Risk assessment of imported COVID-19 in China: A modelling study in Sichuan Province.

The importation of COVID-19 cases in China is due to the returning of Chinese citizens abroad, where the majority of cases stand. This study aimed to evaluate the risk of importing COVID-19 into the Sichuan Province of China and conduct a short-term risk prediction assessment and analysis. Data on COVID-19 cases in each country and Sichuan were collected, as well as visitors to Sichuan, population, area, and medical resources in each city in Sichuan province. According to different control strategies of entry aviation and quarantine control, we built models of epidemic transmission to estimate the risk for imported COVID-19 cases in 21 cities of Sichuan. Within 140 days of the policy change's implementation, the number of susceptible, infected, and recovered people in all cities followed the same pattern over time: (1) the number of susceptible people declined slowly at first, then accelerated to reach a stable value; (2) the number of infections gradually increased to a peak, then decreased; and (3) the number of recovered patients gradually increased to a stable value. Under the four different scenarios, there were no significant differences between the risk peaks because the social distance did not change. However, the peak time would be delayed due to the implementation of flight control and nucleic acid detection measures. The improvement of foreign epidemics (reduction of attenuation factors) all delayed the arrival of the peak risk value in Chengdu by about 20 days; however, the size of the peak value did not change significantly. The improvement of nucleic acid detection accuracy delayed the arrival of the peak risk value in Chengdu, but the size of the peak value did not change significantly. Therefore, flight control and the improvement of nucleic acid detection accuracy and overseas epidemic situations have positively affected the prevention and control of the epidemic in Sichuan.

Innovations in Public Health Surveillance for Emerging Infections.

Public health surveillance is defined as the ongoing, systematic collection, analysis, and interpretation of health data and is closely integrated with the timely dissemination of information that the public needs to know and upon which the public should act. Public health surveillance is central to modern public health practice by contributing data and information usually through a national notifiable disease reporting system (NNDRS). Although early identification and prediction of future disease trends may be technically feasible, more work is needed to improve accuracy so that policy makers can use these predictions to guide prevention and control efforts. In this article, we review the advantages and limitations of the current NNDRS in most countries, discuss some lessons learned about prevention and control from the first wave of COVID-19, and describe some technological innovations in public health surveillance, including geographic information systems (GIS), spatial modeling, artificial intelligence, information technology, data science, and the digital twin method. We conclude that the technology-driven innovative public health surveillance systems are expected to further improve the timeliness, completeness, and accuracy of case reporting during outbreaks and also enhance feedback and transparency, whereby all stakeholders should receive actionable information on control and be able to limit disease risk earlier than ever before.

Impact of Implementing and Lifting COVID-19 Lockdown on Study and Physical Activity Patterns Among Youths in China.

OBJECTIVE: The youths' study and physical activity (PA) patterns may have been affected by lockdown measures due to COVID-19. This study aimed to reveal how youths' study and PA patterns had changed after implementing and lifting COVID-19 lockdown in China. METHODS: The COVID-19 Impact on Lifestyle Change Survey (COINLICS) was used, where 10082 youth participants voluntarily reported their study and PA patterns in the 3 periods before, during, and after COVID-19 lockdown. PA was measured as the weekly frequency of engaging in active transport for commuting/errands, leisure-time walking, leisure-time moderate-/vigorous-intensity physical activity (MVPA), and moderate-/vigorous-intensity housework (MVH); study patterns were measured as the daily average study time and the major study modes. We assessed differences of these variables across educational levels, sex, and periods. RESULTS: The significant decreases were generally observed during lockdown in the frequency of active transport for commuting/ errands (1.3 to 0.2 days/ week), leisure-time walking (1.0 to 0.2 days/ week), leisure-time MVPA (0.7 to 0.3 days/ week), and MVH (2.3 to 2.0 days/ week), with heterogeneities existing between sexes and across educational levels, except for the increase in MVH engagement among graduate students, especially female (1.5 to 2.4 days/ week). Rebounds were observed in the frequency of all activities except MVH after lifting lockdown (2.0 to 1.9 days/ week). The average study time generally increased during lockdown, with more youths studying for 1 - 4 hours/ day and less studying for < 1 hour/ day, and further increased after lockdown. A main shift of study modes has been from in-class to online study after implementing lockdown. CONCLUSIONS: The youths' PA level have generally decreased, and study patterns significantly changed during and after lockdown in China. Our results would inform policymakers and educational administrators of the declined PA levels and changed study patterns among youths during COVID-19 lockdown for better policy making. In - class and/ or extracurricular PA programs could be designed to counteract those effects under cooperation of youths' parents.

Global spreading of Omicron variant of COVID-19.

Although two years have passed since the coronavirus disease 2019 (COVID-19) outbreak, various variants are still rampant across the globe. The Omicron variant, in particular, is rapidly gained dominance through its ability to spread. In this study, we elucidated the spatial distribution pattern of Omicron from a global perspective. We used the cumulative number of notified COVID-19 cases per country spanning four weeks up to February 10, 2022, and the proportion of the Omicron variant genomic sequences from the Global Initiative on Sharing Avian Influenza Data (GISAID). The global spatial distribution of Omicron was investigated by analyzing Global & Local Moran's I and Getis- Ord General G. The spatial weight matrix was defined by combining K-Nearest neighbour and flight connectivity between countries. The results showed that the epidemic is relatively severe in Europe, countries with a high number of Omicron cases and incidence tended to be clustered spatially. In contrast, there are relatively fewer Omicron cases in Asia and Africa, with few hotspots identified. Furthermore, some noted spatial outliers, such as a lowvalue area surrounded by high-value areas, deserve special attention. This study has improved our awareness of the global distribution of Omicron. The findings can provide helpful information for deploying targeted epidemic preparedness for the subsequent COVID-19 variant and future epidemics.

Associations between nighttime light and COVID-19 incidence and mortality in the United States.

COVID-19 has caused almost 770,000 deaths in the United States by November 2021. The nighttime light (NTL), representing the intensity of human activities, may reflect the degree of human contacts and therefore the intensity of COVID-19 transmission. This study intended to assess the associations between NTL differences and COVID-19 incidence and mortality among U.S. counties. The COVID-19 data of U.S. counties as of 31 December 2020 were collected. The average NTL values for each county in 2019 and 2020 were derived from satellite data. A negative binomial mixed model was adopted to assess the relationships between NTL intensity and COVID-19 incidence and mortality. Compared to the counties with the lowest NTL level (0.14-0.37 nW/cm2/sr), those with the highest NTL level (1.78-59.61 nW/cm2/sr) were related with 15% higher mortality rates (mortality rate ratio:1.15, 95 %CI: 1.02-1.30, p-value: 0.02) and 23% higher incidence rates (incidence rate ratio:1.23, 95 %CI: 1.13-1.34, p-value < 0.0001). Our study suggested that more intensive NTL was related with higher incidence and mortality rates of COVID-19, and NTL had a stronger correlation with the COVID-19 incidence rate than mortality rate. Our findings have contributed solid epidemiological evidence to the existing COVID-19 knowledge pool, and would help policymakers develop interventions when faced with the potential risk of the following outbreaks.

Spatiotemporal disparities in regional public risk perception of COVID-19 using Bayesian Spatiotemporally Varying Coefficients (STVC) series models across Chinese cities.

Regional public attention has been critical during the COVID-19 pandemic, impacting the effectiveness of sub-national non-pharmaceutical interventions. While studies have focused on public attention at the national level, sub-national public attention has not been well investigated. Understanding sub-national public attention can aid local governments in designing regional scientific guidelines, especially in large countries with substantial spatiotemporal disparities in the spread of infections. Here, we evaluated the online public attention to the COVID-19 pandemic using internet search data and developed a regional public risk perception index (PRPI) that depicts heterogeneous associations between local pandemic risk and public attention across 366 Chinese cities. We used the Bayesian Spatiotemporally Varying Coefficients (STVC) model, a full-map local regression for estimating spatiotemporal heterogeneous relationships of variables, and improved it to the Bayesian Spatiotemporally Interacting Varying Coefficients (STIVC) model to incorporate space-time interaction non-stationarity at spatial or temporal stratified scales. COVID-19 daily cases (median contribution 82.6%) was the most critical factor affecting public attention, followed by urban socioeconomic conditions (16.7%) and daily population mobility (0.7%). After adjusting national and provincial impacts, city-level influence factors accounted for 89.4% and 58.6% in spatiotemporal variations of public attention. Spatiotemporal disparities were substantial among cities and provinces, suggesting that observing national-level public dynamics alone was insufficient. Multi-period PRPI maps revealed clusters and outlier cities with potential public panic and low health literacy. Bayesian STVC series models are systematically proposed and provide a multi-level spatiotemporal heterogeneous analytical framework for understanding collective human responses to major public health emergencies and disasters.

Cultivating resilience during the COVID-19 pandemic: A socioecological perspective

The coronavirus disease 2019 (COVID-19) pandemic poses wide-ranging impacts on the physical and mental health of people around the world, increasing attention from both researchers and practitioners on the topic of resilience. In this article, we review previous research on resilience from the past several decades, focusing on how to cultivate resilience during emerging situations such as the COVID-19 pandemic at the individual, organizational, community, and national levels from a socioecological perspective. Although previous research has greatly enriched our understanding of the conceptualization, predicting factors, processes, and consequences of resilience from a variety of disciplines and levels, future research is needed to gain a deeper and comprehensive understanding of resilience, including developing an integrative and interdisciplinary framework for cultivating resilience, developing an understanding of resilience from a life span perspective, and developing scalable and cost-effective interventions for enhancing resilience and improving pandemic preparedness. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Spatiotemporal epidemiology of COVID-19 from an epidemic course perspective.

Although coronavirus disease 2019 (COVID-19) remains rampant in many countries, it has recently waned in Sichuan, China. This study examined spatiotemporal variations of the epidemiological characteristics of COVID-19 across its course. Three approaches, i.e. calendar-based, measure-driven and data-driven ones, were applied to all individual cases reported as of 30th November 2020, dividing the COVID-19 pandemic into five periods. A total of 808 people with confirmed diagnosis and 279 asymptomatic cases were reported, the majority of whom were aged 30-49 and <30 years, respectively. The highest risk was seen in Chengdu (capital city), with 411 confirmed and 195 asymptomatic cases. The main sources of infection changed from importation from Hubei Province to importation from other provinces, then local transmission and ultimately importation from foreign countries. The periods highlighted by the three methods presented different epidemic patterns and trends. The calendar-based periods were even with most cases aggregated in the first period, which did not reflect various transmission patterns of COVID-19 due to various sources of infection; the measure-driven and data-driven periods were not consistent with each other, revealing that the effects of implementing prevention measures were reflected on the epidemic trend with a time lag. For example, the decreasing trends of new cases occurred 7, 3 and 4 days later than the firstlevel emergency response, the district-level prevention measures and the second-level emergency response, respectively. This study has advanced our understanding of epidemic course and foreshown all stages of COVID-19 epidemic. Many countries can learn from our findings about what will occur next in their timelines and how to be better prepared.

The epidemiology, pathophysiological mechanisms, and management toward COVID-19 patients with Type 2 diabetes: A systematic review.

This review comprehensively summarizes epidemiologic evidence of COVID-19 in patients with Type 2 diabetes, explores pathophysiological mechanisms, and integrates recommendations and guidelines for patient management. We found that diabetes was a risk factor for diagnosed infection and poor prognosis of COVID-19. Patients with diabetes may be more susceptible to adverse outcomes associated with SARS-CoV-2 infection due to impaired immune function and possible upregulation of enzymes that mediate viral invasion. The chronic inflammation caused by diabetes, coupled with the acute inflammatory reaction caused by SARS-CoV-2, results in a propensity for inflammatory storm. Patients with diabetes should be aware of their increased risk for COVID-19.

Social Capital Changes After COVID-19 Lockdown Among Youths in China: COVID-19 Impact on Lifestyle Change Survey (COINLICS).

Introduction: Social capital, the effective functioning of social groups through networks of relationships, can affect mental health and may be affected by COVID-19. We aimed to examine the changes in social capital before and after the COVID-19 lockdown among the Chinese youth. Methods: A national convenience sample of 10,540 high school, undergraduate, and graduate students, from the COVID-19 Impact on Lifestyle Change Survey (COINLICS), reported their demographic and social capital information before and after the COVID-19 lockdown. Social capital was retrospectively measured at four levels: individual (ISC), family (FSC), community (CSC), and society (SSC). The changes of social capital were also compared across three educational levels. Results: Overall, ISC and CSC scores generally decreased after lockdown (15.1 to 14.8 and 13.4 to 13.1, respectively), while FSC and SSC scores increased significantly (12.7 to 13.0 and 7.1 to 7.2, respectively). At the individual level, most participants showed a constant perceived social capital; more of the remaining participants showed decreased than increased ISC (30.5% vs. 17.0%) and CSC scores (28.4% vs. 19.1%), while more participants showed increased than decreased FSC (21.7% vs. 9.2%) and SSC scores (10.3% vs. 3.9%). Heterogeneities in social capital changes existed across educational levels. Conclusions: Our findings would provide health professionals and policy-makers solid evidence on the changes in social capital of youths after lockdowns, and therefore help the design of future interventions to rebuild or improve their social capital after epidemics/disasters.

Cross-disciplinary approaches to assist with nucleic acid testing for SARS-CoV-2.

Improving the capacity of detecting positive severe acute respiratory syndrome coronavirus 2 is critical for identifying the infection of coronavirus disease 2019 (COVID-19) precisely and thereby curbing the pandemic. Cross-disciplinary approaches may improve the efficiency of COVID-19 diagnosis by compensating to some extent the limitations encountered by traditional test methods during the COVID-19 pandemic. Combining computed tomography (CT), serum-specific antibody detection, and nanopore sequencing with nucleic acid testing for individual testing may improve the accuracy of identifying COVID-19 patients. At community or even regional/national levels, the combination of pooled screening and spatial epidemiological strategies may enable the detection of early transmission of epidemics in a cost-effective way, which is also less affected by restricted access to diagnostic tests and kit supplies. This would significantly advance our capacity of curbing epidemics as soon as possible, and better prepare us for entering a new era of high-impact and high-frequency epidemics.

Changes in patterns of take-away food ordering among youths before and after COVID-19 lockdown in China: the COVID-19 Impact on Lifestyle Change Survey (COINLICS).

BACKGROUND: The lockdown due to COVID-19 may have led to changes in food ordering patterns among youths, which could affect their dietary patterns and the operation of the restaurant industry. OBJECTIVES: This study aimed to examine the impacts of COVID-19 lockdown on patterns of take-away food ordering among youth in China. METHODS: The COVID-19 Impact on Lifestyle Change Survey (COINLICS) was conducted among youths at three educational levels (high or vocational school, college, and graduate school) in China in early May 2020. Information on patterns of take-away food ordering in the months immediately before and after the COVID-19 lockdown period (23 January to 8 April 2020) was collected through an online questionnaire survey. RESULTS: A total of 10,082 participants were included in the analysis. Participants ordering food more than once per week dropped from 15.4 to 9.2%, while 81.1% of participants have never ordered food at both time points. Graduate students, although experiencing a decrease in food ordering for more than once per week (from 33.3 to 10.7%), were more likely to order food compared to undergraduate and high school students. A slight increase was observed for ordering fried food or hamburgers and for breakfast and midnight snacks. CONCLUSIONS: The youth have generally ordered take-away food less frequently after COVID-19 lockdown, and the times and types of ordering have both changed. These findings would contribute solid evidence to the current knowledge pool for reference of health promotion communities to keep youth's lifestyles healthy and of the restaurant industry to achieve more cost-effective operation in China during future health emergencies.

Impacts of lockdown on dietary patterns among youths in China: the COVID-19 Impact on Lifestyle Change Survey.

OBJECTIVE: To assess changes in dietary patterns among youths in China after COVID-19 lockdown. DESIGN: This study was based on the COVID-19 Impact on Lifestyle Change Survey (COINLICS), a national retrospective survey established in early May 2020. The questionnaire was distributed through social media platforms. The sociodemographic information and routine dietary patterns before and after lockdown of participants were investigated. t tests and χ2 tests were used to compare the differences in consumption patterns of twelve major food groups and beverages between sex and across educational levels before and after lockdown. Factor analysis was employed to obtain the main dietary patterns. SETTINGS: China. PARTICIPANTS: A total of 10 082 youths. RESULTS: A significant decrease was observed in the average weekly frequency of rice intake, while significant increases were observed in the frequency of intake of wheat products, other staple foods, fish, eggs, fresh vegetables, preserved vegetables, fresh fruit and dairy products (all P values < 0·01). Heterogeneities of average weekly frequency existed between sex and across educational levels to different extents. The three main dietary patterns derived were loaded most heavily on dairy products, rice and wheat products, separately; the rice pattern became more dominant than the wheat products pattern after lockdown. The frequency of sugar-sweetened beverage consumption had decreased, while the frequency of other beverages had increased. CONCLUSIONS: Our timely survey would inform policymakers and health professionals of these significant changes in youths' dietary patterns after lockdown, with heterogeneities observed to different extents between sex and across educational levels, for better policy-making and public health practice.

New Approaches to Anticipate the Risk of Reverse Zoonosis.

The coronavirus disease 2019 (COVID-19) pandemic can cause reverse zoonoses (i.e., human-animal transmission of COVID-19). It is vital to utilize up-to-date methods to improve the control, management, and prevention of reverse zoonoses. Awareness of reverse zoonoses should be raised at both individual and regional/national levels for better protection of both humans and animals.

COVID-19 Lockdown and Social Capital Changes Among Youths in China.

Social capital refers to the effective functioning of social groups through networks of relationships. The lockdown measures due to coronavirus disease 2019 (COVID-19) may change the social capital among youths. This study aimed to evaluate changes in social capital before and during COVID-19 lockdown among Chinese youths. It was based on the online COVID-19 Impact on Lifestyle Change Survey (COINLICS) conducted among 10 540 youths at three educational levels, including high/vocational school, undergraduate, and graduate, before and during COVID-19 lockdown. Measures of perceptions of social capital were adapted from a validated Chinese version of Health-related Social Capital Measurement based on youths' characteristics of living and studying environment. Social capital was measured at four dimensions, including individual social capital (ISC), family social capital (FSC), community social capital (CSC), and society social capital (SSC). Overall, compared to before lockdown, ISC and CSC scores decreased, while FSC and SSC scores increased during lockdown. When stratified by educational levels, the trends for each dimension of social capital were consistent with the overall population. There were 43.9%, 5.7%, 32.1%, and 3.7% of the participants showing decreased scores during lockdown for ISC, FSC, CSC, and SSC, respectively, while 7.2%, 24.0%, 15.3%, and 10.7% of participants showed increased scores for ISC, FSC, CSC, and SSC, respectively. Our timely, large-scale study showed decreased social capital in individual and community dimensions and increased social capital in family and society dimensions during lockdown.

Spatial technologies to strengthen traditional testing for SARS-CoV-2.

Advanced spatial and digital technologies may help us to take fuller advantage of limited testing resources to monitor the infection status of a large population in a cost-effective manner. Moreover, they may provide additional evidence to supplement results of nucleic acid testing (NAT) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to decrease false-negative and false-positive rates.

Changes in dietary patterns among youths in China during COVID-19 epidemic: The COVID-19 impact on lifestyle change survey (COINLICS).

Limited studies have focused on how COVID-19 outbreak and thereby lockdown have affected the youth's diet patterns. This study aimed to assess changes in diet patterns among youths in China under the COVID-19 lockdown, based on the COVID-19 Impact on Lifestyle Change Survey (COINLICS), a nationwide retrospective survey distributed via social media platforms during 9-12 May 2020 where 10,082 youth participants in China have voluntarily reported their basic sociodemographic information and routine diet patterns in the months before and after COVID-19 lockdown. We used paired t-tests or χ2 tests to evaluate the significance of differences in consumption patterns of 12 major food groups and beverages across educational levels, between sexes, and before and after COVID-19 lockdown. During the COVID-19 lockdown, significant decreases were observed in the frequency of intake of rice, meat, poultry, fresh vegetables, fresh fruit, soybean products, and dairy products, with significant sex differences (females consuming more rice, fresh vegetables and fruit and less meat, poultry, soybean and dairy products than males). Significant increases were observed in the frequency of consumption of wheat products, other staple foods, and preserved vegetables, with males consuming these foods more frequently than females. Graduate students consumed most foods more frequently except rice and other staple foods and preserved vegetables. The frequency of sugar-sweetened beverage consumption had decreased while frequency of tea drinking had increased. The participating youths' diet patterns had significantly changed during the COVID-19 lockdown, with heterogeneities observed to different extents between sexes and across educational levels. Our findings would inform policy-makers and health professionals of these changes in time for better policy making and public health practice.

Impact of COVID-19 Lockdown on Physical Activity Among the Chinese Youths: The COVID-19 Impact on Lifestyle Change Survey (COINLICS).

Background: The study sought to assess the changes in physical activity (PA) and sedentary time among Chinese youths at different stages after the COVID-19 outbreak. Methods: It was based on a retrospective online survey conducted in May 2020. More than 10,000 youths voluntarily recalled their PA-related information at three stages: before COVID-19 (January), during lockdown (February), and after lockdown (May). χ2 tests were conducted to evaluate the significance of the differences in participants' characteristics between sexes, and Wilcoxon Rank Sum tests were performed to examine the significance of differences in changes in PA and sedentary behavior levels between sexes. Results: A total of 8,115 participants were included, with a mean age of 20. The percentage of no PA per week increased significantly and then slightly fell, and that of ≥150 min/week substantially decreased and then rebounded partially (all p < 0.001) (for instance, the percentage of ≥150 min/week of PA total decreased from 38.6 to 19.4%, then rebounded back to 25.3%). Means hours per day spent in sedentary behaviors had significantly increased during lockdown comparing to pre-COVID-19 (all p < 0.001). There were more participants reported reduced PA level than those indicated increased, and more participating youths had their sedentary behavior level increased than those who had it decreased. Conclusions: The study found COVID-19 had both immediate and longer-term impacts on self-reported physical activities and sedentary behaviors among Chinese youths. Relevant efforts should be strengthened to get youths physically moving again.