RESUMO
Background Wastewater surveillance provides real-time, cost-effective monitoring of SARS-CoV-2 transmission. We developed the first city-level wastewater warning system in mainland China, located in Shenzhen. Our study aimed to reveal cryptic transmissions under the "dynamic COVID-zero" policy and characterize the dynamics of the infected population and variant prevalence, and then guide the allocation of medical resources during the transition to "opening up" in China. Methods In this population-based study, a total of 1,204 COVID-19 cases were enrolled to evaluate the contribution of Omicron variant-specific faecal shedding rates in wastewater. After that, wastewater samples from up to 334 sites distributed in communities and port areas in two districts of Shenzhen covering 1.74 million people were tested daily to evaluate the sensitivity and specificity of this approach and were validated against daily SARS-CoV-2 screening. After the public health policy was switched to "opening up" in December 7, 2022, we conducted wastewater surveillance at wastewater treatment plants and pump stations covering 3.55 million people to estimate infected populations using model prediction and detect the relative abundance of SARS-CoV-2 lineages using wastewater sequencing. Findings In total, 82.4% of SARS-CoV-2 Omicron cases tested positive for faecal viral RNA within the first four days after the diagnosis, which was far more than the proportion of the ancestral variant. A total of 27,759 wastewater samples were detected from July 26 to November 30 in 2022, showing a sensitivity of 73.8% and a specificity of 99.8%. We further found that wastewater surveillance played roles in providing early warnings and revealing cryptic transmissions in two communities. Based on the above results, we employed a prediction model to monitor the daily number of infected individuals in Shenzhen during the transition to "opening up" in China, with over 80% of the population infected in both Futian District and Nanshan District. Notably, the prediction of the daily number of hospital admission was consistent with the actual number. Further sequencing revealed that the Omicron subvariant BA.5.2.48 accounted for the most abundant SARS-CoV-2 RNA in wastewater, and BF.7.14 and BA.5.2.49 ranked second and third, respectively, which was consistent with the clinical sequencing. Interpretation This study provides a scalable solution for wastewater surveillance of SARS-CoV-2 to provide real-time monitoring of the new variants, infected populations and facilitate the precise prediction of hospital admission. This novel framework could be a One Health system for the surveillance of other infectious and emerging pathogens with faecal shedding and antibiotic resistance genes in the future. Funding Sanming Project of Medicine in Shenzhen, Shenzhen Key Medical Discipline Construction Fund.
Assuntos
COVID-19RESUMO
Rapid social development has led to serious air pollution problems in cities, and air pollutants, including gaseous pollutants and particulate matter, have an important impact on climate, the environment, and human health. This study analyzed the characteristics, potential sources, and causes of air pollution in the Wu-Chang-Shi urban cluster. The results showed that NO2, CO, SO2, PM10, and PM2.5 had a tendency to decrease, while O3 showed an increasing trend. The concentrations of SO2, NO2, CO, PM2.5, and PM10 showed the highest values in winter and the lowest values in summer, with similar seasonal variations. However, the concentration of O3 was highest in the summer and lowest in the winter. Compared with the pollutant concentrations in other Chinese cities, PM2.5, PM10, and NO2 are more polluted in the Wu-Chang-Shi urban. Meteorological factors have a greater impact on pollutant concentrations, with higher concentrations of major pollutants observed when wind speeds are low and specific wind directions are observed, and higher secondary pollutant O3 concentrations observed when wind speeds are low and specific wind directions are observed. The backward trajectory and concentration weighting analysis show that the particulate pollutants in the Wu-Chang-Shi urban in winter mainly come from Central Asia and surrounding cities. O3 showed an increasing trend before and after the novel coronavirus outbreak, which may be related to changes in NOX, volatile organic compounds, and solar radiation intensity, and the concentrations of SO2, NO2, CO, PM10, and PM2.5 showed an overall decreasing trend after the outbreak and was smaller than before the outbreak, which is related to the reduction of industrial and anthropogenic source emissions during the outbreak.
RESUMO
Background: It has been reported that the infections have played an important role in the pathogenesis for pediatric rheumatic diseases. The COVID-19 had the impact on the frequency of these diseases and led to a remarkable decrease of them, which confirmed the role of infections in these diseases. Objectives: To investigate the epidemiologic characteristics and pathogen profile of Kawasaki disease(KD) from a single center in China from 2018 to 2020 during the Coronavirus Disease 2019 (COVID-19) pandemic period.