Changes in the epidemiological characteristics of prehospital emergency services before and during the COVID-19 pandemic, Chengdu, 2016-2021.

The coronavirus disease 2019 (COVID-19) brought a healthy crisis all around the world. It's not only affected healthcare utilization, but also some disease's incidence. We collected pre-hospital emergency data in Chengdu from January 2016 to December 2021, and studied the demand for emergency medical services (EMSs), emergency response times (ERTs), and the disease spectrum in the city proper of Chengdu as a whole. A total of 1,122,294 prehospital emergency medical service (EMS) instances met the inclusion criteria. Under the influence of COVID-19, notably in 2020, the epidemiological characteristics of prehospital emergency services in Chengdu were considerably altered. However, as the pandemic was brought under control, they returned to normal or even earlier in 2021.The COVID-19 pandemic had an effect on people's medical care-seeking behavior and the performance of prehospital emergency services. Although the indicators associated with prehospital emergency services eventually recovered as the epidemic was brought under control, they remained marginally different from before the outbreak.

Longitudinal associations between pandemic post-traumatic stress symptoms and subsequent non-suicidal self-injury in adolescents: A multiple mediation model.

BACKGROUNDS: PTSD is one of the most common conditions after people have experienced trauma. While previous studies have found a link between PTSD and non-suicidal self-injury, (NSSI), few studies have longitudinally explored this relationship and the underlying mechanisms. AIMS: This study explored adolescent NSSI frequency after COVID-19 lockdown experiences, the relationship with early PTSD symptoms, and the mediating role of depression and sleep problems. METHODS: A cohort of 1609 adolescents completed two surveys during and after the national lockdown in China; one month into the lockdown and six months later; which assessed demographic and pandemic-related exposure variables; PTSD, depression, sleep, and NSSI. Mediation analyses and hierarchical regression were employed to examine the relationships and the paths between these variables. RESULTS: The NSSI rate was found to be 31.9 % after the three-month lockdown, with 20.6 % of adolescent participants reporting sleeping disorders, and 33.9 % indicating probable depression. Adolescents who had earlier PTSD symptoms, often smoked and/or drank, and had current depression and sleep disorders reported greater NSSI. Early PTSD symptoms were found to predict later NSSI and were mediated by sleep problems and depressive symptoms. Specifically, PTSD avoidance and numbing symptoms were significantly associated with NSSI above and beyond the depressive symptoms, sleeping problems, and the other covariables. CONCLUSION: It is necessary to be vigilant about the increased risk of NSSI in adolescents who have experienced extended pandemic lockdowns. Preventing early adolescent PTSD symptoms, especially avoidance and numbness, and helping teenagers quit smoking and drinking could reduce the risk of sleep disorders, depression, and NSSI.

COVID-19 Information Overload, Negative Emotions and Posttraumatic Stress Disorder: A Cross-Sectional Study.

Background: Under the context of the COVID-19 pandemic, a large amount of COVID-19-related information can cause an individual's perceived information overload, further halting the individual's psychological health. As a minor psychological discomfort could develop severe mental disorders such as posttraumatic stress disorder, it is necessary to understand the chain linkage of COVID-19 information overload turn to posttraumatic stress disorder to ensure timely intervention can be offered at each point of mental state transformation. Hence, we examined the negative outcomes of COVID-19 information overload and investigated the direct and indirect effects of COVID-19 on posttraumatic stress disorder. Methods: A convenient sample of Chinese adults (n = 1150) was investigated by an online survey from July 2020 to March 2021. The extent of COVID-19 information overload was measured by the information overload severity scale on the text of the COVID-19 pandemic. Psychological distress symptoms were measured using a 7-item anxiety scale (GAD-7), the 9-item Patient Health Questionnaire depression module (PHQ-9), and the psychometric properties of the PTSD Checklist (PCL-C). Structural equation modeling and bootstrap methods were utilized to analyze the relationships between variables. Results: COVID-19 information overload is positively related to an individual's anxiety, depression, and posttraumatic stress disorder. Furthermore, COVID-19 information overload can indirectly affect an individual's PTSD symptoms by increasing the feeling of depression. R2 values of anxiety, depression, and PTSD were 0.471, 0.324, and 0.795, respectively. Conclusion: COVID-19 information overload, anxiety, depression, and PTSD are negative psychological states, and each variable is closely linked with the others, suggesting the need for potential psychological interventions at specific times. Practical public training, such as crisis coping and information filtering, is essential. Regulation of technology companies is also essential.

COVID-19 Information Overload, Negative Emotions and Posttraumatic Stress Disorder: A Cross-Sectional Study

Background Under the context of the COVID-19 pandemic, a large amount of COVID-19-related information can cause an individual's perceived information overload, further halting the individual's psychological health. As a minor psychological discomfort could develop severe mental disorders such as posttraumatic stress disorder, it is necessary to understand the chain linkage of COVID-19 information overload turn to posttraumatic stress disorder to ensure timely intervention can be offered at each point of mental state transformation. Hence, we examined the negative outcomes of COVID-19 information overload and investigated the direct and indirect effects of COVID-19 on posttraumatic stress disorder. Methods A convenient sample of Chinese adults (n = 1150) was investigated by an online survey from July 2020 to March 2021. The extent of COVID-19 information overload was measured by the information overload severity scale on the text of the COVID-19 pandemic. Psychological distress symptoms were measured using a 7-item anxiety scale (GAD-7), the 9-item Patient Health Questionnaire depression module (PHQ-9), and the psychometric properties of the PTSD Checklist (PCL-C). Structural equation modeling and bootstrap methods were utilized to analyze the relationships between variables. Results COVID-19 information overload is positively related to an individual's anxiety, depression, and posttraumatic stress disorder. Furthermore, COVID-19 information overload can indirectly affect an individual's PTSD symptoms by increasing the feeling of depression. R2 values of anxiety, depression, and PTSD were 0.471, 0.324, and 0.795, respectively. Conclusion COVID-19 information overload, anxiety, depression, and PTSD are negative psychological states, and each variable is closely linked with the others, suggesting the need for potential psychological interventions at specific times. Practical public training, such as crisis coping and information filtering, is essential. Regulation of technology companies is also essential.

Occurrence and decay of SARS-CoV-2 in community sewage drainage systems.

The rapid spread of the coronavirus disease (COVID-19) pandemic in over 200 countries poses a substantial threat to human health. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19, can be discharged with feces into the drainage system. However, a comprehensive understanding of the occurrence, presence, and potential transmission of SARS-CoV-2 in sewers, especially in community sewers, is still lacking. This study investigated the virus occurrence by viral nucleic acid testing in vent stacks, septic tanks, and the main sewer outlets of community where confirmed patients had lived during the outbreak of the epidemic in Wuhan, China. The results indicated that the risk of long-term emission of SARS-CoV-2 to the environment via vent stacks of buildings was low after confirmed patients were hospitalized. SARS-CoV-2 were mainly detected in the liquid phase, as opposed to being detected in aerosols, and its RNA in the sewage of septic tanks could be detected for only four days after confirmed patients were hospitalized. The surveillance of SARS-CoV-2 in sewage could be a sensitive indicator for the possible presence of asymptomatic patients in the community, though the viral concentration could be diluted more than 10 times, depending on the sampling site, as indicated by the Escherichia coli (E. coli) test. The comprehensive investigation of the community sewage drainage system is helpful to understand the occurrence characteristics of SARS-CoV-2 in sewage after excretion with feces and the feasibility of sewage surveillance for COVID-19 pandemic monitoring.

A content analysis of Chinese news coverage on COVID-19 and tourism. (Special Issue: COVID-19 and tourism.)

News coverage plays a significant role in the tourism industry. 2019 Coronavirus Disease (COVID-19) has severely affected the tourism-related businesses and has been featured in Chinese news coverage. This research studied 499 newspaper articles through automated content analysis. Nine key themes were identified, including COVID-19's impact on tourism, people's sentiment, control of tourism activities and cultural venues, the role of the hospitality industry, national command and local response, tourism disputes and solutions, corporate self-improvement strategies, government assistance, and post-crisis tourism product. This research provides insights into future investigations of the tourism crisis related to an epidemic.

Persistence of SARS-CoV-2 RNA in wastewater after the end of the COVID-19 epidemics.

Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been widely detected in wastewater in many countries to track the COVID-19 pandemic development, it is still a lack of clear understanding of the persistence of SARS-CoV-2 in raw sewage, especially after the end of the COVID-19 pandemic event. To fill this knowledge gap, this study conducted a field trial on the SARS-CoV-2 presence in various wastewater facilities after the end of the COVID-19 epidemics in Beijing. The result showed that the wastewater treatment facility is a large SARS-CoV-2 repository. The viral RNA was still present in hospital sewage for 15 days and was continually detected in municipal WWTPs for more than 19 days after the end of the local COVID-19 epidemics. The T90 values of the SARS-CoV-2 RNA in raw wastewater were 17.17-8.42 days in the wastewater at 4 â„ƒ and 26 â„ƒ, respectively, meaning that the decay rates of low titer viruses in raw sewage were much faster. The results confirmed that the SARS-CoV-2 RNA could persist in wastewater for more than two weeks, especially at lower temperatures. The sewage systems would be a virus repository and prolong the presence of the residual SARS-CoV-2 RNA. The study could enhance further understanding of the presence of SARS-CoV-2 RNA in raw wastewater.

Inactivation and risk control of pathogenic microorganisms in municipal sludge treatment: A review.

The rapid global spread of coronavirus disease 2019 (COVID-19) has promoted concern over human pathogens and their significant threats to public health security. The monitoring and control of human pathogens in public sanitation and health facilities are of great importance. Excessive sludge is an inevitable byproduct of sewage that contains human and animal feces in wastewater treatment plants (WWTPs). It is an important sink of different pollutants and pathogens, and the proper treatment and disposal of sludge are important to minimize potential risks to the environment and public health. However, there is a lack of comprehensive analysis of the diversity, exposure risks, assessment methods and inactivation techniques of pathogenic microorganisms in sludge. Based on this consideration, this review summarizes the control performance of pathogenic microorganisms such as enterovirus, Salmonella spp., and Escherichia coli by different sludge treatment technologies, including composting, anaerobic digestion, aerobic digestion, and microwave irradiation, and the mechanisms of pathogenic microorganism inactivation in sludge treatment processes are discussed. Additionally, this study reviews the diversity, detection methods, and exposure risks of pathogenic microorganisms in sludge. This review advances the quantitative assessment of pathogenic microorganism risks involved in sludge reuse and is practically valuable to optimize the treatment and disposal of sludge for pathogenic microorganism control.

SARS-CoV-2 spillover into hospital outdoor environments.

Facing the ongoing coronavirus infectious disease-2019 (COVID-19) pandemic, many studies focus on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in indoor environment, on solid surface or in wastewater. It remains unclear whether SARS-CoV-2 can spill over into outdoor environments and impose transmission risks to surrounding people and communities. In this study, we investigated the presence of SARS-CoV-2 by measuring viral RNA in 118 samples from outdoor environment of three hospitals in Wuhan. We detected SARS-CoV-2 in soils (205-550 copies/g), aerosols (285-1,130 copies/m3) and wastewaters (255-18,744 copies/L) in locations close to hospital departments receiving COVID-19 patients or in wastewater treatment sectors. These findings revealed a significant viral spillover in hospital outdoor environments that was possibly caused by respiratory droplets from patients or aerosolized particles from wastewater containing SARS-CoV-2. In contrast, SARS-CoV-2 was not detected in other areas or on surfaces with regular implemented disinfection. Soils may behave as viral warehouse through deposition and serve as a secondary source spreading SARS-CoV-2 for a prolonged time. For the first time, our findings demonstrate that there are high-risk areas out of expectation in hospital outdoor environments to spread SARS-CoV-2, calling for sealing of wastewater treatment unit and complete sanitation to prevent COVID-19 transmission risks.

Ultra-fast and onsite interrogation of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in waters via surface enhanced Raman scattering (SERS).

The outbreak of coronavirus infectious disease-2019 (COVID-19) pneumonia challenges the rapid interrogation of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in human and environmental samples. In this study, we developed an assay using surface enhanced Raman scattering (SERS) coupled with multivariate analysis to detect SARS-CoV-2 in an ultra-fast manner without any pretreatment (e.g., RNA extraction). Using silver-nanorod SERS array functionalized with cellular receptor angiotensin-converting enzyme 2 (ACE2), we obtained strong SERS signals of ACE2 at 1032, 1051, 1089, 1189, 1447 and 1527 cm-1. The recognition and binding of receptor binding domain (RBD) of SARS-CoV-2 spike protein on SERS assay significantly quenched the spectral intensities of most peaks and exhibited a shift from 1189 to 1182 cm-1. On-site tests on 23 water samples with a portable Raman spectrometer proved its accuracy and easy-operation for spot detection of SARS-CoV-2 to evaluate disinfection performance, explore viral survival in environmental media, assess viral decay in wastewater treatment plant and track SARS-CoV-2 in pipe network. Our findings raise a state-of-the-art spectroscopic tool to screen and interrogate viruses with RBD for human cell entry, proving its feasibility and potential as an ultra-fast detection tool for wastewater-based epidemiology.

Spatial variation of dissolved organic nitrogen in Wuhan surface waters: Correlation with the occurrence of disinfection byproducts during the COVID-19 pandemic.

Intensified sanitization practices during the recent coronavirus disease-2019 (COVID-19) led to the release of chlorine-based disinfectants in surface water, potentially triggering the formation of disinfection byproducts (DBPs) in the presence of dissolved organic nitrogen (DON). Thus, a comprehensive investigation of DON's spatial distribution and its association with DBP occurrence in the surface water is urgently needed. In this study, a total of 51 water samples were collected from two rivers and four lakes in May 2020 in Wuhan to explore the regional variation of nitrogen (N) species, DON's compositional characteristics, and the three classes of DBP occurrence. In lakes, 53.0% to 86.3% of N existed as DON, with its concentration varying between 0.3-4.0 mg N/L. In contrast, NO3--N was the dominant N species in rivers. Spectral analysis revealed that DON in the lakes contained higher humic and fulvic materials with higher A254, A253/A203, SUVA254, and PIII+IV/PI+II+V ratios, while rivers had higher levels of hydrophilic compounds. Trihalomethanes (THMs) were the most prevalent DBPs in the surface waters, followed by N-nitrosamines and haloacetonitriles (HANs). The levels of N-nitrosamines (23.1-97.4 ng/L) increased significantly after the outbreak of the COVID-19 pandemic. Excessive DON in the surface waters was responsible for the formation of N-nitrosamines. This study confirmed that the presence of DON in surface water could result in DBP formation, especially N-nitrosamines, when disinfectants were discharged into surface water during the COVID-19 pandemic.

Combating COVID-19 with integrated traditional Chinese and Western medicine in China.

COVID-19, an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread throughout the world. China has achieved rapid containment of this highly infectious disease following the principles of early detection, early quarantine and early treatment with integrated traditional Chinese and Western medicine. The inclusion of traditional Chinese medicine (TCM) in the Chinese protocol is based on its successful historic experience in fighting against pestilence. Current findings have shown that the Chinese medicine can reduce the incidence of severe or critical events, improve clinical recovery and help alleviate symptoms such as cough or fever. To date there are over 133 ongoing registered clinical studies on TCM/integrated traditional Chinese and Western medicine. The three Chinese patent medicines (Lianhua Qingwen Keli/Jiaonang (Forsythiae and Honeysuckle Flower Pestilence-Clearing Granules/Capsules), Jinhua Qinggan Keli (Honeysuckle Flower Cold-Relieving Granules) and Xuebijing (Stasis-Resolving & Toxin-Removing) Injection were officially approved by the National Medical Products Administration to list COVID-19 as an additional indication. The pharmacological studies have suggested that Chinese medicine is effective for COVID-19 probably through its host-directed regulation and certain antiviral effects.

Potential spreading risks and disinfection challenges of medical wastewater by the presence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) viral RNA in septic tanks of Fangcang Hospital.

The outbreak of coronavirus infectious disease-2019 (COVID-19) pneumonia raises the concerns of effective deactivation of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in medical wastewater by disinfectants. In this study, we evaluated the presence of SARS-CoV-2 viral RNA in septic tanks of Wuchang Cabin Hospital and found a striking high level of (0.5-18.7) × 103 copies/L after disinfection with sodium hypochlorite. Embedded viruses in stool particles might be released in septic tanks, behaving as a secondary source of SARS-CoV-2 and potentially contributing to its spread through drainage pipelines. Current recommended disinfection strategy (free chlorine ≥0.5 mg/L after at least 30 min suggested by World Health Organization; free chlorine above 6.5 mg/L after 1.5-h contact by China Centers for Disease Control and Prevention) needs to be reevaluated to completely remove SARS-CoV-2 viral RNA in non-centralized disinfection system and effectively deactivate SARS-CoV-2. The effluents showed negative results for SARS-CoV-2 viral RNA when overdosed with sodium hypochlorite but had high a level of disinfection by-product residuals, possessing significant ecological risks.

Clinical features and treatment of COVID-19 patients in northeast Chongqing.

The outbreak of the novel coronavirus in China (SARS-CoV-2) that began in December 2019 presents a significant and urgent threat to global health. This study was conducted to provide the international community with a deeper understanding of this new infectious disease. Epidemiological, clinical features, laboratory findings, radiological characteristics, treatment, and clinical outcomes of 135 patients in northeast Chongqing were collected and analyzed in this study. A total of 135 hospitalized patients with COVID-19 were enrolled. The median age was 47 years (interquartile range, 36-55), and there was no significant gender difference (53.3% men). The majority of patients had contact with people from the Wuhan area. Forty-three (31.9%) patients had underlying disease, primarily hypertension (13 [9.6%]), diabetes (12 [8.9%]), cardiovascular disease (7 [5.2%]), and malignancy (4 [3.0%]). Common symptoms included fever (120 [88.9%]), cough (102 [76.5%]), and fatigue (44 [32.5%]). Chest computed tomography scans showed bilateral patchy shadows or ground glass opacity in the lungs of all the patients. All patients received antiviral therapy (135 [100%]) (Kaletra and interferon were both used), antibacterial therapy (59 [43.7%]), and corticosteroids (36 [26.7%]). In addition, many patients received traditional Chinese medicine (TCM) (124 [91.8%]). It is suggested that patients should receive Kaletra early and should be treated by a combination of Western and Chinese medicines. Compared to the mild cases, the severe ones had lower lymphocyte counts and higher plasma levels of Pt, APTT, d-dimer, lactate dehydrogenase, PCT, ALB, C-reactive protein, and aspartate aminotransferase. This study demonstrates the clinic features and therapies of 135 COVID-19 patients. Kaletra and TCM played an important role in the treatment of the viral pneumonia. Further studies are required to explore the role of Kaletra and TCM in the treatment of COVID-19.