Interpretation of Discrepancies between Cities in the Transmission of COVID-19: Evidence from China in the First Weeks of the Pandemic

OBJECTIVES: This study aims to examine and explain the differences at city level in cumulative COVID-19 cases and time from first to last infection during the first 6 weeks of the epidemic in China. METHODS: A quantitative study is conducted in China based on the multisource spatial data of 315 Chinese cities. Firstly, the spatial discrepancy of COVID-19 transmission was examined based on spatial autocorrelation analysis and hot pot analysis. Next, a comprehensive indicator framework was established by including a wide range of factors such as human mobility, geographical features, public health measures, and residents’ awareness. Finally, multivariate regression models using these variables were constructed to identify the determinants of COVID-19 transmission. RESULTS: Significant spatial discrepancy of transmission was proved, and 10 determinants were identified. CONCLUSIONS: The transmission consequence (measured by the number of cumulative cases) was mostly correlated with the migration scale from Wuhan, followed by socioeconomic factors. Transmission duration (measured as the time from the first to last case within the city) was mostly determined by total migration scale and lockdown speed, which suggests that timely implementation of public health measures facilitated fast control of transmission. Residents’ attention to COVID-19 was proved to be not only helpful for reducing confirmed cases, but also in favor of rapid transmission control. Altitude produced slight but significant effect on transmission duration. These conclusions are expected to provide decision support for the local governments of China and other jurisdictions.