A study on the monitoring of heatwaves and bivariate frequency analysis based on mortality risk assessment in Wuhan, China.

The increasingly frequent occurrence of urban heatwaves has become a significant threat to human health. To quantitatively analyze changes in heatwave characteristics and to investigate the return periods of future heatwaves in Wuhan City, China, this study extracted 9 heatwave definitions and divided them into 3 mortality risk levels to identify and analyze historical observations and future projections of heatwaves. The copula functions were employed to derive the joint distribution of heatwave severity and duration and to analyze the co-occurrence return periods. The results demonstrate the following. (1) As the concentration of greenhouse gas emissions increases, the severity of heatwaves intensifies, and the occurrence of heatwaves increases significantly; moreover, a longer duration of heatwaves correlated with higher risk levels in each emission scenario. (2) Increasing concentrations of greenhouse gas emissions result in significantly shorter heatwave co-occurrence return periods at each level of risk. (3) In the 3 risk levels under each emission scenario, the co-occurrence return periods for heatwaves become longer as heatwave severity intensifies and duration increases. Under the influence of climate change, regional-specific early warning systems for heatwaves are necessary and crucial for policymakers to reduce heat-related mortality risks in the population, especially among vulnerable groups.

[Trends in Oncomelania hupensis distribution in Wuhan City from 2003 to 2022 based on the Joinpoint regression model].

OBJECTIVE: To analyze the trends in Oncomelania hupensis distribution in Wuhan City, Hubei Province from 2003 to 2022, so as to provide insights into precision schistosomiasis control. METHODS: Data pertaining to O. hupensis snail survey in Wuhan City from 2003 to 2022 were collected. The trends in the proportion of areas with snail habitats, actual area with snail habitats, mean density of living snails and prevalence of Schistosoma japonicum infection in snails were evaluated in schistosomiasis-endemic areas of Wuhan City from 2003 to 2022 with the slope of trend curve (ß), annual percent change (APC) and average annual percent change (AAPC) using a Joinpoint regression model. RESULTS: During the period from 2003 through 2022, there were two turning points for the proportion of areas with snail habitats in Wuhan City in 2005 and 2015, with a rise during the period from 2003 to 2005 (ß1 = 5.93, t = 1.280, P > 0.05), a decline from 2005 to 2015 (ß2 = -0.88, t = -2.074, P > 0.05) and a rise from 2015 to 2022 (ß3 = 1.46, t = -2.356, P < 0.05). During the period from 2003 through 2022, there were two turning points for the proportion of areas with snail habitats in islet endemic areas of Wuhan City in 2006 and 2015, with no significant differences in the trends from 2003 to 2006 (ß1 = 4.64, t = 1.888, P > 0.05) or from 2006 to 2015 (ß2 = -1.45, t = -2.143, P > 0.05), and with a tendency towards a rise from 2015 to 2022 (ß3 = 2.04, t = -3.100, P < 0.05). During the period from 2003 through 2022, there were two turning points for the proportion of areas with snail habitats in inner embankment endemic areas of Wuhan City in 2012 and 2020, with a tendency towards a decline from 2003 to 2012 (ß1 = -0.39, t = -4.608, P < 0.05) and with no significant differences in the trends from 2012 to 2020 (ß2 = 0.03, t = 0.245, P > 0.05) and from 2020 to 2022 (ß3 = 1.38, t = 1.479, P > 0.05). During the period from 2003 to 2022, the actual area with snail habitats all appeared a tendency towards a decline in Wuhan City, and in islet and inner embankment endemic areas of Wuhan City from 2003 to 2022 (AAPC = -2.39%, -5.75% and -2.35%, all P values < 0.05). The mean density of living snails reduced from 0.087 snails/0.1 m2 in 2003 to 0.027 snails/0.1 m2 in 2022 in Wuhan City, with a significant difference in the tendency towards the decline (APC = AAPC = -11.47%, P < 0.05). The annual mean decline rate of the mean density of living snails was 17.36% in outside embankment endemic areas of Wuhan City from 2003 to 2022 (APC = AAPC = -17.36%, P < 0.05), and there was no significant difference in the trends in the mean density of living snails in islet endemic areas of Wuhan City from 2003 to 2022 (APC = AAPC = -0.97%, P > 0.05). In addition, the prevalence of S. japonicum infection in snails appeared a tendency towards a decline in Wuhan City from 2003 to 2022 (APC = AAPC = -12.45%, P < 0.05). CONCLUSIONS: The proportion of areas with snail habitats, actual area with snail habitats, mean density of living snails and prevalence of S. japonicum infection in snails all appeared a tendency towards a decline in Wuhan City from 2003 to 2022. Intensified snail control, modification of snail habitats, shrinking of areas with snails and implementation of grazing prohibition in snail-infested settings are required, in order to facilitate the progress towards schistosomiasis elimination in Wuhan City.

Seasonal and interannual changes (2005-2021) of lake water quality and the implications for sustainable management in a rapidly growing metropolitan region, central China.

A series of restoration measures such as municipal wastewater treatment and aquaculture closures have been implemented in Wuhan City during recent years. In order to explore the impact of restoration measures and climate change on lake water quality, long-term (2005-2021) water quality data of 47 lakes were explored to reveal spatiotemporal changes in lake water quality. Percentages of polluted lakes were calculated according to six water-quality parameters, including total phosphorus (TP), ammonia nitrogen (NH3-N), chemical oxygen demand (COD), biological oxygen demand (BOD), chemical oxygen demand using potassium permanganate as oxidant (CODMn) and petroleum contamination (PET), at interannual and monthly timescales. At the interannual timescale, percentages of COD, BOD, CODMn and PET pollution decreased significantly, suggestive of water quality improvement during recent years. At the monthly timescale, low percentages of NH3-N and BOD pollution in March 2020 probably resulted from the sharp reduction in human activities during the COVID-19 lockdown. At the monthly timescale, temperature was positively correlated with percentage of CODMn pollution, but negatively correlated with percentage of NH3-N pollution; precipitation was negatively correlated with percentage of BOD pollution. The similarity of water-quality parameters generally decreased with an increase in geographical distance between each pair of lakes. However, the regression coefficients between the similarity of lake water quality and the geographical distance decreased with time, probably resulting from enhanced similarity of water quality parameters among all lakes with rapid urbanization. Our results highlight the importance of active restoration measures for sustainable management of lakes in Wuhan City, as well as in similar developing regions.

Research on the cascading mechanism of "urban built environment-air pollution-respiratory diseases": a case of Wuhan city.

Background: Most existing studies have only investigated the direct effects of the built environment on respiratory diseases. However, there is mounting evidence that the built environment of cities has an indirect influence on public health via influencing air pollution. Exploring the "urban built environment-air pollution-respiratory diseases" cascade mechanism is important for creating a healthy respiratory environment, which is the aim of this study. Methods: The study gathered clinical data from 2015 to 2017 on patients with respiratory diseases from Tongji Hospital in Wuhan. Additionally, daily air pollution levels (sulfur dioxide (SO2), nitrogen dioxide (NO2), particulate matter (PM2.5, PM10), and ozone (O3)), meteorological data (average temperature and relative humidity), and data on urban built environment were gathered. We used Spearman correlation to investigate the connection between air pollution and meteorological variables; distributed lag non-linear model (DLNM) was used to investigate the short-term relationships between respiratory diseases, air pollutants, and meteorological factors; the impacts of spatial heterogeneity in the built environment on air pollution were examined using the multiscale geographically weighted regression model (MGWR). Results: During the study period, the mean level of respiratory diseases (average age 54) was 15.97 persons per day, of which 9.519 for males (average age 57) and 6.451 for females (average age 48); the 24 h mean levels of PM10, PM2.5, NO2, SO2 and O3 were 78.056 µg/m3, 71.962 µg/m3, 54.468 µg/m3, 12.898 µg/m3, and 46.904 µg/m3, respectively; highest association was investigated between PM10 and SO2 (r = 0.762, p < 0.01), followed by NO2 and PM2.5 (r = 0.73, p < 0.01), and PM10 and PM2.5 (r = 0.704, p < 0.01). We observed a significant lag effect of NO2 on respiratory diseases, for lag 0 day and lag 1 day, a 10 µg/m3 increase in NO2 concentration corresponded to 1.009% (95% CI: 1.001, 1.017%) and 1.005% (95% CI: 1.001, 1.011%) increase of respiratory diseases. The spatial distribution of NO2 was significantly influenced by high-density urban development (population density, building density, number of shopping service facilities, and construction land, the bandwidth of these four factors are 43), while green space and parks can effectively reduce air pollution (R2 = 0.649). Conclusion: Previous studies have focused on the effects of air pollution on respiratory diseases and the effects of built environment on air pollution, while this study combines these three aspects and explores the relationship between them. Furthermore, the theory of the "built environment-air pollution-respiratory diseases" cascading mechanism is practically investigated and broken down into specific experimental steps, which has not been found in previous studies. Additionally, we observed a lag effect of NO2 on respiratory diseases and spatial heterogeneity of built environment in the distribution of NO2.

Sustainable planning in Wuhan City during COVID-19: an analysis of influential factors, risk profiles, and clustered patterns.

The outbreak of novel coronavirus pneumonia (COVID-19) is closely related to the intra-urban environment. It is important to understand the influence mechanism and risk characteristics of urban environment on infectious diseases from the perspective of urban environment composition. In this study, we used python to collect Sina Weibo help data as well as urban multivariate big data, and The random forest model was used to measure the contribution of each influential factor within to the COVID-19 outbreak. A comprehensive risk evaluation system from the perspective of urban environment was constructed, and the entropy weighting method was used to produce the weights of various types of risks, generate the specific values of the four types of risks, and obtain the four levels of comprehensive risk zones through the K-MEANS clustering of Wuhan's central urban area for zoning planning. Based on the results, we found: ①the five most significant indicators contributing to the risk of the Wuhan COVID-19 outbreak were Road Network Density, Shopping Mall Density, Public Transport Density, Educational Facility Density, Bank Density. Floor Area Ration, Poi Functional Mix ②After streamlining five indicators such as Proportion of Aged Population, Tertiary Hospital Density, Open Space Density, Night-time Light Intensity, Number of Beds Available in Designated Hospitals, the prediction accuracy of the random forest model was the highest. ③The spatial characteristics of the four categories of new crown epidemic risk, namely transmission risk, exposure risk, susceptibility risk and Risk of Scarcity of Medical Resources, were highly differentiated, and a four-level integrated risk zone was obtained by K-MEANS clustering. Its distribution pattern was in the form of "multicenter-periphery" gradient diffusion. For the risk composition of the four-level comprehensive zones combined with the internal characteristics of the urban environment in specific zones to develop differentiated control strategies. Targeted policies were then devised for each partition, offering a practical advantage over singular COVID-19 impact factor analyses. This methodology, beneficial for future public health crises, enables the swift identification of unique risk profiles in different partitions, streamlining the formulation of precise policies. The overarching goal is to maintain regular social development, harmonizing preventive measures and economic efforts.

[Construction of a schistosomiasis transmission risk assessment system in Wuhan City based on analytic hierarchy process].

OBJECTIVE: To construct a schistosomiasis transmission risk assessment system in Wuhan City and preliminary evaluate its application effect, so as to promote the rational allocation of schistosomiasis control resources and accelerate the progress towards schistosomiasis elimination. METHODS: The schistosomiasis risk assessment indicators were collected through referring schistosomiasis surveillance data of Wuhan City from 2014 to 2020, literature review and expert interviews. Indicators within each criterion and sub-criterion were screened using the Delphi method, and a hierarchical structure model was created based on analytic hierarchy process. Quantitative assignment of each indicator was conducted according to relative importance, and the weight and combination weight of each criterion were calculated in each analytic hierarchy framework to create a schistosomiasis transmission risk assessment system, which was used for the schistosomiasis transmission risk assessment in 12 national schistosomiasis surveillance sites in Wuhan City. RESULTS: A three-level schistosomiasis transmission risk assessment system was preliminarily constructed, which included a target layer, 5 criterion layers and 21 sub-criterion layers. Of all indicators in the criterion layer, transmission route had the highest weight (0.433), followed by source of Schistosoma japonicum infection (0.294); and among all indicators in the sub-criterion layer, S. japonicum infection in Oncomelania hupensis and sentinel mice had the highest combination weight (0.125), followed by prevalence of S. japonicum infection in humans (0.091) and bovines (0.053), snail control by chemical treatment (0.049), positive rate of inquiry examinations (0.048), allocation of schistosomiasis control professionals (0.045), and areas of submerged snail-infested settings (0.041). Of the 12 national schistosomiasis surveillance sites in Wuhan City, there were 5 sites with weights of > 0.8, 4 sites with weights of 0.6 to 0.8, and 3 sites with weights of < 0.6 in 2020. CONCLUSIONS: A schistosomiasis transmission risk assessment system has been constructed based on analytic hierarchy process in Wuhan City, which may provide a evidence-based basis for health resource allocation and decision-making for schistosomiasis control.

Modelling the roles of visitor flows and returning migrants in the spatial diffusion of COVID-19 from Wuhan city in China.

COVID-19 has spread to many cities and countries in the world since the major outbreak in Wuhan city in later 2019. Population flow is the main channel of COVID-19 transmission between different cities and countries. This study recognizes that the flows of different population groups such as visitors and migrants returning to hometown are different in nature due to different length of stay and exposure to infection risks, contributing to the spatial diffusion of COVID-19 differently. To model population flows and the spatial diffusion of COVID-19 more accurately, a population group based SEIR (susceptible-exposed-infectious-recovered) metapopulation model is developed consisting of 32 regions including Wuhan, the rest of Hubei and other 30 provinces in Mainland China. The paper found that, in terms of the total export, Wuhan residents as visitors and Wuhan migrants returned to hometown were the first and second largest contributors in the simulation period. In terms of the net export, Wuhan migrants returned to hometown were the largest contributor, followed by Wuhan residents as visitors.

Assessment of the urban waterlogging resilience and identification of its driving factors: A case study of Wuhan City, China.

With rapid urbanization and extreme rainstorm events associated with climate change, urban waterlogging has become one of the most frequent and severe disasters globally. In this study, a multi-dimensional and multi-process index system based on the Pressure-State-Response (PSR) framework was developed to measure the level of urban waterlogging resilience (UWR). The spatial distribution of UWR on a block scale was explored based on the entropy weight method with the natural breakpoint method (EWM-NBM) in the central district of Wuhan City, China. In addition, the effects of the runoff control facilities and early warning measures on UWR were also quantified. Further, the Geodetector was used to investigate the main driving factors of UWR and their interactions. Results showed that the constructed index system for UWR based on the PSR framework performed reasonably, and the EWM-NBM was validated to be effective in the integrated assessment. In terms of the validation results, 82.72 % of the recorded waterlogging points belonged to high and very-high risk levels. The spatial heterogeneity of UWR was significant in the study area where the higher-level UWR mainly appears in the areas near the undeveloped suburban and water bodies (lakes and rivers), and the lower-level UWR was concentrated in central urban areas with more impervious surfaces. There was a clear increasing trend in UWR after the implementation of runoff control facilities and early warning measures, but its spatial distribution remained almost invariant. Among all the indexes, the impervious surface percentage had the strongest (69.58 %) explanatory ability for the UWR, and mean annual precipitation (15.51 %), GDP (14.03 %), and population density (11.98 %) also demanded attention. Most driving factors of UWR showed nonlinear interactions. This research could provide a benchmark for urban planning to enhance UWR to mitigate the waterlogging within the main urban area.

Construction of a schistosomiasis transmission risk assessment system in Wuhan City based on analytic hierarchy process / 中国血吸虫病防治杂志

Objective To construct a schistosomiasis transmission risk assessment system in Wuhan City and preliminary evaluate its application effect, so as to promote the rational allocation of schistosomiasis control resources and accelerate the progress towards schistosomiasis elimination. Methods The schistosomiasis risk assessment indicators were collected through referring schistosomiasis surveillance data of Wuhan City from 2014 to 2020, literature review and expert interviews. Indicators within each criterion and sub-criterion were screened using the Delphi method, and a hierarchical structure model was created based on analytic hierarchy process. Quantitative assignment of each indicator was conducted according to relative importance, and the weight and combination weight of each criterion were calculated in each analytic hierarchy framework to create a schistosomiasis transmission risk assessment system, which was used for the schistosomiasis transmission risk assessment in 12 national schistosomiasis surveillance sites in Wuhan City. Results A three-level schistosomiasis transmission risk assessment system was preliminarily constructed, which included a target layer, 5 criterion layers and 21 sub-criterion layers. Of all indicators in the criterion layer, transmission route had the highest weight (0.433), followed by source of Schistosoma japonicum infection (0.294); and among all indicators in the sub-criterion layer, S. japonicum infection in Oncomelania hupensis and sentinel mice had the highest combination weight (0.125), followed by prevalence of S. japonicum infection in humans (0.091) and bovines (0.053), snail control by chemical treatment (0.049), positive rate of inquiry examinations (0.048), allocation of schistosomiasis control professionals (0.045), and areas of submerged snail-infested settings (0.041). Of the 12 national schistosomiasis surveillance sites in Wuhan City, there were 5 sites with weights of > 0.8, 4 sites with weights of 0.6 to 0.8, and 3 sites with weights of < 0.6 in 2020. Conclusion A schistosomiasis transmission risk assessment system has been constructed based on analytic hierarchy process in Wuhan City, which may provide a evidence-based basis for health resource allocation and decision-making for schistosomiasis control.

[Effect of peer education on knowledge, attitude and practices towards schistosomiasis among primary school students in endemic foci of Wuhan City].

OBJECTIVE: To evaluate the effect of peer education on knowledge, attitude and practices towards schistosomiasis control among primary school students in endemic foci of Wuhan City. METHODS: Yucai Hankou Primary School in Jiang' an District, Wuhan City was selected in 2021, and all students at grades 4 and 5 were sampled using a cluster sampling method to receive peer education about schistosomiasis. The changes of knowledge, attitude and practices towards schistosomiasis control were compared before and after peer education to evaluate the effect of peer education on knowledge, attitude and practices towards schistosomiasis control. RESULTS: The overall awareness of schistosomiasis control knowledge and the overall proportion of correct attitudes towards schistosomiasis control and correct schistosomiasis-related behaviors increased from 51.50%, 93.70% and 92.99% before peer education to 86.50%, 98.98% and 98.72% after peer education among primary school students, respectively (χ2=149.457, 21.692 and 20.691, all P values < 0.05). The overall awareness of schistosomiasis control knowledge and the overall proportion of correct attitudes towards schistosomiasis control and correct schistosomiasis-related behaviors were 49.19%, 92.20% and 92.72% among Grade 4 primary school students and 53.83%, 95.21% and 93.28% among Grade 5 primary school students prior to peer education (χ2 = 1.214, 2.034 and 0.096, all P values > 0.05), and increased to 75.93%, 98.09% and 97.59% among Grade 4 primary school students and 97.16%, 99.87% and 99.87% among Grade 5 primary school students after peer education, respectively (χ2 = 40.798, 9.572, 7.207, 133.194, 9.678 and 14.926, all P values < 0.05). The overall awareness of schistosomiasis control knowledge and the overall proportion of correct attitudes towards schistosomiasis control and correct schistosomiasis-related behaviors were 51.25%, 76.92% and 77.97% among male primary school students and 51.80%, 94.42% and 95.70% among female primary school students prior to peer education, the differences in the overall proportion of correct attitudes towards schistosomiasis control and correct schistosomiasis-related behaviors between male primary school students and female primary school students were significant (χ2 = 30.462 and 33.416, both P values < 0.05), and increased to 86.23%, 98.25% and 97.79% among male primary school students and 86.83%, 99.85% and 99.85% among female primary school students after peer education (χ2 = 0.081, 3.529 and 3.335, all P values > 0.05), respectively. CONCLUSIONS: Peer education is effective to improve the knowledge, attitude and practices towards schistosomiasis control among primary school students in endemic foci of Wuhan City, which may be more effective to improve the awareness of schistosomiasis control knowledge and proportion of correct schistosomiasis-related behaviors among primary school students at high grades.

Cost-effectiveness simulation analysis of medical services for COVID-19 in Wuhan city / 中华医院管理杂志

Objective:To analyze the cost-effectiveness simulation of medical services for COVID-19 epidemic in Wuhan city based on the social perspective, for the sake of providing references and suggestions to deal with possible public health emergencies in the future.Methods:Through policy documents and literature review, interview survey and Delphi method, the cost and cost-effectiveness of medical services for COVID-19 in Wuhan were simulated based on the decision-tree model, from December 27, 2019 to April 26, 2020.Results:The average curing cost of per patient diagnosed with COVID-19 in Wuhan was 175 462.10 yuan, a figure calculated in the baseline that these epidemic prevention and control measures were taken on January 23, 2020. In Hypothesis 1 (with epidemic prevention and control measures taken one week before), the cost was 164 552.43 yuan, and in Hypothesis 2 (with epidemic prevention and control measures taken one week later), the cost was 187 542.37 yuan. Compared with the baseline, the incremental cost-effectiveness ratio of the medical service for COVID-19 in Wuhan under Hypothesis 1 was 183 000 yuan per patient, which was more cost effective.Conclusions:The public health prevention and control measures played an important role during the COVID-19 epidemic in Wuhan. With the cost-effectiveness simulation results taken into account, this study can provide decision-makers with better references in likewise events.

[Effects of urban construction on Oncomelania snails control in Wuhan City].

OBJECTIVE: To evaluate the effectiveness of urban construction projects on Oncomelania snails control in Wuhan City, so as to provide insights into the development of an integrated control strategy for urban schistosomiasis. METHODS: The data pertaining to the endemic situation of schistosomiasis, schistosomiasis control data, the construction of the Yangtze River Bridge, marshland management and park constructions were collected from Wuhan City from 1990 to 2020. The changes of areas of snail habitats and high-risk settings were compared before and after implementation of these urban construction projects to evaluate the effectiveness of urban construction projects on Oncomelania snails control. RESULTS: The number of schistosomiasis cases decreased by 97.35%, and the number of cattle with schistosomiasis decreased by 100% in Wuhan City from 1990 to 2020, with a 41.99% reduction in areas of snail habitats, including 94.97% and 34.40% reductions in snail habitats inside and outside the embankment decreased. During the period from 1990 through 2020, a total of 10 Yangtze River bridges were built in Wuhan City, and areas of snail habitats around the bridges reduced from 11 699.05 hm2 before the bridge building to 8 726.14 hm2 after the building (a 25.41% reduction), while the areas of high-risk settings reduced from 411.69 hm2 before the bridge building to 276.78 hm2 after the building (a 32.77% reduction). Following treatment of three marshlands in Hankou, Hanyang and Wuchang, the areas of snail habitats reduced from 225.80 hm2 before the management to 199.47 hm2 after the management (a 11.66% reduction), and the areas of high-risk settings reduced from 23.14 hm2 before the treatment to 17.73 hm2 after the building (a 23.38% reduction). Following the building of 5 parks in snail-infested settings, the areas of snail habitats reduced from 319.61 hm2 before the construction to 280.80 hm2 after the construction (a 12.14% reduction), and the areas of high-risk settings reduced from 35.00 hm2 before the construction to 27.73 hm2 after the construction (a 20.77% reduction). CONCLUSIONS: Simultaneous implementation of urban construction projects and schistosomiasis control measures is effective to shrink snail-infested setting and high-risk settings and control the endemic situation of schistosomiasis in endemic foci in Wuhan City.

Revisiting the Effects of High-Speed Railway Transfers in the Early COVID-19 Cross-Province Transmission in Mainland China.

Coronavirus disease 2019 (COVID-19) is an ongoing pandemic that was reported at the end of 2019 in Wuhan, China, and was rapidly disseminated to all provinces in around one month. The study aims to assess the changes in intercity railway passenger transport on the early spatial transmission of COVID-19 in mainland China. Examining the role of railway transport properties in disease transmission could help quantify the spatial spillover effects of large-scale travel restriction interventions. This study used daily high-speed railway schedule data to compare the differences in city-level network properties (destination arrival and transfer service) before and after the Wuhan city lockdown in the early stages of the spatial transmission of COVID-19 in mainland China. Bayesian multivariate regression was used to examine the association between structural changes in the railway origin-destination network and the incidence of COVID-19 cases. Our results show that the provinces with rising transfer activities after the Wuhan city lockdown had more confirmed COVID-19 cases, but changes in destination arrival did not have significant effects. The regions with increasing transfer activities were located in provinces neighboring Hubei in the widthwise and longitudinal directions. These results indicate that transfer activities enhance interpersonal transmission probability and could be a crucial risk factor for increasing epidemic severity after the Wuhan city lockdown. The destinations of railway passengers might not be affected by the Wuhan city lockdown, but their itinerary routes could be changed due to the replacement of an important transfer hub (Wuhan city) in the Chinese railway transportation network. As a result, transfer services in the high-speed rail network could explain why the provinces surrounded by Hubei had a higher number of confirmed COVID-19 cases than other provinces.

Measuring and Quantifying Impacts of Environmental Parameters on Airborne Particulate Matter in Under-Viaducts Spaces in Wuhan, China.

Particulate pollution caused by urban traffic emissions has become a significant public hazard. Many urban roads of under-viaduct spaces (UVSs) have become concentrated areas of particulate pollution. This study aims to explore the effects of landscape parameters on particulate matter in UVSs in Wuhan, China. We selected 14 types of UVS sections and nine potential environmental parameters to monitor four types of particulate matter (PM1.0, PM2.5, PM10, and TSP). Finally, linear regression analysis was employed to quantify the relative contributions of environmental parameters to the reduction in the concentration of the four types of particulate matter in the summer and winter. The results showed that particulate matter concentrations exhibit spatial and seasonal differences in UVSs. A single landscape parameter was correlated with particulate matter concentration, while compound environmental parameters had significant effects on the particulate matter concentration in UVSs. Meteorological factors and greening structures had a dominant impact on the particulate matter concentrations in summer and winter, respectively. Therefore, adjusting and optimizing the environmental parameters could reduce particulate pollution in UVSs and could have practical significance for the planning and design of UVSs.

The comparison of epidemiological characteristics between confirmed and clinically diagnosed cases with COVID-19 during the early epidemic in Wuhan, China.

BACKGROUND: To put COVID-19 patients into hospital timely, the clinical diagnosis had been implemented in Wuhan in the early epidemic. Here we compared the epidemiological characteristics of laboratory-confirmed and clinically diagnosed cases with COVID-19 in Wuhan. METHODS: Demographics, case severity and outcomes of 29,886 confirmed cases and 21,960 clinically diagnosed cases reported between December 2019 and February 24, 2020, were compared. The risk factors were estimated, and the effective reproduction number (Rt) of SARS-CoV-2 was also calculated. RESULTS: The age and occupation distribution of confirmed cases and clinically diagnosed cases were consistent, and their sex ratio were 1.0 and 0.9, respectively. The epidemic curve of clinical diagnosis cases was similar to that of confirmed cases, and the city centers had more cumulative cases and higher incidence density than suburbs in both of two groups. The proportion of severe and critical cases (21.5 % vs. 14.0 %, P < 0.0001) and case fatality rates (5.2 % vs. 1.2 %, P < 0.0001) of confirmed cases were all higher than those of clinically diagnosed cases. Risk factors for death we observed in both of two groups were older age, male, severe or critical cases. Rt showed the same trend in two groups, it dropped below 1.0 on February 6 among confirmed cases, and February 8 among clinically diagnosed cases. CONCLUSIONS: The demographic characteristics and spatiotemporal distributions of confirmed and clinically diagnosed cases are roughly similar, but the disease severity and clinical outcome of clinically diagnosed cases are better than those of confirmed cases. In cases when detection kits are insufficient during the early epidemic, the implementation of clinical diagnosis is necessary and effective.

Dynamics of the coronavirus disease 2019 (COVID-19) epidemic in Wuhan City, Hubei Province and China: a second derivative analysis of the cumulative daily diagnosed cases during the first 85 days.

BACKGROUND: Controlling the coronavirus disease 2019 (COVID-19) epidemic requires information beyond new and cumulative cases. This study aims to conduct an in-depth analysis by geographic strata: Wuhan City (hereafter referred to as Wuhan) only, Hubei Province (hereafter referred to as Hubei) excluding Wuhan, and China excluding Hubei. METHODS: Daily cumulative confirmed COVID-19 cases between December 8, 2019 (the date of symptom onset based on patients' recall during the investigation), and March 1, 2020, from official sources and published studies were analyzed. The second derivative model was used for information extraction. Data analysis was conducted separately for the three strata. RESULTS: A total of 80 026 diagnosed COVID-19 cases were reported during the first 85 days of the epidemic, with 49 315 cases from Wuhan, 17 788 from Hubei excluding Wuhan, and 12 923 from China excluding Hubei. Analytical results indicate that the COVID-19 epidemic consists of an Acceleration, a Deceleration, and a Stabilization Phase in all three geographic strata, plus a Silent Attack Phase for Wuhan only. Given the reported incubation period of 14 days, effects of the massive anti-epidemic actions were revealed by both the Acceleration and Deceleration Phases. The Acceleration Phase signaled the effect of the intervention to detect the infected; the Deceleration Phase signaled the declines in new infections after the infected were detected, treated and quarantined. CONCLUSION: Findings of the study provide new evidence to better monitor the epidemic, evaluate its response to intervention, and predict the trend long. In addition to re-evaluating the control of the COVID-19 epidemic in China, this study provided a model for monitoring outbreaks of COVID-19 in different countries across the world.

Genetic Diversity, Complicated Recombination, and Deteriorating Drug Resistance Among HIV-1-Infected Individuals in Wuhan, China.

To identify genotype distribution and drug resistance in people infected by HIV-1 in Wuhan, China, 105 infected people diagnosed with HIV-1 from January to December in 2019 were involved in this study. Ninety-eight gag genes, 101 PR genes, and 98 RT genes were successfully amplified. The phylogenetic analysis results showed that CRF01_AE (38.2%) and CRF07_BC (35.3%) were the two dominant genotypes, followed by CRF55_01B (6.9%), CRF59_01B (2.0%), B (2.0%), B' (2.0%), CRF08_BC (1.0%), CRF80_0107 (1.0%), and unique recombinant form (URF) (11.8%). Most URFs were the recombinants between CRF01_AE and CRF07_BC or CRF07_BC and CRF55_01B. Among the 93 subjects of antiretroviral therapy (ART)-naive, transmitted drug resistance against non-nucleoside reverse transcriptase inhibitors (NNRTIs) was 23.9%, of which V179D/E was the most frequent mutation, accounting for 18.2%. Among the 12 subjects of ART-experienced, drug resistance to first-line regimens developed severely.

[An acute schistosomiasis case in Wuhan City imported from another province of China in 2020].

An imported case of acute schistosomiasis was reported in Wuhan City in 2020. The case was infected with Schistosoma by contact with the infested water due to playing water in the Yangtze River when working out of Hubei Province. The patient visited four medical institutions and the duration from onset to definitive diagnosis was 20 days. The patient's low awareness of schistosomiasis prevention and control knowledge and lack of diagnosis and treatment awareness for schistosomiasis among medical institutions were considered as main causes of the development of acute schistosomiasis and progression to severe case. Intensifying schistosomiasis health education among mobile populations and improving the awareness and capability of early diagnosis of schistosomiasis among clinicians are recommended.

Joint estimation of case fatality rate of COVID-19 and power of quarantine strategy performed in Wuhan, China.

From the first case of COVID-19 confirmed in Wuhan, the capital of Hubei Province, China, in early December 2019, it has been found in more than 160 countries and caused over 11,000 deaths as of March 20, 2020. Wuhan, as the city where the epidemic first broke out, has made great sacrifices to block the possible transmission. In this research, we estimate the case fatality rate (CFR) of COVID-19 and quantify the effect of quarantine strategy utilized in Wuhan by developing an extended Susceptible-Infected-Recovered (SIR) model. The outcomes suggest that the CFR is 4.4% (95% CI [3.6%, 5.2%]) and the effect of the quarantine strategy is 99.3% (95% CI [99.2%, 99.5%]), which implies that such a method can significantly reduce the number of infections.

An acute schistosomiasis case in Wuhan City imported from another province of China in 2020 / 中国血吸虫病防治杂志

An imported case of acute schistosomiasis was reported in Wuhan City in 2020. The case was infected with Schistosoma by contact with the infested water due to playing water in the Yangtze River when working out of Hubei Province. The patient visited four medical institutions and the duration from onset to definitive diagnosis was 20 days. The patient’s low awareness of schistosomiasis prevention and control knowledge and lack of diagnosis and treatment awareness for schistosomiasis among medical institutions were considered as main causes of the development of acute schistosomiasis and progression to severe case. Intensifying schistosomiasis health education among mobile populations and improving the awareness and capability of early diagnosis of schistosomiasis among clinicians are recommended.