Implementation and evaluation of crowdsourcing in global health education.

BACKGROUND: Current global health course is most set as elective course taught in traditional teacher-taught model with low credit and short term. Innovate teaching models are required. Crowdsourcing characterized by high flexibility and strong application-orientation holds its potential to enhance global health education. We applied crowdsourcing to global health teaching for undergraduates, aiming to develop and evaluate a new teaching model for global health education. METHODS: Crowdsourcing was implemented into traditional course-based teaching via introducing five COVID-19 related global health debates. Undergraduate students majoring in preventative medicine and nursing grouped in teams of 5-8, were asked to resolve these debates in reference to main content of the course and with manner they thought most effective to deliver the messages. Students' experience and teaching effect, were evaluated by questionnaires and teachers' ratings, respectively. McNemar's test was used to compare the difference in students' experience before and after the course, and regression models were used to explore the influencing factors of the teaching effect. RESULTS: A total of 172 undergraduates were included, of which 122 (71%) were females. Students' evaluation of the new teaching model improved after the course, but were polarized. Students' self-reported teaching effect averaged 67.53 ± 16.8 and the teachers' rating score averaged 90.84 ± 4.9. Students majoring in preventive medicine, participated in student union, spent more time on revision, and had positive feedback on the new teaching model tended to perform better. CONCLUSION: We innovatively implemented crowdsourcing into global health teaching, and found this new teaching model was positively received by undergraduate students with improved teaching effects. More studies are needed to optimize the implementation of crowdsourcing alike new methods into global health education, to enrich global health teaching models.

Temporal characteristics and spatial heterogeneity of air quality changes due to the COVID-19 lockdown in China.

Previous studies have evaluated the impact of lockdown measures on air quality during the COVID-19 pandemic in China, but few have focused on the temporal characteristics and spatial heterogeneity of the impact across all 337 prefecture cities. In this study, we estimated the impact of the lockdown measures on air quality in each of 337 cities using the Regression Discontinuity in Time method. There was a short-term influence from January 24th to March 31th in 2020. The 337 cities could be divided into six categories showing different response and resilience patterns to the epidemic. Fine particulate matter (PM2.5) in 89.5% of the cities was sensitive to the lockdown measures. The change of air pollutants showed high spatial heterogeneity. The provinces with a greater than 20% reduction in PM2.5 and PM10 and greater than 40% reduction in NO2 during the impact period were mainly concentrated southeast of the "Hu Line". Compared to the no-pandemic scenario, the national annual average concentration of PM2.5, NO2, PM10, SO2, and CO in 2020 were decreased by 6.3%, 10.6%, 7.4%, 9.0%, and 12.5%, respectively, while that of O3 increased by 1.1%.This result indicates that 2020 can still be used as a baseline for setting and allocating air improvement targets for the next five years.

The effect of dispatch of national medical teams to Wuhan on its control and prevention of COVID-19.

OBJECTIVES: As a unique prevention and control measure, the dispatch of national medical teams to Wuhan has played a key role in protecting Wuhan against COVID-19. This study aimed to quantitatively evaluate the effect of this key measure in reducing infections and fatalities. STUDY DESIGN: A scenario analysis is used in this study, where the forming of scenarios is on the basis of the stages of medical to Wuhan. We divided the evaluation into 4 scenarios: Scenario Ⅰ-no dispatch, Scenario Ⅱ-dispatch of 4599 medical staff, Scenario Ⅲ-dispatch of 16,000 staff, and Scenario Ⅳ-dispatch of 32,000 staff. METHODS: The extended Susceptible-Exposed-Infectious-Recovered-Death model was adopted to quantify the effect of the dispatch of national medical teams to Wuhan on COVID-19 prevention and control. RESULTS: The dispatch dramatically cuts the channels for the transmission of the virus and succeeds in raising the cure rates while reducing the fatality rates. If there were no dispatch at all, a cumulative total of 158,881 confirmed cases, 18,700 fatalities and a fatality rate of 11.77% would have occurred in Wuhan, which are 3.2 times, 4.8 times and 1.5 times the real figures respectively. The dispatch has avoided 108,541 confirmed cases and 14,831 fatalities in this city. CONCLUSIONS: The proven successful measure provides valuable experience and enlightenment to international cooperation on prevention and control of COVID-19, as well as a similar outbreak of new emerging infectious diseases.

Analyzing the effects of public interventions on reducing public gatherings in China during the COVID-19 epidemic via mobile terminals positioning data.

At the beginning of 2020, the novel coronavirus disease (COVID-19) became an outbreak in China. On January 23, China raised its national public health response to the highest level. As part of the emergency response, a series of public social distancing interventions were implemented to reduce the transmission rate of COVID-19. In this article, we explored the feasibility of using mobile terminal positioning data to study the impact of some nonpharmaceutical public health interventions implemented by China. First, this article introduced a hybrid method for measuring the number of people in public places based on anonymized mobile terminal positioning data. Additionally, the difference-in-difference (DID) model was used to estimate the effect of the interventions on reducing public gatherings in different provinces and during different stages. The data-driven experimental results showed that the interventions that China implemented reduced the number of people in public places by approximately 60% between January 24 and February 28. Among the 31 provinces in the Chinese mainland, some provinces, such as Tianjin and Chongqing, were more affected by the interventions, while other provinces, such as Gansu, were less affected. In terms of the stages, the phase with the greatest intervention effect was from February 3 to 14, during which the number of daily confirmed cases in China showed a turning point. In conclusion, the interventions significantly reduced public gatherings, and the effects of interventions varied with provinces and time.

Live poultry market closure and avian influenza A (H7N9) infection in cities of China, 2013-2017: an ecological study.

BACKGROUND: Previous studies have proven that the closure of live poultry markets (LPMs) was an effective intervention to reduce human risk of avian influenza A (H7N9) infection, but evidence is limited on the impact of scale and duration of LPMs closure on the transmission of H7N9. METHOD: Five cities (i.e., Shanghai, Suzhou, Shenzhen, Guangzhou and Hangzhou) with the largest number of H7N9 cases in mainland China from 2013 to 2017 were selected in this study. Data on laboratory-confirmed H7N9 human cases in those five cities were obtained from the Chinese National Influenza Centre. The detailed information of LPMs closure (i.e., area and duration) was obtained from the Ministry of Agriculture. We used a generalized linear model with a Poisson link to estimate the effect of LPMs closure, reported as relative risk reduction (RRR). We used classification and regression trees (CARTs) model to select and quantify the dominant factor of H7N9 infection. RESULTS: All five cities implemented the LPMs closure, and the risk of H7N9 infection decreased significantly after LPMs closure with RRR ranging from 0.80 to 0.93. Respectively, a long-term LPMs closure for 10-13 weeks elicited a sustained and highly significant risk reduction of H7N9 infection (RRR = 0.98). Short-time LPMs closure with 2 weeks in every epidemic did not reduce the risk of H7N9 infection (p > 0.05). Partially closed LPMs in some suburbs contributed only 35% for reduction rate (RRR = 0.35). Shenzhen implemented partial closure for first 3 epidemics (p > 0.05) and all closure in the latest 2 epidemic waves (RRR = 0.64). CONCLUSION: Our findings suggest that LPMs all closure in whole city can be a highly effective measure comparing with partial closure (i.e. only urban closure, suburb and rural remain open). Extend the duration of closure and consider permanently closing the LPMs will help improve the control effect. The effect of LPMs closure seems greater than that of meteorology on H7N9 transmission.