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• As of March 10, 2020, Italy had reported 9172 COVID-19 cases with 463 deaths. • We report the real-time reproductive numbers (R (t)) and case fatality rates for selected European countries (Italy, France, Germany, and Spain) by March 9, 2020. • The R (t) was greater than 2 in the selected European countries, indicating that the outbreak will continue. As a global pandemic is inevitable, real-time monitoring of transmission is vital for containing the spread of COVID-19. The main objective of this study was to report the real-time effective reproduction numbers (R (t)) and case fatality rates (CFR) in Europe. Data for this study were obtained mainly from the World Health Organization website, up to March 9, 2020. R (t) were estimated by exponential growth rate (EG) and time-dependent (TD) methods. 'R0' package in R was employed to estimate R (t) by fitting the existing epidemic curve. Both the naïve CFR (nCFR) and adjusted CFR (aCFR) were estimated. With the EG method, R (t) was 3.27 (95% confidence interval (CI) 3.17–3.38) for Italy, 6.32 (95% CI 5.72–6.99) for France, 6.07 (95% CI 5.51–6.69) for Germany, and 5.08 (95% CI 4.51–5.74) for Spain. With the TD method, the R value for March 9 was 3.10 (95% CI 2.21–4.11) for Italy, 6.56 (95% CI 2.04–12.26) for France, 4.43 (95% CI 1.83–7.92) for Germany, and 3.95 (95% CI 0–10.19) for Spain. This study provides important findings on the early outbreak of COVID-19 in Europe. Due to the recent rapid increase in new cases of COVID-19, real-time monitoring of the transmissibility and mortality in Spain and France is a priority. [ABSTRACT FROM AUTHOR]

Purpose: To develop a Chinese version of the new, 5-level EQ-5D descriptive system (EQ-5D-5L) from the existing EQ-5D-3L by identifying Chinese label wording suitable for constructing EQ-5D-5L's 5-point response scales., Methods: In face-to-face interviews, perceived severity of selected Chinese labels when they were used to describe EQ-5D health problems was measured from 50 native Chinese speakers using a 0 (no problems) to 100 (the worst problems) visual analog scale. Selection of label wording was based on the severity scores and semantic similarity with label wording used in the existing English and Spanish EQ-5D-5L., Results: The severity scores supported the use of Chinese wording of 'only a little' (range of median: 12.5-17), 'moderate' (range of median: 50-53), and 'severe' (range of median: 82.5-90) as the descriptors for the intermediate functional levels of the five EQ-5D dimensions and the label wording of 'very severe' (median: 90) to describe the worst level of pain/discomfort and anxiety/depression., Conclusions: The Chinese version of the EQ-5D-5L comprises descriptors with similar interpretations as those used its English and Spanish counterparts. The response scaling exercise is a useful method for cross-cultural adaptation of health-status instruments.