Cost-Effectiveness Analysis of Nonpharmaceutical Interventions Combined with Inactivated Vaccination and Oral Medicine in China

Objectives: Various interventions were used to control the COVID-19 pandemic and protect population health, including vaccination, medication and nonpharmaceutical interventions (NPIs). This study aims to examine the cost-effectiveness of different combinations of NPIs (including social distancing, mask wearing, tracing-testing-isolation, mass testing, and lockdown), oral medicine (Paxlovid), and vaccination (including two-dose and three-dose vaccination) under the Delta and Omicron pandemic in China. Method(s): We constructed a Markov model using a SIRI structure with a one-week cycle length over one-year time horizon to estimate the cost-effectiveness of different combinations in China from societal perspective. Effectiveness of interventions, disease transition probabilities and costs were from published data, quality-adjusted life years (QALYs) gained and incremental cost-effectiveness ratios (ICER) and net monetary benefits were calculated for one-year time horizon. One-way and probabilistic sensitivity analyses were performed to test the robustness of the model. Scenario analysis was developed to examine different situations under the Omicron pandemic. Result(s): Under the Delta pandemic, implementing the combination of social distancing, mask wearing, mass testing and three-dose vaccination was the optimal strategy, with cost at $11165635.33 and utility of 94309.94 QALYs, and had 60% probability of being cost-effective compared with other strategies. Three-dose vaccination combinations were better than two-dose combinations. Under the Omicron pandemic, antigen testing was better than nucleic testing by avoiding cross infections;second, adding Paxlovid or lockdown to the combined intervention strategies could increase limited health outcomes at huge cost and thus were not cost-effective;last, encouraging patients to stay at home can save societal costs compared with concentrated quarantine at hospitals. Conclusion(s): Three-dose vaccination and self-quarantine of asymptomatic and mild cases can save total costs. Under the Omicron pandemic outbreak, antigen testing is a better way to control the pandemic, and adding Paxlovid or lockdown to intervention combinations is not cost-effective.Copyright © 2023

Generative Data Augmentation for Non-IID Problem in Decentralized Clinical Machine Learning

Swarm learning (SL) is an emerging promising decentralized machine learning paradigm and has achieved high performance in clinical applications. SL solves the problem of a central structure in federated learning by combining edge computing and blockchain-based peer-to-peer network. While there are promising results in the assumption of the independent and identically distributed (IID) data across participants, SL suffers from performance degradation as the degree of the non-IID data increases. To address this problem, we propose a generative augmentation framework in swarm learning called SL-GAN, which augments the non-IID data by generating the synthetic data from participants. SL-GAN trains generators and discriminators locally, and periodically aggregation via a randomly elected coordinator in SL network. Under the standard assumptions, we theoretically prove the convergence of SL-GAN using stochastic approximations. Experimental results demonstrate that SL-GAN outperforms state-of-art methods on three real world clinical datasets including Tuberculosis, Leukemia, COVID-19. © 2022 IEEE.

Towards Privacy-Preserving Computation on Gene: Construct Covid-19 Phylogenetic Tree using Homomorphic Encryption

Constructing a phylogenetic tree is an essential method of analyzing the evolution of the covid-19 virus. In the case of multiple entities holding different coronavirus genetic data, it is simple to aggregate all data into one entity and then calculate the phylogenetic tree. However, such a method is challenging to carry out. Genetic data is susceptible and has high economic value, and it is usually impossible to copy between different entities directly. Also, the direct sharing of genetic data can lead to data leaks or even legal problems. In this paper, we propose a homomorphic-encryption-based solution to tackle this problem, where two participants, A and B, both hold a part of covid-19 genetic data and compute the gene distance matrix calculation of the overall dataset without revealing the genetic data held by both parties. After the computation, participant A can decrypt the final distance matrix from the encrypted result and then use the plain-text result to construct the covid-19 phylogenetic tree. Experiment results show that the proposed method can process the genetic data accurately in a short time, and the phylogenetic tree generated by the proposed solution has no loss of accuracy compared to plain-text calculation. In terms of engineering optimization, we propose an optimized encryption method, which can further shorten the encryption time of the entire dataset without reducing the security level. © 2022 IEEE.

Evaluation of nasal swab collection methods on a university campus during the SARS-CoV-2 pandemic

Background. Characterizing SARS-CoV-2 outbreaks on university campuses is critical for informed public health measures and understanding transmission dynamics. Figure 1. Dropbox and Kiosk Samples Collected September 10, 2021 to April 23, 2022. Methods. Faculty, staff, and students at a major public university in Seattle, WA, USA were enrolled in a COVID-19 testing study. Individuals could test using observed self-swabs at on-campus kiosks or unobserved self-swabs using a kit and returning it to a dropbox on campus. Sample collection volume for observed self-swabs was limited by staffing and space. All samples were returned to the laboratory and tested for SARS-CoV-2 by qRT-PCR. Results. From September 10, 2021 to April 23, 2022, 38,400 individuals were enrolled in the study. Of these individuals, 5,089 used dropboxes only, 14,421 used kiosks only, and 5,820 used both. A total of 21,653 dropbox swabs and 75,493 observed self-swabs were collected. Median age was similar between individuals using dropboxes and observed self-swabs (20 vs. 22 years). A greater proportion of dropbox users were students compared to faculty and staff (students made up 83% of dropbox only population, 75% of kiosk only, and 86% of both, chi2 p-value< 0.0001). Symptom data was reported for 65,349 swabs. Dropbox users were less likely to have symptoms compared to observed self-swab users (24% of swabs vs. 54%, chi2 p-value< 0.0001). SARS-CoV-2 positivity was slightly lower for dropboxes compared to kiosks (4% vs. 5%;p=0.001). Dropboxes were highly utilized during periods of increased testing demand, including after academic breaks and variant emergence (Figure 1). Of the total tests distributed for use, a greater proportion of dropbox kits were unable to be resulted (6%) compared to observed self-swab kits (0.02%). Conclusion. Dropboxes provided a flexible, high-volume collection method at times of increased testing demand. Individuals who used dropboxes were less likely to report symptoms and slightly less likely to test positive, suggesting a role for dropbox utilization in high-risk asymptomatic individuals during periods of high community transmission on a university campus.

Environmental and Nasal Pathogen Surveillance in Seattle Area Homeless Shelters

Background. The need for community surveillance of respiratory viruses in high-risk settings such as homeless shelters has been underscored by the COVID-19 pandemic. Here, we show that sampling high-touch surfaces is a low-cost, minimally intensive means of community respiratory virus surveillance. Methods. Environmental samples were collected weekly from adult and family homeless shelters in King County, WA from November 2019 - April 2020. At times when residents were present, a 10cm2 area of selected high-touch surfaces were swabbed and bioaerosol samples were collected in high-traffic areas. Surfaces included entrance and restroom doorknobs, counters, and surfaces unique to each shelter. Study staff collected mid-turbinate swabs from shelter resident participants aged > 3 months with symptoms of acute respiratory illness (ARI). All samples were tested by RT-PCR for 27 viruses. From January 1, 2020 onward, samples were also tested for SARS-CoV-2. Results. A total of 788 environmental swabs, 1509 nasal swabs, and 98 bioaerosol samples from 6 adult and 3 family shelters were tested. Adenovirus (109 positive swabs, 13.8% of tested swabs), rhinovirus (107, 13.6%) and human bocavirus (62, 7.9%) were the most frequently detected viruses in surface swabs. Rhinovirus (160, 10.6%), human coronaviruses (79, 5.24%) and influenza B (43, 2.85%) were the most detected in nasal swabs. All viruses detected in nasal swabs were found in surface swabs. Of 9 surfaces, exterior bathroom doorknobs were the physical location with the highest number of pathogens detected. SARS-CoV-2 was first detected in surface swabs on 3/20/20, and in nasal swabs on 3/10/20. Bioaerosol samples detected virus in a low percentage of samples relative to surface and nasal swabs. Table 1 Count and period prevalence of environmental viral detection by shelter type, November 18, 2019 - April 10, 2020. (Figure Presented) Conclusion. Respiratory viruses detected through environmental sampling in homeless shelters were similar to the viruses detected from ARI episodes in study participants. Environmental surface sampling presents a plausible, minimally invasive method of surveillance for both endemic and emerging respiratory pathogens, as evidenced by the detection of SARS-CoV-2 during the early stages of the pandemic. Further research could focus on sampling public locations for broader community surveillance and culturing viruses found on these surfaces.

Human Parainfluenza Epidemiology in Homeless Shelters - King County, Washington

Background. Human parainfluenza viruses (HPIV) cause respiratory illness in individuals of all ages. However, HPIV epidemiology data in people experiencing homelessness (PEH) are limited. Methods. We analyzed cross-sectional data from a clinical trial and SARS-CoV-2 surveillance study in 23 homeless shelters in King County, Washington from October 2019-May 2021. Questionnaires and nasal swab specimens were obtained from eligible participants at enrollment. Between October 2019-March 31, 2020, participants included those aged > 3 months with acute respiratory illness. Monthly shelter surveillance was also conducted where participants were recruited regardless of symptoms. With the community spread of SARS-CoV-2, the study design transitioned from a clinical trial to a SARS-CoV-2 surveillance study which expanded enrollment eligibility to include participants with or without symptoms from April 1, 2020, onward. Participants were not followed longitudinally but were permitted to enroll multiple times during the study period. Specimens were tested for HPIV 1-4 and other respiratory viruses using RT-PCR. Results. Among 14,464 specimens, 32 were HPIV-positive from 29 participants (median age 9 years, range 0.3-64 years;45% female;28% Black;10% with chronic conditions) of which 59% were children. Family shelters had the highest percentage of HPIV infections (Table). HPIV was detected every month before the community spread of SARS-CoV-2. All HPIV-positive samples in May 2021 came from a single family shelter (Figure). Only 67% of HPIV-positive participants had symptoms with runny nose, cough and sore throat the most commonly reported. HPIV codetection with other respiratory viruses occurred in 19% of HPIV-positive specimens;Rhinovirus co-detection (16%) was the most common. Human Parainfluenza Encounters by Shelter Type Before and After April 1, 2020 Human Parainfluenza Positive Samples by Shelter Type Among Unique Participants Conclusion. HPIV affected PEH of all ages with most cases in shelters with children. Coinciding with community-wide SARS-CoV-2 mitigation efforts, the number of HPIV infections were reduced. However, a cluster of HPIV infections still occurred within one family shelter. Shelter-specific public health measures including nonpharmaceutical interventions used during the COVID-19 pandemic may reduce HPIV infections among residents.

The role of booster vaccination and ongoing viral evolution in seasonal circulation of SARS-CoV-2.

Periodic resurgences of COVID-19 in the coming years can be expected, while public health interventions may be able to reduce their intensity. We used a transmission model to assess how the use of booster doses and non-pharmaceutical interventions (NPIs) amid ongoing pathogen evolution might influence future transmission waves. We find that incidence is likely to increase as NPIs relax, with a second seasonally driven surge expected in autumn 2022. However, booster doses can greatly reduce the intensity of both waves and reduce cumulative deaths by 20% between 7 January 2022 and 7 January 2023. Reintroducing NPIs during the autumn as incidence begins to increase again could also be impactful. Combining boosters and NPIs results in a 30% decrease in cumulative deaths, with potential for greater impacts if variant-adapted boosters are used. Reintroducing these NPIs in autumn 2022 as transmission rates increase provides similar benefits to sustaining NPIs indefinitely (307 000 deaths with indefinite NPIs and boosters compared with 304 000 deaths with transient NPIs and boosters). If novel variants with increased transmissibility or immune escape emerge, deaths will be higher, but vaccination and NPIs are expected to remain effective tools to decrease both cumulative and peak health system burden, providing proportionally similar relative impacts.

[Progress in research of economic evaluation of non-pharmaceutical interventions for COVID-19 prevention and control].

Objective: To understand the research progresses of economic evaluation of non-pharmaceutical interventions (NPIs) both at home and abroad, and provide reference for economic evaluation of NPIs using real-world data in China. Methods: The literature retrieval was conducted by searching Chinese and English databases to indude papers about economic evaluation of NPIs and integrated NPIs published from January, 2020 to December, 2021, and the results were analyzed comprehensively. Results: A total of 30 Chinese and English literatures about economic evaluation of NPIs for COVID-19 prevention and control were included; including 7 papers about nucleic acid and testing and screening, 6 papers about individual prevention and protection measures, 12 papers about integrated implementation of individual prevention and protection, social distancing, nucleic acid or antigen testing, community screening and symptom screening, as well as close contact tracing and isolation/quarantine, and 5 papers about contain strategies, such as lockdown. This study found that personal protection, social distancing, and testing-tracing-isolation measures were cost-effective; however, different combinations of NPIs might lead to different results. Moreover, the cost of lockdown was high, which might cause huge economic burden. Conclusions: Most NPIs are cost-effective except lockdown, while the cost-effectiveness of the integrations of NPIs at different levels and in different scenarios needs to be further evaluated. It is necessary to carry out economic evaluation of integrated NPIs and the combination of NPIs with other interventions, such as vaccination and medication, based on real-world settings in China.

[Progress in the study of antiviral activity of cepharanthine against SARS-CoV-2].

As a member of the dibenzyl isoquinoline alkaloid family, cepharathine is an alkaloid from the traditional Chinese medicine cepharathine, which is mainly used for treatment of leukopenia and other diseases. Recent studies of the inhibitory effect of cepharathine against SARS-CoV-2 have attracted widespread attention and aroused heated discussion. As the original discoverer of the anti-SARS-CoV-2 activity of cepharanthine, here we briefly summarize the discovery of cepharanthine and review important progress in relevant studies concerning the discovery and validation of anti-SARS-CoV-2 activity of cepharathine, its antiviral mechanisms and clinical trials of its applications in COVID-19 therapy.

Safe and effective administration of multiple recombinant factors on VA-ECMO via post-oxygenator pigtail during acute massive pulmonary hemorrhage

Introduction: Massive bleeding on extracorporeal membrane oxygenation (ECMO) is associated with multiple coagulation defects, including depletion of coagulation factors and development of acquired von Willebrand syndrome (AVWS). The use of recombinant factors, in particular recombinant activated factor VII (rFVIIa, Novoseven), to treat severe refractory hemorrhage in ECMO has been described. However, the use of multiple recombinant factors has been avoided in large part due to concern for circuit complications and thrombosis. Here, we describe the safe and effective administration of rFVIIa and recombinant von Willebrand factor complex (vWF/ FVIII, Humate-P) via post-oxygenator pigtail catheter on VA-ECMO for the treatment of massive pulmonary hemorrhage. Case Description: A 21-month-old (13.4 kg) girl with a recent history of COVID-19 infection presented to an outside hospital with parainfluenza bronchiolitis resulting in acute refractory hypoxemic respiratory failure (oxygenation index 58), refractory septic shock, and myocardial dysfunction. She was cannulated to VA-ECMO and subsequently diagnosed with necrotizing pneumonia from Pseudomonas and herpes simplex infections. Her course was complicated by a large left-sided pneumatocele and bronchopleural fistula requiring multiple chest tubes. She also had right mainstem bronchus obstruction from necrotic airway debris and complete right lung atelectasis. She was noted to have prolonged episodes of mucosal and cutaneous bleeding (oropharynx, chest tube insertion sites, peripheral IV insertion sites) associated with absent high molecular weight von Willebrand multimers consistent with AVWS. Tranexamic acid infusion was initiated and bivalirudin anticoagulation was discontinued. VA-ECMO flows were escalated to 140-160 ml/kg/min to maintain circuit integrity and meet high patient metabolic demand in the absence of anticoagulation. On ECMO day 26, she underwent bronchoscopy to clear necrotic debris from her airway to assist with lung recruitment. The procedure was notable for mucosal bleeding requiring topical epinephrine and rFVIIa. Post-procedure, she developed acute hemorrhage from her right mainstem bronchus, resulting in significant hemothorax (estimated 950 ml) with mediastinal shift, increased venous pressures, desaturation and decreased ECMO blood flow rate, necessitating massive transfusion of 2,050 ml (150 ml/kg) of packed red blood cells, platelets, plasma and cryoprecipitate. An airway blocker was placed in the mid-trachea to control bleeding. In addition to transfusion of appropriate blood products and continuation of tranexamic acid infusion, she was given both rFVIIa (100mcg/kg) and vWF-FVIII (70 units vWF/kg loading dose on the day of hemorrhage, followed by 40 units vWF/kg every 12 hours for 3 additional doses). Both products were administered over 10 minutes through a post-oxygenator pigtail to allow the product to circulate throughout the patient prior to entering the ECMO circuit. The circuit was closely monitored during administration and no changes to circuit integrity were noted in the subsequent hours while hemostasis was achieved. The ECMO circuit remained without thrombosis for 9 days after the bleeding event. Discussion: Balancing anticoagulation and hemostasis is a central challenge in maintaining ECMO support, especially given the prevalence of acquired coagulopathies such as AVWS. For our patient, AVWS contributed to mucosal bleeding necessitating cessation of anticoagulation and utilization of a high ECMO blood flow strategy to minimize circuit clot burden. This was further complicated by absent native lung function and minimal myocardial function, resulting in complete dependence on ECMO. An acute massive pulmonary hemorrhage was treated with multiple recombinant factors (rFVIIa and vWF/FVIII), that are often avoided on ECMO. To minimize clotting risk to the circuit and to maximize transit of these factors to our patient, we added a post-oxygenator pigtail for administration. While this approach was the result of extreme circumstances, th use of a post-oxygenator pigtail for administration of recombinant factors may represent a viable strategy for refractory hemorrhage while on ECMO.

Application of Convolutional Neural Network in COVID-19 Diagnosis

Since the outbreak and spread of COVID-19 in large areas of the world, the importance of rapid diagnosis of COVID-19 has increased. In the first week after the onset of COVID-19, the density of lesions is uneven, and chest CT is often difficult to show local subpleural ground-glass shadows, resulting in missed diagnosis. The COVID-19 intelligent diagnosis system based on the convolutional neural network algorithm can not only accurately identify the feature points, reduce the workload of doctors and improve the diagnosis efficiency, but also reduce the rate of missed diagnosis and misdiagnosis, which is conducive to epidemic control. © 2022 ACM.

[Progress in research of economic evaluation of COVID-19 vaccination strategies].

Objective: To understand the research progresses of economic evaluation of COVID-19 vaccination strategies both at home and abroad, and provide reference for the economic evaluation of COVID-19 vaccination strategies using real word data in China. Methods: Literature retrieval was conducted for related papers published from January, 2020 to December, 2021 in Chinese and English databases, including the economic evaluation of COVID-19 vaccination, and the results of the related literatures were narratively integrated. Results: A total of 16 English literatures (including 3 reviews) were included, and it was found that the COVID-19 vaccination was cost-effective or cost-saving regardless of the vaccine types, while the cost-effectiveness in different population and under different vaccination dose strategies varied due to vaccine efficacy, vaccine price, duration of natural immunity, duration of vaccination campaign, vaccine supply, and vaccination pace. Conclusions: China lacks suitable evidences of economic evaluation of COVID-19 vaccination strategies based on real-world data in the context of long-term epidemic. Therefore, further researches of suitable strategies of booster COVID-19 vaccination are needed.

Impacts of COVID-19 on Ship Behaviours in Port Area: An AIS Data-Based Pattern Recognition Approach

The advent of the COVID-19 pandemic disrupted global commercial activities and the tourism industry heavily. Impacts on maritime transportation were huge, as seaborne trade represents over 80%of global merchandise trade. Investigating how COVID-19 has affected ship behaviours is significant for economic condition evaluation, port management. This paper develops an analysis method to mine knowledge from raw Automation Identification System (AIS) data. First, berths are identified by improved density-based spatial clustering of applications with noise by Pythagoras distance (PD-DBSCAN). Data features, such as ship deadweight, arrival time, dwelling time, ship types, etc., can then be extracted using information matching and statistical analysis. Next, the dynamic time warping method is employed to analyse abnormal ship behaviour patterns and quantify the impacts of COVID-19. After that, a significance test is employed to determine an impact threshold through year-on-year analysis on ship flow, daily throughout and berthing time of quays. Finally, statistical analysis is used for the short-term impact analysis. This research examines a case study based on four-year AIS data in the Oslo port area. The results show that the proposed method can identify abnormal patterns caused by COVID-19 and estimate its impacts. Passenger ships are influenced heavily compared with cargo ships. The variation of passenger ships' flow is over 90%during 2020, larger than the average variation before 2020. The discovered knowledge could be used for future decision-making and preplanning in the next health crisis. IEEE

Global to local impacts on atmospheric CO2from the COVID-19 lockdown, biosphere and weather variabilities

The worldwide lockdown in response to the COVID-19 pandemic in year 2020 led to an economic slowdown and a large reduction in fossil fuel CO2 emissions (Le Quéré 2020 Nat. Clim. Change 10 647-53, Liu 2020 Nat. Commun. 11);however, it is unclear how much it would slow the increasing trend of atmospheric CO2 concentration, the main driver of climate change, and whether this impact can be observed considering the large biosphere and weather variabilities. We used a state-of-the-art atmospheric transport model to simulate CO2, and the model was driven by a new daily fossil fuel emissions dataset and hourly biospheric fluxes from a carbon cycle model forced with observed climate variability. Our results show a 0.21 ppm decrease in the atmospheric column CO2 anomaly in the Northern Hemisphere latitude band 0-45 N in March 2020, and an average of 0.14 ppm for the period of February-April 2020, which is the largest decrease in the last 10 years. A similar decrease was observed by the carbon observing satellite GOSAT (Yokota et al 2009 Sola 5 160-3). Using model sensitivity experiments, we further found that the COVID and weather variability are the major contributors to this CO2 drawdown, and the biosphere showed a small positive anomaly. Measurements at marine boundary layer stations, such as Hawaii, exhibit 1-2 ppm anomalies, mostly due to weather and the biosphere. At the city scale, the on-road CO2 enhancement measured in Beijing shows a reduction by 20-30 ppm, which is consistent with the drastically reduced traffic during the COVID lockdown. A stepwise drop of 20 ppm during the city-wide lockdown was observed in the city of Chengdu. The ability of our current carbon monitoring systems in detecting the small and short-lasting COVID signals at different policy relevant scales (country and city) against the background of fossil fuel CO2 accumulated over the last two centuries is encouraging. The COVID-19 pandemic is an unintended experiment. Its impact suggests that to keep atmospheric CO2 at a climate-safe level will require sustained effort of similar magnitude and improved accuracy, as well as expanded spatiotemporal coverage of our monitoring systems. © 2021 The Author(s). Published by IOP Publishing Ltd.

[Spatial accessibility of fever clinics for multi-tiered prevention and control on COVID-19 in Beijing]

OBJECTIVE: To simulate the different prevalence of corona virus disease 2019 (COVID-19) in Beijing as the spreading and the outbreak city and analyze the response capacity of its medical resources of fever clinics, and to provide a scientific basis for optimizing the spatial layout in Beijing under severe epidemics. METHODS: The study obtained epidemiological indicators for COVID-19, factors about medical resources and population movement as parameters for the SEIR model and utilized the model to predict the maximum number of infections on a single day at different control levels in Beijing, simulated as an epidemic spreading city and an epidemic outbreak city respectively. The modified two-step floating catchment area method under ArcGIS 10.6 environment was used to analyze spatial accessibility to fever clinics services for the patients in Beijing. RESULTS: According to the results of the SEIR model, the highest number of infections in a single day in Beijing simulated as an epidemic spreading city at low, medium and high levels of prevention and control were 8 514, 183, and 68 cases, the highest number of infections in a single day in Beijing simulated as an outbreak city was 22 803, 10 868 and 3 725 cases, respectively. The following result showed that Beijing was simulated as an epidemic spreading city: among the 585 communities in Beijing, under the low level of prevention and control, there were 17 communities (2.91%) with excellent accessibility to fever clinics, and that of 41 communities (7.01%) with fever clinics was good. Spatial accessibility of fever clinics in 56 communities (9.57%) was ranked average, and 62 communities' (10.60%) accessibility was fair and 409 communities (69.91%) had poor accessibility;at the medium level of prevention and control, only the west region of Fangshan District and Mentougou District, the north region of Yanqing District, Huairou District and Miyun District had poor accessibility;under the high level of prevention and control, 559 communities' (95.56%) had excellent accessibility. The accessibility in 24 communities (4.10%) was good and in 2 communities (0.34%) was average. In brief, the existing fever clinics could meet the common demand. Beijing was simulated as an outbreak city: under the low level of prevention and control, only 1 community (0.17%) had excellent accessibility to fever clinics, and 5 communities (0.86%) had good accessibility. The accessibility of fever clinics in 10 communities (1.71%) was average and in 12 communities (2.05%) was fair. The accessibility of fever clinics in 557 communities (95.21%), nearly all areas of Beijing, was poor;under the middle and high level of prevention and control, the accessibility of ecological conservation areas was also relatively poor. CONCLUSION: The distribution of fever clinic resources in Beijing is uneven. When Beijing is simulated as an epidemic spreading city: under the high level of prevention and control, the number of fever clinics can be appropriately reduced to avoid cross-infection;at the medium level of prevention and control, the fever clinics can basically meet the needs of patients with fever in Beijing, but the accessibility of fever clinics in ecological conservation areas is insufficient, and priority should be given to the construction of fever clinics in public hospitals above the second level in the ecological conservation areas. When the level of prevention and control is low, the accessibility of fever clinics in ecological conservation areas is poor. Priority should be given to the construction of fever clinics in ecological conservation areas, and temporary fever sentinels can be established to relieve the pressure of fever clinics. When Beijing is simulated as an outbreak city and has low prevention and control, due to a large number of infections, it is necessary to upgrade the prevention and control level to reduce the flow of people to curb the development of the epidemic.