Simulation Study on Airflow Organization and Environment in Reconstructed Fangcang Shelter Hospital Based on CFD

With frequent outbreaks of COVID-19, the rapid and effective construction of large-space buildings into Fangcang shelter hospitals has gradually become one of the effective means to control the epidemic. Reasonable design of the ventilation system of the Fangcang shelter hospital can optimize the indoor airflow organization, so that the internal environment can meet the comfort of patients and at the same time can effectively discharge pollutants, which is particularly important for the establishment of the Fangcang shelter hospital. In this paper, through the reconstruction of a large-space gymnasium, CFD software is used to simulate the living environment and pollutant emission efficiency of the reconstructed Fangcang shelter hospital in summer under different air supply temperatures, air supply heights and exhaust air volume parameters. The results show that when the air supply parameters are set to an air supply height of 4.5 m, an air supply temperature of 18 °C, and an exhaust air volume of a single bed of 150 m3/h, the thermal comfort can reach level I, and the ventilation efficiency for pollutants can reach 69.6%. In addition, the ventilation efficiency is 70.1% and 70.3% when the exhaust air volume of a single bed is continuously increased to 200 and 250 m3/h, which can no longer effectively improve the pollutant emission and will cause an uncomfortable blowing feeling to patients. © 2023 by the authors.

The Effect of Fangcang Shelter Hospitals under Resource Constraints on the Spread of Epidemics.

Since the outbreak of the COVID-19 pandemic, Fangcang shelter hospitals have been built and operated in several cities, and have played a huge role in epidemic prevention and control. How to use medical resources effectively in order to maximize epidemic prevention and control is a big challenge that the government should address. In this paper, a two-stage infectious disease model was developed to analyze the role of Fangcang shelter hospitals in epidemic prevention and control, and examine the impact of medical resources allocation on epidemic prevention and control. Our model suggested that the Fangcang shelter hospital could effectively control the rapid spread of the epidemic, and for a very large city with a population of about 10 million and a relative shortage of medical resources, the model predicted that the final number of confirmed cases could be only 3.4% of the total population in the best case scenario. The paper further discusses the optimal solutions regarding medical resource allocation when medical resources are either limited or abundant. The results show that the optimal allocation ratio of resources between designated hospitals and Fangcang shelter hospitals varies with the amount of additional resources. When resources are relatively sufficient, the upper limit of the proportion of makeshift hospitals is about 91%, while the lower limit decreases with the increase in resources. Meanwhile, there is a negative correlation between the intensity of medical work and the proportion of distribution. Our work deepens our understanding of the role of Fangcang shelter hospitals in the pandemic and provides a reference for feasible strategies by which to contain the pandemic.

An optimal aggregation method for interval grey numbers using on Steiner-Weber point with application

Aiming at the problem of low accuracy of two-dimensional preference information aggregation, this paper takes two-dimensional interval grey numbers as an example to define its preference information mapping rules. This rule maps preference information to preference points on a two-dimensional plane. Based on the theory of plane Steiner-Weber point, we construct a two-dimensional optimal model, and prove the optimality of the model theoretically. Then, adopt plant growth simulation algorithm (PGSA) to solve the proposed model. The obtained optimal aggregation point that can represent the comprehensive opinions. Finally, by analyzing the selection problem of Fangcang shelter hospital and comparing it with the particle swarm optimization (PSO) method, we conclude that the sum of weighted Euclidean distance obtained by our method is minimal. The aggregation precision of our method is higher than that of other aggregation method to a certain extent. © 2023 Elsevier Ltd

DELAYED MODEL FOR THE TRANSMISSION AND CONTROL OF COVID-19 WITH FANGCANG SHELTER HOSPITALS

The ongoing coronavirus disease 2019 (COVID-19) pandemic poses a huge threat to global public health. Motivated by China's experience of using Fangcang shelter hospitals (FSHs) to successfully combat the epidemic in its initial stages, we present a two-stage delay model considering the average waiting time of patients' admission to study the impact of hospital beds and centralized quarantine on mitigating and controlling of the outbreak. We compute the basic reproduction number in terms of the hospital resources and perform a sensitivity analysis of the average waiting times of patients before admission to the hospitals. We conclude that, while designated hospitals save lives in severely infected individuals, the FSHs played a key role in mitigating and eventually curbing the epidemic. We also quantified some key epidemiological indicators, such as the final size of infections and deaths, the peak height and its timing, and the maximum occupation of beds in FSHs. Our study suggests that, for a jurisdiction (region or country) still struggling with COVID-19, when possible, it is essential to increase testing capacity and use a centralized quarantine to massively reduce the severity and magnitude of the epidemic that follows. © 2023 Society for Industrial and Applied Mathematics.

Clinical Practice and Effectiveness Analysis of the Management of Corona Virus Disease 2019 Infected at Shanghai Fangcang Shelter Hospital: A Descriptive Study.

Background: The Fangcang shelter hospital has gradually become the primary management mode in China's fight against this Corona Virus Disease 2019 (COVID-19) in 2020. In early 2022, the Fangcang shelter hospital management model was successfully applied to the new outbreak of COVID-19 in Shanghai also. Although Fangcang shelter hospitals are no longer the prevailing mode of prevention of COVID-19, the management experience of Shanghai makeshift hospitals is worthy of reference for public health. Methods: The authors conducted a descriptive statistical analysis of Hall 6-2 of the Shanghai National Convention and Exhibition Center Fangcang shelter hospital. The whole hall of the Fangcang shelter hospital was managed by the one hospital, and the inclusion of third-party management personnel alleviated the shortage of medical personnel human resources. Through practice, a new procedure for treating batch infected people was introduced. Results: By optimizing ward management, 72 on-duty doctors, 360 on-duty nurses, 3 sense-control administrators, and 15 administrators cured 18,574 infected people in 40 days, and created a record of a doctor managing 700 infected people without compromising the quality of treatment. There have been no deaths and no complaints from the infected people located in Hall 6-2 of the Shanghai National Convention and Exhibition Center Fangcang shelter hospital. Conclusion: Compared with previous data, the new management mode of Fangcang shelter hospitals provides a reference for the management of the new infectious diseases for public health.

Risk factor analysis of omicron patients with mental health problems in the Fangcang shelter hospital based on psychiatric drug intervention during the COVID-19 pandemic in Shanghai, China.

Backgrounds: The widespread coronavirus disease 2019 (COVID-19) outbreak impacted the mental health of infected patients admitted to Fangcang shelter hospital a large-scale, temporary structure converted from existing public venues to isolate patients with mild or moderate symptoms of COVID-19 infection. Objective: This study aimed to investigate the risk factors of the infected patients from a new pharmacological perspective based on psychiatric drug consumption rather than questionnaires for the first time. Methods: We summarised the medical information and analysed the prevalence proportion, characteristics, and the related risk factors of omicron variants infected patients in the Fangcang Shelter Hospital of the National Exhibition and Convention Center (Shanghai) from 9 April 2022 to 31 May 2022. Results: In this study, 6,218 individuals at 3.57% of all admitted patients in the Fangcang shelter were collected suffering from mental health problems in severe conditions including schizophrenia, depression, insomnia, and anxiety who needed psychiatric drug intervention. In the group, 97.44% experienced their first prescription of psychiatric drugs and had no diagnosed historical psychiatric diseases. Further analysis indicated that female sex, no vaccination, older age, longer hospitalization time, and more comorbidities were independent risk factors for the drug-intervened patients. Conclusion: This is the first study to analyse the mental health problems of omicron variants infected patients hospitalised in Fangcang shelter hospitals. The research demonstrated the necessity of potential mental and psychological service development in Fangcang shelters during the COVID-19 pandemic and other public emergency responses.

Characteristics and Occurrence Scenarios of Staff Exposed to SARS-CoV-2 Omicron in Shanghai Lingang Fangcang Shelter Hospital, CHINA.

Objective: To analyze the characteristics and occurrence scenarios of occupational exposure of staff in the Shanghai Lingang Fangcang Shelter Hospital. Methods: We collected the data of 80 staff with occupational exposure (including doctors, nurses, cleaning, security guards, and maintenance staff) in the Shanghai Lingang Fangcang Shelter Hospital from April 5 to May 20, 2022. The basic information of occupational exposure, factors influencing different occupational exposure types, ways to discover occupational exposure, discovery places of occupational exposure, and specific occurrence scenarios were compiled and analyzed among these data. Results: Occupational exposure mainly occurred in nurses (37, 46.25%), and cleaning (21, 26.25%). After the occurrence of occupational exposure, 20 staff (25%) did not know the occurrence time. Moreover, occupational exposure types were listed from high to low proportion as follows: broken protective clothing (56, 70%), mask loosening or displacement (13, 16.25%), skin exposure (6, 7.5%), and sharp object injuries (5, 6.25%). Occupational exposure was discovered mainly through self-discovery (56, 70%), while other discovery ways were majorly colleague discovery (12, 15%) and infection control supervisor discovery (12, 15%). Furthermore, occupational exposure was discovered principally in the public area (53.75%) and the office area (25%) of the cabin, but the proportion of mask loosening or displacement (38.46%) and skin exposure (50%) was also high in the first unloading area. Broken protective clothing occurred in the following scenarios: scratching while working in the cabin (37, 66.07%) and not knowing its occurrence time (25%). The occurrence scenarios of mask loosening or displacement were mainly not knowing its occurrence time (6, 46.15%), self-discovery (3, 23.08%), and at the time of removal (3, 23.08%). Conclusion: Targeted training and prevention of occupational exposure should be performed to decrease infection risk and ensure staff safety in Fangcang shelter hospitals.

Contamination of personal protective equipment and environmental surfaces in Fangcang shelter hospitals.

BACKGROUND: Fangcang shelter hospitals emerged as a new public health concept after COVID-19. Data regarding contamination of Fangcang shelter environments remains scarce. This study aims to investigate the extent of SARS-CoV-2 contamination on personal protective equipment and surfaces in Fangcang hospitals. METHODS: Between March and May 2022, during wave of omicron variant, a prospective study was conducted in two Fangcang hospitals in Shanghai, China. Swabs of personal protective equipment worn and environmental surfaces of contaminated areas, doffing rooms, and potentially contaminated areas were collected. SARS-CoV-2 RNA was detected by reverse transcription quantitative polymerase chain reaction. If viral RNA was detected, sampling was repeated after cleaning and disinfection. RESULTS: A total of 602 samples were collected. 13.3% of the personal protective equipment were contaminated. Positive rate was higher in the contaminated areas (48.4%) than in the doffing rooms (11.7%) and the potentially contaminated areas (0; P<0.05). Contamination was highest in patient occupied areas 67.5%. After cleaning, samples taken at previously contaminated surfaces are all negative. CONCLUSIONS: SARS-CoV-2 RNA contamination is prevalent in Fangcang hospitals and healthcare workers are under risk of infection. Potentially contaminated areas and surfaces after cleaning and disinfection are negative, underlying the importance of infection control policy.

Stress load of Chinese nurses in Fangcang Shelter Hospitals during the COVID-19 pandemic: A latent profile analysis.

The Omicron wave of the COVID-19 pandemic significantly affected Shanghai, China, from March to June 2022. Numbers of Fangcang Shelter Hospitals (FSHs) were conversed from stadiums and exhibition centers to tackle the pandemic. This study aimed to identify the stress load profiles of nurses working in FSHs and explore the characteristics and factors influencing stress load profiles. Totally, 609 out of 700 FSH nurses (with an effective response rate of 87%) participated in an online survey investigating their socio-demographic information, work-related stressors, and stress load. Results of the latent profile analysis identified four classes of stress load, which were labeled as the low (Class 1), mild (Class 2), moderate (Class 3), and high (Class 4) stress load class. Maternity status and self-perceived health condition were significantly different between the four stress load classes by comparisons using the Chi-square test and the Kruskal-Wallis test. The contributors to the stress load profiles were determined by the multinomial logistic regression analysis, including age, education, maternity status, self-perceived health condition, working time in FSHs, and the four dimensions of work-related stressors. Participants who were less healthy (OR = 0.045, 95% CI:0.012,0.171), worked longer time in FSHs (OR = 40.483, 95% CI: 12.103,135.410), faced with more workload (OR = 3.664, 95% CI: 1.047,12.815), and worse working environment (OR = 12.274, 95% CI: 3.029,49.729) were more likely to be classified to the high stress load class. The task arrangement and working environment for FSH nurses should be optimized, and psychological training should be conducted routinely.

Psychological experience of Juvenile patients' parents in Fangcang shelter hospital during the Omicron wave of COVID-19 pandemic in Shanghai, China: a qualitative study.

OBJECTIVE: To explore the psychological experience of Juvenile patient's parents in Fangcang shelter hospital during the Omicron wave of COVID-19 pandemic. METHODS: A qualitative study was conducted by using a phenomenological research method. Sixteen parents of juvenile patients with COVID-19 were recruited from National Exhibition and Convention Center (Shanghai, China) Fangcang shelter hospital (FSH) using purposive sampling. Data were collected by face-to-face in-depth interviews over 27 days, from April 9 to May 6, 2022. The interview data were analyzed using Colaizzi seven-step analysis method. RESULTS: The psychological experiences of the parents of juvenile patients in the Fangcang shelter hospital were summarized into three themes: "perception regarding the FSH", "worried about the unmet needs of juvenile patients ", and "the psychological burden after discharge". These themes were classified into 9 sub-themes, including the acceptance of FSH, adaptability to FSH, concerns about cross-infection in the FSH, special needs of infants and young children, psychological needs of preschool children, the learning demands of school-age children, concern about re-positive, fear of sequelae, worry about social acceptance. CONCLUSION: Juvenile patients and their parents in the Fangcang shelter hospitals have both positive and negative experiences. It is suggested that facilities for minors should be planned in advance. Humanistic care for adolescent patients and health education for the public are also critical.

Study on the Localization of Fangcang Shelter Hospitals During Pandemic Outbreaks.

In the event of pandemic, it is essential for government authority to implement responses to control the pandemic and protect people's health with rapidity and efficicency. In this study, we first develop an evaluation framework consisting of the entropy weight method (EWM) and the technique for order preference by similarity to ideal solution (TOPSIS) to identify the preliminary selection of Fangcang shelter hospitals; next, we consider the timeliness of isolation and treatment of patients with different degrees of severity of the infectious disease, with the referral to and triage in Fangcang shelter hospitals characterized and two optimization models developed. The computational results of Model 1 and Model 2 are compared and analyzed. A case study in Xuzhou, Jiangsu Province, China, is used to demonstrate the real-life applicability of the proposed models. The two-stage localization method gives decision-makers more options in case of emergencies and can effectively designate the location. This article may give recommendations of and new insights into parameter settings in isolation hospital for governments and public health managers.

A Study on the Effect of the Pre-Go-Live Training in Anxiety and Depression of Medical Staff Based on the Data of Wuhan Fangcang Shelter Hospital During COVID-19 in the Era of Big Data.

Coronavirus disease 2019 (COVID-19) broke out in 2019. In the past 4 years, China has adopted many measures to control the epidemic, including building Fangcang shelter hospitals to isolate confirmed positive cases. Therefore, we aim to explore the mental health status of medical staff in the Wuhan Fangcang shelter hospital and discuss the relevant factors that affect the medical staff's mental status. The subjects of the research were staff from several Fangcang shelter hospitals in Wuhan during the epidemic of COVID-19. Patient Health Questionnaire-9 items Scale (PHQ-9) was used to assess the severity of the participants' depressive symptoms, and Generalized Anxiety Disorder-7 items Scale (GAD-7) was used to evaluate the severity of the participants' anxiety symptoms. The demographic information and health adjustment methods were collected in a self-made questionnaire, and regression analysis on related factors that affect mental health was performed. The three most frequently used methods of psychological adjustment for the staff in the Fangcang shelter hospital are common recreational activities, such as reading, streaming videos, listening to music, and playing games. (93.8%), communicating with colleagues in the Fangcang shelter hospital (92.5%), and communicating with family members and friends (78.3%). Binary logistic regression analysis showed that developing depression symptoms has relation to 2 factors, which are having not participated in medical emergency rescue missions (odds ratio = 2.610; 95% confidence interval 1.398-4.872, P = 0.003) and inadequate training before entering the shelter hospital (odds ratio = 2.804, 95% confidence interval 1.293-6.08, P = 0.009). Compared with adequate pre-job training, insufficient training increases the risk of anxiety symptoms (odds ratio = 2.692; 95% confidence interval 1.3-5.575, P = 0.008). Lack of experience and inadequate training in medical emergency rescue missions exposed the medical staff to a higher risk of developing symptoms of depression and anxiety. Psychological adjustment methods that are helpful to adjust their mental state are most commonly used.

The prevalence and influencing factors for compassion fatigue among nurses in Fangcang shelter hospitals: A cross-sectional study.

AIM: We aim to investigate the prevalence and associated factors for compassion fatigue among nurses in Fangcang Shelter Hospitals in Wuhan. Studies have shown that compassion fatigue was more common among nurses than other health-care providers, and its predictors were also different. In recent years, most studies have investigated compassion fatigue in emergency and oncology nurses, whereas there is little information on compassion fatigue among nurses from the frontline of Fangcang Shelter Hospitals during the COVID-19 pandemic. METHODS: A descriptive, cross-sectional design was used in this study. An online survey was conducted among nurses (n = 972) of five Fangcang Shelter Hospitals in Wuhan, Hubei province, China, from 6 March to 10 March 2020. A self-administered questionnaire including demographic information, work-related information, General Health Questionnaire, Perceived Stress Scale and Compassion Fatigue Scale was used. RESULTS: The prevalence of compassion fatigue among nurses in Fangcang Shelter Hospitals was moderate, and most cases were mild. There was a significant relationship between compassion fatigue and work-related factors, mental health and perceived stress among nurses working in Fangcang Shelter Hospitals. CONCLUSIONS: Various factors contribute to compassion fatigue, including lower job satisfaction and job adaptability, less praise from patients, more fear of infection and more perceived stress. A good working atmosphere, organizational support and psychological consultation are essential to alleviate nurses' compassion fatigue during the anti-epidemic period.

Emergency Preparedness and Management of Mobile Cabin Hospitals in China During the COVID-19 Pandemic.

The healthcare systems in China and globally have faced serious challenges during the coronavirus disease (COVID-19) pandemic. The shortage of beds in traditional hospitals has exacerbated the threat of COVID-19. To increase the number of available beds, China implemented a special public health measure of opening mobile cabin hospitals. Mobile cabin hospitals, also called Fangcang shelter hospitals, refer to large-scale public venues such as indoor stadiums and exhibition centers converted to temporary hospitals. This study is a mini review of the practice of mobile cabin hospitals in China. The first part is regarding emergency preparedness, including site selection, conversion, layout, and zoning before opening the hospital, and the second is on hospital management, including organization management, management of nosocomial infections, information technology support, and material supply. This review provides some practical recommendations for countries that need mobile cabin hospitals to relieve the pressure of the pandemic on the healthcare systems.

Modeling and Evaluation of the Joint Prevention and Control Mechanism for Curbing COVID-19 in Wuhan.

The spread of COVID-19 in Wuhan was successfully curbed under the strategy of "Joint Prevention and Control Mechanism." To understand how this measure stopped the epidemics in Wuhan, we establish a compartmental model with time-varying parameters over different stages. In the early stage of the epidemic, due to resource limitations, the number of daily reported cases may lower than the actual number. We employ a dynamic-based approach to calibrate the accumulated clinically diagnosed data with a sudden jump on February 12 and 13. The model simulation shows reasonably good match with the adjusted data which allows the prediction of the cumulative confirmed cases. Numerical results reveal that the "Joint Prevention and Control Mechanism" played a significant role on the containment of COVID-19. The spread of COVID-19 cannot be inhibited if any of the measures was not effectively implemented. Our analysis also illustrates that the Fangcang Shelter Hospitals are very helpful when the beds in the designated hospitals are insufficient. Comprised with Fangcang Shelter Hospitals, the designated hospitals can contain the transmission of COVID-19 more effectively. Our findings suggest that the combined multiple measures are essential to curb an ongoing epidemic if the prevention and control measures can be fully implemented.

Factors Predicting Progression to Severe COVID-19: A Competing Risk Survival Analysis of 1753 Patients in Community Isolation in Wuhan, China.

Most studies of coronavirus disease 2019 (COVID-19) progression have focused on the transfer of patients within secondary or tertiary care hospitals from regular wards to intensive care units. Little is known about the risk factors predicting the progression to severe COVID-19 among patients in community isolation, who are either asymptomatic or suffer from only mild to moderate symptoms. Using a multivariable competing risk survival analysis, we identify several important predictors of progression to severe COVID-19-rather than to recovery-among patients in the largest community isolation center in Wuhan, China from 6 February 2020 (when the center opened) to 9 March 2020 (when it closed). All patients in community isolation in Wuhan were either asymptomatic or suffered from mild to moderate COVID-19 symptoms. We performed competing risk survival analysis on time-to-event data from a cohort study of all COVID-19 patients (n = 1753) in the isolation center. The potential predictors we investigated were the routine patient data collected upon admission to the isolation center: age, sex, respiratory symptoms, gastrointestinal symptoms, general symptoms, and computed tomography (CT) scan signs. The main outcomes were time to severe COVID-19 or recovery. The factors predicting progression to severe COVID-19 were: male sex (hazard ratio (HR) = 1.29, 95% confidence interval (CI) 1.04-1.58, p = 0.018), young and old age, dyspnea (HR = 1.58, 95% CI 1.24-2.01, p < 0.001), and CT signs of ground-glass opacity (HR = 1.39, 95% CI 1.04-1.86, p = 0.024) and infiltrating shadows (HR = 1.84, 95% CI 1.22-2.78, p = 0.004). The risk of progression was found to be lower among patients with nausea or vomiting (HR = 0.53, 95% CI 0.30-0.96, p = 0.036) and headaches (HR = 0.54, 95% CI 0.29-0.99, p = 0.046). Our results suggest that several factors that can be easily measured even in resource-poor settings (dyspnea, sex, and age) can be used to identify mild COVID-19 patients who are at increased risk of disease progression. Looking for CT signs of ground-glass opacity and infiltrating shadows may be an affordable option to support triage decisions in resource-rich settings. Common and unspecific symptoms (headaches, nausea, and vomiting) are likely to have led to the identification and subsequent community isolation of COVID-19 patients who were relatively unlikely to deteriorate. Future public health and clinical guidelines should build on this evidence to improve the screening, triage, and monitoring of COVID-19 patients who are asymtomatic or suffer from mild to moderate symptoms.

Mental health needs of the COVID-19 patients and staff in the Fangcang shelter hospital: a qualitative research in Wuhan, China.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, Fangcang shelter hospitals were opened in Wuhan, China, to isolate and care for patients with mild or moderate symptoms. The patients and staff in the hospitals faced mental health challenges. This paper reports the experiences and mental health needs from them. METHOD: Following the qualitative design, semi-structured interviews were conducted in the EastWest Lake Fangcang Shelter Hospital, Wuhan on March 2020. Data collection and analysis was based on grounded theory. Open coding was adapted and a structured codebook was developed through coding seminars. The themes and subthemes were then confirmed through thematic analysis. The findings were further explained and integrated in a theoretical framework. RESULTS: A total of 10 COVID-19 patients and 13 staff, including doctors, nurses, psychiatrists, and policemen participated in the interviews. They have common needs, as well as their own needs. The perspectives from the staff also did complement for needs of the patients. The mental health needs were generalized into four themes, that is, basic needs, information and communication, emotional needs, and social support, each with several subthemes. In addition, there were some external factors that regulated the internal needs, which were summarized in a theoretical framework. CONCLUSIONS: The study indicates the directions on hospital management, mental health services, policy making, and social work to meet the mental health needs of the inpatients and staff from temporary shelter hospitals like Fangcang in Wuhan during the COVID-19 pandemic.

Quantitative assessment of the effectiveness of joint measures led by Fangcang shelter hospitals in response to COVID-19 epidemic in Wuhan, China.

OBJECTIVE: To quantitatively evaluate the effectiveness of Fangcang shelter hospitals, designated hospitals, and the time interval from illness onset to diagnosis toward the prevention and control of the COVID-19 epidemic. METHODS: We used SEIAR and SEIA-CQFH warehouse models to simulate the two-period epidemic in Wuhan and calculate the time dependent basic reproduction numbers (BRNs) of symptomatic infected individuals, asymptomatic infected individuals, exposed individuals, and community-isolated infected individuals. Scenarios that varied in terms of the maximum numbers of open beds in Fangcang shelter hospitals and designated hospitals, and the time intervals from illness onset to hospitals visit and diagnosis were considered to quantitatively assess the optimal measures. RESULTS: The BRN decreased from 4.50 on Jan 22, 2020 to 0.18 on March 18, 2020. Without Fangcang shelter hospitals, the cumulative numbers of cases and deaths would increase by 18.58 and 51.73%, respectively. If the number of beds in the designated hospitals decreased by 1/2 and 1/4, the number of cumulative cases would increase by 178.04 and 92.1%, respectively. If the time interval from illness onset to hospital visit was 4 days, the number of cumulative cases and deaths would increase by 2.79 and 6.19%, respectively. If Fangcang shelter hospitals were not established, the number of beds in designated hospitals reduced 1/4, and the time interval from visiting hospitals to diagnosis became 4 days, the cumulative number of cases would increase by 268.97%. CONCLUSION: The declining BRNs indicate the high effectiveness of the joint measures. The joint measures led by Fangcang shelter hospitals are crucial and need to be rolled out globally, especially when medical resources are limited.

Practice in Information Technology Support for Fangcang Shelter Hospital during COVID-19 Epidemic in Wuhan, China.

In confronting the sudden epidemic of COVID-19, China and other countries have been under great deal of pressure to block virus transmission and reduce death cases. Fangcang shelter hospital, which is converted from large-scale public venue, is proposed and proven to be an effective way for administering medical care and social isolation. This paper presents the practice in information technology support for a Fangcang shelter hospital in Wuhan, China. The experiences include the deployment strategy of IT infrastructure, the redesign of function modules in the hospital information system (HIS), equipment maintenance and medical staff training. The deployment strategy and HIS modules have ensured smoothness and efficiency of clinical work. The team established a quick response mechanism and adhered to the principle of nosocomial infection control. Deployment of network and modification of HIS was finished in the 48 hours before patient admittance. A repair hotline and remote support for equipment and software were available whenever medical workers met with any questions. No engineer ever entered the contaminated areas and no one was infected by the coronavirus during the hospital operation. Up to now, Fangcang shelter hospital is adopted by many regions around the world facing the collapse of their medical systems. This valuable experience in informatization construction and service in Wuhan may help participators involving in Fangcang shelter hospital get better information technology support, and find more practical interventions to fight the epidemic.

Factors associated with mental health outcomes among health care workers in the Fangcang shelter hospital in China.

BACKGROUND: Faced with surging infections and considering that 80% of cases were mild and moderate, the city government transformed stadiums and exhibition centers into the Fangcang shelter hospitals (temporary treatment centers) in Wuhan. AIM: The aims of this study were to evaluate psychological impact on health care workers in the Fangcang shelter hospitals and analyze potential risk factors associated with these symptoms, including PTSS, symptoms of anxiety, depression, insomnia, and perceived stress. METHODS: This cross-sectional study used an online survey to assess mental health problems of 522 health care workers in a Jianghan Fangcang shelter from February 21 to February 28, 2020. RESULTS: Overall, 25.3%, 25.3%, 51.0%, 58.0%, 14.8%, and 39.1% of all participants reported symptoms of posttraumatic stress, anxiety, depression, insomnia, and perceived stress, respectively. Multivariable logistic regression analysis showed that, occupation and technical title were associated with all investigated outcomes. Nurses were more likely to endorse posttraumatic stress symptoms (OR, 4.63; 95% CI, 2.43-8.82; p < .001), anxiety symptom (OR, 4.58; 95% CI, 2.76-7.62; p < .001), depression symptom (OR, 3.45; 95% CI, 2.17-5.64; p < .001). Participants with senior technical title were associated with higher perceived stress and insomnia than other technical title. CONCLUSION: In this survey, participants reported high rates of symptoms of posttraumatic stress, anxiety, depression, insomnia, and perceived stress. Combining with the special environment of the shelter hospitals and the psychological needs, the health care workers should be given more effective interventions to relieve their stress and improve mental symptoms.