Driving Factors and Scale Effects of Residents' Willingness to Pay for Environmental Protection under the Impact of COVID-19

In recent years, environmental degradation and the COVID-19 pandemic have seriously affected economic development and social stability. Addressing the impact of major public health events on residents' willingness to pay for environmental protection (WTPEP) and analyzing the drivers are necessary for improving human well-being and environmental sustainability. We designed a questionnaire to analyze the change in residents' WTPEP before and during COVID-19 and an established ordinary least squares (OLS), spatial lag model (SLM), spatial error model (SEM), geographically weighted regression (GWR), and multiscale GWR to explore driver factors and scale effects of WTPEP based on the theory of environment Kuznets curve (EKC). The results show that (1) WTPEP is 0–20,000 yuan before COVID-19 and 0–50,000 yuan during COVID-19. Residents' WTPEP improved during COVID-19, which indicates that residents' demand for an ecological environment is increasing;(2) The shapes and inflection points of the relationships between income and WTPEP are spatially heterogeneous before and during COVID-19, but the northern WTPEP is larger than southern, which indicates that there is a spatial imbalance in WTPEP;(3) Environmental degradation, health, environmental quality, and education are WTPEP's significant macro-drivers, whereas income, age, and gender are significant micro-drivers. Those factors can help policymakers better understand which factors are more suitable for macro or micro environmental policy-making and what targeted measures could be taken to solve the contradiction between the growing ecological environment demand of residents and the spatial imbalance of WTPEP in the future.

The effect of corticosteroid treatment on patients with coronavirus infection: a systematic review and meta-analysis.

OBJECTIVES: An outbreak of novel coronavirus in 2019 threatens the health of people, and there is no proven pharmacological treatment. Although corticosteroids were widely used during outbreaks of severe acute respiratory syndrome and Middle East respiratory syndrome, their efficacy remainedhighly controversial. We aimed to further evaluate the influence of corticosteroids on patients with coronavirus infection. METHODS: We conducted a comprehensive search of literature published in PubMed, Embase, Cochrane library, and China National Knowledge Infrastructure (CNKI) from January 1, 2002 to March 15, 2020. All statistical analyses in this study were performed on stata14.0. RESULTS: A total of 5270 patients from 15 studies were included in this meta-analysis. The result indicated that critical patients were more likely to require corticosteroids therapy (risk ratio [RR] = 1.56, 95% confidence interval [CI] = 1.28-1.90, P<0.001). However, corticosteroid treatment was associated with higher mortality (RR = 2.11, 95%CI = 1.13-3.94, P = 0.019), longer length of stay (weighted mean difference [WMD] = 6.31, 95%CI = 5.26-7.37, P<0.001), a higher rate of bacterial infection (RR = 2.08, 95%CI = 1.54-2.81, P<0.001), and hypokalemia (RR = 2.21, 95%CI = 1.07-4.55, P = 0.032) but not hyperglycemia (RR = 1.37, 95%CI=0.68-2.76, P = 0.376) or hypocalcemia (RR = 1.35, 95%CI = 0.77-2.37, P = 0.302). CONCLUSIONS: Patients with severe conditions are more likely to require corticosteroids. Corticosteroid use is associated with increased mortality in patients with coronavirus pneumonia.