Administrative Mechanism of Joint Participation and Cooperation in the Early Stages of the COVID-19 Outbreak in Wuhan.

INTRODUCTION: From December 2019 to January 2020, a novel coronavirus disease (officially COVID-19) was reported in Wuhan and continued to spread all China. This study describes the administrative mechanism of joint participation and cooperation during the early stages of the COVID-19 outbreak in Wuhan and the rest of the country by health practitioners and administrative authorities. METHODS: This study adopted a qualitative design. An analytical framework based on the theory of policy participation that included stimulus, setting, and position of policy participation was constructed. Qualitative data of policy participation by health practitioners and administrative authorities consisted of publicly available data. RESULTS: Early during the outbreak, from December 2019 to January 2020, three main stages occurred according to the containment situation. The first stage was characterized by limited knowledge of the transmission dynamics of the virus and a consequently weak response. In the second stage, the disease spreads rapidly because of travel during a national festival. In the third stage, particularly when top Chinese leaders delivered instructions to intensify containment efforts, diverse departments initiated joint prevention and control measures to combat COVID-19. CONCLUSION: The administrative mechanism of joint participation and cooperation was instrumental in avoiding a substantial increase in both cases and fatalities in the initial stage of the outbreak. This joint participation provides valuable experience and initiatives for major public health emergency preparedness, and the new empirical evidence further highlights the importance of policy participation theory in epidemic prevention in other countries.

Institutional Diversity in Response to the COVID-19 Emergency.

Four-quadrant modeling may offer some constructive insights into the institutional diversity of the emergency responses to COVID-19. This study utilized a typological method to investigate institutional arrangements and the emergency management of epidemic responses in China. The task environment for emergencies was divided into four categories. Targeted policies were assigned to explicit task environments by placing them in one of the four quadrants: public health procedures, medical operation standards, supervisory and regulatory measures, and norms and instructions. Institutional diversity resulted when the very loci of decision-making carried a dominant or subordinate role, providing a hierarchical system for relating the institutional processes needed to address the challenges of institutional fragments.

Evidence-Based Framework and Implementation of China's Strategy in Combating COVID-19.

INTRODUCTION: In less than two months, the COVID-19 outbreak in China was controlled through the stringent strategies of screening and isolation. This article aims to use empirical data from all cases from a prefecture-level city of China to introduce and examine the feasibility and efficiency of the screening and isolation strategies and how these were essential in combatting the COVID-19 outbreak. METHODS: For this retrospective study, all confirmed COVID-19 patients were recruited from the Taizhou prefecture-level city of Zhejiang province, China. RESULTS: Of the city's total population, 24% were screened for COVID-19 and isolated at home or designated locations for two weeks. From these, a total of 146 confirmed cases of COVID-19 were analysed. Of all cases, 51% were traced from Wuhan, and 21% of patients were in close contact with confirmed cases from outside of the city. Initially, 13% of all patients reported having no clear symptoms, while 42% of patients presented with fever and/or other symptoms. Compared with local patients, new arrivals to the city had fewer days between their exposure and the development of symptoms of COVID-19 (P<0.001), and fewer days from the time they developed symptoms to the confirmation of COVID-19 (P<0.001), respectively. CONCLUSION: This study has fully confirmed that controlling the COVID-19 outbreak through screening and isolation is effective, efficient, and essential. The evidence-based framework and implementation of China's strategy to combat COVID-19 can explain how China contained the COVID-19 outbreak in a short time period. This study offers important references and implications for containing the COVID-19 pandemic in the global community.

Taizhou's COVID-19 prevention and control experience with telemedicine features.

The outbreak of coronavirus disease 2019 (COVID-19) has spread rapidly around the world. As of May 30, 2020, a total of 84 568 confirmed COVID-19 cases have been recorded in China, with a mortality rate of approximately 5.5%. Taizhou is a prefecture-level city in Zhejiang Province. A total of 146 cases were diagnosed in this epidemic, with a fatality rate of 0%. This condition is due to the establishment of an "Internet +" diagnosis and treatment model based on online medical application (APP), telemedicine, WeChat service, and consultation hotline in Taizhou. Taizhou led in opening the "COVID-19 Prevention and Treatment Special Line" in China, which is conducive to pre-hospital screening, suppressing social panic, and clinical support. Hospitals also carried out related online lectures and popularization of science. We summarize Taizhou's COVID-19 prevention and control experience with telemedicine features, with a view to providing reference for the control of the epidemic at home and abroad.

A Comparative Study on the Clinical Features of Coronavirus 2019 (COVID-19) Pneumonia With Other Pneumonias.

BACKGROUND: A novel coronavirus (COVID-19) has raised world concern since it emerged in Wuhan, China in December 2019. The infection may result in severe pneumonia with clusters of illness onsets. Its impacts on public health make it paramount to clarify the clinical features with other pneumonias. METHODS: Nineteen COVID-19 and 15 other patients with pneumonia (non-COVID-19) in areas outside of Hubei were involved in this study. Both COVID-19 and non-COVID-19 patients were confirmed to be infected using throat swabs and/or sputa with/without COVID-2019 by real-time RT-PCR. We analyzed the demographic, epidemiological, clinical, and radiological features from those patients, and compared the differences between COVID-19 and non-COVID-19. RESULTS: All patients had a history of exposure to confirmed cases of COVID-19 or travel to Hubei before illness. The median (IQR) duration was 8 (6-11) and 5 (4-11) days from exposure to onset in COVID-19 and non-COVID-19 cases, respectively. The clinical symptoms were similar between COVID-19 and non-COVID-19. The most common symptoms were fever and cough. Fifteen (78.95%) COVID-19 but 4 (26.67%) non-COVID-19 patients had bilateral involvement while 17 COVID-19 patients (89.47%) but 1 non-COVID-19 patient (6.67%) had multiple mottling and ground-glass opacity on chest CT images. Compared with non-COVID-19, COVID-19 presents remarkably more abnormal laboratory tests, including AST, ALT, γ-GT, LDH, and α-HBDH. CONCLUSIONS: The COVID-19 infection has onsets similar to other pneumonias. CT scan may be a reliable test for screening COVID-19 cases. Liver function damage is more frequent in COVID-19 than non-COVID-19 patients. LDH and α-HBDH may be considerable markers for evaluation of COVID-19.

Protecting healthcare personnel from 2019-nCoV infection risks: lessons and suggestions.

The outbreak of a novel coronavirus disease (COVID-19, caused by the 2019-nCoV infection) in December 2019 is one of the most severe public health emergencies since the founding of People's Republic of China in 1949. Healthcare personnel (HCP) nationwide are facing heavy workloads and high risk of infection, especially those who care for patients in Hubei Province. Sadly, as of February 20, 2020, over two thousand COVID-19 cases are confirmed among HCP from 476 hospitals nationwide, with nearly 90% of them from Hubei Province. Based on literature search and interviews with some HCP working at Wuhan, capital city of Hubei, we have summarized some of the effective measures taken to reduce infection among HCP, and also made suggestions for improving occupational safety during an infectious disease outbreak. The experience and lessons learned should be a valuable asset for international health community to contain the ongoing COVID-19 epidemic around the world.