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Wastewater-based epidemiology (WBE) has exhibited great utility in the early and rapid identification of SARS-CoV-2. However, the efficacy of wastewater surveillance under China's previous strict epidemic prevention policy remains to be described. We collected the WBE data of wastewater treatment plants (WWTPs) in the Third People's Hospital of Shenzhen and several communities to determine the significant effectiveness of routine wastewater surveillance in monitoring the local spread of SARS-CoV-2 under tight containment of the epidemic. The results of 1 month of continuous wastewater surveillance showed that positive signals for SARS-CoV-2 RNA were detected in the wastewater samples, and a significant positive correlation was observed between the virus concentration and the number of daily cases. In addition, the community's domestic wastewater surveillance results were confirmed even 3 days before, or simultaneously with, the infected patient being confirmed as having the virus. Meanwhile, an automated sewage virus detection robot, ShenNong No.1 robot, was developed, showing a high degree of agreement with experimental data, offering the possibility of large-scale multi-point surveillance. Overall, our results illustrated the clear indicative role of wastewater surveillance in combating COVID-19 and provided a practical basis for rapidly expanding the feasibility and value of routine wastewater surveillance for future emerging infectious diseases.
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Urban Living Labs (ULLs) are widely believed to provide a safe environment for experimentation, co-creation and evaluation of innovations in real-life settings. A growing number of cities have been adopting ULLs to co-create and test Nature-Based Solutions (NBS). However, many of these cities have been facing major barriers in trying to adopt the ULL approach for implementing NBS. In this study, we seek to identify these barriers and provide a systemic understanding. Barriers are identified by means of workshops and interviews. Subsequently, interpretive structural modelling serves to identify the interdependencies among the barriers, resulting in a structural model of barriers in adopting ULLs for NBS. Our results show that political and institutional barriers are significantly limiting the adoption of ULLs. Moreover, knowledge brokers and other intermediaries, as well as cross-sectoral collaboration, play a key role in getting ULLs adopted. The findings from this study can help cities to develop strategies that overcome the main barriers for ULL adoption in the context of nature-based solutions.
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Objective: Athletes are suffering from many uncertainties and hope to achieve the best possible position under the current circumstances of this global coronavirus disease (COVID-19) pandemic. In this study, we aimed to address the severity and psychological support for athletes with COVID-19. Methods: We extracted public data and news reports of the up-to-date first seven cases of elite athletes with COVID-19 confirmed in China and made psychological recommendations based on scientific evidence. Results: The severity and mortality in athletes who tested positive to COVID-19 are mild and extremely low. The included cases from different sports are two soccer players, two athletes from ice hockey, and three from fencing. In this study, we adapted well-recognized psychological questionnaires, improvised it for athletes to use under the COVID-19 pandemic, and also provided recommended psychological support. Conclusion: The severity and mortality in Chinese athletes contracted with COVID-19 are mild and low with zero death. Psychological support of any kind from nurses, team medical staff, psychologists, family, and friends through social media and telecommunication should be adopted and can be of great help.
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Background: Interleukin-6 (IL-6) is known to be detrimental in coronavirus disease 2019 (COVID-19) because of its involvement in driving cytokine storm. This systematic review and meta-analysis aimed to assess the safety and efficacy of anti-IL-6 signaling (anti-IL6/IL-6R/JAK) agents on COVID-19 based on the current evidence. Methods: Studies were identified through systematic searches of PubMed, EMBASE, ISI Web of Science, Cochrane library, ongoing clinical trial registries (clinicaltrials.gov), and preprint servers (medRxiv, ChinaXiv) on August 10, 2020, as well as eligibility checks according to predefined selection criteria. Statistical analysis was performed using Review Manager (version 5.3) and STATA 12.0. Results: Thirty-one studies were included in the pooled analysis of mortality, and 12 studies were identified for the analysis of risk of secondary infections. For mortality analysis, 5630 COVID-19 cases including 2,132 treated patients and 3,498 controls were analyzed. Anti-IL-6 signaling agents plus standard of care (SOC) significantly decreased the mortality rate compared to SOC alone (pooled OR = 0.61, 95% CI 0.45-0.84, p = 0.002). For the analysis of secondary infection risk, 1,624 patients with COVID-19 including 639 treated patients and 985 controls were included, showing that anti-IL-6 signaling agents did not increase the rate of secondary infections (pooled OR = 1.21, 95% CI 0.70-2.08, p = 0.50). By contrast, for patients with critical COVID-19 disease, anti-IL-6 signaling agents failed to reduce mortality compared to SOC alone (pooled OR = 0.75, 95% CI 0.42-1.33, p = 0.33), but they tended to increase the risk of secondary infections (pooled OR = 1.85, 95% CI 0.95-3.61, p = 0.07). A blockade of IL-6 signaling failed to reduce the mechanical ventilation rate, ICU admission rate, or elevate the clinical improvement rate. Conclusion: IL-6 signaling inhibitors reduced the mortality rate without increasing secondary infections in patients with COVID-19 based on current studies. For patients with critical disease, IL-6 signaling inhibitors did not exhibit any benefit.
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Abstract Purpose: This study investigated the KAP towards COVID-19 and their influencing factors among primary and middle school students during the self-quarantine period in Beijing. Methods: This was a cross-sectional study among students from 18 primary and middle schools in Beijing during March 2020. Stratified cluster sampling was conducted. Demographic and KAP-related COVID-19 information was collected through an online questionnaire. The influencing factors were analyzed by multivariable logistic regression. Results: A total of 7,377 students were included. The overall correct rate for COVID-19 knowledge was 74.1%, while only 31.5% and 40.5% could identify the high-risk places of cross-infection and warning body temperature. Although 94.5% of respondents believed the epidemic could be controlled, over 50% expressed various concerns about the epidemic. The compliance rates for basic preventing behaviors were all over 80%, while those for "rational and effective ventilation" (39.2%) and "dinning separately" (38.6%) were low. The KAP levels were significantly differed according to various school categories of students. The COVID-19 knowledge (OR= 3.309, 95% CI: 2.921, 3.748) and attitude (OR=1.145, 95% CI: 1.003, 1.308) were associated with preventive practices. Besides, female, urban students, those with a healthy lifestyle, and those with the willingness to engage in healthcare tended to have better preventive practices. Conclusion: Most students in Beijing hold a high level of knowledge, optimistic attitudes and have appropriate practices towards COVID-19. However, targeted interventions are still necessary, especially for students with high-risk characteristics. Keywords: COVID-19; primary and middle school students; knowledge; attitude; practice