Influencing factors of hospital-acquired COVID-19 prevention and control status among emergency support frontline healthcare workers under closed-loop management: a cross-sectional study.

Background: This study aimed to understand the hospital-acquired COVID-19 infection rate and infection prevention and control status of emergency support frontline healthcare workers (ESFHCWs) under closed-loop management, and to explore the related factors affecting hospital-acquired COVID-19 prevention and control status. Methods: The study site was a provincial-level tertiary hospital in the Xinjiang Uygur Autonomous Region specializing in treating COVID-19 patients. ESFHCWs were assigned from different hospitals in Zhejiang Province to provide emergency medical support in this specialized hospital. All ESFHCWs were managed using a closed loop. A self-designed questionnaire was used to estimate basic information, work experience, and the status of infection prevention and control (SIPC). A total of 269 ESFHCWs responded to the questionnaire. A generalized linear regression model was used to estimate the factors influencing SIPC. Results: There were six hospital-acquired COVID-19 cases, with an infection rate of 2.23%. The independent risk factors influencing COVID-19 prevention and control status were work seniority, anxiety disorder, and consumption of gastrointestinal, anti-inflammatory and anti-asthmatic, and hypnotic sedative drugs. Compared with ESFHCWs with more than 10 years of work seniority, ESFHCWs with less than 5 years of work seniority and 5-10 years of work seniority had lower COVID-19 SIPC scores. Among ESFHCWs with anxiety disorder, the SIPC score was significantly lower than that of ESFHCWs without anxiety disorder. The SIPC scores of ESFHCWs taking other medications (gastrointestinal, anti-inflammatory and anti-asthmatic, and hypnotic sedative drugs) were lower than those of ESFHCWs who did not. Conclusion: The closed-loop management method may be effective in reducing the infection rate of hospital-acquired COVID-19 among ESFHCWs. HCWs with less than 10 years of work seniority, anxiety disorder, and other medications (gastrointestinal, anti-inflammatory and anti-asthmatic, and hypnotic sedative drugs) were probably not suitable for participating in emergency assistant actions because of their poor SIPC scores. Further studies are needed to develop the selection criteria for ESFHCWs.

The impact of COVID-19 on maritime pilots: Evidence and lessons.

The COVID-19 pandemic led to port congestion and disruption to global logistics and supply chains. While previous research has examined the impact on port performance and economics, social issues, such as the impact on port personnel (including pilots), have been overlooked. In this context, this paper examines the challenges experienced by Chinese pilots during the pandemic through in-depth interviews with 28 pilots. It shows that the draconian pandemic control measures adopted in China, rather than the pandemic itself, impaired pilots' physical and mental health, reduced their availability, and introduced new safety hazards, which curtailed both the port's capacity and ability to provide efficient and safe pilotage and resulted in sub-standard services. The findings suggest that there is a serious issue regarding the absence of effective mechanisms for pilots to raise their health and safety concerns and how these might be addressed by port administrators and/or local authorities. Worker participation and involvement in occupational health and safety management was problematic. These findings have implications for pilot station management at both company and government administrative and legislative levels.

Psychological status of medical staff dedicated to nucleic acid collection in COVID-19 epidemic during closed-loop management: A cross-sectional study.

Background: To investigate the depression, anxiety and somnipathy situation occurred in the nucleic acid collection staff during the closed-loop management period of COVID-19. And try to understand the influencing factors of related psychological status. Methods: A cross-sectional study of 1,014 nucleic acid collection staff from seven Chinese hospitals was conducted. Various investigation methods were involved in the questionnaires to collect data, including 12-items self-made questionnaire survey of basic demographic information, 9-items patient health questionnaire depression scale (PHQ-9), 7-items generalized anxiety disorder scale (GAD-7) and Pittsburgh sleep quality index (PSQI). Data analysis was performed using SPSS version 26.0 and Excel software. Mann-Whitney U-test, Chi-square test, correlation analysis, mono-factor analysis and binary logistic regression were applied accordingly for further analysis. Results: The positive rate of depression, anxiety and sleep disorder of 1,014 nucleic acid collectors under closed-loop management were 33.5, 27.2, and 50.1%, respectively. Depression was significantly positively correlated with anxiety and sleep (P < 0.05). The scores of depression scale were positively correlated with the age and the fear for infection (r = 0.106, 0.218, both P < 0.05); The scores of anxiety scale were also positively correlated with the age and the fear for infection (r = 0.124, 0.225, both P < 0.05); The length of service, collection time and the degree of worry about infection and was positively correlated with the score of sleep scale (r = 0.077, 0.074, 0.195, both P < 0.05); Education level had a significant negative association with PHQ-9, GAD-7 and PSQI (r = -0.167,-0.172, both P < 0.05). Binary logistic regression analysis showed that age, technical title, education level, collection time, collection frequency, collection location, fear for infection and external environment were important influencing factors of depression, anxiety and sleep disorders. Conclusion: The results of this study suggested that when carrying out nucleic acid collection mission, managers should intervene to optimize the collection location, control the duration of each collection mission, replace the collection staff in time and pay close attention to the psychological state of the collection staff.

The relationship between mindfulness and mental health among Chinese college students during the closed-loop management of the COVID-19 pandemic: A moderated mediation model.

To prevent the spread of the COVID-19 epidemic on campus, universities in outbreak areas in China can implement closed-loop management. OBJECTS: This study aimed to explore the relationship between mindfulness and mental health of college students under closed-loop management. MEASURES: 11,939 college students from a university in Changsha, China participated in the online survey during the closed-loop management period. The Chinese version of Perceived Stress Scale, the Emotion Regulation Questionnaire-Cognitive Reappraisal, the Mindful Attention Awareness Scale, the 7-item General Anxiety Disorder questionnaire, and the 9-item Patient Health Questionnaire were administered to the college students. RESULTS: We found that mindfulness was negative association with mental health during the closed-loop management period. Perceived stress mediated the relationship between mindfulness and mental health. Cognitive reappraisal moderated the relationship between mindfulness and perceived stress. Specifically, when the level of mindfulness is the same, individuals with more cognitive reappraisal tend to experience a less perceived stress. CONCLUSION: The results of this study are of great significance to improve the mental health of college students during closed-loop management period.

Information technology and artificial intelligence support in management experiences of the pediatric designated hospital during the COVID-19 epidemic in 2022 in Shanghai.

Objective: To describe the information technology and artificial intelligence support in management experiences of the pediatric designated hospital in the wave of COVID-19 in Shanghai. Methods: We retrospectively concluded the management experiences at the largest pediatric designated hospital from March 1st to May 11th in 2022 in Shanghai. We summarized the application of Internet hospital, face recognition technology in outpatient department, critical illness warning system and remote consultation system in the ward and the structed electronic medical record in the inpatient system. We illustrated the role of the information system through the number and prognosis of patients treated. Results: The COVID-19 designated hospitals were built particularly for critical patients requiring high-level medical care, responded quickly and scientifically to prevent and control the epidemic situation. From March 1st to May 11th, 2022, we received and treated 768 children confirmed by positive RT-PCR and treated at our center. In our management, we use Internet Information on the Internet Hospital, face recognition technology in outpatient department, critical illness warning system and remote consultation system in the ward, structed electronic medical record in the inpatient system. No deaths or nosocomial infections occurred. The number of offline outpatient visits dropped, from March to May 2022, 146,106, 48,379, 57,686 respectively. But the outpatient volume on the internet hospital increased significantly (3,347 in March 2022 vs. 372 in March 2021; 4,465 in April 2022 vs. 409 in April 2021; 4,677 in May 2022 vs. 538 in May 2021). Conclusions: Information technology and artificial intelligence has provided significant supports in the management. The system might optimize the admission screening process, increases the communication inside and outside the ward, achieves early detection and diagnosis, timely isolates patients, and timely treatment of various types of children.

Exploration of centralized closed-loop management mode for gynecological day surgery / 中华医院管理杂志

Day surgery can effectively improve the utilization of medical resources. In October 2015, an obstetrics and gynecology hospital established a gynecological day surgery center to centrally manage gynecological day surgery and continuously optimize the management process. In July 2019, the hospital established an intelligent information platform for gynecological daytime surgery managemen. Based on this platform, the " evaluation-appointment-hospitalization-follow-up-chronic disease management" information management process was implemented, the " pre hospital-in hospital-post hospital" full process medical quality and safety monitoring was carried out to form a centralized closed-loop management mode for gynecological day surgery led by gynecologists. Under this management mode, the number of gynecological day surgeries in the hospital has increased from 2 866 cases in 2019 to 4 065 cases in 2021, providing convenient medical services and personalized chronic disease management services, and ensuring the quality and safety of gynecological day medical care, for reference for promoting the high-quality development of day surgeries in specialized hospitals.

Drug closed-loop management system using mobile technology.

BACKGROUND: Drug closed-loop management reflects the level of hospital management and pharmacist service. It is a challenge for hospital pharmacists to realize the whole-process closed-loop management of drugs in hospital pharmacies. Therefore, this study aimed to evaluate the operational effect of using mobile technology to build a closed-loop drug management system. METHODS: Using mobile technology, replacing the traditional paper dispensing model and constructing a multinode information collection system according to the Healthcare Information and Management Systems Society Standard, we reformed the hospital information system and inpatient pharmacy workflow and then evaluated the new approach using statistical methods. RESULTS: After the transformation, the entire process of drug data can be traced. Closed-loop management, as well as real-time data verification and control, thereby improves the work efficiency and reduces the drug dispensing time. By reducing the work error rate, the number of dispensing errors decreased from 5 to 1 case/month. The comprehensive dispensing process can achieve the whole workflow of paperless operation and reduce the use of paper A4 by 180,000 pieces per year. CONCLUSIONS: Mobile technology can improve the service level of pharmacies, enhance the level of drug management and hospital quality management, ensure the safety of medication for inpatients, and significantly reduce the amount of paper used.

Comparison of anxiety and depressive symptoms of head and neck cancer patients in a closed-loop management system before and during the 2019 coronavirus pandemic: a comparative study.

BACKGROUND: The coronavirus disease of 2019 (COVID-19) poses an unprecedented challenge to health and the financial system, especially the healthcare of patients with cancer. However, the research on the negative effect of the pandemic on the anxiety and depressive symptoms of cancer patients in closed-loop is rarely reported at present. In view of the limitations of previous studies. In this study, we compared the anxiety and depressive symptoms of head and neck cancer patients in the closed-loop management system before and during the 2019 coronavirus pandemic. METHODS: In this comparative study, a total of 526 head and neck cancer patients (269 and 257 patients before and during the COVID-19 pandemic) were enrolled in the present study. The two groups of patients' median age (53 years, 52 years), female distribution (70.26%, 66.15%) and male distribution (29.74%, 33.85%) were analyzed before and after the COVID-19 epidemic. They received questionnaires using the standardized data forms of Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) to collect the relevant data of patients for retrospective investigation. For data analysis, either the chi-squared test or Fisher's exact test was employed for categorical variables, and we described the time trend of psychological states before and after the outbreak with Cochran-Armitage trend (CAT) test. RESULTS: A total of 526 head and neck cancer patients were included in the final analysis; 26.85% and 50.19% of cases experienced anxiety and depression during the COVID-19 epidemic. In contrast, 18.22% and 33.46% of cases had experienced anxiety and depression before the pandemic. According to the statistical results, the prevalence of anxiety and depression in patients during the COVID-19 epidemic was higher compared to that of patients prior to the pandemic (P=0.018). More importantly, both anxiety and depression incidence trends increased significantly before and after the outbreak of COVID-19 (P=0.000). CONCLUSIONS: The present study demonstrates the significant impact of COVID-19 on the psychological states of cancer patients in the case of closed-loop management system, effectively indicating the need for appropriate changes in treatment decisions, enhanced psychotherapy, and interventions to reduce the incidence of anxiety, depression, and even suicide during this pandemic.

Sleep clinic service model with closed-loop management for insomnia.

Insomnia is a common medical condition associated with other psychological and physiological disorders, and may require long-term treatment and outpatient management. As such, it is critical that effective treatment and management is provided in clinical practice. This study introduces an innovative outpatient service model for patients with insomnia, which includes providing medical care before, during and after diagnosis in public hospital clinics, completing prescribed treatments at home and return visits. It is a digital health-based, patient-centred, collaborative care model with closed-loop management. The proposed management strategy may help achieve a balance between the efficiency and the quality of outpatient medical care for insomnia.

Practice and experience of regional medical center entrance linkage and closed-loop management under the wartime situation of the COVID-19 in China.

On 28 July 2021, the first indigenous case of novel coronavirus pneumonia (COVID-19) emerged in Yangzhou, marking the beginning of a public health crisis caused by the new coronavirus pneumonia. It is a significant challenge for hospitals to carry out prevention and control measures to ensure the safety of medical professionals and patients when facing the changes in an epidemic situation. Subei People's Hospital, as one of the first group of "Grade III-class A" hospitals in Jiangsu Province and the Yangzhou Regional Medical Centre, responded quickly and scientifically to prevent and control the disease. A closed-loop management system was implemented at the hospital entrance (consisting of the outpatient clinic, emergency clinic, fever clinic, and buffer ward) and an epidemic prevention and control group was established with the assistance of multiple departments. This group optimized the pre-screening and triage system, standardized the fever clinic consultation process, and improved the construction of an information-based prevention and control network so that patients were detected, diagnosed, isolated, and treated early. The emergency management capability was improved to achieve zero missed consultations of patients attending for COVID-19 and to effectively maintain medical order during this critical period. This current report systematically summarizes the operational practices and the effectiveness achieved by implementation of the entrance closed-loop management in the hospital and analyzed the key operational issues for future reference by medical institutions and management departments.

Bubble Strategy - A Practical Solution to Return to Regular Life in the Intertwined Era of Vaccine Rollouts and Virus Mutation.

For a long time, vaccination and herd immunity were considered to be the magic solution for controlling coronavirus disease 2019 (COVID-19). However, the emergence of new variants altered people's expectations and prolonged the pandemic duration, especially the Omicron strain with substantially increased transmissibility and decreased vaccine efficacy. Therefore, we are in urgent need of a practical solution to resume regular life to some extent, while mitigating COVID-19 risks in the tight race between vaccine rollouts and virus variation. This commentary proposed that bubble strategy (or closed loop management), utilized in Tokyo 2020 Olympic Games and to be implemented in Beijing 2022 Winter Games, could serve as a novel technique of non-pharmaceutical interventions in coping with such a situation.

The Role of Thoracic Surgeon in the Fight Against COVID-19 Pandemic Frontline.

As the COVID-19 pandemic ravages the whole world, frontline doctors are tirelessly fighting to contain and manage the disastrous effects of the virus. However, thoracic surgeons will also become frontline doctors, because everyone around them is likely to be infected after the closed-loop management of the hospital. Stress, difficulty, fears, physical and psychological burnout and lowered morale are some side effects. We feature the perspectives of thoracic surgeons at the epicenter of the COVID-19 fight in Fudan University Shanghai Cancer Center, which highlight the emotions, measures, motivation and belief of thoracic surgeons while they work on frontlines.

Practical research on fishbone diagram combined with PDCA closed-loop management in orthopedic operating room teaching / 中华医学教育探索杂志

Objective:To explore the effect of fishbone diagram combined with PDCA(plan, do, check, action) closed-loop management in the teaching of orthopedic interns in operating room.Methods:The 60 interns received by the Department of Orthopedics in our hospital from January 2019 to August 2020 were randomly divided into the conventional group and the observation group in average. The conventional group used traditional methods, and the observation group introduced fishbone diagram combined with PDCA closed-loop management. The theoretical and practical assessment scores and the evaluation of satisfaction with the teaching were compared between the two groups before and after the teaching in the operating room. SPSS 22.0 was used for t-test and Chi-square test. Results:The scores of each theoretical assessment, the total scores of theoretical assessments, and the scores of practical assessments, in the observation group were higher than those of the conventional group ( P<0.05). The satisfaction rates of interest, effectiveness, rationality, and popularization with teaching in the observation group were 100.00%, 100.00%, 96.67%, and 100.00% respectively, which were higher than those (80.00%, 83.33%, 80.00%, and 83.33% respectively) in the conventional group. Conclusion:The application of fishbone diagram combined with PDCA closed-loop management in orthopedic operating room teaching can improve the performance of interns in the assessment, and can also achieve better teaching satisfaction.

Application of closed-loop blood transfusion information system in the whole process management of blood transfusion / 中国输血杂志

【Objective】 To explore the effect of mobile transfusion closed-loop information system in the whole process management of clinical blood transfusion. 【Methods】 The hospital information system (HIS) of Soochow Hospital affiliated to Nanjing Medical University was integrated with the blood information system (BIS) and personal digital assistant (PDA) to build a closed-loop transfusion management process to ensure the safety of clinical blood use. From May 2021 to April 2022, 1 395 patients who were admitted to our hospital for blood transfusion therapy were studied. Among them, 632 patients from May to October 2021 (before the implementation of closed-loop management) were the control group, and 763 patients from November 2021 to April 2022 (after the implementation of closed-loop management) were the observation group. Before and after the implementation of closed-loop management, we compared the implementation rate of double-checking before blood sample collection, rate of transfusion within 30 min after blood issuing, implementation rate of double-checking of bedside transfusion, situation of patrol every 15 minutes, rate of transfusion completed within 4 h, rate of nursing documentation standardization, so as to evaluate the improvement effect of the whole process of transfusion management. 【Results】 The implementation rate of double-checking before blood sample collection was 99.48%(759/763) in the observation group and 93.99%(594/632) in the control group; the transfusion rate within 30 min after blood issuing was 95.02%(725/763) in the observation group and 91.46%(578/632) in the control group; the implementation rate of double-checking of bedside transfusion was 100%(763/763) in the observation group and 95.73%(605/632) in the control group; the complete rate of patrol every 15-min was 94.36%(720/763) in the observation group and 90.35%(571/632) in the control group; the completion rate of transfusion within 4 h was 95.81%(731/763) in the observation group and 92.25%(583/632) in the control group; the rate of nursing paperwork standardization was 98.03%(748/763) in the observation group and 81.80%(517/632) in the control group, and the difference between the two groups was statistically significant (P<0.05). 【Conclusion】 The mobile transfusion closed-loop information system can realize the whole process management of clinical blood transfusion, effectively improve the standardization of blood transfusion and transfusion documents, and guarantee the safety of clinical blood transfusion.

Design and implementation of single disease data quality management system based on hospital information system / 中华医院管理杂志

Quality management and control of single disease is a means to continuously improve medical quality and safety by building a set of quality control indicators and evaluation systems based on the whole process of disease diagnosis and treatment. In the actual single disease management process, the reporting of each disease involved data from various systems such as electronic medical records, and the data integration was difficult. While the traditional manual reporting method took a lot of time and the data accuracy could not be guaranteed. In the development process of hospital informatization, a hospital has designed a set of intelligent full-closed loop single disease management platform based on the hospital information system, by integrating the existing human and information data resources of the hospital. This platform integrated functions of single disease intranet reporting, in-depth capture of reporting elements, single-disease quality index management, and single-disease real-time intelligent control, in order to promote more refined and intelligent disease management and thus steadily improve medical quality and safety.

Practice of a hemodialysis alliance in the context of closed-loop hospital management / 中华医院管理杂志

Closed-loop hospital management can effectivly cope with the COVID-19 pandemic. In order to ensure the continuity of treatments for hemodialysis patients under closed-loop management and minimize possible medical and infection risks, Huashan Hospital affiliated to Fudan University and 9 hospitals in Shanghai established a hemodialysis alliance in January 2021.The alliance optimized hemodialysis resources within the region through overall planning by preparing sites, materials and personnel shifts in advance, and establishing management systems and work processes to ensure that patients could be quickly and orderly diverted to other blood dialysis centers for uninterrupted high-quality hemodialysis services, in case that some hemodialysis centers in the alliance under closed-loop management.From November 2021 to April 2022, 317 of 1 459 hemodialysis patients in the alliance were diverted to other centers for treatment, accumulating 1 215 times/cases of treatments without obvious adverse reactions. The practice could provide a reference for medical institutions to quickly establish mutual support mode under major public health events.

Closed-loop management strategies for patients with severe mental disorder complicated with COVID-19 infection / 四川精神卫生

With the fluctuating condition of the COVID-19 epidemic， the current findings remain unclear about the preventive measures and coping strategies for patients with severe mental disorders at the nodes of the transmission chain. Past experience in prevention and control has shown that establishing an effective system for emerging infectious disease prevention and control and establishing transitional wards in specialist mental healthcare institutions play a significant role in reducing the risk of epidemic transmission. However， there is no formulated strategy for the management of patients with severe mental disorders and COVID-19 infection who have recurrent or worsened mental symptoms during the diagnosis and treatment of COVID-19 and are unable to cooperate with the treatment in Fangcang shelter hospitals or infectious wards. Based on the field research in the front line of the epidemic prevention， this paper discusses the management strategies of patients with severe mental disorders and COVID-19 infection in the context of the practical difficulties in managing patients with severe mental disorders and COVID-19 infection， emergency management strategies， protective conditions for front-line psychiatric medical staff and the legal basis for the management of patients with severe mental disorders and COVID-19 infection in emergency situations.

Analysis on application effects of RAID quality improvement model in closed-loop management of central retinal artery occlusion nursing.

OBJECTIVE: This study aimed to analyze the clinical value of applying RAID quality improvement model in closed-loop management of central retinal artery occlusion (CRAO) nursing. METHODS: Twelve ophthalmic nurses were trained. Soon afterwards, their related knowledge, operation and scene simulation test scores before and after training were examined and compared. Before and after training, 20 CRAO patients who admitted to the second ward of ophthalmology (Ophthalmology Section 2) of our hospital were included into control group and research group. The former applied routine management, while the latter employed RAID quality improvement model. RESULTS: Before intervention, the ESCA scores and the time window of first-aid of the two groups had no significant difference (all P>0.05). While after intervention, the scores of the research group were dramatically improved; the self-care skills, health knowledge, self-responsibility and self-awareness were obviously higher than those of the control group (all P<0.05); the time window of first-aid in the research group was remarkably shorter than that before intervention, dramatically higher than that in the control group (32.34±8.14 vs. 49.46±8.13; P<0.05). After nursing, the overall satisfaction of patients in the research group (95.00%) was higher than that in the control group (70.00%; P<0.05). Meanwhile, compared with those before training, the examination scores of related knowledge and skills of ophthalmic nurses after training were obviously improved (all P<0.05). The incidence of complications in the research group was 5.00%, while that in the control group was 30.00%. The indexes in the research group were lower than those in the control group, with statistically remarkable differences (P<0.05). CONCLUSION: RAID quality improvement model is effective in closed-loop management of CRAO nursing, which can effectively improve the quality of nursing for specific diseases and control related indicators. Hence, it's worthy to be promoted.

A Study on the Improvement of Nursing Interruption Risk by a Closed-Loop Management Model.

OBJECTIVE: This study aimed to evaluate the effect of closed-loop management on nursing disruption risk. METHODS: Using a quasi-experimental research method, convenient sampling was used to extract 20 nurses working at our hospital as the research objects. The control group members were selected from January to March 2018 via the traditional method, and the experimental group members were selected from April to June 2018 via the closed-loop management method. At three months before and after the implementation of the management model, a self-designed quantitative test form and satisfaction questionnaire were used to analyze the frequency of nursing disruption events, the accuracy rate of doctors' advice, the average drug delivery time of the static distribution center, the implementation rate of personal digital assistant (PDA) code scanning, and the report rate of risk-outcome nursing disruption events. RESULTS: After the implementation of the management model, the frequency of nursing disruptions and average drug delivery time of the static distribution center were significantly lower than before, and the differences were statistically significant (p < 0.05). Moreover, the accuracy rate of doctors' advice, the implementation rate of PDA code scanning, and the reporting rate of risk-outcome nursing disruption events were significantly higher than before, and these differences were statistically significant as well (p < 0.05). CONCLUSION: The application of a closed-loop management model could significantly reduce the occurrence and optimize the outcomes of nursing disruption events and improve the work processes of medical care.

Study on the COVID-19 infection status, prevention and control strategies among people entering Shenzhen.

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) confirmed cases overseas have continued to rise in the last months, and many people overseas have chosen to return to China. This increases the risk of a large number of imported cases which may cause a relapse of the COVID-19 outbreak. In order to prevent imported infection, the Shenzhen government has implemented a closed-loop management strategy using nucleic acid testing (NAT) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and requiring 14 days of medical observation for individuals with an overseas tour history (Hong Kong, Macao, Taiwan province and other countries). Our study aims to describe the status of COVID-19 infection among people entering Shenzhen, and to evaluate the effect of the closed-loop management strategy. METHODS: We undertook a descriptive study and risk analysis by the entry time, time of reporting, and local confirmed cases in countries of origin. The NAT were completed in Shenzhen Center for Disease Control and Prevention (CDC), ten district-level CDCs, and fever clinics. RESULTS: A total of 86,844 people from overseas entered Shenzhen from January 1 to April 18, 2020; there were 39 imported COVID cases and 293 close contacts. The infection rate of people entering was 4.49‰ [95% Confidence interval (CI): 3.26‰-6.05‰]. Fourteen imported cases (35.9%) came from the UK, and nine (23.08%) came from the USA. People entering from the USA since March 9 or from the UK since March 13 are the high-risk population. As of July 17, there have been no new confirmed cases in Shenzhen for 153 days, and the numbers of confirmed case, close contacts, and asymptomatic cases are 0. CONCLUSIONS: The closed-loop management has been effective in preventing imported infection and controlling domestic relapse. The distribution of entry time and report time for imported cases overseas was similar. This shows that it is important to implement closed-loop management at the port of entry.