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Objectives: Various interventions were used to control the COVID-19 pandemic and protect population health, including vaccination, medication and nonpharmaceutical interventions (NPIs). This study aims to examine the cost-effectiveness of different combinations of NPIs (including social distancing, mask wearing, tracing-testing-isolation, mass testing, and lockdown), oral medicine (Paxlovid), and vaccination (including two-dose and three-dose vaccination) under the Delta and Omicron pandemic in China. Method(s): We constructed a Markov model using a SIRI structure with a one-week cycle length over one-year time horizon to estimate the cost-effectiveness of different combinations in China from societal perspective. Effectiveness of interventions, disease transition probabilities and costs were from published data, quality-adjusted life years (QALYs) gained and incremental cost-effectiveness ratios (ICER) and net monetary benefits were calculated for one-year time horizon. One-way and probabilistic sensitivity analyses were performed to test the robustness of the model. Scenario analysis was developed to examine different situations under the Omicron pandemic. Result(s): Under the Delta pandemic, implementing the combination of social distancing, mask wearing, mass testing and three-dose vaccination was the optimal strategy, with cost at $11165635.33 and utility of 94309.94 QALYs, and had 60% probability of being cost-effective compared with other strategies. Three-dose vaccination combinations were better than two-dose combinations. Under the Omicron pandemic, antigen testing was better than nucleic testing by avoiding cross infections;second, adding Paxlovid or lockdown to the combined intervention strategies could increase limited health outcomes at huge cost and thus were not cost-effective;last, encouraging patients to stay at home can save societal costs compared with concentrated quarantine at hospitals. Conclusion(s): Three-dose vaccination and self-quarantine of asymptomatic and mild cases can save total costs. Under the Omicron pandemic outbreak, antigen testing is a better way to control the pandemic, and adding Paxlovid or lockdown to intervention combinations is not cost-effective.Copyright © 2023
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Individualized lung-protective ventilation strategy is essential for patients with COVID-19. In this study, a wireless, low-power and miniaturized electrical impedance tomography (EIT) system was developed for remote and long-term monitoring of lung ventilation for patients with COVID-19 in the isolation ward of ICU. A new strategy of combining filtering and improved voltage-controlled current was employed to design the current source for a simplified system structure, and a new differential receiver circuit consisting of a buffer amplification and a differential amplification was proposed to design the voltage measurement unit for high precision. Moreover, a Bluetooth interface was adopted for wireless data transmission, and components characterized by low power consumption were selected to minimize the system power consumption. The proposed EIT system occupies a total size of 6.5*4.5*0.6 cm3 and can work stably within 25 m from the wireless terminal installed with host EIT software. The system has a signal-to-noise of 70 dB at 50 kHz, stability of 0.1% relative change, and power consumption of 114 mW, as tested with a resistor phantom. Further, a comparison between the proposed system and a commercial ICU EIT device was conducted on nine healthy volunteers for ventilation monitoring. The correlation between lung volume and relative impedance changes was higher than 0.9 for both EIT systems (p<0.001). The analysis of the corresponding EIT images revealed that both systems delivered comparable images in terms of linearity, repeatability and regional ventilation distribution. The test and experimental results suggested that the proposed system could conveniently provide reliable data acquisition for remote and long-term lung ventilation monitoring. CCBYNCND
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In order to fight against the spread of COVID-19, the most hard-hit countries in the spring of 2020 implemented different lockdown strategies. To assess the impact of the COVID-19 pandemic lockdown on air quality worldwide, Air Quality Index (AQI) data was used to estimate the change in air quality in 20 major cities on six continents. Our results show significant declines of AQI in NO2, SO2, CO, PM2.5 and PM10 in most cities, mainly due to the reduction of transportation, industry and commercial activities during lockdown. This work shows the reduction of primary pollutants, especially NO2, is mainly due to lockdown policies. However, preexisting local environmental policy regulations also contributed to declining NO2, SO2 and PM2.5 emissions, especially in Asian countries. In addition, higher rainfall during the lockdown period could cause decline of PM2.5, especially in Johannesburg. By contrast, the changes of AQI in ground-level O-3 were not significant in most of cities, as meteorological variability and ratio of VOC/NOx are key factors in ground-level O-3 formation.