COVID-19 Data Prediction and Visualization in Mainland China

Contemporarily, COVID-19 shows a sign of recurrence in Mainland China. To better understand the situation, this paper investigates the growth pattern of COVID-19 based on the research of past data through regression models. The proposed work collects the data on COVID-19 in Mainland China from January 21st, 2020, to April 30th, 2020, including confirmed, recovered, and death cases. Based on polynomial regression and support vector machine regressor, it predicts the further trend of COVID-19. The paper uses root mean squared error to evaluate the performance of both models and concludes that there is no best model due to the high frequency of daily changes. According to the analysis, support vector machine regressors fit the growth of COVID-19 confirmed case better than polynomial regression does. The best solution is to utilize different types of models to generate a range of prediction result. These results shed light on guiding further exploration of the growth of COVID-19. © 2023 SPIE.

Student and Language Teacher Perceptions of Using a WeChat-Based MALL Program during the COVID-19 Pandemic at a Chinese University

The outbreak of COVID-19 has impacted conventional educational practice in universities worldwide. Chinese universities are no exception. WeChat, a social application widely used in China, has been considered a viable tool for language education. However, the perspectives of Chinese university students and English language teachers in terms of using WeChat for English vocabulary learning and teaching during the pandemic remain unclear. The aim of the present study was twofold: First, it explored Chinese university students' and language teachers' opinions of adopting a self-developed WeChat-assisted lexical-learning program (the WALL program) during COVID-19. Second, it gathered their evaluations of the WALL program. To achieve the aim, two sets of semi-structured interviews were used to gather qualitative data about five students' and three English language teachers' perceptions at a university in northern China. The results first revealed that the eight participants showed overwhelming opinions in support of adopting the program for vocabulary learning and teaching during the pandemic. In addition, it received mostly positive evaluations. However, the program had two main drawbacks: distracting learning environments and uncertain learning effects. The present study then made recommendations for future WeChat-based language learning and teaching programs. The findings are expected to provide pedagogical insights for tertiary educational institutions, practitioners, and students in the chosen context in order to deal with the future design and implementation of sound MALL-based approaches. © 2023 by the author.

Differential attitudes and outcomes of endodontics education between mainland and non-mainland chinese students during COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has changed the learning style and campus life of dental students. This study aimed to evaluate the learning attitudes and outcomes of endodontics among mainland Chinese students and non-mainland Chinese students (students from Hong Kong, Macao, and Taiwan) during the pandemic. METHODS: A cross-sectional survey was conducted in November 2022 at the School of Stomatology, Jinan University, utilizing a self-report online questionnaire, including demographic characteristics and attitudes toward the endodontic course and the COVID-19 pandemic. The endodontics scores were collected from recruited students for further analysis. The collected data were analyzed using SPSS 22.0 software, with independent two-sample t-tests to compare continuous variables and chi-square tests for categorical variables. RESULTS: A total of 215 dental students completed the survey, with 126 (58.6%) of them being non-mainland Chinese students. Compared to mainland Chinese students, non-mainland Chinese students had lower scores in both theoretical (63.6 ± 13.5 vs. 83.2 ± 8.00) and skill (88.4 ± 5.38 vs. 90.0 ± 4.91) endodontic assessments. Non-mainland Chinese students reported significantly greater impacts of the COVID-19 pandemic on their learning emotions, personal hygiene, and future career choices compared to mainland Chinese students. CONCLUSIONS: Non-mainland Chinese students had poorer academic performance in endodontics and experienced a greater impact from the COVID-19 pandemic in terms of their studies and lives. Dental educators should consider the diversity of students and take necessary measures to support their mental health and enhance learning outcomes in the post-COVID-19 era.

The initial attempt at home hemodialysis in mainland China.

BACKGROUND: Observational studies have shown home hemodialysis (HHD) to be associated with better survival than facility hemodialysis (HD) and peritoneal dialysis (PD). Patients on HHD have reported higher quality of life and independence. HHD is considered to be an economical way to manage end-stage kidney disease (ESKD). The coronavirus disease 2019 pandemic has had a significant impact on patients with ESKD. Patients on HHD may have an advantage over in-center HD patients because of a lower risk of exposure to infection. PARTICIPANTS AND METHODS: We enrolled HD patients from our dialysis center. We first established the HHD training center. The training center was approved by the Chinese government. Doctors, nurses and engineers train and assess patients separately. There are three forms of patient monitoring: home visits, internet remote monitoring, and outpatient services. Demographic and medical data included age, sex, blood pressure, and dialysis-related data. Laboratory tests were conducted in our central testing laboratory, including hemoglobin (Hgb), serum creatinine (Cr), urea nitrogen (BUN), uric acid (UA), albumin (Alb), calcium (Ca), phosphorus (P), parathyroid hormone (PTH), and brain natriuretic peptide (BNP) levels. RESULTS: Six patients who underwent regular dialysis in the HD center of our hospital were selected for HHD training. We enrolled 6 patients, including 4 males and 2 females. The mean age of the patients was 47.5 (34.7-55.7) years, and the mean dialysis age was 33.5 (11.2-41.5) months. After an average of 16.0 (11.2-25.5) months of training, Alb, P and BNP levels were improved compared with the baseline values. After training, three patients returned home to begin independent HD. During the follow-up, there were no serious adverse events leading to hospitalization or death, but there were several adverse events. They were solved quickly by extra home visits of the technicians or online by remote monitoring. During the follow-up time, the laboratory indicators of all the patients, including Hgb, Alb, Ca, P, PTH, BNP, and ß2-MG levels, remained stable before and after HHD treatment. CONCLUSION: HHD is feasible and safe for ESKD in China, but larger-scale and longer-term studies are needed for further confirmation.

Public information needs during the COVID-19 outbreak: a qualitative study in mainland China

PurposeThe impact of COVID-19 has led to a surge in the public's reliance on the Internet for pandemic information, and the policy of home isolation has exacerbated this. This study aimed to investigate public information needs and ways of accessing and disseminating information during COVID-19 in mainland China.Design/methodology/approachThis study used a qualitative research approach to conduct semi-structured interviews with 15 participants from 9 cities in mainland China about information needs and access behaviors during the COVID-19 outbreak. All interview recordings were converted into text and proofread, then coded and summarised in correspondence with the research questions using the grounded theory.FindingsThis study summarized the dynamics of public information needs during the 2.5-year pandemic and identified the difficulties in accessing certain information.Originality/valueAlthough information needs of public health emergencies have been a hot topic during COVID-19, scant studies focus on information needs in specific countries in Asia, especially in mainland China, the first country with a major outbreak and stringent lockdown mandates. Therefore, the current study is well enriched by focusing on information demand behavior in the context of COVID-19. Possible measures for improvement were also given to existing and potential problems, taking into account the participants' views.

The Development of Children’s Musical Theater in Mainland China

This paper selects mainland China as the research area, studies the development status of children's musicals in the region, and puts forward five problems in the development of children's musicals in mainland China: First, the development level of children's musical shows regional, and the development field is unbalanced. Second,The creators of children's musicals who know drama don't know music, and those who know music don't know drama. Third, the creators do not have enough knowledge about children's development, so the works created do not meet children's unique requirements. Fourth, the market operation mechanism is not mature. Due to the COVID-19 pandemic, children's musicals have been stagnant for the past few years. By grasping the existing problems in the development of children's musicals in mainland China, this paper provides some suggestions for the creators and researchers engaged in this field. © 2022, Association Res Militaris. All rights reserved.

Using search trends to analyze web-based users' behavior profiles connected with COVID-19 in mainland China: infodemiology study based on hot words and Baidu Index.

Background: Mainland China, the world's most populous region, experienced a large-scale coronavirus disease 2019 (COVID-19) outbreak in 2020 and 2021, respectively. Existing infodemiology studies have primarily concentrated on the prospective surveillance of confirmed cases or symptoms which met the criterion for investigators; nevertheless, the actual impact regarding COVID-19 on the public and subsequent attitudes of different groups towards the COVID-19 epidemic were neglected. Methods: This study aimed to examine the public web-based search trends and behavior patterns related to COVID-19 outbreaks in mainland China by using hot words and Baidu Index (BI). The initial hot words (the high-frequency words on the Internet) and the epidemic data (2019/12/01-2021/11/30) were mined from infodemiology platforms. The final hot words table was established by two-rounds of hot words screening and double-level hot words classification. Temporal distribution and demographic portraits of COVID-19 were queried by search trends service supplied from BI to perform the correlation analysis. Further, we used the parameter estimation to quantitatively forecast the geographical distribution of COVID-19 in the future. Results: The final English-Chinese bilingual table was established including six domains and 32 subordinate hot words. According to the temporal distribution of domains and subordinate hot words in 2020 and 2021, the peaks of searching subordinate hot words and COVID-19 outbreak periods had significant temporal correlation and the subordinate hot words in COVID-19 Related and Territory domains were reliable for COVID-19 surveillance. Gender distribution results showed that Territory domain (the male proportion: 67.69%; standard deviation (SD): 5.88%) and Symptoms/Symptom and Public Health (the female proportion: 57.95%, 56.61%; SD: 0, 9.06%) domains were searched more by male and female groups respectively. The results of age distribution of hot words showed that people aged 20-50 (middle-aged people) had a higher online search intensity, and the group of 20-29, 30-39 years old focused more on Media and Symptoms/Symptom (proportion: 45.43%, 51.66%; SD: 15.37%, 16.59%) domains respectively. Finally, based on frequency rankings of searching hot words and confirmed cases in Mainland China, the epidemic situation of provinces and Chinese administrative divisions were divided into 5 levels of early-warning regions. Central, East and South China regions would be impacted again by the COVID-19 in the future.

Tourism policy responses to COVID-19 and first-stage tourism recovery in China

In order to find a coordinated approach to support tourism recovery following the impacts of COVID-19, this research examines the experiences of mainland China, the first country whose domestic tourism recovered in the first stage (the first year after the pandemic outbreak). Through the content analysis of tourism policy documents at national, provincial, and city levels, we generated the features of the policy responses from the supply and demand sides, and the policy trends before and after the first peak of the recovery. Next, we summarized the three steps which make up the first stage, and describe the effective policy focus for each step. This process-oriented policy analysis can guide other countries in how to cope with tourism recovery during the first stage.

Collateral Impact of COVID-19 Prevention Measures on Re-Emergence of Scarlet Fever and Pertussis in Mainland China and Hong Kong China.

The incidence of scarlet fever and pertussis has increased significantly in China in recent years. During the COVID-19 pandemic, stringent non-pharmaceutical intervention measures were widely adopted to contain the spread of the virus, which may also have essential collateral impacts on other infectious diseases, such as scarlet fever and pertussis. We compared the incidence data of scarlet fever and pertussis in Mainland China and Hong Kong from 2004 to 2021 before and after the COVID-19 pandemic. The results show that the incidence of both diseases decreased significantly in 2020-2021 compared to the after-re-emergence stage in these two locations. Specifically, in 2020, scarlet fever decreased by 73.13% and pertussis by 76.63% in Mainland China, and 83.70% and 76.10%, respectively, in Hong Kong. In the absence of COVID-19, the predicted incidence of both diseases was much higher than the actual incidence in Mainland China and Hong Kong in 2020-2021. This study demonstrates that non-pharmaceutical measures implemented during the COVID-19 pandemic can partially reduce scarlet fever and pertussis re-emergence in Mainland China and Hong Kong.

Tasks of COVID-19 prevention and control management teams at primary health care facilities in mainland China: a nationwide online cross-sectional survey.

BACKGROUND: This research aimed to investigate the tasks performed by Coronavirus Disease 2019(COVID-19) prevention and control management teams at primary healthcare (PHC) facilities during COVID-19 pandemic across the mainland China. METHODS: An online survey was performed and COVID-19 prevention and control management teams at PHC facilities were invited to participate in this research. The top 7 most important tasks in the three different periods of COVID-19 containment were selected and ranked. Participations of tasks were surveyed. RESULTS: A total of 998 valid responses (an effective rate of 99.11%) were collected. The respondents were divided into Group A (≤5 respondents within each PHC facility, n1 = 718) and Group B (> 5 respondents within each PHC facility, n2 = 280). The consensus was selected from top 7 most important tasks including screening at travel centers/intervals and screening at entry centers, at-home/centralized quarantine management, transferring, pre-examination/triage and fever sentinel surveillance clinic/fever clinic. Pre-examination/triage and fever sentinel surveillance clinic/fever clinic works became more significant in the regular prevention and control period. Adjusted analysis found that team members of Group A with a college, undergraduate college and graduate school educational background were less involved in pre-examination/triage works (aOR: 0.28; 95%CI: 0.09-0.86, P = 0.026; aOR: 0.30; 95%CI: 0.10-0.90, P = 0.031; aOR: 0.21; 95%CI: 0.05-0.82, P = 0.024). Those who were over the median age were twice more likely to be engaged in managing fever sentinel surveillance of clinic/fever clinic visitors (aOR: 2.18; 95%CI: 1.16-4.08, P = 0.015). Those being specialized in nursing and other specialties were less likely to participate in fever sentinel surveillance of clinic/fever clinic works (aOR: 0.44; 95%CI: 0.24-0.81, P = 0.009; aOR: 0.30; 95%CI: 0.16-0.58, P < 0.001). Those came from central and western China were less likely to participate in centralized quarantine management (aOR: 0.61; 95%CI: 0.38-0.98, P = 0.042; aOR: 0.64; 95%CI: 0.42-0.97, P = 0.037). Team members came from central and western China were twice less likely to participate in screening at travel centers/intervals (aOR: 1.75; 95%CI: 1.14-2.70, P = 0.011; aOR: 1.63; 95%CI: 1.07-2.48, P = 0.024). CONCLUSION: In mainland China, team members of COVID-19 prevention and control at PHC facilities are mainly responsible for screening, quarantine, transferring and monitoring during the COVID-19 pandemic. Pre-examination/triage and the fever sentinel surveillance clinic/fever clinic were gradually valued. Team members with lower educational background are competent in pre-examination/triage works, but more experienced general practitioners are more likely to be in charge of fever sentinel surveillance clinic/fever clinics work. The necessity of COVID-19 prevention and control management teams to participate in screening at travel centers/intervals is subjected to further discussions.

Dementia-friendly initiatives within the context of COVID-19 pandemic: Challenges and strategies perceived by service professional stakeholders from the USA and China.

PURPOSES: Dementia-friendly initiatives (DFI) are community-based movements aimed to address stigma, exclusion, and discrimination associated with dementia. This study examined the challenges faced and strategies used by DFI prior to and during the COVID-19 pandemic from the perspectives of stakeholders in the USA and China. METHODS: Qualitative interviews with 17 stakeholders involved in DFI from the United States and mainland China were conducted via the Zoom platform. Semi-structured interview questions focused on DFI challenges and strategies prior to and during the pandemic. Thematic analysis was used to analyze the data. RESULTS: Three major challenges prior to the COVID-19 pandemic included low participation of persons with dementia, difficulties in building community collaborations, and limited funding and resources needed to sustain DFI. During the COVID-19 pandemic, challenges included exacerbated difficulties of involving persons with dementia and reduced policy support for DFI. Strategies implemented prior to COVID-19 included partnerships with community organizations to outreach and engage persons with dementia, and coordination of resources and diversification of funding sources to sustain DFI. Strategies during the COVID-19 pandemic centered on the implementation of person-centered technology to support persons with dementia and family caregivers, and the development of new programs that integrated efforts to address the impact of COVID-19. IMPLICATIONS: DFI in the USA and mainland China shared similar challenges for DFI prior to and during COVID-19. During the COVID-19 pandemic, DFI in both countries showed resourcefulness through reliance on technology, community collaboration, and COVID-19-related resources to provide support and services. While it remains critical to advocate to the central government to fund DFI, DFI in both societies need to be open to other funding sources, hire persons with dementia as key staff members of DFI, and demonstrate its effectiveness through rigorous evaluation.

The Prevalence of and Factors Associated With Anxiety and Depression Among Working-Age Adults in Mainland China at the Early Remission Stage of the Coronavirus 2019 Pandemic.

Background: The Coronavirus 2019 (COVID-19) outbreak has led to a considerable proportion of adverse psychological symptoms in different subpopulations. This study aimed to investigate the status of anxiety and depression and their associated factors in the adult, working-age population in Mainland China at the early remission stage of the COVID-19 pandemic. Methods: An online study was conducted among 1,863 participants in 29 provinces in Mainland China from March 23 to 31, 2020. Their mental health was evaluated by the generalized anxiety disorder scale (GAD-7) and the patient health questionnaire (PHQ-9). Descriptive analysis, Chi-square, and multiple logistic regressions were applied. Results: About 44.5% of the participants had anxiety, 49.2% had depression, and 37.9% showed a combination of depression and anxiety. Around 83.7% of the participants claimed that the pandemic had a negative impact on their medical needs, which was the primary predictor of mental health, the degree of impact being positively related to the prevalence of anxiety and depression. More chronic diseases, moderate to bad self-rated health, severe perceived infection risk, and younger age group were the common risk factors for anxiety and depression. Having no children, unemployment, and a college-level educational background were associated with higher anxiety prevalence, whereas unmarried participants were correlated with higher depression prevalence. Conclusion: The working-age population showed a relatively high risk of anxiety and depression in Mainland China at the early remission stage of the pandemic. To improve medical services capacity for routine and delayed medical service needs should be a part of policy-makers' priority agenda during this period of crisis.

Vaccine bidding, procurement and distribution management practices in mainland China: A nationwide study.

OBJECTIVE: To conduct a nationwide evaluation of vaccine bidding, procurement and distribution management for understanding and improving the current situation well in mainland China. METHODS: An institution survey was carried out to collect information on tendering, procurement, distribution and related issues to vaccines by structured questionnaires administered to 31 provinces in mainland China from April to July 2019. RESULTS: In 13 (41.9%) of 31 provinces, centralized bidding of National Immunization Program (NIP) vaccines was accomplished, and others conducted independent tendering and purchasing in 2018. For non-NIP vaccines, all provinces implemented unified bidding at the provincial level and over half (18, 58.1%) of them chose provincial public resource trading platforms, but their modes varied over provinces. Then procurement was undertaken by the district-level centers for disease control and prevention (CDC) while they were unable to choose the best option of too many vaccines targeted by the province-level CDC for local populations. The distribution modes of NIP and non-National Immunization Program (non-NIP) vaccines were similar overall in a province but very different over provinces. Main mode was that CDCs at different levels delivered about two thirds (64.5%) of NIP vaccines distribution and more than one third (35.5%) of non-NIP vaccines. Another distribution mode was occupied as fully buying the service from third parties in 3 municipalities. Some provinces mixed both modes, too. The total distribution volume of vaccines was 430.7 million doses in 2018. The top five non-NIP vaccines delivered in 2018 were human rabies vaccine, varicella vaccine, EV71 hand foot mouth disease vaccine, hepatitis B vaccine and influenza vaccine. CONCLUSION: The vaccine biding, procurement and distribution management varied over provinces in mainland China in 2018, especially for non-NIP vaccines. Specific policies and measures should be developed for different regions to improve the immunization management better.

Molecular evolution and genomic characteristics of genotype H1 of measles virus.

Measles is one of the most infectious diseases of humans. It is caused by the measles virus (MeV) and can lead to serious illness, lifelong complications, and even death. Whole-genome sequencing (WGS) is now available to study molecular epidemiology and identify MeV transmission pathways. In the present study, WGS of 23 MeV strains of genotype H1, collected in Mainland China between 2006 and 2018, were generated and compared to 31 WGSs from the public domain to analyze genomic characteristics, evolutionary rates and date of emergence of H1 genotype. The noncoding region between M and F protein genes (M/F NCR) was the most variable region throughout the genome. Although the nucleotide substitution rate of H1 WGS was around 0.75 × 10-3 substitution per site per year, the M/F NCR had an evolutionary rate three times higher, with 2.44 × 10-3 substitution per site per year. Phylogenetic analysis identified three distinct genetic groups. The Time of the Most Recent Common Ancestor (TMRCA) of H1 genotype was estimated at approximately 1988, while the first genetic group appeared around 1995 followed by two other genetic groups in 1999-2002. Bayesian skyline plot showed that the genetic diversity of the H1 genotype remained stable even though the number of MeV cases decreased 50 times between 2014 (52 628) and 2020 (993). The current coronavirus disease 2019 (COVID-19) pandemic might have some effect on the measles epidemic and further studies will be necessary to assess the genetic diversity of the H1 genotype in a post-COVID area.

Epidemiological features and spatial-temporal distribution of visceral leishmaniasis in mainland China: a population-based surveillance study from 2004 to 2019.

BACKGROUND: Although visceral leishmaniasis (VL) was largely brought under control in most regions of China during the previous century, VL cases have rebounded in western and central China in recent decades. The aim of this study was to investigate the epidemiological features and spatial-temporal distribution of VL in mainland China from 2004 to 2019. METHODS: Incidence and mortality data for VL during the period 2004-2019 were collected from the Public Health Sciences Data Center of China and annual national epidemic reports of VL, whose data source was the National Diseases Reporting Information System. Joinpoint regression analysis was performed to explore the trends of VL. Spatial autocorrelation and spatial-temporal clustering analysis were conducted to identify the distribution and risk areas of VL transmission. RESULTS: A total of 4877 VL cases were reported in mainland China during 2004-2019, with mean annual incidence of 0.0228/100,000. VL incidence showed a decreasing trend in general during our study period (annual percentage change [APC] = -4.2564, 95% confidence interval [CI]: -8.0856 to -0.2677). Among mainly endemic provinces, VL was initially heavily epidemic in Gansu, Sichuan, and especially Xinjiang, but subsequently decreased considerably. In contrast, Shaanxi and Shanxi witnessed significantly increasing trends, especially in 2017-2019. The first-level spatial-temporal aggregation area covered two endemic provinces in northwestern China, including Gansu and Xinjiang, with the gathering time from 2004 to 2011 (relative risk [RR] = 13.91, log-likelihood ratio [LLR] = 3308.87, P < 0.001). The secondary aggregation area was detected in Shanxi province of central China, with the gathering time of 2019 (RR = 1.61, LLR = 4.88, P = 0.041). The epidemic peak of October to November disappeared in 2018-2019, leaving only one peak in March to May. CONCLUSIONS: Our findings suggest that VL is still an important endemic infectious disease in China. Epidemic trends in different provinces changed significantly and spatial-temporal aggregation areas shifted from northwestern to central China during our study period. Mitigation strategies, including large-scale screening, insecticide spraying, and health education encouraging behavioral change, in combination with other integrated approaches, are needed to decrease transmission risk in areas at risk, especially in Shanxi, Shaanxi, and Gansu provinces.

The Homeless People in China During the COVID-19 Pandemic: Victims of the Strict Pandemic Control Measures of the Government.

Background: By implementing aggressive control measures, China has rapidly and effectively controlled the Coronavirus disease 2019 (COVID-19) pandemic. However, the neglected homeless population may become victims of that perceived success. Due to political sensitivity, we know little about them. Aims: This study aimed to investigate how the pandemic and the pandemic control strategies of the government affected the lives of the homeless people in mainland China. Methods: A total of 103 eligible participants experiencing absolute homelessness were recruited from Guangzhou City during July and August 2020. Surveys measured demographic characteristics including health status, changes in daily living, and actions of the government toward the homeless during the pandemic. Sankey diagrams and ordered logit regression models were used to examine the impact on the homeless of inhumane government efforts to drive the homeless away. Qualitative materials were analyzed by using an inductive approach to provide more details. Results: First, the homeless people in Guangzhou tended to be male, aged 40 to 64 years, less well-educated, and they originated from outside Guangdong although they were living in the city center. Most had little connection with their families. After a long period of homelessness, almost half of the participants were in poor health with various conditions, which made them extremely vulnerable to COVID-19. Second, the pandemic caused a substantial decline in incomes of homeless people, had less of a negative impact on their food intake, and affected sleep time in different ways. Third, during the COVID-19 pandemic, humanitarian aid from local governments of China decreased, whereas inhumane efforts to drive the homeless away intensified. Fourth, quantitative models and qualitative materials demonstrate the devastating effect of the strict pandemic control strategy of the government on the lives of homeless people, which may further cause their health problems. Conclusion: This study for the first time illustrated the characteristic features of the street homeless population in mainland China and their living situation during the COVID-19 pandemic, and most importantly demonstrated the devastating effect of the strict pandemic control of the government, which has been considered a great success in previous studies, on lives of homeless people. Urgent measures should be taken to ensure the protection of the homeless population and prevent an impending humanitarian crisis.

Impact of COVID-19 Pandemic on the Clinical Activities in Obstetrics and Gynecology: A National Survey in China.

Objective: Few studies have quantified the influence of coronavirus disease 2019 (COVID-19) pandemic on medical providers. This is the first national study to investigate the impact of the pandemic on physicians practicing obstetrics and gynecology in China. Methods: A two-stage, stratified, cluster sampling method was performed based on the city categories (category 1, fewer than 10,000 beds; category 2, 10,000-30,000; and category 3, more than 30,000) and public hospital levels (primary, secondary, and tertiary). Physicians practicing obstetrics and gynecology reported the relevant changes in their general clinical activities and changes in the management of specific diseases or conditions occurring during the periods that they were most strongly affected. These changes were compared by municipal and hospital characteristics. Results: Questionnaires were collected from a representative sample of 11,806 physicians actively practicing obstetrics and gynecology in 779 hospitals from 157 cities of 31 provinces. Except emergency visits and online consultations, category 3 cities, tertiary hospitals and general hospitals had greater reductions in overall clinical activities than category 1 cities, primary hospitals and specialized hospitals (all adjusted p < 0.05), respectively. The differences also existed in the management of specific diseases and conditions, especially for less urgent conditions, including cervical cancer screening, instructions regarding contraception and miscarriage, and assisted reproduction (all p < 0.05). Conclusions: During the COVID-19 pandemic, the clinical obstetrics and gynecology activities in China markedly decreased, with significant differences across municipal and hospital characteristics. Trial Registration: This study was registered with ClinicalTrials.gov on July 27, 2020 (NCT04491201).

Genomic Epidemiology of SARS-CoV-2 From Mainland China With Newly Obtained Genomes From Henan Province.

Even though the COVID-19 epidemic in China has been successfully put under control within a few months, it is still very important to infer the origin time and genetic diversity from the perspective of the whole genome sequence of its agent, SARS-CoV-2. Yet, the sequence of the entire virus genome from China in the current public database is very unevenly distributed with reference to time and place of collection. In particular, only one sequence was obtained in Henan province, adjacent to China's worst-case province, Hubei Province. Herein, we used high-throughput sequencing techniques to get 19 whole-genome sequences of SARS-CoV-2 from 18 severe patients admitted to the First Affiliated Hospital of Zhengzhou University, a provincial designated hospital for the treatment of severe COVID-19 cases in Henan province. The demographic, baseline, and clinical characteristics of these patients were described. To investigate the molecular epidemiology of SARS-CoV-2 of the current COVID-19 outbreak in China, 729 genome sequences (including 19 sequences from this study) sampled from Mainland China were analyzed with state-of-the-art comprehensive methods, including likelihood-mapping, split network, ML phylogenetic, and Bayesian time-scaled phylogenetic analyses. We estimated that the evolutionary rate and the time to the most recent common ancestor (TMRCA) of SARS-CoV-2 from Mainland China were 9.25 × 10-4 substitutions per site per year (95% BCI: 6.75 × 10-4 to 1.28 × 10-3) and October 1, 2019 (95% BCI: August 22, 2019 to November 6, 2019), respectively. Our results contribute to studying the molecular epidemiology and genetic diversity of SARS-CoV-2 over time in Mainland China.

Cross-Border Medical Services for Hong Kong's Older Adults in Mainland China: The Implications of COVID-19 for the Future of Telemedicine.

Cross-border services and support are becoming an increasingly important part of Hong Kong's social policy because an increasing number of its older citizens are choosing to live in mainland China. Unfortunately, with the recent outbreak of COVID-19, medical services for cross-border older adults have been blocked due to strict immigration controls. This article examines the effects of COVID-19 on these older adults, with a specific focus on the interruption of medical services and the remedial measures taken by the government and non-governmental organizations. It also discusses the prospect of delivering care for cross-border older people using telemedicine, which is considered one of the most important methods for overcoming space-distance and reducing the risk of cross-contamination caused by close contact.

Modeling the complete spatiotemporal spread of the COVID-19 epidemic in mainland China.

OBJECTIVES: The novel coronavirus (COVID-19) epidemic is reaching its final phase in China. The epidemic data are available for a complete assessment of epidemiological parameters in all regions and time periods. METHODS: This study aims to present a spatiotemporal epidemic model based on spatially stratified heterogeneity (SSH) to simulate the epidemic spread. A susceptible-exposed/latent-infected-removed (SEIR) model was constructed for each SSH-identified stratum (each administrative city) to estimate the spatiotemporal epidemiological parameters of the outbreak. RESULTS: We estimated that the mean latent and removed periods were 5.40 and 2.13 days, respectively. There was an average of 1.72 latent or infected persons per 10,000 Wuhan travelers to other locations until January 20th, 2020. The space-time basic reproduction number (R0) estimates indicate an initial value between 2 and 3.5 in most cities on this date. The mean period for R0 estimates to decrease to 80%, and 50% of initial values in cities were an average of 14.73 and 19.62 days, respectively. CONCLUSIONS: Our model estimates the complete spatiotemporal epidemiological characteristics of the outbreak in a space-time domain. These findings will help enhance a comprehensive understanding of the outbreak and inform the strategies of prevention and control in other countries worldwide.