Integrated surveillance and early warning system for emerging infectious diseases based on One Health concept: Structures and innovations.

One Health is an upgrade and optimization of health concepts, which recognizes the integrated health of the human-animal-environment. It emphasizes the use of interdisciplinary collaboration, multi-sectoral coordination, and multi-organizational One Health approaches to solve scientific questions. The surveillance and early warning system is the basis of public health emergency prevention and control. The COVID-19 pandemic and the emerging infectious disease (EID) have put great challenges on the existing surveillance and early warning systems worldwide. Guided by the concept of One Health, we attempt to build a new pattern of integrated surveillance and early warning system for EID. We will detail the system including the One Health-based organizational structure, zoonotic and environmental science surveillance network, EID reporting process, and support and guarantee from education and policy. The integrated surveillance and early warning system for EID constructed here has practical and application prospects, and will provide guidance for the prevention and control of COVID-19 and the possible EID in the future.Copyright © 2022, National Institute of Parasitic Diseases. All rights reserved.

Changes in contents of PM2.5 components over Jinan city before and after implementation of epidemic control measures during the 2020 Spring Festival

To understand the influence of coronavirus disease control policies on changes in characteristics of particulate matter smaller than 2.5 μm (PM2.5), concentrations of various PM2.5 components in Jinan city before and after implementation of the epidemic control measures during the 2020 Spring Festival were studied using online monitoring data. Standardized multiple linear regression was used to analyze the contribution of meteorological factors to the variations in concentrations of PM2.5 components. After the epidemic control measures were implemented, the concentrations of PM2.5 components in the area decreased significantly, and the rate at which the daily average concentration was exceeded decreased by 24.8%. The concentrations of all PM2.5 components decreased to various degrees, with those of trace elements (TE), elemental carbon (EC), and nitrate (NO3−) having decreased significantly by 50.3%, 46.8%, and 31.5%, respectively. In terms of component proportions, those of TE and EC decreased after the epidemic control measures were initiated whereas those of ammonium (NH4+), organic matter (OM), sulfate (SO4 2− ), and mineral dust increased;the proportion of NO3 − changed slightly, and the total proportion of secondary ions SO4 2−, NO3−, and NH4 + increased by 14.3%. Comparison of the proportions of PM2.5 components showed that after the epidemic control measures were implemented, the proportions of NO3 − and EC in PM2.5 that cause a light pollution level decreased whereas those of OM, SO4 2−, and NH4 + increased. This indicated that people traveled less, motor vehicle emissions decreased, work at construction sites stopped, and NO3 − proportion was greatly reduced while epidemic control measures were in place. However, afterward, decrease in concentrations of PM2.5 components and increase in secondary transformation of volatile organic compounds led to an increase in OM concentration. Compared with those before the epidemic control measures were implemented, the NO2/SO2 and NO3– /SO4 2− ratios fell significantly, and their average values decreased by 30.0% and 14.0%, respectively, indicating that the contribution of mobile sources (e.g., automobile exhaust) to pollution had decreased during the epidemic control period. Under the influence of the control measures, the OC concentration also decreased for excellent, good, and mild pollution levels;however, the secondary organic carbon concentration increased, indicating that secondary conversions did not decrease under the epidemic control conditions. Standardized multiple linear regression analyses of meteorological factors showed that changes in the height of the boundary layer contributed the most (46.5%) to changes in concentrations of PM2.5 components before the epidemic control measures were implemented;afterward, humidity was the primary factor governing the increase in these concentrations. © 2022, The Science Press. All rights reserved.

Set-Valued Medical Image Classification with Evidential CNN: A First Test with Covid-19 Dataset

Deep learning based models have been achieving ever high accuracy for precise image classification. However, in the medical sector where decisions should to be made more cautiously and where inaccuracy is less of a concern than precision and recall, it might be more appropriate to resort to imprecise classifiers, e.g. set-valued classifiers. In this work, an evidential convolutional neural network (ECNN) method is applied for set-valued medical image classification with Covid-19 X-ray dataset. Experimental result shows that the ECNN classifier is able to assign confusing image patterns to multi-class sets, while maintaining high accuracy compared to traditional probabilistic CNN classifiers. This result reveals that the ECNN classifier holds good promise of being applied for imprecise medical image classification. © 2022 IEEE.

Integrated surveillance and early warning system for emerging infectious diseases based on One Health concept: Structures and innovations

One Health is an upgrade and optimization of health concepts, which recognizes the integrated health of the human-animal-environment. It emphasizes the use of interdisciplinary collaboration, multi-sectoral coordination, and multi-organizational One Health approaches to solve scientific questions. The surveillance and early warning system is the basis of public health emergency prevention and control. The COVID-19 pandemic and the emerging infectious disease (EID) have put great challenges on the existing surveillance and early warning systems worldwide. Guided by the concept of One Health, we attempt to build a new pattern of integrated surveillance and early warning system for EID. We will detail the system including the One Health-based organizational structure, zoonotic and environmental science surveillance network, EID reporting process, and support and guarantee from education and policy. The integrated surveillance and early warning system for EID constructed here has practical and application prospects, and will provide guidance for the prevention and control of COVID-19 and the possible EID in the future. © 2022, National Institute of Parasitic Diseases. All rights reserved.

Therapeutical drugs for corona virus disease 2019 in clinical use

The global epidemic of corona virus disease 2019 (COVID-19) has posed a serious threat to the safety of people's lives and property. It is still urgent to develop effective drugs against COVID-19. In this review, the clinical therapeutic drugs for COVID-19 patients in China and abroad are summarized from three categories, which are chemical drugs, biological drugs and traditional Chinese medicine, aiming to provide some useful references for clinical treatment and drug discoveries in the future. Copyright © 2022, Chinese Journal of New Drugs Co. Ltd. All right reserved.

Advances in peptidomimetic inhibitors of coronavirus main protease

Coronavirus (CoVs) is a widespread pathogen that can infect humans and animals to cause serious acute and chronic respiratory diseases. Among them, SARS-CoV broke out in 2003, MERS-CoV was discovered and spread widely in 2012, and SARS-CoV-2 emerged at the end of 2019. They all belong to β-coronavirus. Peptidomimetic inhibitors targeting coronavirus main proteases (Mpro, 3CLpro) have attracted much attention because of their broad spectrum and strong antiviral efficacy. In this review, peptidomimetic inhibitors of coronavirus main protease were classified and summarized according to the different "warheads" in design strategy. And also, the molecular structures, biological activity and design ideas of the inhibitors were analyzed and discussed, which is aimed to provide useful reference for further design and development of coronavirus inhibitors.

COMASNet: Precise face mask detector network

With the spread of the novel coronavirus in the world, COVID-19 is causing a global health crisis with countries already aware of the importance of the epidemic. According to the World Health Organization (WHO), wearing a mask is a necessary strategy for the prevention of COVID-19 infection. Due to this guideline, governments around the world are constantly asking people to wear masks in public places. However, it is currently inefficient to manually monitor if people are wearing a mask in public. Thus, to resolve this issue, in this paper we proposed a new robust and accurate model called COMASNet modified from the object recognition method (YOLOv5) to automatically detect if people are wearing a mask. Extensive experimental results on the proposed model gives us an accuracy of 98.1%. Besides this, our method has great advantages in identifying masks in a crowd compared with other models. © 2021 IEEE.

Impact of the covid-19 pandemic on online consumer purchasing behavior

With the spread of the COVID-19 pandemic and the increasing importance of e-commerce, the study of online consumer behavior is of particular relevance. The purpose of this study was to form a methodological approach to assess the relationships and the level of influence of the factors activating the purchasing behavior of online consumers against the background of the COVID-19 pandemic. The research methodology was based on the transformation of Cattell’s questionnaire and the implementation of correlation analysis. To determine the predisposition of online consumer behavior at the time of making a purchase decision, this study used the questionnaire method. The survey was conducted among online shoppers in the top 10 countries in terms of e-commerce market growth. The scientific contribution is the proposed methodological toolkit to assess the purchasing behavior of online consumers, which identifies the most influential factors in their purchasing behavior and provides an opportunity to assess the dynamics of their activity during the study period, to identify key trends and determine changes in their behavior. The research revealed what changes in online consumer buying behavior are typical in the COVID-19 pandemic. The impact of consumer awareness and experience has increased. Online consumers have become more experienced, which has influenced the activity of their buying behavior. This study proved the shifting influence of online consumer purchasing behavior factors during the pandemic. The increasing importance of the speed of decision making by consumers when purchasing goods and services online was determined. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Relationships Among Online Teaching Design, Experience, and Perception of College Teachers During the Pandemic

The outbreak of COVID-19 forced many higher education institutions worldwide to transfer from dominantly off-line teaching to online teaching mode in a short time. Instructors’ online teaching design is critical to learning achievements of undergraduate students during and even after the pandemic. The current study investigates the relationships between college teachers’ online teaching design, online teaching experience, and perceptions. A total of 1, 318 instructors (645 females, 673 males) from a Southeastern university in China completed an online survey and statistical analyses were conducted to compare their online teaching design across experiences and perceptions of online teaching. Results showed that college teachers designed online teaching differently across genders and ages. Additionally, teachers’ perception and prior experience of online teaching might also affect their online teaching design. The implications and suggestions for improving teachers’ online teaching design practice from the institutional perspectives are discussed. © 2021, Springer Nature Switzerland AG.

Evaluation of aerosolized epoprostenol in COVID-19 ards patients

INTRODUCTION: ARDS contributes to high mortality and morbidity observed with coronavirus disease 2019 (COVID-19). Epoprostenol has antithrombotic, antiproliferative, and vasodilatory properties and improves respiratory parameters in ARDS. The role of aerosolized epoprostenol (aEPO) in COVID-19 has not been evaluated. We hypothesized that aEPO may improve oxygenation in intubated COVID-19 patients. METHODS: We performed a single-center, retrospective, propensity-score matched cohort study. A medical chart review was conducted for COVID-19 ARDS adult patients admitted between March 1, 2020 and May 1, 2020. Patients receiving aEPO (0.05 mcg/kg/minute) versus patients not receiving aEPO were matched for Rothman index and baseline PaO2:FiO2 (PF) ratios, and evaluated for effect of aEPO on PF ratio, gradient between arterial to end-tidal CO2, and dead space (primary endpoints). Secondary endpoints evaluated included in-hospital mortality, mechanical ventilation-free days, and ICU and hospital length of stay. Safety endpoints evaluated included incidence of hypotension, significant bleeding, thrombocytopenia, and rebound hypoxemia. RESULTS: Nineteen patients treated with aEPO were compared to 19 propensity-matched controls. Baseline characteristics were well matched. Management of ARDS was similar between groups. The mean ± SD duration of aEPO treatment was 5 ± 2.8 days. There were no significant differences in PF ratios between aEPO cohort and non-aEPO cohort at 3 hours (125 ± 56 vs 115 ± 40 mmHg), 6 hours (124 ± 41 vs 147 ± 73 mmHg), 12 hours (112 ± 39 vs 163 ± 62 mmHg), 24 hours (114 ± 33 vs 176 ± 64 mmHg), and 48 hours (150 ± 54 vs 212 ± 84 mmHg), although there was a trend toward higher PF ratios for the control group. There were no significant differences in gradient between arterial to end-tidal CO2 and dead space between cohorts. There were significantly more deaths in the control group compared to aEPO by day 10 (21% vs 0, p<0.05), though there was no difference in 28-day mortality (41% vs 48%, p=0.35). There were no significant differences in other secondary and safety end points. CONCLUSIONS: In this small case-control study, aEPO did not demonstrate better efficacy or safety compared to not receiving aEPO. Large randomized control trials are needed to confirm early survival benefit noted with aEPO.

[Study on transmission dynamic of 15 clusters of COVID-2019 cases in Ningbo].

Objective: To describe the basic characteristics of clusters of coronavirus diseases 2019 (COVID-19) cases in Ningbo, Zhejiang province, and evaluate the generation time (Tg) and basic reproduction number (R(0)) of COVID-19. Methods: The basic information and onset times of the clusters of COVID-19 cases in Ningbo were investigated, the inter-generational interval of the cases were fitted by using gamma distribution, and the R(0) was calculated based on the SEIR model. Results: In the 15 clusters of COVID-19 cases, a total of 52 confirmed cases, 5 cases of nucleic acid-positive asymptomatic cases. The cases occurred from January 23 to February 4, the cases were mainly women. The incubation period was (6.11±3.38) days, and the median was 5 days. The Tg was (6.93±3.70) days. There were no significant differences in Tg between age group<60 years and age group 60 years and above, and between men and women (P=0.551). According to the Tg calculated in this paper, the R(0) of COVID-19 in Ningbo was 3.06 (95%CI: 2.64- 3.51); according to the reported case transmission interval of 7.5 days in the literature, the R(0) was 3.32 (95%CI: 2.51-9.38). Conclusion: There is no age and gender specific differences in the Tg of clusters of COVID-19 cases in Ningbo, and COVID-19 has high infectivity and spreading power in early phase.

Multi-route transmission potential of SARS-CoV-2 in healthcare facilities

Understanding the transmission mechanism of SARS-CoV-2 is a prerequisite to effective control measures. To investigate the potential modes of SARS-CoV-2 transmission, 21 COVID-19 patients from 12-47 days after symptom onset were recruited. We monitored the release of SARS-CoV-2 from the patients' exhaled breath and systematically investigated environmental contamination of air, public surfaces, personal necessities, and the drainage system. SARS-CoV-2 RNA was detected in 0 of 9 exhaled breath samples, 2 of 8 exhaled breath condensate samples, 1 of 12 bedside air samples, 4 of 132 samples from private surfaces, 0 of 70 samples from frequently touched public surfaces in isolation rooms, and 7 of 23 feces-related air/surface/water samples. The maximum viral RNA concentrations were 1857 copies/m3 in the air, 38 copies/cm2 in sampled surfaces and 3092 copies/mL in sewage/wastewater samples. Our results suggest that nosocomial transmission of SARS-CoV-2 can occur via multiple routes. However, the low detection frequency and limited quantity of viral RNA from the breath and environmental specimens may be related to the reduced viral load of the COVID-19 patients on later days after symptom onset. These findings suggest that the transmission dynamics of SARS-CoV-2 differ from those of SARS-CoV in healthcare settings.

China's experience in COVID-19 prevention and control among children in its different regions.

OBJECTIVE: To summarize the experience of three Chinese cities (Wuhan, Shanghai and Haikou) and provide a reference for global efforts to combat COVID-19 spread among children. MATERIALS AND METHODS: Through collecting the measures and outcomes of preventing and controlling COVID-19 in China's three hospitals, we compared the effect of different strategies. RESULTS: From January to March 2020, the number of suspected and confirmed COVID-19 cases in Wuhan increased exponentially, and Wuhan Children's Hospital as a whole was transformed into a designated quarantine and treatment facility, which is the "Wuhan Model". Shanghai has more children's hospitals with better capabilities to tackle public health emergency. Besides, it is far away from Wuhan and had a small caseload. Children's Hospital of Fudan University, a facility in Shanghai to treat pediatric infectious diseases, is famous for its well-equipped building for infectious disease treatment and professional medical team, and therefore no major transformation was required. That is the "Shanghai Model". Haikou is located on an island. Amid the outbreak, large numbers of tourists and travelers from Hubei had already arrived in Haikou. Hainan Women and Children's Medical Center, as the only pediatric care hospital in Hainan Province, did not have a separate building for infectious disease treatment. After a citywide survey of the medical resources and facilities available, a temporarily idle hospital 3 kilometers away from Hainan Women and Children's Medical Center was requisitioned as the quarantine and treatment facility for pediatric cases. That is the "Hainan Model". The three models enabled the treatment of all suspected and confirmed cases and no fatality was reported. CONCLUSIONS: The COVID-19 coping strategies for children should be designed according to the existing conditions of the local children's hospitals and the risk levels of the epidemic.

[Investigation of a cluster epidemic of COVID-19 in Ningbo].

Objective: To investigate a cluster epidemic of COVID-19 after a mass gathering activity in Ningbo of Zhejiang province and analyze the transmission chain and status of infection cases of different generations. Methods: The tracking of all the close contacts of the first COVID-19 case and epidemiological investigation were conducted on January 29, 2020 after a cluster epidemic of COVID-19 related with a Buddhism rally on January 19 (the 1.19 rally) in Ningbo occurred. The swabs of nose/throat of the cases and close contacts were collected and tested for nucleic acids by real-time fluorescence quantitative RT-PCR. Results: From January 26 to February 20, 2020, a total of 67 COVID-19 cases and 15 asymptomatic infection cases related with the 1.19 rally were reported in Ningbo. The initial case was the infection source who infected 29 second generation cases and 4 asymptomatic infection cases, in whom 23 second generation cases and 3 asymptomatic infection cases once took bus with the initial case, the attack rate was 33.82% (23/68) and the infection rate was 38.24% (26/68). The risks of suffering from COVID-19 and being infected were 28.91 times and 26.01 times higher in rally participants taking bus with initial case compared with those taking no bus with initial case. In this epidemic, 37 third+generation cases and 11 related asymptomatic infection cases occurred, the attack rate was 2.88% (37/1 283) and the infection rate was 4.76% (48/1 008). The main transmission routes included vehicle sharing and family transmission. Conclusion: It was a cluster epidemic of COVID-19 caused by a super spreader in a massive rally. The epidemic has been under effective control.