Volume 8, Issue 1 (3-2020)                   Jorjani Biomed J 2020, 8(1): 24-33 | Back to browse issues page


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Nazari S S, norouzi S, Asghari Jafar-abadi M. How is Coronavirus distributed in the world? A Spatial-Temporal Assessment Using Geographic Information System Approach. Jorjani Biomed J 2020; 8 (1) :24-33
URL: http://goums.ac.ir/jorjanijournal/article-1-702-en.html
1- Department of Zanjan University of Medical Sciences
2- Department of Zanjan University of Medical Sciences , snorouzibiostatistics@gmail.com
3- Road Traffic Injury Research Center, Tabriz University of Medical Sciences,Tabriz, Iran
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Introduction
In late December 2019, a number of patients were admitted to hospitals in China's Hubei Province with an initial diagnosis of pneumonia and symptoms such as fever, cough and shortness of breath for unknown reasons. After review, it was determined that the patients were epidemiologically related to a wholesale market for seafood and wet animals in Hubei, China (1, 2). Preliminary reports of the spread and pathogenicity of the new corona virus (COVID-19, named by the World Health Organization (WHO) on Feb 11, 2020), predicted the possible outbreak of COVID19. (3, 4). The WHO announced the outbreak of COVID-19 to be a pandemic on March 11, 2020, with the announcement of the director-general, "This is not just a public health crisis, this is a crisis that will touch every sector. So every sector and every individual must be involved in the fights,” (5)
The source of the infection that has been observed so far are mainly patients with coronavirus. But you need to know that a person who is asymptomatic can also be a source of infection (6). The virus can be passed from person to person (7), prevalence through respiratory tract secretions and contact (with surfaces or person to person) are from One of the most important causes of virus transmission. Airborne particles are also another way of transmitting the virus. The virus is generally easily transmitted during gatherings (8-10).
The COVID-19 pandemic virus is full of unknowns, and many of them (unknowns) have spatial dimensions that lead to the understanding of the phenomenon as geography and potential maps (11). Nowadays, it is very important to have timely data and extract the required information from this data. In this regard, Geographic Information Systems (GIS) are considered as an important tool in land data management, which provides the possibility of integrating data from different sources, the possibility of extracting the required information and discovering complex relationships between different phenomena (12).
Therefore, in order to interpret the COVID-19 phenomenon as a global epidemic disease in terms of location and its geographical impact, it is necessary to use geospatial and statistical tools (13). GIS has become an important tool in analyzing and visualizing the spread of COVID-19. For instance, Johns Hopkins University Center for Systems Science and Engineering (JHU CSSE) currently utilizes a GIS dashboard that provides live data of the world wide spatial distribution of COVID-19, including the total number of confirmed cases, mortalities, and recovered patients. A limited number of GIS-based studies have been published since the initial outbreak of COVID-19 (14).
The aim of this study is to implement, geographical and geo-spatial analysis in understanding locations and the distribution patterns of COVID-19.
Materials and Methods
This ecological study was conducted through coronavirus package provides a tidy format dataset of the 2019 Novel Coronavirus COVID-19 epidemic, reported by https://github.com/RamiKrispin/coronavirus. The raw data pulled from the Johns Hopkins University Center for Science and Engineering Systems (JHU CCSE) Coronavirus repository. The information reviewed daily reports of definite cases, definitively recovered and death from coronavirus in countries affected by the disease worldwide divided by state / province from January 22, 2020 to Jun 19, 2020. Variables included location by latitude and longitude, country name, province name (in some countries), date (daily), type (confirmed, recovered and death) and the number of cases.
Inclusion and exclusion criteria
All reported cases of Corona virus during   January 22, 2020 to Jun 19, 2020 were considered as inclusion criteria. Cases reported with a negative value and 0 were excluded.
Analysis method
Data were analyzed by ArcGIS software desktop version 10.2(http://www.esri.com) To understand the patterns and general trends in the data, the spatial statistics tool has been used. In terms of clustering, data were analyzed using the average nearest neighbor, Moran's I and multi-distance spatial cluster analysis. To measure geographical distribution and descriptive analysis, directional distribution, mean and median center and standard distance methods were used.
The average nearest neighbor method first measures the distance between the center point of each event and the center point of its nearest neighbor. If the calculated average distance is less than the average hypothetical random distribution, then it can be concluded that the distribution of the event under study in space is clustered. Moran's I spatial autocorrelation   tool examines the spatial autocorrelation based on the location of two of the desired properties of geographical features. This tool shows that the distribution pattern of these geographical features, considering the studied properties, has a clustered or scattered pattern. The multi-distance, spatial cluster analysis tool, also known as the K-Ripley function, is another very useful tool for statistically examining the spatial pattern of events in place and space. This tool shows the status of clustering events at different geographical distances. Directional distribution indicates whether the distribution of geographical features in space has been directional. Standard distance analysis measures the degree of concentration or distribution of events around the central Mean. Finally, to have an overview of the data, a prediction layer was obtained from places which there was no sample, using geostatistical analysis system. This layer was obtained using the inverse distance weighting, which is a precise method and has no presuppositions for data.
Ethical considerations
Due to the use of registration data and non-use of personal information, the ethical considerations of this study are not of concern.
Results
Table 1 shows the numerical results of the average nearest neighbor analysis. The average observed distance for confirmed, recovered, and death cases respectively were equal 80, 359.26 & 666.01 meters. However, the average value of the expected distance was calculated as 94436.7255, 106138.72 & 120603.20 respectively. The ratio of the nearest neighbor was 0.0008, 0.0034 and 0.0055, respectively. The calculated standard score was -251.55, -212.98 and -172.1, respectively.
Table 1 shows the numerical results of the Moran's I analysis. The Moran's Index for confirmed, recovered, and death cases respectively were equal 0.78, 0.39 & 0.83. However, the expected index was calculated as -0.00006, -0.00008 & -0.00012 respectively.
 
 The variance was 0.000001, 0.000002 and 0.000003 respectively. The calculated standard score was 673.72, 265.25 and 448.26 respectively.
 
 
Table 1: Results of the average nearest neighbor analysis
variable average observed distance (Meters) average value of the expected distance (Meters) ratio of the nearest neighbor Z score P- Value
Confirmed 80.00 94436.7255 0.0008 -251.55 <0.0001
Recovered 359.26 106138.72 0.0034 -212.98 <0.0001
Death 666.01 120603.20 0.0055 -172.1 <0.0001
 
Table 2: Results of Moran's I analysis
variable Moran's Index Expected Index variance Z score P- Value
Confirmed      0.7789 -0.00006 0.000001 673.72 <0.0001
Recovered 0.3866 -0.00008 0.000002 265.25 <0.0001
Death 0.8341 -0.00012 0.000003 448.26 <0.0001
 
 
Figure 1 shows the Average Nearest Neighbor and Moran's I results graphically. Fig1 (a), (b), (c) shows Moran's I results for confirmed, recovered and death cases respectively. Fig1 (d), (e), (f) shows Average Nearest Neighbor results for confirmed, recovered and death cases respectively.
 
 

Fig1 a) Moran's Index result for Confirmed cases          Fig1 d) Nearest Neighbor result for Confirmed cases

Fig1 b) Moran's Index result for Recovered cases          Fig1 e) Nearest Neighbor result for Recovered cases

Fig1 c) Moran's Index result for death cases          Fig1 f) Nearest Neighbor result for death cases
 
 
Figures 2 (a), (b) and (c) are the results of multi-distance, spatial cluster analysis for confirmed, recovered, and death cases, respectively.
In these figures, the blue line indicates the expected items and the red line indicates the observed items. The x-axis indicates an increase in distance
 
Fig2 c) Death multi-distance, spatial cluster analysis Fig2 b) Recovered multi-distance, spatial cluster analysis Fig2 a) Confirmed multi-distance, spatial cluster analysis
 
 
Map 1 shows the global distribution of corona virus, a comparison of the directional distribution of confirmed, recovered and death cases. The central criteria (mean and median) are also shown.
Map 2 shows the standard distance between confirmed, recovered, and death cases, as well as the average calculated by the nearest neighborhood method

Map2) the standard distance of confirmed, recovered and death cases Map1) The directional distribution of confirmed, recovered and death cases along their central points
 
 
 
Maps 3, 4, and 5 show an overview of the prevalence of confirmed, recovered, and death cases, respectively. Areas marked in red and orange indicates more infected areas, and areas marked in blue and green indicate fewer
infection. These maps also show predictions for areas for which there were no samples. In fact, these maps provide an estimate of the corona virus.
 
 
Map 4) recovered geostatistical map Map 3) confirmed geostatistical map

Map 5) death geostatistical map
 
 
Figure 3 (a) shows how the number of cases is distributed over time divided by type (confirmed, recovered and death), and
 
figure 3 (b) shows how the median of cases is distributed over time divided by type. (drawn by spss25)
 
 
Fig3 a) number of cases over time Fig3 b) median of cases over time
 

Discussion
This study focused on geospatial features that can predict the presence or absence of COVID-19. We examined a few spatial statistics tools to investigate the trend of coronavirus.
Our results showed that the spread of COVID-19 had a trend and started from China and then spread to the Middle East, Europe and the United States more likely in a linear manner. The results also showed that the prevalence of mortality was higher than that of recovery. Central mean and median for all types (Confirmed, Recovered and death) were close to each other. The standard distance for confirmed, recovered and death was the same, only differing in location, which could mean that the spread of disease growth and mortality and recovery were almost on the same level. Figures 1 and 2, as well as the results of Table 1 and 2, all suggested that the spread of Corona virus was clustered and not random.
Boulos and Geraghty (2020), presented how various GIS applications and dashboards such as JHU CSSE, WHO dashboard, Health Map, World Pop, and Epi Risk are able to provide a clear representation of the COVID-19 spread (15). Lakhani (2020) utilized GIS mapping to identify COVID-19 health care priority locations pertaining to vulnerable populations, including elderly, palliative, and disabled patients in Melbourne, Australia. The findings suggest potential improvements in quality of care in the midst of the pandemic (16). Gibson and Rush (2020), utilized GIS technology to outline dwelling boundaries to detect the probability of COVID-19 spread in Cape Town, South Africa. Their results suggest that COVID-19 spread can be reduced through social distancing measures as supported by their buffer analysis and cluster identifications (5).
Krivoruchko et al listed different statistical methods for aggregated data analysis that can be implemented within a GIS to provide a powerful set of interactive, analytical tools well suited to health studies(17). Tewara et al used spatial statistical tool in GIS to show distribution of Malaria in Cameron(18). Saxena et al highlighted the utility of GIS and spatial statistical tool in efficient processing of voluminous epidemiological data at micro level and analyzing with sound statistical base(19). A review of GIS studies presented by Chung et al , revealed some issues regarding the use of spatial statistical analyses in health field(20). 
The pandemic caused by the spread of the virus has led to policies in various countries which suit their circumstances. To better understand how coronavirus is spread and pathogenic in the future, we need to do more research on identifying a specific host, its specific mode of transmission, and risk factors for its transmission in medical centers. Appropriate treatment strategies to alleviate the disease also require future research in this area.
Conclusion
This study focused on geospatial features that can predict the presence or absence of COVID-19, because "should be expected to happen more frequently moving forward". Based on analyzing available patterns in spatial statistics tool in ArcGIS and geostatistical models, we examined how the Coronavirus was distributed around the world. The spread of the disease is increasing all over the world. Using the results, it is seen that the spread of Corona virus had a trend and started in China and then spread to the Middle East, Europe and the United States in a likely linear manner.
 
Type of Article: Original article | Subject: Bio-statistics
Received: 2020/01/10 | Accepted: 2020/03/1 | Published: 2020/03/1

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