The effect of resource loss on depression and peritraumatic distress during the early period of the COVID-19: considering the pandemic-situational and social context.

BACKGROUND: The public experienced loss of resources, including their health and property during the COVID-19 pandemic. The Conservation of Resources (COR) theory is a useful tool to explain the effect of resource loss on mental health. This paper examines the effect of resource loss on depression and peritraumatic distress considering the situational and social context of the COVID-19 pandemic applying COR theory. METHODS: An online survey was conducted for Gyeonggi residents when the second wave of COVID-19 in South Korea declined (5 October to 13 October 2020); 2,548 subjects were included in the hierarchical linear regression analysis. RESULTS: COVID-19 infection-related experiences, resource losses (e.g., financial burden, deterioration of health, and decline of self-esteem), and fear of stigma were related to elevated levels of peritraumatic distress and depression. Risk perception was associated with peritraumatic distress. Reduced income or job loss were related to depression. Social support was a protective factor for mental health. CONCLUSIONS: This study suggests that we need to focus on COVID-19 infection-related experiences and loss of daily resources in order to understand mental health deterioration during the COVID-19 pandemic. Moreover, it is important to monitor the mental health of medically and socially vulnerable groups and those who have lost resources due to the pandemic and to provide them with social support services.

Comparative impact of repositioned anticancer therapies on non-cancer COVID-19 patient treatment: a systematic review and network meta-analysis of randomized controlled trials

Purpose: Coronavirus disease 2019 (COVID-19) has emerged as a serious threat to public health;anticancer-repositioning treatment strategy has been formulated to treat the disease. However, evidence supporting the efficacy and safety of repositioned anticancer treatment in treating COVID-19-infected non-cancer patients (CINPs) is limited. Therefore, this study analyzed published randomized controlled trials (RCTs) evaluating the impact of anticancer drugs compared to current standards of care (SOCs) on CINP treatment. Materials and methods: The PubMed and Embase databases were searched to identify eligible RCTs. Outcome measures included mortality, the use of mechanical ventilation (MV), and serious adverse events (SAEs). Results: 25 RCTs were reviewed in our study. Compared to SOCs, repositioned anticancer therapy for treating CINPs was associated with mortality reduction (odds ratio (OR) = 0.78, 95% confidence interval (CI) = 0.65 - 0.94, p = 0.01). Using the repositioned anticancer treatment exhibited statistically significant reduction, in both the number of CINPs using MV (OR = 0.67, 95% CI = 0.51 - 0.88, p = 0.004) and experiencing SAEs (OR = 0.79, 95% CI = 0.69 - 0.91, p = 0.0009). Conclusion: Conclusively, repositioned anticancer treatment was shown significant differences from SOCs in treating CINPs, which appears to be more associated with mortality, MV use, and SAE development reduction in CINPs.

COVID-19 Outbreak in a Military Unit in Korea.

OBJECTIVES: This study presents the response of a military unit to the COVID-19 outbreak in Gyeonggi Province. As soon as two soldiers were identified as index cases, the infectious disease investigators of the Gyeonggi Provincial Government, Korea Disease Control and Prevention Agency and the Armed Forces Epidemiologic Investigation Center, discussed the investigation and response plan for an imminent massive outbreak. METHODS: The joint immediate response team (IRT) conducted interviews with confirmed patients with COVID-19, reviewed medical records, performed contact tracing using global positioning system (GPS), and undertook a field investigation. For risk assessment, the joint IRT visited all eight sites of the military units and the army chaplain's church to evaluate the transmission risk of each site. The evaluation items included the size of the site, the use of air conditioning, whether windows were opened, and whether masks were worn. A pooled testing was used for a low-risk population to quickly detect the spread of COVID-19 in the military base. RESULTS: A day before the symptom onset of the index case, the lecturer and >50% of the attendees were infected with COVID-19 while attending a lecture that lasted 2 h and 30 min. Attendees were not wearing masks and were in a poorly ventilated room. CONCLUSION: Since the disease can be spread before symptom onset, contact tracing must be performed to investigate potential exposures prior to symptom onset and manage any exposed persons.

Patient experience with telehealth service in a mental health setting.

The purpose of the quality improvement project is to explore the patient experience of telehealth services in a mental health setting during the COVID-19 pandemic. A cross-sectional survey design was deployed in an outpatient psychiatric setting. Forty-five participants completed the survey, and the smartphone was the most frequently used and preferred device for their telehealth service. Participants exhibited a high level of usability for telehealth services (Mean = 5.82, SD = 1.21). Telehealth can be a way to solve the problem of not having enough mental health services available, even though there are potential barriers such as digital literacy and human engagement.

Comparative impact of repositioned anticancer therapies on non-cancer COVID-19 patient treatment: A systematic review and network meta-analysis of randomized controlled trials.

PURPOSE: Coronavirus disease 2019 (COVID-19) has emerged as a serious threat to public health; anticancer-repositioning treatment strategy has been formulated to treat the disease. However, evidence supporting the efficacy and safety of repositioned anticancer treatment in treating COVID-19-infected non-cancer patients (CINPs) is limited. Therefore, this study analyzed published randomized controlled trials (RCTs) evaluating the impact of anticancer drugs compared to current standards of care (SOCs) on CINP treatment. MATERIALS AND METHODS: The PubMed and Embase databases were searched to identify eligible RCTs. Outcome measures included mortality, the use of mechanical ventilation (MV), and serious adverse events (SAEs). RESULTS: 25 RCTs were reviewed in our study. Compared to SOCs, repositioned anticancer therapy for treating CINPs was associated with mortality reduction (odds ratio (OR) = 0.78, 95% confidence interval (CI) = 0.65 - 0.94, p = 0.01). Using the repositioned anticancer treatment exhibited statistically significant reduction, in both the number of CINPs using MV (OR = 0.67, 95% CI = 0.51 - 0.88, p = 0.004) and experiencing SAEs (OR = 0.79, 95% CI = 0.69 - 0.91, p = 0.0009). CONCLUSION: Conclusively, repositioned anticancer treatment was shown significant differences from SOCs in treating CINPs, which appears to be more associated with mortality, MV use, and SAE development reduction in CINPs.

Perceived barriers to the process of COVID-19 control among frontline healthcare workers in South Korea: a qualitative study.

OBJECTIVE: This study aimed to explore barriers to disease control perceived by frontline healthcare workers (HCWs) working in community settings during the COVID-19 pandemic in South Korea. DESIGN: A qualitative study was conducted using semistructured focus group interviews. All interviews were conducted in Korean on Zoom between October and November 2020, audio-recorded and transcribed for reflexive thematic analysis. SETTING: All participants were working in Gyeonggi-do, the most populous province in South Korea. The province had the second-highest COVID-19 infection rates at the time of the interview. PARTICIPANTS: Participants serving as HCWs in Gyeonggi Province were eligible to participate in the study. A total of 20 HCWs comprised of public health doctors and professional epidemiologists agreed to participate in the study. RESULTS: Four themes were generated. Each theme described how these barriers affected a disease control process: (1) 'uncooperative public and unprepared community health centre' delayed the investigation of newly diagnosed COVID-19 cases; (2) 'uncoordinated disease control system' impeded the collection and analysis of digital data; (3) 'the gap between responsibilities and capabilities' hindered the classification of close and casual contacts; and (4) 'conflicts with persons who have different interests and priorities' hampered epidemiological decision-making. CONCLUSIONS: Our study found that frontline HCWs experienced various challenges disrupting their work performance to control COVID-19. We provide several recommendations, such as providing HCWs with systematic interview skill training, strengthening patient information security systems, providing sufficient resources, securing a regular workforce, collecting the field experiences of HCWs, implementing task-shifting, and having regular stakeholder meetings. These strategies may promote work capacity among the frontline HCWs and subsequently strengthen emergency preparedness.

COVID-19 outbreak response at a nursing hospital in South Korea in the post-vaccination era, including an estimation of the effectiveness of the first shot of the Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1-S).

OBJECTIVES: We descriptively reviewed a coronavirus disease 2019 (COVID-19) outbreak at a nursing hospital in Gyeonggi Province (South Korea) and assessed the effectiveness of the first dose of the Oxford-AstraZeneca vaccine in a real-world population. METHODS: The general process of the epidemiological investigation included a public health intervention. The relative risk (RR) of vaccinated and unvaccinated groups was calculated and compared to confirm the risk of severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) infection, and vaccine effectiveness was evaluated based on the calculated RR. RESULTS: The population at risk was confined to ward E among 8 wards of Hospital X, where the outbreak occurred. This population comprised 55 people, including 39 patients, 12 nurses, and 4 caregivers, and 19 cases were identified. The RR between the vaccinated and unvaccinated groups was 0.04, resulting in a vaccine effectiveness of 95.3%. The vaccination rate of the nonpatients in ward E was the lowest in the entire hospital, whereas the overall vaccination rate of the combined patient and non-patient groups in ward E was the third lowest. CONCLUSION: The first dose of the Oxford-AstraZeneca vaccine (ChAdOx1-S) was effective in preventing SARS-CoV-2 infection. To prevent COVID-19 outbreaks in medical facilities, it is important to prioritize the vaccination of healthcare providers.

Development of a social distancing monitoring system in Republic of Korea: results of a modified Delphi process.

BACKGROUND: Social distancing policies work in different ways and at different levels. In addition, various forms of monitoring systems have been implemented in different countries. However, there is an almost complete lack of specific monitoring system in Republic of Korea to effectively monitor social distancing measures compliance and outcome. This study aims to develop a monitoring system for social distancing measures compliance and outcome in Korea to evaluate and improve the implemented policy. METHODS: A draft monitoring system was developed after reviewing Korea's social distancing measures (central and local government briefings) and checking available data about social distancing behavior. The modified Delphi process was used to evaluate the draft of the social distancing monitoring system. In total, 27 experts participated in the evaluation. The round 1 evaluation includes (1) commenting on the composition of the monitoring fields (open response), (2) monitoring indicators for each monitoring field (10-point Likert scale), and (3) commenting on the source of data used to develop the monitoring system (open response). In the round 2 evaluation, 55 indicators, excepting open responses, were re-evaluated. RESULTS: The response rate for the Delphi survey was 100% in both the first and second rounds. Of the 55 indicators, 1 indicator, which did not satisfy the quantitative criteria, was excluded. According to the experts' open response comments, 15 indicators were excluded, as these indicators overlapped with other indicators or had little relevance to social distancing. Instead, 23 new indicators were added. Finally, 62 indicators were included with 12 available data sources. The monitoring system domain was divided into 'social distancing measures state, social distancing measures compliance, social distancing outcome'. CONCLUSIONS: This study is significant in that it is the first in Korea to develop a comprehensive monitoring system for checking if social distancing measures are being followed well, and is applicable to estimates utilizing data that are immediately available for each indicator. Furthermore, the developed monitoring system could be a reference for other countries that require the development of such systems to monitor social distancing.

Impact of COVID-19 Pandemic Declaration on New Oncology Trial Commencements: An Interrupted Time Series with Segmented Regression Analysis.

This study aimed to assess the trend in oncology trial commencements registered on ClinicalTrials.gov and to evaluate the contributing factors by comparing the trends in the pre- and post-COVID-19 pandemic era. The ClinicalTrials.gov database was searched to identify oncology study trials starting from 1 January 2018 to 28 February 2021. Data on the variables of start/complete date, phase, status, funding source, center, country and study type were extracted. According to the time point of the COVID-19 pandemic declaration by the World Health Organization (WHO), March 2020, we analyzed the extracted data, including interrupted time series (ITS) analysis and multivariable regression analysis. We identified 18,561 new oncology trials during the study period. A total of 5678 oncology trials in the prepandemic period and 6134 in the postpandemic period were included in the comparative analysis. The year 2020 had the most newly launched trials (32.3%), and the majority of trials were planned to be conducted for longer than two years (70.3%). The results of ITS show the trend in the commencement of oncology trials was significantly increased after the pandemic declaration (coefficient = 27.99; 95% CI = 19.27 to 36.71). Drug intervention trials were the largest contributor to the increased trial number compared to different interventions, such as trials of devices or procedures (OR = 1.14; 95% CI = 1.03 to 1.26, OR = 1.09; 95% CI = 0.91 to 1.29, and OR = 1.12; 95% CI = 0.96 to 1.31, respectively), whereas the United Kingdom was the highest contributor to the number of decreased trials (OR = 0.67; 95% CI = 0.51 to 0.89 p = 0.01) in the postpandemic era. The interruption in oncology trial initiation was diminished shortly after the COVID-19 pandemic declaration, which was influenced by several factors, such as interventions or national responses. Based on the current outcomes, appropriate strategies for developing oncology trials can be planned to mitigate the impact of future crises on oncology trials.

A Buprenorphine Program Evaluation Before and During the COVID-19 Pandemic.

This project evaluated the service delivery (ie, attendance rate) of a buprenorphine management treatment program and compared patient recovery-related information between service methods. This was a medical record review and cross-sectional comparison of pre-COVID-19 vs post onset of COVID-19 data. In the sample of 28 adults, mean attendance rates did not differ significantly before (99.46%) vs during the pandemic (96.13%; t = 1.92, P = .07). Patient participation in therapy before and during the pandemic did differ significantly (χ2 = 1.98, P = .03). The use of telemental health services within a BMT program may be a viable option when normal in-person services are disrupted.

Burnout and peritraumatic distress of healthcare workers in the COVID-19 pandemic.

BACKGROUND: To evaluate the current status of emotional exhaustion and peritraumatic distress of healthcare workers (HCWs) in the COVID-19 pandemic, and identify factors associated with their mental health status. METHODS: An online survey involving 1068 of consented HCWs that included nurses, physicians, and public health officers was conducted in May 2020. Descriptive statistics and multivariate regression analyses were performed on the collected data. RESULTS: Although no significant difference in peritraumatic distress was observed among the surveyed HCWs, the workers' experience of emotional exhaustion varied according to work characteristics. Respondents who were female, older, living with a spouse, and/or full-time workers reported higher levels of emotional exhaustion. Public health officers and other medical personnel who did not have direct contact with confirmed patients and full-time workers had a higher level of peritraumatic distress. Forced involvement in work related to COVID-19, worry about stigma, worry about becoming infected, and perceived sufficiency of organizational support negatively predict emotional exhaustion and peritraumatic distress. CONCLUSIONS: Job-related and emotional stress of HCWs should not be neglected. Evidence-based interventions and supports are required to protect HCWs from mental illness and to promote mental health of those involved in the response to the COVID-19 pandemic.

Factors associated with the difference between the incidence and case-fatality ratio of coronavirus disease 2019 by country.

Coronavirus disease (COVID-19) has been spreading all over the world; however, its incidence and case-fatality ratio differ greatly between countries and between continents. We investigated factors associated with international variation in COVID-19 incidence and case-fatality ratio (CFR) across 107 northern hemisphere countries, using publicly available COVID-19 outcome data as of 14 September 2020. We included country-specific geographic, demographic, socio-economic features, global health security index (GHSI), healthcare capacity, and major health behavior indexes in multivariate models to explain this variation. Multiple linear regression highlighted that incidence was associated with ethnic region (p < 0.05), global health security index 4 (GHSI4) (beta coefficient [ß] 0.50, 95% Confidence Interval [CI] 0.14-0.87), population density (ß 0.35, 95% CI 0.10-0.60), and water safety level (ß 0.51, 95% CI 0.19-0.84). The CFR was associated with ethnic region (p < 0.05), GHSI4 (ß 0.53, 95% CI 0.14-0.92), proportion of population over 65 (ß 0.71, 95% CI 0.19-1.24), international tourism receipt level (ß - 0.23, 95% CI - 0.43 to - 0.03), and the number of physicians (ß - 0.37, 95% CI - 0.69 to - 0.06). Ethnic region was the most influential factor for both COVID-19 incidence (partial [Formula: see text] = 0.545) and CFR (partial [Formula: see text] = 0.372), even after adjusting for various confounding factors.

Perceived sources of occupational burn-out and embitterment among front-line health workers for COVID-19 control in Gyeonggi province, South Korea: a qualitative study.

OBJECTIVES: Front-line health workers (FHWs) for COVID-19 control in South Korea have implemented a labour-intensive contact tracing programme, which places them at high risk for mental health problems. However, a few studies have examined mental health conditions in this population. We employed a qualitative approach to understand the factors perceived as causes of burn-out and embitterment among temporary FHWs to provide recommendations for supporting the workforce. METHODS: We recruited 20 FHWs to participate in semistructured focus group interviews through purposive sampling. The sample size was determined on the basis of data saturation. We collected data from October to November 2020, audiorecording and transcribing the interviews. Data analysis was conducted manually, applying the principles of grounded theory. RESULTS: Five levels of perceived sources of occupational burn-out and embitterment emerged. FHWs showed considerable mistrust of patients and faced ethical dilemmas in accessing and disclosing personal information. Poor collaboration with community health centre workers and interested parties as well as inadequate organisational support aggravated their conditions. Lack of social recognition and employment instability also presented challenges for FHWs' mental health. CONCLUSIONS: The current pandemic response system imposes great moral and emotional burdens on the workforce, prompting the need for initiatives to safeguard the values and needs of those who represent the backbone of the system. This study suggests that multilevel strategies, including providing organisational support and establishing contingency plans for workforce management and resource distribution, may improve FHWs' mental health outcomes as well as the health system for emergency preparedness.

Impact of Public Health Interventions on Seasonal Influenza Activity During the COVID-19 Outbreak in Korea.

BACKGROUND: Coronavirus disease 2019 (COVID-19) was introduced in Korea early with a large outbreak in mid-February. We reviewed the public health interventions used during the COVID-19 outbreak and describe the impact on seasonal influenza activity in Korea. METHODS: National response strategies, public health interventions and daily COVID-19-confirmed cases in Korea were reviewed during the pandemic. National influenza surveillance data were compared between 7 sequential seasons. Characteristics of each season, including rate of influenza-like illness (ILI), duration of epidemic, date of termination of epidemic, distribution of influenza virus strain, and hospitalization, were analyzed. RESULTS: After various public health interventions including enforced public education on hand hygiene, cough etiquette, staying at home with respiratory symptoms, universal mask use in public places, refrain from nonessential social activities, and school closures the duration of the influenza epidemic in 2019/2020 decreased by 6-12 weeks and the influenza activity peak rated 49.8 ILIs/1000 visits compared to 71.9-86.2 ILIs/1000 visits in previous seasons. During the period of enforced social distancing from weeks 9-17 of 2020, influenza hospitalization cases were 11.9-26.9-fold lower compared with previous seasons. During the 2019/2020 season, influenza B accounted for only 4%, in contrast to previous seasons in which influenza B accounted for 26.6-54.9% of all cases. CONCLUSIONS: Efforts to activate a high-level national response not only led to a decrease in COVID-19 but also a substantial decrease in seasonal influenza activity. Interventions applied to control COVID-19 may serve as useful strategies for prevention and control of influenza in upcoming seasons.

Developing a Framework for Pandemic COVID-19 Vaccine Allocation: a Modified Delphi Consensus Study in Korea.

BACKGROUND: This study presents a framework for determining the allocation and distribution of the limited amount of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: After analyzing the pandemic strategies of the major organizations and countries and with a literature review conducted by a core panel, a modified Delphi survey was administered to 13 experts in the fields of vaccination, infectious disease, and public health in the Republic of Korea. The following topics were discussed: 1) identifying the objectives of the vaccination strategy, 2) identifying allocation criteria, and 3) establishing a step-by-step vaccination framework and prioritization strategy based on the allocation criteria. Two rounds of surveys were conducted for each topic, with a structured questionnaire provided via e-mail in the first round. After analyzing the responses, a meeting with the experts was held to obtain consensus on how to prioritize the population groups. RESULTS: The first objective of the vaccination strategy was maintenance of the integrity of the healthcare system and critical infrastructure, followed by reduction of morbidity and mortality and reduction of community transmission. In the initial phase, older adult residents in care homes, high-risk health and social care workers, and personal support workers who work in direct contact with coronavirus disease 2019 (COVID-19) patients would be prioritized. Expansion of vaccine supply would allow immunization of older adults not included in phase 1, followed by healthcare workers not previously included and individuals with comorbidities. Further widespread vaccine supply would ensure availability to the extended adult age groups (50-64 years old), critical workers outside the health sector, residents who cannot socially distance, and, eventually, the remaining populations. CONCLUSION: This survey provides the much needed insight into the decision-making process for vaccine allocation at the national level. However, flexibility in adapting to strategies will be essential, as new information is constantly emerging.

Precautionary Behavior Practices and Psychological Characteristics of COVID-19 Patients and Quarantined Persons.

BACKGROUND: since the coronavirus disease (COVID-19) was first reported in 2019, South Korea has enforced isolation of patients with confirmed cases of COVID-19, as well as quarantine for close contacts of individuals diagnosed with COVID-19 and persons traveling from abroad, in order to contain its spread. Precautionary behavior practices and psychological characteristics of confirmed and quarantined persons were investigated for planning pandemic recovery and preparedness. METHODS: this study was conducted with 1716 confirmed patients and quarantined persons in Daegu and Busan, regions where a high number of cases were confirmed during the early stage of the COVID-19 outbreak in South Korea. We collected online survey data from 23 April to 20 May 2020, in Daegu, and 28 April to 27 May 2020, in Busan, in cooperation with Daegu and Busan Infectious Disease Control Centers and public health centers in the regions. COVID-19 symptoms, pre-cautionary behavior practices, psychological states, and the need for improvement in isolation/quarantine environments were examined using an online survey. RESULTS: compared to patients infected with coronavirus, quarantined persons engaged in more hygiene-related behaviors (e.g., hand washing, cough etiquette, and proper mask-wearing) and social distancing. COVID-19 patients had a strong fear of stigma, while quarantined persons had a strong fear of contracting COVID-19. Study participants responded that it was necessary to provide financial support and adequate information during isolation/quarantine. CONCLUSIONS: the study highlights the importance of precautionary behavior to prevent COVID-19 infection and the need to provide support (both psychological and financial) to patients and quarantined persons, to reinforce effective communication, social solidarity, and public health emergency preparedness (PHEP) in a pandemic situation.

The Development and Operation of a Home Management System during the COVID-19 Pandemic: Experience of the Local Government Gyeonggi-do in Korea.

During the three the coronavirus disease 2019 (COVID-19) surges in South Korea, there was a shortage of hospital beds for COVID-19 patients, and as a result, there were cases of death while waiting for hospitalization. To minimize the risk of death and to allow those confirmed with COVID-19 to safely wait for hospitalization at home, the local government of Gyeonggi-do in South Korea developed a novel home management system (HMS). The HMS team, comprised of doctors and nurses, was organized to operate HMS. HMS provided a two-way channel for the taskforce and patients to monitor the severity of patient's condition and to provide healthcare counseling as needed. In addition, the HMS team cooperated with a triage/bed assignment team to expedite the response in case of an emergency, and managed a database of severity for real-time monitoring of patients. The HMS became operational for the first time in August 2020, initially managing only 181 patients; it currently manages a total of 3,707 patients. The HMS supplemented the government's COVID-19 confirmed case management framework by managing patients waiting at home for hospitalization due to lack of hospital and residential treatment center beds. HMS also could contribute a sense of psychological stability in patients and prevented the situation from worsening by efficient management of hospital beds and reduction of workloads on public healthcare centers. To stabilize and improve the management of COVID-19 confirmed cases, governments should organically develop self-treatment and HMS, and implement a decisive division of roles within the local governments.

Mental wellness among psychiatric-mental health nurses during the COVID-19 pandemic.

Psychiatric nursing providers and their unique challenges in the face of the COVID-19 pandemic are not well-represented in the literature. Therefore, this study sought to describe mental well-being of psychiatric nurses, and sought to elucidate factors related to mental wellness during the COVID-19 pandemic. This study utilized cross-sectional survey methodology to evaluate burnout, mental wellness, COVID-related anxiety, professional fulfillment, depressive symptoms, and anxiety symptoms among psychiatric nurses. There was a total of 151 respondents. A linear regression model was employed to identify predictors of mental wellness. The final regression model included the following predictors: depressive symptoms, burnout, professional fulfillment, and educational status. These predictors together accounted for 73% of the variance for the outcome variable of mental well-being.

Strategical Preparedness and Response Actions in the Healthcare System Against Coronavirus Disease 2019 according to Transmission Scenario in Korea.

The dynamic nature of coronavirus disease 2019 (COVID-19) pandemic requires us to be efficient and flexible in resource utilization. The strategical preparedness and response actions of the healthcare system are the key component to contain COVID-19 and to decrease its case fatality ratio. Depending on the epidemiological situation, each medical institution should systematically share the responsibility for patient screening, disposition and treatment according to clinical severity. To overcome fast-paced COVID-19 pandemic, the government should be rapidly ready and primed for action according to the specific transmission scenario.