ABSTRACT
Objective To assess the cost of launching telemedicine services by Peking Union Medical College Hospital (PUMCH) during coronavirus disease 2019 pandemic. Methods The patients using telemedicine services were enrolled during the period of pilot run from February 10th to April 15th, 2020. The study was done from the social perspective. A decision-tree model was constructed to compare the costs between telemedicine services and conventional clinical services for outpatients. The main outcome was measured as incre- mental cost-effective ness ratios (ICER). Sensitivity analysis was conducted by using one-way sensitivity analysis. Results During a period of forty-seven days, the online fever clinic was applied 3055 person-times(2070 patients) and the online outpatient clinic were applied 36 549 person-times(20 467 patients). On average, 44 febrile cases/d and 435 nonfebrile cases/d were reduced in the outpatient clinic. It helped to reduce roughly 1/4 (febrile) and 1/5(nonfebrile) of total numbers of the patients in the outpatient clinic during the peak period of the epidemic. If calculated according to the actual free-of-charge condition, the ICER was -64.7 yuans/person-time. If the actual cost of each consultant of telemedicine service was estimated according to the level of outpatient-service fee, the ICER was -5.5 yuans/person-time. The results of sensitivity analysis showed that the main factors affecting the ICERs were transportation cost, lost wages, and the efficiency of telemedicine services. Conclusions Launching telemedicine services helped to relieve the pressure at the outpatient clinics, and has the potential to provide significant cost saving compared to conventional clinic services for outpatients. It is worth considering applying this practice widely in the medical and health services.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.
ABSTRACT
The declaration of COVID-19 as a pandemic has largely amplified the spread of related information on social platforms, such as Twitter, Facebook and WeChat. In this work, we investigate how the disease and information co-evolve in the population. We focus on COVID-19 and its information during the period when the disease was widely spread in China, i.e., from January 25th to March 24th, 2020. The co-evolution between disease and information is explored via the spatial analysis of the two spreading processes. We visualize the geo-location of both disease and information at the province level and find that disease is more geo-localized compared to information. High correlation between disease and information data is observed, and also people care about the spread of disease only when it comes to their neighborhood. Regard to the content of the information, we obtain that positive messages are more negatively correlated with the disease compared to negative and neutral messages. Additionally, two machine learning algorithms, i.e., linear regression and random forest, are introduced to further predict the number of infected using characteristics, such as disease spatial related and information-related features. We obtain that both the disease spatial related characteristics of nearby cities and information-related characteristics can help to improve the prediction accuracy. The methodology proposed in this paper may shed light on new clues of emerging infections prediction. © 2013 IEEE.
ABSTRACT
Objective To assess the cost of launching telemedicine services by Peking Union Medical College Hospital (PUMCH) during coronavirus disease 2019 pandemic. Methods The patients using telemedicine services were enrolled during the period of pilot run from February 10th to April 15th, 2020. The study was done from the social perspective. A decision-tree model was constructed to compare the costs between telemedicine services and conventional clinical services for outpatients. The main outcome was measured as incre- mental cost-effective ness ratios (ICER). Sensitivity analysis was conducted by using one-way sensitivity analysis. Results During a period of forty-seven days, the online fever clinic was applied 3055 person-times(2070 patients) and the online outpatient clinic were applied 36 549 person-times(20 467 patients). On average, 44 febrile cases/d and 435 nonfebrile cases/d were reduced in the outpatient clinic. It helped to reduce roughly 1/4 (febrile) and 1/5(nonfebrile) of total numbers of the patients in the outpatient clinic during the peak period of the epidemic. If calculated according to the actual free-of-charge condition, the ICER was -64.7 yuans/person-time. If the actual cost of each consultant of telemedicine service was estimated according to the level of outpatient-service fee, the ICER was -5.5 yuans/person-time. The results of sensitivity analysis showed that the main factors affecting the ICERs were transportation cost, lost wages, and the efficiency of telemedicine services. Conclusions Launching telemedicine services helped to relieve the pressure at the outpatient clinics, and has the potential to provide significant cost saving compared to conventional clinic services for outpatients. It is worth considering applying this practice widely in the medical and health services. © 2021, Peking Union Medical College Hospital. All rights reserved.
ABSTRACT
On the eve of the Spring Festival in 2020, the coronavirus disease 2019 (COVID-19) was reported. Subsequently, the Chinese government at all levels took emergency measures to control the spread of COVID-19 among people. Guangdong and Hunan are large population floating provinces. The spread of COVID-19 is affected by population migration. Before the Spring Festival, Guangdong and Hunan Provinces dominated population export and import, respectively;after the Spring Festival, the trend of population flow was reversed by the resumption of work. Taking Guangdong and Hunan as examples, we establish a three-stage dynamical model to study the impact of population migration on the spread of COVID-19. The result reveals that Guangdong Province mainly emigrated the population and the scale of infection was reduced before the Spring Festival. However, the situation in Hunan Province was just the opposite. After the Spring Festival, work resumption was taking place across China and the migration of Guangdong may cause a second outbreak of the epidemic. While people in Hunan leave the province to work, the migration of population will have little effect on the spread of COVID-19. © Copyright © 2020 Xing, Li, Li and Sun.
ABSTRACT
As of July 21, 2020, the coronavirus SARS-CoV-2 had spread to almost all countries around the world and caused more than 14.8 million confirmed cases, owing to its high transmissibility and fast rate of spread. Of the infected locations, the Diamond Princess cruise ship is special in that it is an isolated system with a population highly concentrated in a limited space, providing particularly favorable conditions for the transmission of the novel coronavirus-associated pneumonia, COVID-19. The Japanese government's emergency measures for controlling the spread of COVID-19 on the cruise ship have also been questioned. In this paper we develop a homogeneous mixed difference system to describe the mechanism of transmission of COVID-19 on the cruise ship, reverse-predict the epidemic transmission trend from January 20 to February 20, 2020, including the daily number of infected people and the peak time of infection, estimate the range of the basic reproduction number of virus transmission on the cruise ship, and assess the effects of prevention and control measures. It is concluded that the isolation of people, along with rapid and comprehensive detection of infections, play an important role in controlling the epidemic. In fact, the Japanese government's emergency measures did have a certain effect on limiting the spread of COVID-19, but the number of infected people could have been reduced by at least 60% if all personnel on the cruise ship had been tested and isolated promptly as early as February 5. © Copyright © 2020 Zhang, Sun, Li, Gao, Ren, Pei and Jin.
ABSTRACT
OBJECTIVE: Lopinavir/ritonavir has modest antiviral activity against severe acute respiratory syndrome coronavirus 2. The aim was to investigate the viral kinetics and factors associated with viral clearance during lopinavir/ritonavir-based combination treatment in non-severe patients. PATIENTS AND METHODS: Sixty-four patients were retrospectively enrolled. Viral RNA was detected by real-time RT-PCR assay from sputum or throat swab samples at different time points. The patterns of viral kinetics were characterized, and factors associated with rapid viral clearance, which was defined as viral RNA undetectable within two weeks, were analyzed using multivariate logistic regression analyses. RESULTS: All patients achieved viral RNA negativity and were discharged from the hospital. Furthermore, 48 (75%) and 16 (25%) patients achieved rapid and delayed viral clearance, respectively. The lymphocyte counts of rapid viral clearance patients (1.40 [1.20-1.80] × 109/L) were higher, when compared to delayed viral clearance patients (1.00 [0.70-1.47] × 109/L) (p=0.024). The multivariate logistic analysis revealed that high lymphocyte count (≥1.3×109/L) is an independent factor associated with rapid viral clearance (OR=7.62, 95% CI=1.15-50.34, p=0.035). CONCLUSIONS: The viral shedding exhibited different patterns during treatment. Immune insufficiency is responsible for the delayed viral clearance, suggesting that an immunomodulator should be considered to promote viral clearance in patients with low lymphocyte counts.