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Background. Protection offered by five different forms of immunity, combining natural and vaccine immunity, was investigated against symptomatic SARS-CoV-2 infection from Omicron BA.1 or BA.2, and severe, critical, or fatal COVID-19 from BA.1 or BA.2, in Qatar, between December 23, 2021 and February 21, 2022. Methods. Six national, matched, test-negative case-control studies were conducted on a sample of 272,861 PCR-positive tests and 669,628 PCR-negative tests to estimate effectiveness of BNT162b2 (Pfizer-BioNTech) vaccine, mRNA-1273 (Moderna) vaccine, natural immunity due to prior infection with pre-Omicron variants, and hybrid immunity from prior infection and vaccination. Results. Effectiveness of prior infection alone against symptomatic BA.2 infection was 46.1% (95% CI: 39.5-51.9%). Effectiveness of two-dose BNT162b2 vaccination alone was negligible at -1.1% (95% CI: -7.1-4.6), but nearly all individuals received their second dose >6 months earlier. Effectiveness of three-dose BNT162b2 vaccination alone was 52.2% (95% CI: 48.1-55.9%). Effectiveness of hybrid immunity of prior infection and two-dose BNT162b2 vaccination was 55.1% (95% CI: 50.9-58.9%). Effectiveness of hybrid immunity of prior infection and three-dose BNT162b2 vaccination was 77.3% (95% CI: 72.4-81.4%). Meanwhile, prior infection, BNT162b2 vaccination, and hybrid immunity all showed strong effectiveness ( >70%) against severe, critical, or fatal COVID-19 due to BA.2. Similar patterns of effectiveness were observed for BA.1 and for the mRNA-1273 vaccine. Conclusion. There are no discernable differences between BA.1 and BA.2 in the effects of prior infection, vaccination, and hybrid immunity. Vaccination enhances the protection of those with a prior infection. Hybrid immunity resulting from prior infection and recent booster vaccination conferred the strongest protection.
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With the normalization of COVID-19 epidemic prevention and control, big data analysis technology has become an important support for scientific and accurate prevention and control. As a transportation means for water traffic, ship management plays an important role in the whole COVID-19 epidemic prevention system. It is the key to improve the efficiency of water traffic epidemic prevention to identify and track the key ships. To improve the efficiency and accuracy of key ships identification and tracking in epidemic prevention and control, a real-time ship tracking and control platform for epidemic prevention is proposed. By fusing the multi-source information, the platform changes the epidemic prevention way of water traffic from the manual query method to the data analysis method. The platform has been applied in the local maritime regulatory department, and it improves the identifying, tracking and control efficiency of key ships. © 2022 IEEE.
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Objective: To investigate the detection effect and danamic changes of total antibodies and IgM antibodies of Novel Coronavirus (SARS⁃CoV⁃2) by chemiluminescence microparticle immunoassay. Methods: The confirmed COVID⁃19 group consisted of 197 patients admitted in the Zhongnan Hospital of Wuhan University, including 24 patients who with negative nucleic acid tests but confirmed by clinical symptoms and CT tests. In addition,142 patients without COVID⁃19 were set as control group. The total antibodies and IgM antibodies in the blood samples of these patients were detected by chemiluminescence. From all subjects involved in this study, we collected 242 samples for antibodies test and 853 nucleic acid test samples of all diagnosed patients at different onset times, and conducted statistical analysis on the test results of samples at different onset time points. Results: The clinical detection sensitivity respectively for total SARS⁃CoV⁃2 antibodies and IgM antibodies was 97.97% and 82.23%, respectively, and the clinical specificity was 98.59% and 100%, respectively. The detection rate of patient⁃specific total antibodies increased with time, and the detection rate of IgM antibodies showed a trend of first increasing and then decreasing. The 24 patients with negative nucleic acid tests included 24 cases had positive SARS⁃CoV⁃2 total antibodies and 21 cases had positive IgM⁃specific antibodies. Conclusion: Both detection methods have good specificity and sensitivity. The total SARS⁃CoV⁃2 total and IgM antibodies can be used as effective indicators for SARS⁃CoV⁃2 infection, but it is not suitable for early diagnosis. © 2022, Editorial Board of Medical Journal of Wuhan University. All right reserved.
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Purpose : Routine use of face masks for both patients and physicians during intravitreal anti-vascular endothelial growth factor (VEGF) injections has increased with the emergence of the COVID-19 pandemic. This study evaluates the impact of physician, ancillary staff, and patient face mask use on rates and outcomes of post-injection endophthalmitis. Methods : In this retrospective comparative cohort study, all eye receiving intravitreal antiVEGF factor injections from 10/1/2019 to 7/31/2020 were included from twelve centers. Cases were divided into a no face mask group if no face masks were worn by the physician or patient during intravitreal injections or a universal face mask group if face masks were worn by the physician, ancillary staff, and patient during intravitreal injections. The main outcome measures were rate of endophthalmitis, visual acuity, and microbial spectrum. Results : Of 505,968 intravitreal injections administered, 85 of 294,514 (0.0289%;1 in 3,464 injections) cases of endophthalmitis occurred in the no face mask group, and 45 of 211,454 (0.0213%;1 in 4,699 injections) cases occurred in the universal face mask group (odds ratio, 0.74;95%CI, 0.51-1.18;p=0.097;Table 1). In the no face mask group, there were 27 cases (0.0092%;1 in 10,908 injections) of culture-positive endophthalmitis compared to 9 cases (0.004%;1 in 23,494 injections) in the universal face mask group (OR, 0.46;95%CI, 0.22-0.99;p=0.041). Three cases of oral flora-associated endophthalmitis occurred in the no face mask group (0.001%;1 in 98,171 injections) compared to one (0.0005%;1 in 211,454) in the universal face mask group (p=0.645). At endophthalmitis presentation, mean logMAR visual acuity was 2.04 for no face mask group compared to 1.65 for the universal face mask group (p=0.022), although no difference was observed three months after treatment (p=0.764;Table 2). Conclusions : Universal face mask use during intravitreal anti-VEGF injections did not show a statistically significant reduction in presumed endophthalmitis, but there was a reduced rate of culture-positive endophthalmitis. Future studies are warranted to assess the role of face mask use to reduce endophthalmitis risk, particularly that due to oral flora.
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In contemporary China, the rapidly urbanized cities are exposed to a broad range of natural and human-made emergencies, such as COVID-19. Responding to emergencies successfully requires widespread participation of local government sectors that engages in diversified collaboration behav-iors across organizational boundaries for achieving sustainability. However, the multi-organizational collaborative process is highly dynamic and complex, as well as its outcomes are uncertain under-lying the emergency response network. Examining characteristics of the collaborative process and exploring how collaborative behaviors local governmental sectors engaging in the impact their perceived outcomes is essential to understand how disastrous situations are addressed by collaborative efforts in emergency management. This research investigates diversified collaborative behaviors in emergency response and then examines this using a multi-dimensional model consisting of joint decision making, joint implementation, compromised autonomy, resource sharing, and trust building. We surveyed 148 local governments and their affiliated sectors in China in-depth understanding how collaborative processes contribute to perceived outcomes from perspectives of participating sectors in the context of a centralized political-administrative system. A structural equation model (SEM) is employed to encode multiple dimensions of the collaborative process, perceived outcomes, as well as their relationships. The empirical finding indicates that joint decision making and implementation positively affect the perceived outcomes significantly. The empirical results indicate that joint decision making and joint implementation affect perceived outcomes significantly. Instead, resource sharing and trust building do not affect the outcomes positively as expected. Additionally, compromised autonomy negatively affects the collaborative outcomes. We also discuss the institutional advantages for achieving successful outcomes in emergency management in China by reducing the degree of compromised autonomy. Our findings provide insight that can improve efforts to build and maintain a collaborative process to respond to emergencies. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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China and the United States (US) have established respective cultural institutions in each other, namely the Confucius Institute and the American Cultural Centre. While they differ in the establishment background and management model, in their counterpart countries' view, both Confucius Institutes and American Cultural Centres serve the function of public diplomacy as a 'quasi-diplomatic agency', attracting extensive political attention. When comparing the history of their developments in the US and China, a similar trend of 'rise-to-fall' and 'positivity-to-negativity' can be observed. The stagnation of American Cultural Centres in China and the crisis of Confucius Institutes in the US both originate from the same source - political pressure. The development paths of both institutions are closely related to the development and transformation of Sino-US political relations. In this process, China's attitude is relatively moderate in an attempt to maintain the continuous development of a friendly bilateral relation, while the US is anxious about China's rising status as its economic and strategic competitor, thereby adjusting its China policy and imposing rigid political controls over Confucius Institutes. Affected by the Sino-US trade dispute and the COVID-19 pandemic, Sino-US relations deteriorate further;accordingly, the future outlook of Confucius Institutes in the US is worrying. However, with abundant uncertainties, the future of the Confucius Institute remains to be further studied.
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Objective: To analyze the clinical characteristics and control methods of coronavirus disease 2019 (COVID-19) complicated with venous thromboembolism(VTE), and to provide scientific basis for disease prevention, diagnosis and treatment. Methods: We retrospectively studied the cases of COVID-19 complicated with VTE in Renmin Hospital of Wuhan University from January 30, 2020 to March 19, 2020, and their clinical features, results of exmaninations, treatment methods, complications, and prognosis were reviewed. Results: Among the 1 448 COVID-19 patients, 17(1.17%) were VTE positive, 60-69 years old patients were more common. The main clinical types were critical (64.7%) and severe (35.7%) types. The main clinical symptoms were lower extremity swelling (70.6%) and pain (35.7%);58.8% of the patients had a history of high risk factors related to VTE. Most VTE patients were peripheral (58.8%) and involved bilateral limbs (41.2%). The proportion of neutrophils, D-dimer and fibrin degradation products at the last examination were lower than those on admission to the hospital, while the total number and proportion of lymphocytes were higher. Of the 17 VTE cases, 64.7% received venous catheterization, 58.8% received endotracheal intubation or tracheotomy, and 2 patients received extracorporeal membrane oxygenation (ECMO). The rate of bleeding was as high as 53%, and the risk of cardiovascular and cerebrovascular accidents was very high;the prognosis of the patients was poor, and the mortality rate was 23.5%. The cure rate was 17.6%, and the improvement rate was 47.1%. Two patients were still in critically ill. Conclusion: Venous thromboembolism was common in elderly COVID-19 patients with severe types and critical types. Most patients were male and characterized by atypical symptoms, and the early active VTE risk assessment and prevention procedures should be adopted. The risk for bleeding and cardiovascular/cerebrovascular accidents was high, although most cases had good outcomes after active treatment. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
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The COVID-19 pandemic has refocused attention worldwide on the dangers of infectious diseases, in terms of both global health and the effects on the world economy. Even in high income countries, health systems have been found wanting in dealing with the new infectious agent. However, the even greater long-term danger of antimicrobial resistance in pathogenic bacteria and fungi is still under-appreciated, especially among the general public. Although antimicrobial drug development faces significant scientific challenges, the gravest challenge at the moment appears to be economic, where the lack of a viable market has led to a collapse in drug development pipelines. There is therefore a critical need for governments across the world to further incentivize the development of antimicrobials. Most incentive strategies over the past decade have focused on so-called "push" incentives that bridge the costs of antimicrobial research and development, but these have been insufficient for reviving the pipeline. In this Perspective, we analyze the current incentive strategies in place for antimicrobial drug development, and focus on "pull" incentives, which instead aim to improve revenue generation and thereby resolve the antimicrobial market failure challenge. We further analyze these incentives in a broader "One Health" context and stress the importance of developing and enforcing strict protocols to ensure appropriate manufacturing practices and responsible use. Our analysis reiterates the importance of international cooperation, coordination across antimicrobial research, and sustained funding in tackling this significant global challenge. A failure to invest wisely and continuously to incentivize antimicrobial pipelines will have catastrophic consequences for global health and wellbeing in the years to come.
Subject(s)
COVID-19 , Drug Resistance, Bacterial , Anti-Bacterial Agents/pharmacology , Drug Development , Government , Humans , Motivation , Pandemics , SARS-CoV-2ABSTRACT
Objective: To compare the chemiluminescence and colloidal gold method in the detection of 2019 novel Coronavirus (2019-nCoV, or SARS-CoV-2) specific antibody and to evaluate the importance in the diagnosis and treatment of COVID-19. Methods: A total of 191 cases of diagnosed and suspected COVID-19 patients admitted in Febrary 2020 in Wuhan Leishenshan Hospital were included. The patients were divided into 2019-nCoV continuous positive group, 2019-nCoV positive to negative group, and 2019-nCoV suspect group according to the results of pharyngeal swab 2019-nCoV nucleic acid detection. In addition, 27 patients without COVID-19 were set as control group to test the specificity. The serum samples were collected, and colloidal gold and chemiluminescence method were used to detect total antibodies (IgM+IgG) and IgM. SPSS 24.0 was used to compare the difference in antibody detection rates between the two methods. Results: The specificity of total antibodies (IgM+IgG) and IgM detection was 100%. Two methods of total antibody detection had no significant difference in continuous positive group (P=1.00). In positive to negative group and suspect group, the positive detection rate of chemiluminescence method was significantly higher than colloidal gold method (95.2% vs 76.2% and 94.9% vs 70.5%, respectively, both P0.05). The chemiluminescence method showed no significant difference between the three groups in IgM detection (P0.05). Conclusion: The detection of 2019-nCoV specific antibody can be an important supplemental method to pharyngeal swab 2019-nCoV nucleic acid detection during the diagnosis and treatment of COVID-19. The chemiluminescence method is better than colloidal gold method in the detection of total antibody. The IgM detection using chemiluminescence method is suitable for all stages of the disease. © 2020, Editorial Board of Medical Journal of Wuhan University. All right reserved.