BACKGROUND: On December 31, 2019, an outbreak of COVID-19 in Wuhan, China, was reported. The outbreak spread rapidly to other Chinese cities and to multiple countries. We describe the spatio-temporal pattern and measure the spatial association of the early stages of the COVID-19 epidemic in mainland China from January 16 to February 6, 2020. METHODS: We explored the spatial epidemic dynamics of COVID-19 in mainland China. Moran's I spatial statistic with various definitions of neighbors was used to conduct a test to determine whether a spatial association of the COVID-19 infections existed. RESULTS: We observed the spatial spread of the COVID-19 pandemic in China. The results showed that most of the models, except medical-care-based connection models, indicated a significant spatial association of COVID-19 infections from around January 22, 2020. CONCLUSIONS: Spatial analysis is of great help in understanding the spread of infectious diseases, and spatial association is the key to the spatial spread during the early stages of the COVID-19 pandemic in mainland China.
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