温州市COVID-19疫情时空演化与医疗服务可达性研究

A study on the spatio-temporal evolution of COVID-19 epidemic andaccessibility of medical services in Wenzhou City

新型冠状病毒肺炎(COVID-19)疫情给人民健康和地区发展带来严重损失,已成为影响全球的重大突发公共卫生事件。地理学视角下个体人群水平的扩散研究,对疫情“落地到人”的精准防控具有重要意义。鉴于此,以此次疫情中国高发市域温州市为研究区,综合运用文本分析、数理统计、空间分析等方法,解析疫情的时空演化特征,评估确诊病例的就医可达性,并提出相应防控建议。结果表明:①时间上,疫情发展可分为市外输入期、市内扩散期、稳定控制期、境外输入期4个时期;男女确诊病例比为1.11∶1,男性高发期较女性有所提前,其中15~59岁为重点感染人群。②空间上,沿城市交通干线呈“东北—西南”轴向递减分布;高发于小区、村庄,城镇多于乡村;流出人口数量显著影响区县确诊病例分布,且市外输入以武汉返温型流入为最。③就医可达性呈圈层梯度结构分布,区县差异显著,且医院病床供需比分布不均,据此对不在服务区的疫点提出两种布局优化方案。最后,基于温州市疫情发展提出“外严、内稳、适当开放”的防控举措。

The Corona Virus Disease 2019(COVID-19)outbreak has caused serious damage to people′s health and regional development,which has become a major public health emergency with global implications.From a geographic perspective,research on the spread of the disease at the individual level is important for the precise prevention and control of the disease from the ground up.Based on the details of confirmed cases and POI data,this study explores the Spatial and temporal evolution characteristics of the epidemic,assesses the medical accessibility of confirmed cases,and proposes corresponding prevention and control recommendations by comprehensively using text analysis,mathematical statistics,and spatial analysis.The results show that:①In terms of time,the development of the epidemic can be divided into four stages:out-of-city input,inside-city diffusion,overall stable control,and abroad input.The ratio of male to female cases was 1.11∶1.Among them,15 to 59 years old were the most infected group.The peak period for males was earlier than that for females.②Spatially,the distribution along the urban traffic trunk line decreased in the direction of"from northeast to the southwest."More cases from urban confirmed than villages.The number of outflows significantly affects the distribution of confirmed cases in counties,and the inflow from Wuhan is the most frequent type.③The accessibility to medical care is distributed in a circle-level gradient structure,with significant differences between districts and counties,and the supply-demand ratio of hospital beds is unevenly distributed.Based on this,two layout optimization schemes are proposed for epidemic spots not in the service area.Finally,based on the development of Wenzhou′s epidemic situation,the prevention and control measures of"external strictness,internal stability,and appropriate opening"are proposed.