ABSTRACT
Traditional Chinese medicine (TCM) has played an important role in the prevention and control of the novel coronavirus pneumonia (COVID-19), and community prevention has become the most essential part in reducing the risk of spread and protecting public health. However, most communities use a unified TCM prevention program for all residents, which violates the "treatment based on syndrome differentiation" principle of TCM and limits the effectiveness of prevention. In this paper, we propose an intelligent optimization method to develop diversified TCM prevention programs for community residents. First, we use a fuzzy clustering method to divide the population based on both modern medicine and TCM health characteristics;we then use an interactive optimization method, in which TCM experts develop different TCM prevention programs for different clusters, and a heuristic algorithm is used to optimize the programs under the resource constraints. We demonstrate the computational efficiency of the proposed method, and report the application results of the method in TCM-based prevention of COVID-19 in 12 communities in Zhejiang province, China, during the peak of the pandemic.
ABSTRACT
BACKGROUND: With an estimated basic reproductive number of 3.77, the Coronavirus Disease 2019 (COVID-19) continues to spread. It is urgent to exert adequate efforts for the management of dialysis patients, caregivers, and healthcare personnel (HCP). This study aimed at reporting practical workflow, identification of high-risk or suspected cases of CO-VID-19, and subsequent response measures. METHODS: At the time of the COVID-19 outbreak, precautions and practice protocols were applied in our dialysis units (DUs). This single-center study retrospectively reviewed all high-risk/suspected cases from January 23, 2020, to February 10, 2020. Epidemiological, clinical feature, and detailed data on all cases were recorded. RESULTS: Practical workflow for the clinical management of dialysis patients, caregivers, and HCP was initiated. A total of 6 high-risk/suspected cases were identified. Female gender, older age, presence of cardiovascular disease, diabetes, anuresis, immunocompromised status, hypoalbuminemia, and underweight were noticeable features in these cases. Direct evidence of infection or epidemiological risk was detected in five cases. Close monitoring for temperature and oxygen saturation during hemodialysis sessions may be reasonable. No confirmed COVID-19 cases were reported in our DU, but certain cases showed rapid deterioration due to other critically severe condition needing hospitalization. Portable dialysis machines are of great need to ensure dialysis care provision. CONCLUSIONS: Our study described a practical workflow for patient-centered management during COVID-19 outbreak. Potential risk factors and underlying clinical patterns were reported. Further studies regarding the efficacy of infection control precautions and practice protocols tailored for dialysis settings are warranted.