Assessing vaccine hesitancy using the WHO scale for caregivers of children under 3 years old in China.

Introduction: Vaccine hesitancy may increase infectious disease burden and impede disease control efforts, while few studies have measured such a phenomenon with a standardized tool in China. This study aimed to test the validation of the Vaccine Hesitancy Scale (VHS) developed by the WHO SAGE Working Group among caregivers and examine demographic characteristics associated with caregiver hesitancy in six provinces of China. Methods: Using a multistage sampling design, this study was conducted in 36 immunization clinics in six provinces from December 2019 to August 2020. Caregivers of children aged 0-3 years were included. The VHS was used to assess vaccine hesitancy. The construct validity and internal consistency of the scale were assessed. Associations between caregivers' characteristics and vaccine hesitancy were examined by simple and multiple linear regression models. Results: Of the 3,359 participants included, a two-factor structure within the scale was identified, consisting of "lack of confidence" (1.89 ± 0.53) and "risks" (3.20 ± 0.75). Caregivers engaged in medical work expressed more confidence and were less concerned about risks compared to those of non-medical staff (p < 0.05). Participants with higher income levels were more confident (p < 0.05), while those surveyed after the COVID-19 pandemic, who were mothers, who had an older child, or who were raising a second or above birth child, had less concern about risks (p < 0.05). Discussion: We found that the VHS had acceptable reliability and construct validity and caregivers' hesitancy was driven more by concerns about risks than by the lack of confidence. Countering these concerns will be particularly important among non-medical staff, lower income, child's fathers, having a younger child, or raising first-birth child groups.

Analysis of Spatiotemporal Transmission Characteristics of African Swine Fever (ASF) in Mainland China

In view of the rapid spread of African swine fever in Mainland China from 2018 to 2019, we used spatiotemporal statistical analysis methods to study the spatiotemporal transmission features of African swine fever. The results reveal that the hot spots of African swine fever were concentrated in some cities in Northeast and Southwest China. Seven spatiotemporal clusters of African swine fever were identified, and the most likely spatiotemporal cluster was located in the Buyi and Miao Autonomous Prefecture of QianNan in Guizhou Province, and the cluster date was from 19 June to 25 June 2019. The first secondary cluster covered five cities (Shenyang, Yingkou, Panjin, Anshan, and Liaoyang) in Liaoning Province from 1 August to 10 October 2018. In addition, from the global and local transmission direction and speed of African swine fever in Mainland China, the spatial transmission speed of ASF was found to be slow from August to October 2018, and fast from February to March 2019. Lastly, the global and local isolation and exposure of sites infected with ASF were calculated in Mainland China to reveal the infection risk of different susceptible sites and time periods. [ FROM AUTHOR]

Quantitative evaluation of the role of Fangcang shelter hospitals in the control of Omicron transmission: A case study of the outbreak in Shanghai, China in 2022.

Since Omicron began to spread in China, Shanghai has become one of the cities with more severe outbreaks. Under the comprehensive consideration of the vaccine coverage rate, the number of Fangcang shelter hospital beds and the number of designated hospital beds in Shanghai, this paper established a deterministic compartmental model and used the Nelder-Mead Simplex Direct Search Algorithm and chi-square values to estimate the model parameters. we calculate ℛ0 = 3.6429 when the number of beds in the Fangcang shelter hospital is relatively tight in the second stage and ℛ0 = 0.4974 in the fifth stage when there are enough beds in both Fangcang shelter hospital and designated hospital. Then we perform a sensitivity analysis on ℛ0 by using perturbation of fixed point estimation of model parameters in the fifth stage, and obtain three parameters that are more sensitive to ℛ0, which are transmission rate (ß 1d ), proportion of the infectious (η) and the hospitalization rate of asymptomatic infected cases (δ 1). Through simulation, we obtain that if the hospitalization rate of asymptomatic infections δ 2 > 0.9373 or the transmission rate ß 1b  < 0.0467, the second stage of Omicron transmission in Shanghai can be well controlled. Finally, we find the measure that converting the National Convention and Exhibition Center (NECC) into a Fangcang shelter hospital has played an important role in curbing the epidemic. Whether this temporary Fangcang shelter hospital is not built or delayed, the cumulative number of confirmed cases will both exceed 100,000, and the cumulative asymptomatic infections will both exceed 1 million. In addition, for a city of 10 million people, we obtain that if a permanent Fangcang shelter hospital with 17,784 beds is built ahead of epidemic, there will be no shortage of beds during the outbreak of Omicron. Our findings enrich the content of the impact of Fangcang shelter hospital beds on the spread of Omicron and confirm the correct policy adopted by the Chinese government.

Assessing the effectiveness of the intervention measures of COVID-19 in China based on dynamical method.

Normalized interventions were implemented in different cities in China to contain the outbreak of COVID-19 before December 2022. However, the differences in the intensity and timeliness of the implementations lead to differences in final size of the infections. Taking the outbreak of COVID-19 in three representative cities Xi'an, Zhengzhou and Yuzhou in January 2022, as examples, we develop a compartmental model to describe the spread of novel coronavirus and implementation of interventions to assess concretely the effectiveness of Chinese interventions and explore their impact on epidemic patterns. After applying reported human confirmed cases to verify the rationality of the model, we apply the model to speculate transmission trend and length of concealed period at the initial spread phase of the epidemic (they are estimated as 10.5, 7.8, 8.2 days, respectively), to estimate the range of basic reproduction number (2.9, 0.7, 1.6), and to define two indexes (transmission rate v t and controlled rate v c ) to evaluate the overall effect of the interventions. It is shown that for Zhengzhou, v c is always more than v t with regular interventions, and Xi'an take 8 days to achieve v c  > v t twice as long as Yuzhou, which can interpret the fact that the epidemic situation in Xi'an was more severe. By carrying out parameter values, it is concluded that in the early stage, strengthening the precision of close contact tracking and frequency of large-scale nucleic acid testing of non-quarantined population are the most effective on controlling the outbreaks and reducing final size. And, if the close contact tracking strategy is sufficiently implemented, at the late stage large-scale nucleic acid testing of non-quarantined population is not essential.

COVID-19 vaccination boosts the potency and breadth of the immune response against SARS-CoV-2 among recovered patients in Wuhan.

The immunity of patients who recover from coronavirus disease 2019 (COVID-19) could be long lasting but persist at a lower level. Thus, recovered patients still need to be vaccinated to prevent reinfection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or its mutated variants. Here, we report that the inactivated COVID-19 vaccine can stimulate immunity in recovered patients to maintain high levels of anti-receptor-binding domain (RBD) and anti-nucleocapsid protein (NP) antibody titers within 9 months, and high neutralizing activity against the prototype, Delta, and Omicron strains was observed. Nevertheless, the antibody response decreased over time, and the Omicron variant exhibited more pronounced resistance to neutralization than the prototype and Delta strains. Moreover, the intensity of the SARS-CoV-2-specific CD4+ T cell response was also increased in recovered patients who received COVID-19 vaccines. Overall, the repeated antigen exposure provided by inactivated COVID-19 vaccination greatly boosted both the potency and breadth of the humoral and cellular immune responses against SARS-CoV-2, effectively protecting recovered individuals from reinfection by circulating SARS-CoV-2 and its variants.

Developing a Novel Immune-Related Seven-Gene Signature and Immune Infiltration Pattern in Patients with COVID-19 and Cardiovascular Disease.

BACKGROUND: patients with pre-existence of cardiovascular disease (CVD) are vulnerable to coronavirus disease 2019 (COVID-19), and COVID-19 will cause long-term burden of CVD. However, the common pathogenic mechanisms are not fully elucidated. More detailed knowledge of linking biological molecules and the role of immune signature would allow more valuable and specific clinical management. METHODS: the gene expression profiles of CVD and COVID-19 were retrieved from the GEO database. Common differentially expressed genes (DEGs) were screened with the Limma R package and the WGCNA algorithm, and then functional enrichment analysis, protein-protein interaction network, hub genes, and small therapeutic molecules analyses were performed. The hub immune-related genes (HIRGs) were intersected, and their associations with immune cells, expressional correlation, evaluated performance, and potential signal pathways were further investigated. RESULTS: In total, 57 common DEGs were identified as a shared transcriptional signature between CVD and COVID-19, and 12 hub genes were screened using five topological algorithms. There are common altered immune responses in the response of these two diseases, and seven HIRGs, including C5AR1, MMP9, CYBB, FPR2, CSF1R, TLR2, and TLR4, were identified, with positive correlation to altered macrophages and neutrophils. Nine small molecular agents (SMAs) were detected as promising therapeutic drugs. These seven HIRGs mainly participated in the inflammatory immune response through activation of Il2 stat5 signaling and Tnfa signaling via nfκb pathways, and ROC curves confirmed their good discriminatory capacity in the two diseases. CONCLUSIONS: this study established the co-expression network and identified a new immune-related seven-gene signature as therapeutic targets, which may provide new insights into pathogenic mechanisms and novel clinical management strategies.

Exploring the impact of shielding advice on the wellbeing of individuals identified as clinically extremely vulnerable amid the COVID-19 pandemic: a mixed-methods evaluation.

BACKGROUND: The national shielding programme was introduced by UK Government at the beginning of the COVID-19 pandemic, with individuals identified as clinically extremely vulnerable (CEV) offered advice and support to stay at home and avoid all non-essential contact. This study aimed to explore the impact and responses of "shielding" on the health and wellbeing of CEV individuals in Southwest England during the first COVID-19 lockdown. METHODS: A two-stage mixed methods study, including a structured survey (7 August-23 October 2020) and semi-structured telephone interviews (26 August-30 September 2020) with a sample of individuals who had been identified as CEV and advised to "shield" by Bristol, North Somerset & South Gloucestershire (BNSSG) Clinical Commissioning Group (CCG). RESULTS: The survey was completed by 203 people (57% female, 54% > 69 years, 94% White British, 64% retired) in Southwest England identified as CEV by BNSSG CCG. Thirteen survey respondents participated in follow-up interviews (53% female, 40% > 69 years, 100% White British, 61% retired). Receipt of 'official' communication from NHS England or General Practitioner (GP) was considered by participants as the legitimate start of shielding. 80% of survey responders felt they received all relevant advice needed to shield, yet interviewees criticised the timing of advice and often sought supplementary information. Shielding behaviours were nuanced, adapted to suit personal circumstances, and waned over time. Few interviewees received community support, although food boxes and informal social support were obtained by some. Worrying about COVID-19 was common for survey responders (90%). Since shielding had begun, physical and mental health reportedly worsened for 35% and 42% of survey responders respectively. 21% of survey responders scored ≥ 10 on the PHQ-9 questionnaire indicating possible depression and 15% scored ≥ 10 on the GAD-7 questionnaire indicating possible anxiety. CONCLUSIONS: This research highlights the difficulties in providing generic messaging that is applicable and appropriate given the diversity of individuals identified as CEV and the importance of sharing tailored and timely advice to inform shielding decisions. Providing messages that reinforce self-determined action and assistance from support services could reduce the negative impact of shielding on mental health and feelings of social isolation.

Mechanisms and strategies for operation of fever clinics in a general hospital during prevention and control of COVID-19

OBJECTIVE: To explore the mechanisms and strategies for operation of fever clinics of a general hospital during prevention and control of COVID-19. METHODS: The working characteristics and management modes of the fever clinic of the First Medical Center of Chinese PLA General Hospital were analyzed and summarized during the period of normalized prevention and control without cases and the period with local outbreak. RESULTS: During the period of normalized prevention and control, strict pre-job admission was carried out, the new recruits must pass the qualification test for special positions, the daily training was intensified, the treatment procedures were optimized, the step of identification of infectious diseases was moved forward to the triage;the closed-loop management of information was improved, the links such as identification of infectious diseases, treatment warning, prewarning and reporting have been achieved, and the standard prevention measures were taken. During the period of local outbreak, the application for demand of personnel and prevention supplies was put forward, fever clinic was designed and expanded, supporting personnel was trained, shifts were reasonably arranged, supervisors were added, and 24-hour logistic shifts wee also added. Zero infection of health care workers and zero case of nosocomial infection were achieved during the prevention and control of epidemic. CONCLUSION: The fever clinic is an outpost of prevention and control of infectious diseases. Combined with the characteristics, it is recommended that the construction of departments, personnel management and hardware configuration should be solidified and promoted.

Transmission characteristic and dynamic analysis of COVID-19 on contact network with Tianjin city in China.

The outbreak of 2019 novel coronavirus pneumonia (COVID-19) has had a profound impact on people's lives around the world, and the spread of COVID-19 between individuals were mainly caused by contact transmission of the social networks. In order to analyze the network transmission of COVID-19, we constructed a case contact network using available contact data of 136 early diagnosed cases in Tianjin. Based on the constructed case contact network, the structural characteristics of the network were first analyzed, and then the centrality of the nodes was analyzed to find the key nodes. In addition, since the constructed network may contain missing edges and false edges, link prediction algorithms were used to reconstruct the network. Finally, to understand the spread of COVID-19 in the network, an individual-based susceptible-latent-exposed-infected-recover (SLEIR) model is established and simulated in the network. The results showed that the disease peak scale caused by the node with the highest centrality is larger, and reducing the contact infection rate of the infected person during the incubation period has a greater impact on the peak disease scale.

Detection method for antibodies against SARS-CoV-2 and clinical application

To determine if a method to detect antibodies against SARS-CoV-2 can be applied clinically. In this retrospective study, the sera samples of 39 patients with newly diagnosed coronavirus disease 2019 (COVID- 19) and 90 healthy people were analyzed by antibody-detection reagents within enzyme-linked immunosorbent assays. The sera samples of confirmed cases at different onset times and 40 suspected cases were also tested. Then. we combined the results of antibody tests. nucleic-acid tests, and patient data. The sensitivity and specificity for SARS-COV-2-specific total antibodies was 92.31% and 100%, respectively. The production time of total antibodies in serum samples increased with time. and the median detection time was 13 days. The result of antibody testing of one confirmed case preceded the result of the nucleic-acid test. Moreover, the antibodies 0f 40 suspected cases were all negative. Detection of the total antibodies against SARS-CoV-2 can be used as an auxiliary diagnostic indicator of infection by this virus, as well as a supplementary means to exclude suspected cases/populations in areas with a high prevalence of negative detection of the nucleic acids of SARS-CoV-2.

Surface charge changes in spike RBD mutations of SARS-CoV-2 and its variant strains alter the virus evasiveness via HSPGs: A review and mechanistic hypothesis.

With the COVID-19 pandemic continuing, more contagious SARS-CoV-2 variants, including Omicron, have been emerging. The mutations, especially those that occurred on the spike (S) protein receptor-binding domain (RBD), are of significant concern due to their potential capacity to increase viral infectivity, virulence, and breakthrough antibodies' protection. However, the molecular mechanism involved in the pathophysiological change of SARS-CoV-2 mutations remains poorly understood. Here, we summarized 21 RBD mutations and their human angiotensin-converting enzyme 2 (hACE2) and/or neutralizing antibodies' binding characteristics. We found that most RBD mutations, which could increase surface positive charge or polarity, enhanced their hACE2 binding affinity and immune evasion. Based on the dependence of electrostatic interaction of the epitope residue of virus and docking protein (like virus receptors or antibodies) for its invasion, we postulated that the charge and/or polarity changes of novel mutations on the RBD domain of S protein could affect its affinity for the hACE2 and antibodies. Thus, we modeled mutant S trimers and RBD-hACE2 complexes and calculated their electrotactic distribution to study surface charge changes. Meanwhile, we emphasized that heparan sulfate proteoglycans (HSPGs) might play an important role in the hACE2-mediated entry of SARS-CoV-2 into cells. Those hypotheses provide some hints on how SARS-CoV-2 mutations enhance viral fitness and immune evasion, which may indicate potential ways for drug design, next-generation vaccine development, and antibody therapies.

Aerosol Characteristics during the COVID-19 Lockdown in China: Optical Properties, Vertical Distribution, and Potential Source

The concentration changes of aerosols have attracted wide-ranging attention during the COVID-19 lockdown (CLD) period, but the studies involving aerosol optical properties (AOPs) are relatively insufficient, mainly AOD (fine-mode AOD (AODf) and coarse-mode AOD (AODc)), aerosol absorption optical depth (AAOD), and aerosol extinction coefficient (AEC). Here, the remote-sensing observations, Modern-Era Retrospective analysis for Research and Applications, Version 2 (MERRA-2) products, backward-trajectory, and potential-source-contribution models are used to assess the impact of AOPs, vertical distribution, and possible sources on the atmosphere environment in North China Plain (NCP), Central China (CC), Yangtze River Delta (YRD), Pearl River Delta (PRD), and Sichuan Basin (SB) during the CLD period. The results demonstrate that both AOD (MODIS) and near-surface AEC (CALIPSO, <2 km) decreased in most areas of China. Compared with previous years (average 2017–2019), the AOD (AEC) of NCP, CC, YRD, PRD, and SB reduced by 3.33% (10.76%), 14.36% (32.48%), 10.80% (29.64%), 31.44% (22.68%), and 15.50% (8.44%), respectively. In addition, MODIS (AODc) and MERRA-2 (AODc) decreased in the five study areas compared with previous years, so the reduction in dust activities also contributed to improving regional air quality during the epidemic. Despite the reduction of anthropogenic emissions (AODf) in most areas of China during the CLD periods, severe haze events (AODf > 0.6) still occurred in some areas. Compared to previous years, there were increases in BC, OC (MERRA-2), and national raw coal consumption during CLD. Therefore, emissions from some key sectors (raw coal heating, thermal power generation, and residential coal) did not decrease, and this may have increased AODf during the CLD. Based on backward -rajectory and potential source contribution models, the study area was mainly influenced by local anthropogenic emissions, but some areas were also influenced by northwestern dust, Southeast Asian biomass burning, and marine aerosol transport. This paper underscores the importance of emissions from the residential sector and thermal power plants for atmospheric pollution in China and suggests that these sources must be taken into account in developing pollution-mitigation plans. [ FROM AUTHOR] Copyright of Remote Sensing is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Role of LL-37 in thrombotic complications in patients with COVID-19.

Blood clot formation induced by dysfunctional coagulation is a frequent complication of coronavirus disease 2019 (COVID-19) and a high-risk factor for severe illness and death. Neutrophil extracellular traps (NETs) are implicated in COVID-19-induced immunothrombosis. Furthermore, human cathelicidin, a NET component, can perturb the interaction between the SARS-CoV-2 spike protein and its ACE2 receptor, which mediates viral entry into cells. At present, however, the levels of cathelicidin antimicrobial peptides after SARS-CoV-2 infection and their role in COVID-19 thrombosis formation remain unclear. In the current study, we analyzed coagulation function and found a decrease in thrombin time but an increase in fibrinogen level, prothrombin time, and activated partial thromboplastin time in COVID-19 patients. In addition, the cathelicidin antimicrobial peptide LL-37 was upregulated by the spike protein and significantly elevated in the plasma of patients. Furthermore, LL-37 levels were negatively correlated with thrombin time but positively correlated with fibrinogen level. In addition to platelet activation, cathelicidin peptides enhanced the activity of coagulation factors, such as factor Xa (FXa) and thrombin, which may induce hypercoagulation in diseases with high cathelicidin peptide levels. Injection of cathelicidin peptides promoted the formation of thrombosis, whereas deletion of cathelicidin inhibited thrombosis in vivo. These results suggest that cathelicidin antimicrobial peptide LL-37 is elevated during SARS-CoV-2 infection, which may induce hypercoagulation in COVID-19 patients by activating coagulation factors.

Transmission dynamics of COVID-19 in Wuhan, China: effects of lockdown and medical resources.

Due to the strong infectivity of COVID-19, it spread all over the world in about three months and thus has been studied from different aspects including its source of infection, pathological characteristics, diagnostic technology and treatment. Yet, the influences of control strategies on the transmission dynamics of COVID-19 are far from being well understood. In order to reveal the mechanisms of disease spread, we present dynamical models to show the propagation of COVID-19 in Wuhan. Based on mathematical analysis and data analysis, we systematically explore the effects of lockdown and medical resources on the COVID-19 transmission in Wuhan. It is found that the later lockdown is adopted by Wuhan, the fewer people will be infected in Wuhan, and nevertheless it will have an impact on other cities in China and even the world. Moreover, the richer the medical resources, the higher the peak of new infection, but the smaller the final scale. These findings well indicate that the control measures taken by the Chinese government are correct and timely.

Optimal Breeding Strategy for Livestock with a Dynamic Price

China’s livestock output has been growing, but domestic livestock products such as beef, mutton and pork have been unable to meet domestic consumers’ demands. The imbalance between supply and demand causes unstable livestock prices and affects profits on livestock. Therefore, the purpose of this paper is to provide the optimal breeding strategy for livestock farmers to maximize profits and adjust the balance between supply and demand. Firstly, when the price changes, livestock farmers will respond in two ways: by not adjusting the scale of livestock with the price or adjusting the scale with the price. Therefore, combining the model of price and the behavior of livestock farmers, two livestock breeding models were established. Secondly, we proposed four optimal breeding strategies based on the previously studied models and the main research method is Pontryagin’s Maximum Principle. Optimal breeding strategies are achieved by controlling the growth and output of livestock. Further, their existence was verified. Finally, we simulated two situations and found the most suitable strategy for both situations by comparing profits of four strategies. From that, we obtained several conclusions: The optimal strategy under constant prices is not always reasonable. The effect of price on livestock can promote a faster balance. To get more profits, the livestock farmers should adjust the farm’s productivity reasonably. It is necessary to calculate the optimal strategy results under different behaviors.

Application value of chemiluminescent immunoassay in the detection of 2019-nCoV antibodies

Objective: To evaluate the application value of chemiluminescent immunoassay in the detection of 2019-nCoV antibodies.

Individual hurricane evacuation intentions during the COVID-19 pandemic: insights for risk communication and emergency management policies.

The U.S. 2020 hurricane season was extraordinary because of a record number of named storms coinciding with the COVID-19 pandemic. This study draws lessons on how individual hurricane preparedness is influenced by the additional risk stemming from a pandemic, which turns out to be a combination of perceptions of flood and pandemic risks that have opposite effects on preparedness behavior. We conducted a survey in early June 2020 of 600 respondents in flood-prone areas in Florida to obtain insights into households' risk perceptions and preparedness for the upcoming hurricane season under COVID-19. The results show that concerns over COVID-19 dominated flood risk perceptions and negatively impacted people's evacuation intentions. Whereas hotel costs were the main obstacle to evacuating during Hurricane Dorian in 2019 in the same geographic study area, the main evacuation obstacle identified in the 2020 hurricane season is COVID-19. Our statistical analyses investigating the factors influencing evacuation intentions show that older individuals are less likely to evacuate under a voluntary order, because they are more concerned about the consequences of becoming infected by COVID-19. We observe similar findings based on a real-time survey we conducted in Florida with another group of respondents under the threat of Hurricane Eta at the end of the hurricane season in November 2020. We discuss the implications of our findings for risk communication and emergency management policies that aim to improve hurricane preparedness when dealing with additional health risks such as a pandemic, a situation that may be exacerbated under the future climate. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11069-021-05064-2.

Forecasting of the efficiency of monoclonal therapy in the treatment of CoViD-19 induced by the Omicron variant of SARS-CoV2.

On November 26, 2021, the World Health Organization (WHO) announced a new variant of concern of SARS-CoV2 called Omicron. This variant has biological-functional characteristics such as to make it much faster in the infectious process so as to show an even more intense spread. Although many data are currently incomplete, it is possible to identify, based on the viral biochemical characteristics, a possible therapy consisting of a monoclonal antibody called Sotrovimab. The model proposed here is based on the mathematical analysis of the dynamics of action of this monoclonal antibody and two cell populations: the immune memory cells and the infected cells. Indeed, a delay exists during the physiological immune response and the response induced by administration of Sotrovimab. This manuscript presents that delay in a novel manner. The model is developed with the aid of information based on the chemical kinetics. The machine learning tools have been used to satisfy the criteria designed by the dynamical analysis. Regression learner tools of Python are used as the reverse engineering tools for the understanding of the balance in the mathematical model, maintained by the parameters and their corresponding intervals and thresholds set by the dynamical analysis.

Guidelines on the treatment with integrated traditional Chinese medicine and western medicine for severe coronavirus disease 2019.

Severe Coronavirus Disease 2019 (COVID-19) is characterized by numerous complications, complex disease, and high mortality, making its treatment a top priority in the treatment of COVID-19. Integrated traditional Chinese medicine (TCM) and western medicine played an important role in the prevention, treatment, and rehabilitation of COVID-19 during the epidemic. However, currently there are no evidence-based guidelines for the integrated treatment of severe COVID-19 with TCM and western medicine. Therefore, it is important to develop an evidence-based guideline on the treatment of severe COVID-19 with integrated TCM and western medicine, in order to provide clinical guidance and decision basis for healthcare professionals, public health personnel, and scientific researchers involved in the diagnosis, treatment, and care of COVID-19 patients. We developed and completed the guideline by referring to the standardization process of the "WHO handbook for guideline development", the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, and the Reporting Items for Practice Guidelines in Healthcare (RIGHT).

Individual hurricane evacuation intentions during the COVID-19 pandemic: insights for risk communication and emergency management policies

The U.S. 2020 hurricane season was extraordinary because of a record number of named storms coinciding with the COVID-19 pandemic. This study draws lessons on how individual hurricane preparedness is influenced by the additional risk stemming from a pandemic, which turns out to be a combination of perceptions of flood and pandemic risks that have opposite effects on preparedness behavior. We conducted a survey in early June 2020 of 600 respondents in flood-prone areas in Florida to obtain insights into households’ risk perceptions and preparedness for the upcoming hurricane season under COVID-19. The results show that concerns over COVID-19 dominated flood risk perceptions and negatively impacted people’s evacuation intentions. Whereas hotel costs were the main obstacle to evacuating during Hurricane Dorian in 2019 in the same geographic study area, the main evacuation obstacle identified in the 2020 hurricane season is COVID-19. Our statistical analyses investigating the factors influencing evacuation intentions show that older individuals are less likely to evacuate under a voluntary order, because they are more concerned about the consequences of becoming infected by COVID-19. We observe similar findings based on a real-time survey we conducted in Florida with another group of respondents under the threat of Hurricane Eta at the end of the hurricane season in November 2020. We discuss the implications of our findings for risk communication and emergency management policies that aim to improve hurricane preparedness when dealing with additional health risks such as a pandemic, a situation that may be exacerbated under the future climate. Supplementary Information The online version contains supplementary material available at 10.1007/s11069-021-05064-2.