Epidemiological characteristics and transmission dynamics of the COVID-19 outbreak in Hohhot, China: a time-varying SQEIAHR model analysis

Background: On September 28, 2022, the first case of Omicron subvariant BF.7 was discovered among coronavirus disease 2019 (COVID-19) infections in Hohhot, China, and then the epidemic broke out on a large scale during the National Day holiday. It is imminently necessary to construct a mathematical model to investigate the transmission dynamics of COVID-19 in Hohhot. Methods: In this study, we first investigated the epidemiological characteristics of COVID-19 cases in Hohhot, including the spatiotemporal distribution and sociodemographic distribution. Then, we proposed a time-varying Susceptible-Quarantined Susceptible-Exposed-Quarantined Exposed-Infected-Asymptomatic-Hospitalized-Removed (SQEIAHR) model to derive the epidemic curves. The next-generation matrix method was used to calculate the effective reproduction number (R-e). Finally, we explored the effects of higher stringency measures on the development of the epidemic through scenario analysis. Results: Of the 4,889 positive infected cases, the vast majority were asymptomatic and mild, mainly concentrated in central areas such as Xincheng District. People in the 30-59 age group primarily were affected by the current outbreak, accounting for 53.74%, but females and males were almost equally affected (1.03:1). Community screening (35.70%) and centralized isolation screening (26.28%) were the main ways to identify positive infected cases. Our model predicted the peak of the epidemic on October 6, 2022, the dynamic zero-COVID date on October 15, 2022, a number of peak cases of 629, and a cumulative number of infections of 4,963 (95% confidential interval (95%CI): 4,692 similar to 5,267), all four of which were highly consistent with the actual situation in Hohhot. Early in the outbreak, the basic reproduction number (R-0) was approximately 7.01 (95%CI: 6.93 similar to 7.09), and then R-e declined sharply to below 1.0 on October 6, 2022. Scenario analysis of higher stringency measures showed the importance of decreasing the transmission rate and increasing the quarantine rate to shorten the time to peak, dynamic zero-COVID and an R-e below 1.0, as well as to reduce the number of peak cases and final affected population. Conclusion: Our model was effective in predicting the epidemic trends of COVID-19, and the implementation of a more stringent combination of measures was indispensable in containing the spread of the virus.