Cities and epidemics: Reflection based on spatio-temporal spread and medical carrying capacity of early COVID-19 outbreak in China

New and more dreadful viruses may emerge again in the future and cause a large demand for medical care. It is essential to explore different cities’ early spatio-temporal spread characteristics of the COVID-19 epidemic and the medical carrying capacity. This study examined the situation of six high-incidence Chinese cities using an integrated manual text and spatial analysis approach. Results show that the initial COVID-19 outbreak went through three phases: unknown-origin incubation, Wuhan-related outbreak, and local exposure outbreak. Cities with massive confirmed cases exhibited the multicore pattern, while those with fewer cases exhibited the single-core pattern. The cores were hierarchically located in the central built-up areas of cities’ economic, political, or transportation centers, and the radii of the cores shrank as the central built-up area’s level decreased, showing the hierarchical decay and the core-edge structure. That is, a decentralized built environment (non-clustered economies and populations) is less likely to create a large-scale epidemic cluster. Besides, the clusters of excellent hospital resources were consistent with those of COVID-19 outbreaks, but their carrying capacity still needs urgent improvement. And the essence of prevention and control is the governance of human activities and the management, allocation, and efficient use of limited resources about people, places, and materials leveraging IT and GIS, to confront the contradiction between supply and demand.