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Aiming at the new coronavirus that appeared in 2019, which has caused a large number of infected patients worldwide due to its high contagiousness, in order to detect the source of infection in time and cut off the chain of transmission, we developed a new Chest X-ray (CXR) image classification algorithm with high accuracy, simple operation and fast processing for COVID-19. The algorithm is based on ConvNeXt pure convolutional neural network, we adjusted the network structure and loss function, added some new Data Augmentation methods and introduced attention mechanism. Compared with other classical convolutional neural network classification algorithms such as AlexNet, ResNet-34, ResNet-50, ResNet-101, ConvNeXt-tiny, ConvNeXt-small and ConvNeXt-base, the improved algorithm has better performance on COVID dataset.
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Recently, crowd counting has attracted significant attention, particularly in the context of the COVID-19 pandemic, due to its ability to automatically provide accurate crowd numbers in images. To address the challenges of location-level labeling, several transformer-based crowd counting methods have been proposed with only count-level supervision. However, these methods directly use the transformer as an encoder without considering the uneven crowd distribution. To address this issue, we propose CCTwins, a novel transformer-based crowd counting method with only count-level supervision. Specifically, we introduce an adaptive scene consistency attention mechanism to enhance the transformer-based model Twins-SVT-L for feature extraction in crowded scenes. Additionally, we design a multi-level weakly-supervised loss function that generates estimated crowd numbers in a coarse-to-fine manner, making it more appropriate for weakly-supervised settings. Moreover, intermediate features supervised by count-level labels are utilized to fuse multi-scale features. Experimental results on four public datasets demonstrate that our proposed method outperforms the state-of-the-art weakly-supervised methods, achieving up to a 16.6% improvement in MAE and up to a 13.8% improvement in RMSE across all evaluation settings. Moreover, the proposed CCTwins obtains competitive counting performance, even when compared to the state-of-the-art fully-supervised methods. IEEE
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Objective To analyze the epidemiological characteristics of community transmission of the coronavirus disease 2019 (COVID-19) caused by four imported cases in Hebei Province, and to provide a scientific basis for the prevention and control of the disease. Methods Descriptive epidemiological methods were used to analyze the epidemiological characteristics of four community-transmitted COVID-19 outbreaks reported in the China Disease Control and Prevention Information System from January 1, 2020 to December 31, 2021 in Hebei Province. Results From January 1, 2020 to December 31, 2021, four community-transmitted COVID-19 outbreaks caused by imported COVID-19 occurred in Hebei Province, respectively related of Hubei (Wuhan) Province, Beijing Xinfadi market, Overseas cases and Ejina banner of Inner Mongolia Autonomous Region. Total of 1 656 cases (1 420 confirmed cases and 236 asymptomatic cases) were reported, including 375 cases in phase A (From January 22 to April 16, 2020), and phase B (from June 14 to June 24, 2020) 27 cases were reported, with 1 116 cases reported in the third phase (Phase C, January 2 to February 14, 2021), and 138 cases reported in the fourth phase (Phase D, October 23 to November 14, 2021). The 1 656 cases were distributed in 104 counties of 11 districts (100.00%), accounting for 60.46% of the total number of counties in the province. There were 743 male cases and 913 female cases, with a male to female ratio of 0.81:1. The minimum age was 13 days, the maximum age was 94 years old, and the average age (median) was 40.3 years old. The incidence was 64.01% between 30 and 70 years old. Farmers and students accounted for 54.41% and 14.73% of the total cases respectively. Of the 1 420 confirmed cases, 312 were mild cases, accounting for 21.97%;Common type 1 095 cases (77.11%);There was 1 severe case and 12 critical cases, accounting for 0.07% and 0.85%, respectively. 7 patients died from 61.0 to 85.7 years old. The mean (median) time from onset to diagnosis was 1.9 days (0-31 days), and the mean (median) time of hospital stay was 15 days (1.5-56 days). Conclusions Four times in Hebei province COVID-19 outbreak in scale, duration, population, epidemic and type of input source, there are some certain difference, but there are some common characteristics, such as the outbreak occurs mainly during the legal holidays or after starting and spreading epidemic area is mainly in rural areas, aggregation epidemic is the main mode of transmission, etc. To this end, special efforts should be made to strengthen the management of people moving around during holidays, and strengthen the implementation of epidemic prevention and control measures in places with high concentration of people. To prevent the spread of the epidemic, we will step up surveillance in rural areas, farmers' markets, medical workers and other key areas and groups, and ensure early detection and timely response.Copyright © 2022 China Tropical Medicine. All rights reserved.
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[Background] Since the outbreak of the COVID-19 epidemic, staff of the centers for disease control and prevention (CDC) have been burdened with heavy epidemic prevention control, and excessive occupational stress can cause depression and other psychological problems. [Objective] To explore the status of occupational stress, resilience, and depression of CDC staff and potential relationships between them. [Methods] From December 2020 to April 2021, a survey was conducted at provincial and municipal levels, and the stratified cluster sampling method was used at county (district) level to select a total of 3 514 samples. Their occupational stress, resilience, and depression status were evaluated using the Chinese Effort-Reward Imbalance Scale (ERI), the Chinese Connor-Davidson Resilience Scale (CD-RISC), and the Patient Health Questionnaire (PHQ-9). Independent sample t test, analysis of variance, chi2 test, Pearson correlation analysis, and mediation test (structural equation model) were conducted. [Results] The positive rate of occupational stress was 34.29% in the CDC staff, the resilience score was 66.28+/-15.32, and the positive rate of depression was 48.58%. Significant differences were found in the positive rates of occupational stress among different groups of gender, age, education background, marital status, administrative duty, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P < 0.05);in the resilience scores among different groups of gender, age, administrative duty, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P < 0.05);in the positive rates of depression among different groups of gender, age, educational background, personal monthly income, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P < 0.05). Occupational stress was negatively correlated with resilience (r=-0.165, P < 0.01). Resilience was negatively correlated with depression (r=-0.383, P < 0.01). Occupational stress was positively correlated with depression (r=0.343, P < 0.01). The structural equation embracing a partial mediating effect of resilience on the relationship occupational stress and depression was established, and the partial mediating effect was 0.039, accounting for 10.46% of the total effect. [Conclusion] High positive rates of occupational stress, reduced resilience, and depression are shown among CDC staff in the context of the COVID-19 epidemic, and resilience partially mediates the effect of occupational stress on depression. The study findings suggest that improving resilience may reduce occupational stress and depression in CDC staff.Copyright © 2022, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.
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Tourism is linked to multiple dimensions, such as the economy, society, and environment, and the relationships among its influencing factors are complex, diverse, and overlapping. This study constructed an evaluation index system to measure the degree of coordinated development of tourism, transportation, and the regional economy, then built a tourism-transportation-based Spatial Durbin Model (SDM) regarding the process of the coordinated development of tourism in the Beijing-Tianjin-Hebei region (BTHR) from 2010 to 2020. This paper explains the current status of sustainable tourism development in the BTHR and the impact and spillover effects of transportation on tourism development. The results show that the normalized tourism coordinated development index (NTCDI) of the BTHR increased from 13.61 in 2010 to 18.75 in 2019, then decreased to 14.45 in 2020. The results of SDM show that different transportation modes have different spillover effects on tourism. Specifically, civil aviation transportation has a positive impact and significant spillover on a city's tourism revenue (TR), while high-speed railway transportation has a negative spillover effect. The model results also show that the degree of openness of the city and city economic development level have significant positive effects and spillover effects on tourism development. Finally, the implications of related variables are discussed, and some suggestions are put forward on tourism development in the BTHR. However, there are some limitations in this study. In the future, international cooperation and data sharing will be strengthened, and multivariate methods such as social network analysis, artificial intelligence, and machine learning will be further integrated to achieve accurate simulation and prediction of the spatial spillover effects of tourism transportation.
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Objective: To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon alpha-2b (rIFNalpha-2b) and the combination of lopinavir/ritonavir plus rIFNalpha-2b for patients with COVID-19 in Zhejiang province. Method(s): A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNalpha-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: <48 h, 3-5 d and >5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data. Result(s): The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2+/-4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0+/-5.0) d] (t=6.159, P<0.01). The length of hospital stay in the triple combination group [12.0 (9.0, 17.0) d] was also shorter than that in the dual combination group [15.0 (10.0, 18.0) d] (H=2.073, P<0.05). Compared with the antiviral treatment which was started within after the symptom onset of in the triple combination group, the time from the symptom onset to the viral negative conversion was 13.0 (10.0, 17.0), 17.0 (13.0, 22.0) and 21.0 (18.0, 24.0) d in subgroups of 48 h, 3-5 d and >5 d, respectively (Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8+/-3.9), (13.5+/-5.1) and (11.2+/-4.3) d, respectively(Z=6.722, P<0.05). Conclusion(s): The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNalpha-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy;and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy.Copyright © 2020 by the Chinese Medical Association.
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Objective: To evaluate the imaging features of CT scan in patients with COVID-19. Method(s): Clinical data of 56 patients with COVID-19 from January 17 to 19, 2020 admitted to Wenzhou Central Hospital and the Second Affiliated Hospital of Wenzhou Medical University were retrospectively reviewed. The clinical manifestations, lung imaging characteristics and treatment outcomes of patients with different severity were analyzed with SAS software. Result(s): Fever (92.8%, 52/56), dry cough (75.0%, 42/56) and asthenia (58.9%, 33/56) were the first symptoms in most of the patients;some patients also had shortness of breath (25.0%, 14/56) and pharyngeal pain (10.7%, 6/56). Chest high-resolution CT scan showed that in 42 moderate patients, ground glass-like high-density shadows in the lung were observed in 30 cases (71.4%);localized plaque consolidation shadows and bronchial inflation signs were observed in 10 cases (23.8%). In 12 severe patients, 11 had high-density patches involving multiple lung lobes (>=3). In 2 critically ill patients the patches and stripes involving the entire lung were observed;and cord-like high-density shadow, local consolidation and fibrosis were also shown. Conclusion(s): The multiple ground-glass changes outside the lungs are early imaging manifestations of COVID-19 patients. The increase in pulmonary lobe consolidation and fibrosis may indicate the disease progression, and the degree of lung consolidation and fibrosis is closely related to the disease severity.Copyright © 2020 by the Chinese Medical Association.
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The pandemic of coronavirus disease 2019 is "not over,"in fact, the "dynamic clearing"policy for SARS-CoV-2 control and prevention in China has been firmly enforced. This study aimed to analyze the clinical symptoms and dynamic viral RNA changes in 2021 at Guangzhou Eighth People's Hospital. This study showed that 31.4% of the patients (695/2212) tested negative for viral RNA from admission to the final release from quarantine. Of all negative cases, 86.5% (601/695) remained in the hospital for no more than 5 days and were asymptomatic or mild. Among the remaining 402 patients who stayed for no more than 5 days, 76.4% (307/402) were viral RNA retest positive during the isolation stage. However, 96.4% of the peak viral RNA (296/307) was over Ct = 33 cycles during the isolation stage. © Wolters Kluwer Health, Inc. All rights reserved.
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Objective: To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon alpha-2b (rIFNalpha-2b) and the combination of lopinavir/ritonavir plus rIFNalpha-2b for patients with COVID-19 in Zhejiang province. Method(s): A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNalpha-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: <48 h, 3-5 d and >5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data. Result(s): The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2+/-4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0+/-5.0) d] (t=6.159, P<0.01). The length of hospital stay in the triple combination group [12.0 (9.0, 17.0) d] was also shorter than that in the dual combination group [15.0 (10.0, 18.0) d] (H=2.073, P<0.05). Compared with the antiviral treatment which was started within after the symptom onset of in the triple combination group, the time from the symptom onset to the viral negative conversion was 13.0 (10.0, 17.0), 17.0 (13.0, 22.0) and 21.0 (18.0, 24.0) d in subgroups of 48 h, 3-5 d and >5 d, respectively (Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8+/-3.9), (13.5+/-5.1) and (11.2+/-4.3) d, respectively(Z=6.722, P<0.05). Conclusion(s): The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNalpha-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy;and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy.Copyright © 2020 by the Chinese Medical Association.
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Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide. Traditional Chinese Medicine (TCM) was considered important by Chinese health authorities in the fight against COVID-19. This review systematically analyzed and evaluated the safety and efficacy of TCM combined with Western Medicine (WM) for the treatment of COVID-19. We sought to provide summary evidence for clinicians when using TCM. We searched for studies in PubMed, Web of Science, Embase, Medline, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data from database inception to June 1, 2021. Overall, 31 studies (14,579 participants) were involved in the final systematic review, including 15 randomized controlled trials and 16 observational studies. TCM combined with WM showed main outcomes of a higher clinical efficacy rate (odds ratio [OR] =2.48, 95% confidence interval [CI] =1.90-3.24, I 2 = 4%) and lower case fatality rate (OR = 0.31, 95% CI = 0.19-0.49, I 2 = 80%) compared with WM treatment alone. No significant overall adverse events were found between TCM plus WM group and WM group (OR = 1.43, 95% CI = 0.63-2.23, I 2 = 75%). Some larger randomized control trials would assist in defining the effect of TCM combined with WM on the treatment of COVID-19 complications such as cardiac injury. TCM combined with WM may be safe and effective for the treatment of COVID-19. © 2022 Heart and Mind ;Published by Wolters Kluwer - Medknow.
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Objective: To evaluate the imaging features of CT scan in patients with COVID-19. Method(s): Clinical data of 56 patients with COVID-19 from January 17 to 19, 2020 admitted to Wenzhou Central Hospital and the Second Affiliated Hospital of Wenzhou Medical University were retrospectively reviewed. The clinical manifestations, lung imaging characteristics and treatment outcomes of patients with different severity were analyzed with SAS software. Result(s): Fever (92.8%, 52/56), dry cough (75.0%, 42/56) and asthenia (58.9%, 33/56) were the first symptoms in most of the patients;some patients also had shortness of breath (25.0%, 14/56) and pharyngeal pain (10.7%, 6/56). Chest high-resolution CT scan showed that in 42 moderate patients, ground glass-like high-density shadows in the lung were observed in 30 cases (71.4%);localized plaque consolidation shadows and bronchial inflation signs were observed in 10 cases (23.8%). In 12 severe patients, 11 had high-density patches involving multiple lung lobes (>=3). In 2 critically ill patients the patches and stripes involving the entire lung were observed;and cord-like high-density shadow, local consolidation and fibrosis were also shown. Conclusion(s): The multiple ground-glass changes outside the lungs are early imaging manifestations of COVID-19 patients. The increase in pulmonary lobe consolidation and fibrosis may indicate the disease progression, and the degree of lung consolidation and fibrosis is closely related to the disease severity.Copyright © 2020 by the Chinese Medical Association.
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In recent years, natural disasters have been raging around the world, among which COVID-19, a public health pandemic, is still spreading all over the world. Emergency material distribution (EMD) in rescue work is facing serious challenges in the term of coordination, efficiency, traceability, identification, credibility, and security, privacy, and transparency. To address the issues, this paper develops a framework based on blockchain technology so that the operation information of EMD can be safely and promptly transmitted to the blockchain system. The scheme could achieve to query, track and record the operation status of emergency material collection, vehicle scheduling, inventory management, relief material allocation and others in real time. By using this framework, a case study on medical rescue materials distribution for COVID-19 is provided to illustrate how blockchain technology and Internet of Things (IoT) technology can be effective. The research provides insights on using the disruptive blockchain technology to effectively coordinate the deployment of emergency supplies, vehicles and personnel, and improve the transparency and credibility of rescue work to minimize the losses caused by disasters. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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To compete with the speedy revolution of high technological innovation and restarted economy for the post-COVID-19 period in China, governments and organizations should be active in attracting high-tech talent to enhance independent and indigenous R&D capability. Talent agglomeration effectiveness is the strongest endogenous force pushing competitiveness for regional economy and industrial development. Due to the complexity of high-tech talent agglomeration, there are still considerable gaps to evaluate the incentive factors. This study evaluates the influential indicator system by using a hybrid fuzzy set theory extended Analytic Hierarchy Process (AHP) approach for proximity to reality from individual, organizational and environmental dimensions. The statistical analysis is adopted to verify the results of fuzzy AHP analysis. This research explores the founding that individual incentives are more important than environmental factors, and environmental incentives are more influential than organizational incentives. Job satisfaction, welfare system, and geographical location are the highest ranking factors. High-tech start-ups should give priority to combine geographical location with political support to reserve site selection or firm relocation for a great effectiveness of high-tech talent agglomeration. © 2022 Elsevier Ltd
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Currently, the significance of social media in disseminating noteworthy information on topics such as health, politics, and the economy is indisputable. During the COVID-19 pandemic, anti-vaxxers have used social media to distribute fake news and anxiety-provoking information about the vaccine. Such social media practice may harm the public. Here, we characterise the psycho-linguistic features of anti-vaxxers on the online social network Twitter. For this, we collected COVID-19 related tweets from February 2020 to June 2021 to analyse vaccination stance, linguistic features, and social network characteristics. Our results demonstrated that, compared to pro-vaxxers, anti-vaxxers tend to have more negative emotions, narrative thinking, and immoral tendencies. Furthermore, we found a tighter network structure in anti-vaxxers even after mass vaccination. This study can advance our understanding of the online anti-vaccination movement, and become critical for social media management and policy action during and after the pandemic.
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The COVID-19 pandemic changed behaviors, at least temporarily, and possibly more permanently, with implications for both work and leisure activities. Some of those behavioral changes, such as dining in restaurants, have significant ripple effects on businesses and employment. We investigate the response to health risks in China with a study of decisions about eating out during the pandemic. We find that compared to a traditional measure of financial risk attitude, dining out behavior better captures individuals' attitude toward the health risk posed by the pandemic and is more significant in predicting their expected total consumption during the recovery phase of the pandemic. In addition, we find that the effect of domestic in-migration is positive with respect to dining out, a signifier of confidence in the government response to the safety of internal flows. In contrast, international migration and port city of entry status are strongly negative with respect to dining out. The risk from the virus is perceived to be much stronger in such contexts. From a policy perspective establishing border controls was critical in re-creating a robust economy. Additional city and household level characteristics that affect dining-out behavior are also identified. © The Author(s) 2022.
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Toward efficient learning of massive publications during the COVID-19 pandemic, we propose a pipeline, Knowledge Extraction for COVID-19 Publications (KEP), that aims at automatic extraction and representation of key knowledge from user-interested publications. The first version, KEP-1.0, has been developed and published on the Python Package Index (PyPI) (URL: https://pypi.org/project/KEP/). In this first release, knowledge about key topics, disease discussions, and location mentions for each publication is provided. KEP-1.0 not only extracts relevant knowledge but, more importantly, emphasizes the top discussed entities and presents visualizable plots, including bar graphs and word clouds. This allows a rapid preliminary understanding of the main discussions in the publication from these three aspects. Moreover, an enhanced TF-IDF algorithm, the weighted TF-IDF, targeting the publication topic identification purpose, has been proposed and evaluated. The pipeline is fully open-sourced and customizable. KEP-1.0 is ready for use in its current form or to be embedded into existing literature platforms. This pipeline is designed for COVID-related publications, but it has the potential to benefit similar knowledge extraction tasks for other topics of interest with a rapidly increasing number of publications. © 2022 IEEE.
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The adverse impact of the outbreak of COVID-19 has reduced ports' operational efficiency. In addition, ports and inland logistics providers are generally independent of each other and difficult to work together, which leads to time loss. Thus, as the core player, ports can integrate with inland logistics providers to improve the efficiency and resilience of maritime supply chains. This study examines the strategic options of two competing maritime supply chains consisting of ports and inland logistics providers. We investigate the impact of cooperation between ports and inland logistics providers and government regulation on the maritime supply chain by comparing members' optimal pricing and overall social welfare under centralized, decentralized, and hybrid scenarios. Results indicate that the hybrid scenario is an equilibrium strategy for maritime supply chain, although this strategy is not optimal for governments seeking to improve supply chain resilience and maximize social welfare. Furthermore, observations show that through government economic intervention, both seaborne supplies can be incentivized to adopt an integrated strategy, and business and society can achieve a win-win situation.
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Objective To analyze the epidemiological characteristics of community transmission of the coronavirus disease 2019 (COVID-19) caused by four imported cases in Hebei Province, and to provide a scientific basis for the prevention and control of the disease. Methods Descriptive epidemiological methods were used to analyze the epidemiological characteristics of four community-transmitted COVID-19 outbreaks reported in the China Disease Control and Prevention Information System from January 1, 2020 to December 31, 2021 in Hebei Province. Results From January 1, 2020 to December 31, 2021, four community-transmitted COVID-19 outbreaks caused by imported COVID-19 occurred in Hebei Province, respectively related of Hubei (Wuhan) Province, Beijing Xinfadi market, Overseas cases and Ejina banner of Inner Mongolia Autonomous Region. Total of 1 656 cases (1 420 confirmed cases and 236 asymptomatic cases) were reported, including 375 cases in phase A (From January 22 to April 16, 2020), and phase B (from June 14 to June 24, 2020) 27 cases were reported, with 1 116 cases reported in the third phase (Phase C, January 2 to February 14, 2021), and 138 cases reported in the fourth phase (Phase D, October 23 to November 14, 2021). The 1 656 cases were distributed in 104 counties of 11 districts (100.00%), accounting for 60.46% of the total number of counties in the province. There were 743 male cases and 913 female cases, with a male to female ratio of 0.81∶1. The minimum age was 13 days, the maximum age was 94 years old, and the average age (median) was 40.3 years old. The incidence was 64.01% between 30 and 70 years old. Farmers and students accounted for 54.41% and 14.73% of the total cases respectively. Of the 1 420 confirmed cases, 312 were mild cases, accounting for 21.97%;Common type 1 095 cases (77.11%);There was 1 severe case and 12 critical cases, accounting for 0.07% and 0.85%, respectively. 7 patients died from 61.0 to 85.7 years old. The mean (median) time from onset to diagnosis was 1.9 days (0-31 days), and the mean (median) time of hospital stay was 15 days (1.5-56 days). Conclusions Four times in Hebei province COVID-19 outbreak in scale, duration, population, epidemic and type of input source, there are some certain difference, but there are some common characteristics, such as the outbreak occurs mainly during the legal holidays or after starting and spreading epidemic area is mainly in rural areas, aggregation epidemic is the main mode of transmission, etc. To this end, special efforts should be made to strengthen the management of people moving around during holidays, and strengthen the implementation of epidemic prevention and control measures in places with high concentration of people. To prevent the spread of the epidemic, we will step up surveillance in rural areas, farmers′ markets, medical workers and other key areas and groups, and ensure early detection and timely response. © 2022 China Tropical Medicine. All rights reserved.