i</mml:mi>
</mml:msub>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:msup>
<mml:mo>&#x2b;</mml:mo>
<mml:msub>
<mml:mi>R</mml:mi>
<mml:mn>1</mml:mn>
</mml:msub>
</mml:mrow>
</mml:math>
<label>(4)</label>
</disp-formula>with <italic>R</italic>
<sub>
<italic>0</italic>
</sub> being the initial basic reproduction number (defined as the average number of secondary infections caused by a single infected individual in a fully susceptible population [<xref ref-type="bibr" rid="B10">10</xref>]) and <italic>R</italic>
<sub>
<italic>1</italic>
</sub> being the final basic reproduction number, <italic>q</italic> being a recession coefficient in the exponential function, and <italic>T</italic>
<sub>
<italic>i</italic>
</sub> being the intervention time when a significant change can be found in <inline-formula id="inf1">
<mml:math id="m5">
<mml:mrow>
<mml:msub>
<mml:mi>R</mml:mi>
<mml:mn>0</mml:mn>
</mml:msub>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
</mml:math>
</inline-formula> [<xref ref-type="bibr" rid="B11">11</xref>]. According to previous reports, the incubation period of Omicron variant is 3&#xa0;days and <italic>&#x3b1;</italic> is set as 0.33 [<xref ref-type="bibr" rid="B11">11</xref>]. The infectious period is the average duration from being infectious to losing infectiousness (death, cured or quarantined). However, the infection period may vary among countries because it is influenced by the ability of detection, quarantine and medical condition. In simulation, we try different values of <italic>&#x3b3;</italic> from 0.1 to 0.5 with 0.01 intervals to select the most appropriate infection period with best fitting performance.</p>
</sec>
<sec sec-type="results" id="s3">
<title>Results</title>
<p>As shown in <xref ref-type="fig" rid="F1">Figure 1</xref>, our model achieves satisfactory results in most selected cases with <italic>R</italic>
<sup>
<italic>2</italic>
</sup> &#x3e; 0.99. In the simulation, we tried different values of <italic>&#x3b3;</italic> and found that setting <italic>&#x3b3;</italic> to 0.2 and corresponding infection duration of 5&#xa0;days gives the best fitting performance in most selected cases. Under the condition of <italic>&#x3b3;</italic> &#x3d; 0.2, the adjusted epidemiological parameters are shown in <xref ref-type="table" rid="T2">Table 2</xref>. The initial basic reproduction number <italic>R</italic>
<sub>
<italic>0</italic>
</sub> ranges from 2.01 (Changchun) to 8.72 (Jilin), and after the intervention period <italic>T</italic>
<sub>
<italic>i</italic>
</sub>, <inline-formula id="inf2">
<mml:math id="m6">
<mml:mrow>
<mml:msub>
<mml:mi>R</mml:mi>
<mml:mn>0</mml:mn>
</mml:msub>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
</mml:math>
</inline-formula> decreases to <italic>R</italic>
<sub>
<italic>1</italic>
</sub>, which is less than one in all cases. On average, the date <italic>T</italic>
<sub>
<italic>max</italic>
</sub> with the maximum daily infections arrives 6&#xa0;days later than the intervention date <italic>T</italic>
<sub>
<italic>i</italic>
</sub>, and for each day <italic>T</italic>
<sub>
<italic>i</italic>
</sub> is delayed, <italic>T</italic>
<sub>
<italic>max</italic>
</sub> is delayed by 2.6&#xa0;days on average.</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>The curves of fitted and actual daily new confirmed cases for the selected cities. <bold>(A)</bold> Shanghai, <bold>(B)</bold> Hong Kong, <bold>(C)</bold> Changchun, <bold>(D)</bold> Jilin, <bold>(E)</bold> Guangzhou, <bold>(F)</bold> Shaanxi, <bold>(G)</bold> Shenzhen round 1, <bold>(H)</bold> Shenzhen round 2, <bold>(I)</bold> Tianjin round 1, <bold>(J)</bold> Tianjin round 2, <bold>(K)</bold> Hangzhou <bold>(L)</bold> Harbin (China 2022).</p>
</caption>
<graphic xlink:href="ijph-67-1605177-g001.tif"/>
</fig>
<table-wrap id="T2" position="float">
<label>TABLE 2</label>
<caption>
<p>Epidemiology parameters of selected cases (China 2022).</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">City/province</th>
<th align="center">
<italic>R</italic>
<sub>
<italic>0</italic>
</sub>
</th>
<th align="center">
<italic>R</italic>
<sub>
<italic>1</italic>
</sub>
</th>
<th align="center">
<italic>q</italic>
</th>
<th align="center">
<italic>T</italic>
<sub>
<italic>max</italic>
</sub>
</th>
<th align="center">
<italic>T</italic>
<sub>
<italic>i</italic>
</sub>
</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Changchun</td>
<td align="char" char=".">2.01</td>
<td align="center">0.1</td>
<td align="char" char=".">3.17</td>
<td align="center">27</td>
<td align="left">31 March</td>
</tr>
<tr>
<td align="left">Jilin</td>
<td align="char" char=".">8.72</td>
<td align="center">0.51</td>
<td align="char" char=".">5.99</td>
<td align="center">10</td>
<td align="left">11 March</td>
</tr>
<tr>
<td align="left">Hangzhou</td>
<td align="char" char=".">3.56</td>
<td align="center">0</td>
<td align="char" char=".">8.95</td>
<td align="center">4</td>
<td align="left">26 January</td>
</tr>
<tr>
<td align="left">Shanghai</td>
<td align="char" char=".">3.34</td>
<td align="center">0.75</td>
<td align="char" char=".">7.76</td>
<td align="center">26</td>
<td align="left">6 April</td>
</tr>
<tr>
<td align="left">Guangzhou</td>
<td align="char" char=".">3.35</td>
<td align="center">0</td>
<td align="char" char=".">5.98</td>
<td align="center">7</td>
<td align="left">11 April</td>
</tr>
<tr>
<td align="left">Hong Kong</td>
<td align="char" char=".">3.1</td>
<td align="center">0.49</td>
<td align="char" char=".">2.28</td>
<td align="center">26</td>
<td align="left">27 February</td>
</tr>
<tr>
<td align="left">Shenzhen&#x23;1</td>
<td align="char" char=".">4.33</td>
<td align="center">0.46</td>
<td align="char" char=".">6.4</td>
<td align="center">10</td>
<td align="left">24 February</td>
</tr>
<tr>
<td align="left">Shenzhen&#x23;2</td>
<td align="char" char=".">3.99</td>
<td align="center">0</td>
<td align="char" char=".">7.8</td>
<td align="center">7</td>
<td align="left">12 March</td>
</tr>
<tr>
<td align="left">Tianjin&#x23;1</td>
<td align="char" char=".">3.5</td>
<td align="center">0.18</td>
<td align="char" char=".">2.21</td>
<td align="center">6</td>
<td align="left">11 March</td>
</tr>
<tr>
<td align="left">Tianjin&#x23;2</td>
<td align="char" char=".">3.03</td>
<td align="center">0</td>
<td align="char" char=".">8.79</td>
<td align="center">5</td>
<td align="left">14 April</td>
</tr>
<tr>
<td align="left">Harbin</td>
<td align="char" char=".">3.92</td>
<td align="center">0</td>
<td align="char" char=".">9.15</td>
<td align="center">8</td>
<td align="left">15 April</td>
</tr>
<tr>
<td align="left">Shaanxi</td>
<td align="char" char=".">3.68</td>
<td align="center">0</td>
<td align="char" char=".">4.59</td>
<td align="center">7</td>
<td align="left">10 March</td>
</tr>
</tbody>
</table>
</table-wrap>
<p>We take the logarithm of the maximum daily infections based on 10 and establish its linear relationship with the duration of the epidemic in each selected case (<xref ref-type="fig" rid="F2">Figure 2</xref>). For the cases with completed epidemic, we compare the actual duration with the predicted duration (<xref ref-type="table" rid="T3">Table 3</xref>), and the error ranges from &#x2212;5.4 to 6.4&#xa0;days. According to this function, we predicted that daily infections in Shanghai will decrease to less than 260 (1% of the maximum value) on 22 May, 5&#xa0;days earlier than the actual date of 27 May.</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Relationship between the maximum daily infections (Log10) and the duration of the epidemic (China 2022).</p>
</caption>
<graphic xlink:href="ijph-67-1605177-g002.tif"/>
</fig>
<table-wrap id="T3" position="float">
<label>TABLE 3</label>
<caption>
<p>Selected cases with Omicron outbreaks (China 2022).</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">City/province</th>
<th align="center">Duration (days)</th>
<th align="center">Predicted duration (days)</th>
<th align="center">Error (days)</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Changchun</td>
<td align="center">54</td>
<td align="center">48.6</td>
<td align="char" char=".">&#x2212;5.4</td>
</tr>
<tr>
<td align="left">Jilin</td>
<td align="center">44</td>
<td align="center">44.4</td>
<td align="char" char=".">0.4</td>
</tr>
<tr>
<td align="left">Hangzhou</td>
<td align="center">9</td>
<td align="center">8.8</td>
<td align="char" char=".">&#x2212;0.2</td>
</tr>
<tr>
<td align="left">Shanghai</td>
<td align="center">71</td>
<td align="center">66.5</td>
<td align="char" char=".">4.5</td>
</tr>
<tr>
<td align="left">Guangzhou</td>
<td align="center">16</td>
<td align="center">13.8</td>
<td align="char" char=".">&#x2212;2.2</td>
</tr>
<tr>
<td align="left">Hong Kong</td>
<td align="center">72</td>
<td align="center">74</td>
<td align="char" char=".">2</td>
</tr>
<tr>
<td align="left">Shenzhen&#x23;1</td>
<td align="center">16</td>
<td align="center">12.9</td>
<td align="char" char=".">&#x2212;3.1</td>
</tr>
<tr>
<td align="left">Shenzhen&#x23;2</td>
<td align="center">21</td>
<td align="center">21.7</td>
<td align="char" char=".">0.7</td>
</tr>
<tr>
<td align="left">Tianjin&#x23;1</td>
<td align="center">12</td>
<td align="center">18.4</td>
<td align="char" char=".">6.4</td>
</tr>
<tr>
<td align="left">Tianjin&#x23;2</td>
<td align="center">19</td>
<td align="center">18.4</td>
<td align="char" char=".">&#x2212;0.6</td>
</tr>
<tr>
<td align="left">Harbin</td>
<td align="center">17</td>
<td align="center">20.2</td>
<td align="char" char=".">3.2</td>
</tr>
<tr>
<td align="left">Shaanxi</td>
<td align="center">17</td>
<td align="center">15.8</td>
<td align="char" char=".">&#x2212;1.2</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec sec-type="discussion" id="s4">
<title>Discussion</title>
<p>The validity of the SEIR model depends on accurate estimation of the characteristics of virus transmission [<xref ref-type="bibr" rid="B12">12</xref>]. A fixed infection rate <italic>&#x3b3;</italic> &#x3d; 0.2 may contribute to other studies of Omicron using the SEIR model. The initial basic reproduction number <italic>R</italic>
<sub>
<italic>0</italic>
</sub> reflects the basic capacity of epidemic prevention and control before the intervention. Except in Jilin city, the <italic>R</italic>
<sub>
<italic>0</italic>
</sub> of the Omicron variant in selected cases ranges from 2 to 4.4, with an average of 3.43. According to a review of the basic reproduction number for Omicron [<xref ref-type="bibr" rid="B13">13</xref>], the average effective <italic>R</italic>
<sub>
<italic>0</italic>
</sub> is 3.4 with a range of 0.88&#x2013;9.4, which is highly consistent with our results. The high <italic>R</italic>
<sub>
<italic>0</italic>
</sub> in the case of Jilin city can be attributed to severe cluster infections in the initial stage [<xref ref-type="bibr" rid="B14">14</xref>], but the value decreases significantly after 6&#xa0;days, and the maximum daily infections come four more days later. Some previous studies have evaluated an extremely high value of <italic>R</italic>
<sub>
<italic>0</italic>
</sub> of Omicron variant in the very early stage when no control measures were implemented. For instance, <italic>R</italic>
<sub>
<italic>0</italic>
</sub> could be as high as 10 in the United Kingdom, while the Omicron variant was 3.3 times more transmissible than the Delta variant in the case South Africa [<xref ref-type="bibr" rid="B4">4</xref>, <xref ref-type="bibr" rid="B15">15</xref>]. The differences between the values of <italic>R</italic>
<sub>
<italic>0</italic>
</sub> in the cases of China and other countries may be attributed to the rapid and reasonable reactions to the new sporadic relapses in China [<xref ref-type="bibr" rid="B16">16</xref>, <xref ref-type="bibr" rid="B17">17</xref>]. The final reproduction number <italic>R</italic>
<sub>
<italic>1</italic>
</sub> reflects the transmission ability at which virus spreads in the community after the intervention. In most cases where the dynamic zero COVID target has been reached, <italic>R</italic>
<sub>
<italic>1</italic>
</sub> is zero or close to zero, indicating that the transmission chain has been completely broken. Our simulation functions, especially <xref ref-type="disp-formula" rid="e4">Eq. 4</xref>, are established under the conditions that effective control measures are implemented and a significant decrease in the transmission rate can be found. In addition, other long-term factors such as seasonality, vaccination, reinfection and demographics are not accounted for in our study for brevity [<xref ref-type="bibr" rid="B18">18</xref>].</p>
<p>The control measures implemented in China (i.e., mask wearing and routine nucleic acid testing) are important non-pharmaceutical interventions and can effectively prevent community transmission of the virus [<xref ref-type="bibr" rid="B19">19</xref>, <xref ref-type="bibr" rid="B20">20</xref>]. The intervention date <italic>T</italic>
<sub>
<italic>i</italic>
</sub> is the date when <inline-formula id="inf3">
<mml:math id="m7">
<mml:mrow>
<mml:msub>
<mml:mi>R</mml:mi>
<mml:mn>0</mml:mn>
</mml:msub>
<mml:mrow>
<mml:mo>(</mml:mo>
<mml:mrow>
<mml:mi>t</mml:mi>
</mml:mrow>
<mml:mo>)</mml:mo>
</mml:mrow>
</mml:mrow>
</mml:math>
</inline-formula> changes appreciably and may not coincide with the date <italic>T</italic>
<sub>
<italic>max</italic>
</sub>, when daily infections reach their maximum and when control measures are implemented. Our results show that the later control measures are taken to break the transmission chain, the more time is spent on controlling the epidemic. Therefore, for other cities adhering to the dynamic zero COVID policy, once new infections are tested, it is important to take control measures as soon as possible to shorten the duration of the epidemic.</p>
<p>We propose a brief linear function to approximately predict the duration of a complete round of epidemics, with error within 1&#xa0;week. This method is a nonparametric method that is short enough to avoid the uncertainties introduced by manually setting the epidemiological parameters. It should be noted, however, that this method is only applicable to a single epidemic wave and should be used with caution because it is difficult to judge the maximum point.</p>
</sec>
</body>
<back>
<sec id="s5">
<title>Author Contributions</title>
<p>Conceptualization, YZ and YW; methodology, YZ; investigation, YZ and YW; data curation, YZ; writing&#x2014;original draft preparation, YZ; writing&#x2014;review and editing, YW; visualization, YZ; funding acquisition, YW. All authors have read and agreed to the published version of the manuscript.</p>
</sec>
<sec id="s6">
<title>Funding</title>
<p>This research was funded by The Natural Science Foundation of China, grant numbers U1901215 and 42007205, and Natural Science Fund of Guangdong Province, grant number 2021A1515011375. This is contribution No. IS-3266 from GIGCAS.</p>
</sec>
<sec sec-type="COI-statement" id="s7">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
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