Risk assessment of public health emergencies concerned in the mainland of China, January 2023

Objective: To assess the risk of public health emergencies occurring in the mainland of China or possibly imported from outside China in January 2023. Methods: Based on various data and departmental notification information on domestic and foreign public health emergencies reports and surveillance of key infectious diseases, the expert consultation method was used and experts from provincial (autonomous regions and municipalities directly under the central government) centers for disease prevention and control were invited to participate in the assessment by video conference. Results: The number of public health emergencies reported in January 2023 is expected to increase or be similar to that reported in December 2022. The COVID-19 rebound in the northern hemisphere is likely to continue in January 2023 due to immune escape of BQ, XBB and other possible emerging Omicron variants' subtypes. The increased migration of people in Chinese mainland during the Spring Festival in 2023 could increase the risk of the spread of the SARS-CoV-2 among uninfected people. The level of influenza virus activity is likely to increase in January, and influenza A is likely to dominate. January 2023 remains risky month for nonoccupational carbon monoxide poisoning. Conclusion: Special attention is given to COVID-19, and general attention is given to seasonal influenza and nonoccupational carbon monoxide poisoning.

Real-world effectiveness of primary series and booster doses of inactivated COVID-19 vaccine against Omicron BA.2 variant infection in China: a retrospective cohort study.

BACKGROUND: China has been using inactivated COVID-19 vaccines as primary series and booster doses to protect the population from severe to fatal COVID-19. We evaluated primary and booster vaccine effectiveness (VE) against Omicron BA.2 infection outcomes. METHODS: This was a 13-province retrospective cohort study of quarantined close contacts of BA.2-infected individuals. Outcomes were BA.2 infection, COVID-19 pneumonia or worse, and severe/critical COVID-19. Absolute VE was estimated by comparison with an unvaccinated group. RESULTS: There were 289,427 close-contacts ≥3 years old exposed to Omicron BA.2 cases; 31,831 turned nucleic-acid amplification test (NAAT)-positive during quarantine, 97.2% with mild or asymptomatic infection, 2.6% had COVID-19 pneumonia, and 0.15% had severe/critical COVID-19. None died. Adjusted VE against any infection was 17% for primary series and 22% when boosted. Primary series aVE in adults >18 years was 66% against pneumonia or worse infection and 91% against severe/critical COVID-19. Booster dose aVE was 74% against pneumonia or worse, and 93% against severe/critical COVID-19. CONCLUSIONS: Inactivated COVID-19 vaccines provided modest protection from infection, very good protection against pneumonia, and excellent protection against severe/critical COVID-19. Booster doses are necessary to provide strongest protection.

Unusual Experience in the COVID-19 Pandemic: Young Children's Readjustment from Home to Preschool following School Closures in Different Risk Regions.

Children's readjustment to preschool following long-term school closures during the COVID-19 pandemic merits special attention. This study examined children's preschool readjustment using a survey of 1008 teachers in a high-risk region and 1399 teachers in a fluctuating-risk region of China. Results found are as follows. (1) children's preschool readjustment was at a medium level after the long-term school closures. However, children's preschool readjustment scores in the fluctuating-risk region were significantly lower than those in the high-risk region. (2) Children in both regions were divided into four profiles based on their preschool readjustment: low-level, middle-level, upper-middle-level, and high-level groups. (3) Preschool transition practices and teachers' turnover intention are common factors relating to preschool readjustment in both regions. Teachers' professional development support impacted children's preschool readjustment only in the high-risk region. The findings inform the design of targeted interventions to help children readjust to preschool across different risk regions.

Risk assessment of public health emergencies concerned in the mainland of China, September 2022

Objective: To assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in March 2022.

Risk assessment of public health emergencies concerned in the mainland of China, June 2022

Objective: To assess the risk of public health emergencies, including both indigenous and imported ones, which might occur in the mainland of China in June 2022.

Factors associated with neutralizing antibody levels induced by two inactivated COVID-19 vaccines for 12 months after primary series vaccination.

Background: BBIBP-CorV and CoronaVac inactivated COVID-19 vaccines are widely-used, World Health Organization-emergency-listed vaccines. Understanding antibody level changes over time after vaccination is important for booster dose policies. We evaluated neutralizing antibody (nAb) titers and associated factors for the first 12 months after primary-series vaccination with BBIBP-CorV and CoronaVac. Methods: Our study consisted of a set of cross-sectional sero-surveys in Zhejiang and Shanxi provinces, China. In 2021, we enrolled 1,527 consenting 18-59-year-olds who received two doses of BBIBP-CorV or CoronaVac 1, 3, 6, 9, or 12 months earlier and obtained blood samples and demographic and medical data. We obtained 6-month convalescent sera from 62 individuals in Hebei province. Serum nAb titers were measured by standard micro-neutralization cytopathic effect assay in Vero cells with ancestral SARS-CoV-2 strain HB01. We used the first WHO International Standard (IS) for anti-SARS-CoV-2 immunoglobulin (NIBSC code 20/136) to standardized geometric mean concentrations (IU/mL) derived from the nAb geometric mean titers (GMT over 1:4 was considered seropositive). We analyzed nAb titer trends using Chi-square and factors related to nAb titers with logistic regression and linear models. Results: Numbers of subjects in each of the five month-groupings ranged from 100 to 200 for each vaccine and met group-specific target sample sizes. Seropositivity rates from BBIBP-CorV were 98.0% at 1 month and 53.5% at 12 months, and GMTs were 25.0 and 4.0. Respective seropositivity rates from CoronaVac were 90.0% and 62.5%, and GMTs were 20.2 and 4.1. One-, three-, six-, nine-, and twelve-month GMCs were 217.2, 84.1, 85.7, 44.6, and 10.9 IU/mL in BBIBP-CorV recipients and 195.7, 94.6, 51.7, 27.6, and 13.4 IU/mL in CoronaVac recipients. Six-month convalescent seropositivity was 95.2%; GMC was 108.9 IU/mL. Seropositivity and GMCs were associated with age, sex, and time since vaccination. Conclusions: Neutralizing Ab levels against ancestral SARS-CoV-2 from BBIBP-CorV or CoronaVac vaccination were similar and decreased with increasing time since vaccination; over half of 12-month post-vaccination subjects were seropositive. Seropositivity and GMCs from BBIBP-CorV and CoronaVac six and nine months after vaccination were similar to or slightly lower than in six-month convalescent sera. These real-world data suggest necessity of six-month booster doses.

From Biotechnology to Bioeconomy: A Review of Development Dynamics and Pathways

Based on the logistic growth model, the relationship between technology innovation and the evolution of economic forms was analyzed, and the main characteristics and basic laws of the five economic forms of hunter–gatherer, agriculture, industry, information, and bioeconomy were summarized. Based on a comprehensive and intensive scan of the latest bioeconomy development strategies of various countries, we summarized their two main driving forces from the technological supply side and economic and social demand side, as well as their four distinctive features, namely the comprehensiveness of science and technology innovation, the aggregation of industrial development, the globalization of development goals, and strong policy dependence. Finally, we proposed countermeasures to design the implementation path of the bioeconomy and improve the quality of the bioeconomy factor supply in terms of the development and application of biotechnology, the upgradation of bioindustry clusters, the positive policy environment, and the theorization of the bioeconomy.

Safety, immunogenicity, and immune persistence of two inactivated COVID-19 vaccines replacement vaccination in China: An observational cohort study.

BACKGROUND: To mitigate a national shortage of WIBP-CorV COVID-19 vaccine, China's regulator approved administering BBIBP-CorV after WIBP-CorV for completion of a primary series. In a pragmatic observational study, we compared immunogenicity and safety of a primary series of WIBP-CorV followed by BBIBP-CorV with a primary series of two doses of BBIBP-CorV. METHODS: We invited healthy 18-59-years-old adults who had already received either WIBP-CorV or BBIBP-CorV as their first dose in a primary series to participate in this observational cohort study. Subjects who had received WIBP-CorV as their first dose became the observation group; subjects who had received BBIBP-CorV as their first dose became the control group. All participants received BBIBP-CorV as their second dose. We obtained sera 1, 2, and 6 months after second doses for nAb titer measurement by micro-neutralization cytopathic effect assay with SARS-CoV-2 strain HB01, standardized with WHO International Standard for anti-SARS-CoV-2 immunoglobulin. Safety was assessed for the 7 days after administration of second doses. RESULTS: Between March and December 2021, 275 subjects were included in the observation group and 133 in the control group. Neutralizing seropositivity (≥1:4) rates were 98.91 % and 99.25 % at 1 month and 53.16 % and 70.69 % at 6 months. One-month geometric mean titers (GMTs) were 21.33 and 22.45; one-month geometric mean concentrations (GMCs) were 227.71 IU/mL and 273.27 IU/mL. One to two months after vaccination, observation group seropositivity rates and titers were not significantly different to the control group's. Adverse reaction rates were 11.27 % and 18.80 %, all mild or moderate in severity. CONCLUSIONS: Both primary series were immunogenic; immunogenicity of WIBP-CorV followed by BBIBP-CorV was not different than immunogenicity following two doses of BBIBP-CorV for two months after vaccination; safety profiles were acceptable for both regimens. BBIBP-CorV can be used to complete a primary series that started with WIBP-CorV.

Implementation and Challenges of Online Education during the COVID-19 Outbreak: A National Survey of Children and Parents in China.

This study aims to explore the implementation and challenges of China's national online education strategy - "Suspending Classes Without Stopping Learning" (SCWSL) - during the COVID-19 pandemic from the perspective of children and their parents. Altogether 28,334 children (aged 6-8 years) and their parents were randomly sampled from nine cities in five provinces of China, and a mixed-method design involving a questionnaire and interviews was used. The results indicated that: (1) most children had participated in online education characterized by wide-ranging content, teacher-led interaction, and rich learning platforms; (2) online education had an effect on children's physical and mental health; (3) parent pressure was at a medium to high level due to online education; and (4) parents perceived that offline education was more effective than online education, and this perception varied significantly between geographical regions, living areas, and school types. These findings reveal that the sudden implementation of nationwide online education created many challenges, and also provided practical implications for countries carrying out online education in the post-pandemic era.

Feasibility Studies of Nebulized SARS-CoV-2 Neutralizing Antibody in Mice and Cynomolgus Monkeys.

PURPOSE: Neutralizing antibodies, administrated through intravenous infusion, have shown to be highly efficacious in treating mild and moderate COVID-19 caused by SARS-CoV-2 infection in the lung. However, antibodies do not transport across the plasma-lung barrier efficiently, and up to 100 mg/kg dose was used in human causing significant supply and cost burdens. This study was to explore the feasibility of nebulized antibodies inhalation delivery as an alternative route. METHODS: HB27, a potent RBD-specific humanized monoclonal antibody (Zhu et al. in National Sci Rev. 8:nwaa297, 2020), showed excellent protection against SARS-CoV-2 in animal model and good safety profile in clinical studies. The pharmacokinetics and preliminary safety of HB27 administrated through the respiratory tract were studied in mice and cynomolgus monkeys here. RESULTS: At a single 5 mg/kg dose, the peak HB27 concentration in mice pulmonary epithelial lining fluid (ELF) reached 857.8 µg/mL, 670-fold higher than the PRNT90 value of 1.28 µg/mL, and maintained above PRNT90 over 240 h. In contrast, when administrated by intravenous injection at a 5 mg/kg dose, the antibody concentrations in mice ELF were below PRNT90 value throughout, and were about 50-fold lower than that in the serum. In cynomolgus monkeys administrated with a single dose through inhalation, the antibody concentration in ELF remained high within 3 days. No drug-related safety concerns were observed in the studies. CONCLUSIONS: The study demonstrated that nebulized neutralizing antibody delivery though inhalation could be a more efficient and efficacious alternative approach for treating COVID-19 and other respiratory infectious diseases, and warrants further evaluation in clinical studies.

Association of COVID-19 Vaccination and Clinical Severity of Patients Infected with Delta or Omicron Variants - China, May 21, 2021-February 28, 2022.

What is already known about this topic?: Compared with the international mRNA and adenovirus-vectored coronavirus disease 2019 (COVID-19) vaccines, there is less real-world research data about breakthrough cases in people vaccinated with China-made COVID-19 vaccines. Analyses of clinical outcomes of breakthrough cases will be an important supplement to the clinical trial efficacy and observational effectiveness data of China-made COVID-19 vaccines. What is added by this report?: COVID-19 vaccine age-eligible individuals (≥3 years old) who received full primary series and a booster dose of China-made COVID-19 vaccines had good protection from pneumonia caused by Delta variant infection. There was only one serious Delta case in children (unvaccinated), but among adults 18 years and older, there was good protection from serious illness with primary vaccination and booster vaccination. Among people ≥60 years, full vaccination and booster vaccination were associated with protection from pneumonia and risk of serious COVID-19 caused by Omicron variant infection. There were few serious Omicron cases. What are the implications for public health practice?: Everyone 3 years and older without contraindications should be fully vaccinated against COVID-19; schedule-eligible adults should receive booster doses. The pace of booster dose administration, especially among the elderly, should be accelerated.

Risk assessment of public health emergencies concerned in the mainland of China, September 2021

Objective: To assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in September 2021.

Dual Stressors and Female Pre-school Teachers' Job Satisfaction During the COVID-19: The Mediation of Work-Family Conflict.

Online education has become a vital weapon to fight against the COVID-19 epidemic in the world. In the home-based online education environment, female pre-school teachers are expected to balance the dual roles of teacher and mother at the same time, which may trigger the work-family conflict. Although previous studies analyzed individual stressors, work-family conflict and its outcomes, there is little research on pre-school teachers' work and parenting experience during major public health emergencies. The current study examined the associations among work overload, parenting stress, work-family conflict, and job satisfaction during the COVID-19. Seven hundred eighteen female pre-school teachers with children who worked online at home participated in the study. Female pre-school teachers reported that the COVID-19 has increased work overload and parenting stress. Moreover, work overload was negatively associated with job satisfaction via its positive association with work-to-family conflict. Parenting stress was negatively associated with job satisfaction via both family-to-work conflict and work-to-family conflict. The study contributes to a better understanding of the association among female pre-school teachers' work overload, parenting stress, work-family conflict, and job satisfaction. Our findings highlighted potential avenues for interventions aimed at balancing female pre-school teachers' work and family and improving their job satisfaction during the COVID-19.

Preschool Teachers' Technology Acceptance During the COVID-19: An Adapted Technology Acceptance Model.

Online education has become a major reaction to the COVID-19 epidemic, which requires preschool teachers to quickly adapt to online education and accept educational technology. In this emergency background, research on the preschool teachers' technology acceptance provides clues to improve preschool teachers' intention to use educational technology. The Technology Acceptance Model (TAM) is widely used to examine the process of individuals' technology acceptance in the previous literature. Therefore, this study seeks to examine preschool teachers' technology acceptance with the adapted TAM and their determinant factors. The proposed model was empirically validated by using survey data from 1,568 preschool teachers during the COVID-19. Results indicate that preschool teachers' behavioral intention was moderate to high level. Perceived usefulness and perceived ease of use are direct significant predictors of preschool teachers' behavioral intention. Perceived usefulness is affected by perceived ease of use and job relevance. Computer self-efficacy and perceptions of external control are the positive factors toward perceived ease of use. Our findings present powerful evidence for the applicability of the adapted TAM in a sample of Chinese preschool teachers under emergency circumstances. These results highlighted some potential avenues for interventions aimed at improving preschool teachers' acceptance toward educational technology.