Lessons learned from the 2019-nCoV epidemic on prevention of future infectious diseases

Factors influencing the intention to purchase health insurance: a study of Indian tobacco and alcohol consumers

Introduction

This study empirically investigates the attitude of tobacco and alcohol consumers towards health insurance purchase in India. The study aims to determine the factors which plays a significant role in determining the purchase intention of health insurance among tobacco and alcohol consumers.

Methods

We propose an extended theory of planned behavior (TPB) model comprising factors like attitude, subjective norms, perceived behavior control, perceived usefulness, perceived product risk, and intention to purchase. We collected responses from 420 tobacco and alcohol consumers through a Google Form link shared via different social media platforms. SPSS has been used to perform exploratory factor analysis, whereas AMOS has been used to validate the constructs, confirm the relationships among the variables, and analyze the data.

Results

The analysis outcomes demonstrate that subjective norms, perceived product risk, and perceived behavioral control are the factors that have a positive and significant effect on health insurance purchase intention among consumers.

Discussion

This research offers valuable insights to the insurance sector, government officials, policymakers, and academicians. Insurance companies may consider the criteria analysed when creating policies to promote the expansion of the health insurance sector.

Bayesian Noise Modelling for State Estimation of the Spread of COVID-19 in Saudi Arabia with Extended Kalman Filters

The epistemic uncertainty in coronavirus disease (COVID-19) model-based predictions using complex noisy data greatly affects the accuracy of pandemic trend and state estimations. Quantifying the uncertainty of COVID-19 trends caused by different unobserved hidden variables is needed to evaluate the accuracy of the predictions for complex compartmental epidemiological models. A new approach for estimating the measurement noise covariance from real COVID-19 pandemic data has been presented based on the marginal likelihood (Bayesian evidence) for Bayesian model selection of the stochastic part of the Extended Kalman filter (EKF), with a sixth-order nonlinear epidemic model, known as the SEIQRD (Susceptible-Exposed-Infected-Quarantined-Recovered-Dead) compartmental model. This study presents a method for testing the noise covariance in cases of dependence or independence between the infected and death errors, to better understand their impact on the predictive accuracy and reliability of EKF statistical models. The proposed approach is able to reduce the error in the quantity of interest compared to the arbitrarily chosen values in the EKF estimation.

Comprehensive sentimental analysis of tweets towards COVID-19 in Pakistan: a study on governmental preventive measures

Sentiments are the key factors that lead to influence our behavior. Sentiment analysis is a technique that analyzes people's behaviors, attitudes, and emotions toward a service, product, topic, or event. Since 2020, no country has remained untouched by COVID-19, and the governing bodies of most countries have been applying several anti-pandemic countermeasures to combat it. In this regard, it becomes tremendously important to analyze people's sentiments when tackling infectious diseases similar to COVID-19. The countermeasures taken by any country to control the pandemic leave a direct and crucial impact on each sector of public life, and every individual reacts to them differently. It is necessary to consider these reactions to implement appropriate messaging and decisive policies. Pakistan has done enough to control this virus's spread like every other country. This research aims to perform a sentimental analysis on the famous microblogging social platform, Twitter, to get insights into public sentiments and the attitudes displayed towards the precautionary steps taken by the Government of Pakistan in the years 2020 and 2021. These steps or countermeasures include the closure of educational institutes, suspension of flight operations, lockdown of business activities, enforcement of several standard operating procedures (SOPs), and the commencement of the vaccination program. We implemented four approaches for the analysis, including the Valence Aware Dictionary and sEntiment Reasoner (VADER), TextBlob, Flair, and Bidirectional Encoder Representations from Transformers (BERT). The first two techniques are lexicon-based. Flair is a pre-trained embedding-based approach, whereas BERT is a transformer-based model. BERT was fine-tuned and trained on a labeled dataset, achieving a validation accuracy of 92%. We observed that the polarity score kept varying from month to month in both years for all countermeasures. This score was analyzed with real-time events occurring in the country, which helped understand the public's sentiment and led to the possible formation of a notable conclusion. All implemented approaches showed independent performances. However, we noticed from the classification results of both TextBlob and the fine-tuned BERT model that neutral sentiment was dominant in the data, followed by positive sentiment.

Public Knowledge, Attitudes, and Practices Toward COVID-19 Pandemic: A Cross-Sectional Study in Delhi and National Capital Region (NCR), India

To assess knowledge, attitudes, and practices of people toward coronavirus disease 2019 (COVID-19) pandemic in National Capital Territory of Delhi and National Capital Region (NCR), India. Various nations, including India, devised strategies to impose lockdowns and movement restrictions on their citizens in order to mitigate the effects of COVID-19. Cooperation and compliance by the populace are crucial to the effectiveness of such measures. People's knowledge, attitudes, and behavior toward such diseases are crucial in determining the adaptability of a society to such changes. Using Google Forms, a self-designed semi-structured questionnaire was created. This study is cross-sectional. Participants were eligible to participate if they were over the age of 18 and presently resided in the study area. The questionnaire included demographic variables such as gender, age, location, occupation, and income level. A total of 1,002 people completed the survey. A 48.80% of the respondents in the study group were females. The mean knowledge score was 13.14 (Maximum Score = 17), while the mean attitude score was 27.24 (Maximum Score = 30). Most of the respondents (96%) had adequate knowledge about the disease's symptoms. A 91% of the respondents had an average attitude score. A 74.85% of respondents accepted that they had avoided large social events. Gender had a negligible impact on the average knowledge score, while the score differed significantly across education levels and occupation categories. Consistent dissemination of messages regarding the virus, its spread, control measures implemented, and precautions expected from the public aids in reassuring the public and reducing their anxiety regarding the virus.

Interactions among the human and organizational factors within the public sector regarding epidemic prevention and control

The management of human and organizational factors (HOFs) within the public sector directly concerns the efficacy of epidemic prevention and control (EPC). Insufficient examination of such HOFs has led to defective countermeasures. This study attempts to comprehensively identify the HOFs within the public sector critical to EPC and investigate their interactions with the weighted network theory. A total of 55 HOFs were identified, and their interactions were assessed and visualized in the Chinese context. Then, the established weighted network was analyzed to investigate the interactions and diagnose critical factors and sectors. The analysis shows that there are strong interactions among HOFs, and that the human and organizational risks emerging from administrative departments of public health, centers for disease control and prevention, and medical institutions act as the key risk sources in the complex interconnected EPC system, exacerbating risk and causing a significant domino effect. It is recommended that the authorities devote more resources to the core sectors and endeavor to reinforce those critical HOFs by implementing closer risk communication, collaboration, and response. This study may deepen and broaden the authorities' awareness and understanding of interactions among HOFs regarding epidemic mitigation, and strengthen their capacity to perceive, evaluate, and manage these factors in a proactive and effective way, thereby facilitating the success of EPC.

Using Shannon Entropy to Improve the Identification of MP-SBM Models with Undesirable Output

In the context of the COVID-19 global epidemic, it is particularly important to use limited medical resources to improve the systemic control of infectious diseases. There is a situation where a shortage of medical resources and an uneven distribution of resources in China exist. Therefore, it is important to have an accurate understanding of the current status of the healthcare system in China and to improve the efficiency of their infectious disease control methods. In this study, the MP-SBM-Shannon entropy model (modified panel slacks-based measure Shannon entropy model) was proposed and applied to measure the disposal efficiency of the medical institutions responding to public health emergencies (disposal efficiency) in China from 2012 to 2018. First, a P-SBM (panel slacks-based measure) model, with undesirable outputs based on panel data, is given in this paper. This model measures the efficiency of all DMUs based on the same technical frontier and can be used for the dynamic efficiency analysis of panel data. Then, the MP-SBM model is applied to solve the specific efficiency paradox of the P-SBM model caused by the objective data structure. Finally, based on the MP-SBM model, undesirable outputs are considered in the original efficiency matrix alignment combination for the deficiencies of the existing Shannon entropy-DEA model. The comparative analysis shows that the MP-SBM-Shannon model not only solves the problem of the efficiency paradox of the P-SBM model but also improves the MP-SBM model identification ability and provides a complete ranking with certain advantages. The results of the study show that the disposal efficiency of the medical institutions responding to public health emergencies in China shows an upward trend, but the average combined efficiency is less than 0.47. Therefore, there is still much room for improvement in the efficiency of infectious disease prevention and control in China. It is found that the staffing problem within the Center for Disease Control and the health supervision office are two stumbling blocks.

Ensemble hybrid model for Hindi COVID-19 text classification with metaheuristic optimization algorithm

A SARS-CoV-2 virus has spread around the globe since March 2020. Millions of people infected worldwide with coronavirus. People from every country expressed their sentiments about coronavirus on social media. The aim of this work is to determine the general public opinion of Indian Twitter users about coronavirus. The Hindi tweets posted about COVID-19 is used as input data for sentiment analysis. The natural language processing is applied on input data for feature extraction. Further, the optimal features are selected from the pre-processed data using the metaheuristic based Grey wolf optimization technique. Finally, a hybrid of convolution neural network(CNN) and a long short-term memory (LSTM) model pair is employed to categorize the sentiments as positive, negative, and neutral. The outcome of the proposed model is compared with other machine learning techniques, namely, Random Forest, Decision Tree, K-Nearest Neighbor, Naive Bayes, Support vector machine (SVM), CNN, LSTM, LSTM-CNN, and CNN-LSTM. The highest accuracy of 87.75%, 88.41%, 87.89%, 85.54%, 89.11%, 91.46%, 88.72%, 91.54%, and 92.34% is obtained by Random Forest, Decision Tree, K-Nearest Neighbor, Naive Bayes, SVM, CNN, LSTM, LSTM-CNN, and CNN-LSTM, respectively. The proposed ensemble hybrid model gives the highest 95.54%, 91.44%, 89.63%, and 90.87% classification accuracy, precision, recall, and F-score, respectively.

Cross-Cultural Adaptation and Validation of the Fear of COVID-19 Scale for Chinese University Students: A Cross-Sectional Study

BACKGROUND

fear of COVID-19 is widespread among the population, especially among college students because of their increased exposure to the media information overload of the COVID-19 outbreak. The Fear of COVID-19 scale (FCV-19 S) is a relatively short instrument used to evaluate fears surrounding the COVID-19 pandemic. However, the validity and reliability of the Fear of COVID-19 Scale have not been fully investigated in Chinese university student groups.

OBJECTIVES

this study assessed the cross-cultural adaptability and reliability of the FCV-19S for Chinese university students.

METHODS

a Chinese version of Fear of COVID-19 Scale (C-FCV-19S) was generated using the translation-backward translation method. Psychometric properties of the C-FCV-19S, including internal consistency, split-half reliability, construct reliability, convergent validity, and diagnostic accuracy, were evaluated. The Patient Health Questionnaire (PHQ) and Generalized Anxiety Disorder Questionnaire (GAD-7) scales were also used to evaluate participants for depression and anxiety.

RESULTS

the C-FCV-19S has acceptable internal consistency (Cronbach's alpha: 0.872) and satisfactory split-half reliability (correlation coefficient: 0.799). Using the exploratory factor analysis (EFA), we examined the construct reliability (KMO = 0.920). The confirmatory factor analysis (CFA) confirmed that the bifactor model of scale (including general factor, factor1: the awareness of COVID-19 and physiological arousal, factor 2: fear-related thinking) had a good fit index (χ2/df =6.18, RMSEA= 0.067, SRMR = 0.028, GFI = 0.986, TLI = 0.970 and CFI= 0.988). Using depression-positive and anxiety-positive scores as reference criteria, we found that the areas under the curve were 0.70 and 0.68, respectively, and that the optimal cutoff scores of the C-FCV-19S was 17.5 (sensitivity: 66.3% and 58.7%, respectively).

CONCLUSIONS

the validity and reliability of C-FCV-19S are satisfactory, and the optimal cutoff point was 17.5. The C-FCV-19S can be applied adopted in Chinese university students.

The Analytical Framework of Governance in Health Policies in the Face of Health Emergencies: A Systematic Review

The Governance Analytical Framework (MAG) defines governance as a social fact, endowed with analyzable and interpretable characteristics, through what it calls observable constitutive elements of governance: the problem, the actors, the social norms, the process of decision-making and scope or nodal points; in the sense that each society develops its modes of governance, its decision-making or conflict resolution systems among its members, its norms, and institutions. In this perspective, the purpose of this article was to carry out a systematic review of the scientific literature to understand the role of governance in health policies in health emergencies, such as that caused by the SARS-CoV-2. The systematic review was designed based on the methodology proposed in the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) Declaration. The literature search was carried out in six databases: Psychology and Behavioral Sciences, APA-PsycInfo, MEDLINE, eBook Collection (EBSCOhost), PubMED, and MedicLatina, published in the last 5 years. Fifteen articles that met quality and evidence criteria were analyzed. The governance approach alluding to the health emergency problem in health policies was the most addressed by the authors (80%), followed by a description of the actors (40%), the process of decision-making spaces (33%), and ultimately, social norms or rules with 13%. Formulating a coherent set of global health policies within a large-scale global governance framework is mostly absent. Although the countries adopt international approaches, it is a process differentiated by the social, economic, and political contexts between countries, affecting heterogeneous health outcomes over the pandemic.

Spatial evolution patterns of public panic on Chinese social networks amidst the COVID-19 pandemic

Novel coronavirus pneumonia has had a significant impact on people's lives and psychological health. We developed a stage model to analyse the spatial and temporal distribution of public panic during the two waves of the coronavirus disease 2019 (COVID-19) pandemic. We used tweets with geographic location data from the popular hashtag 'Lockdown Diary' recorded from 23 January to April 8, 2020, and 'Nanjing Outbreak' recorded from 21 July to 1 September 2021 on Weibo. Combining the lexicon-based sentiment analysis and the grounded theory approach, this panic model could explain people's panic and behavioural responses in different areas at different stages of the pandemic. Next, we used the latent Dirichlet allocation topic model to reconfirm the panic model. The results showed that public sentiments fluctuated strongly in the early stages; in this case, panic and prayers were the dominant sentiments. In terms of spatial distribution, public panic showed hierarchical and neighbourhood diffusion, with highly assertive expressions of sentiment at the outbreak sites, economically developed areas, and areas surrounding the outbreak. Most importantly, we considered that public panic was affected by the 17 specific topics extracted based on the perceived and actual distance of the pandemic, thus stimulating the process of panic from minimal, acute, and mild panic to perceived rationality. Consequently, the public's behavioural responses shifted from delayed, negative, and positive, to rational behavioural responses. This study presents a novel approach to explore public panic from both a time and space perspective and provides some suggestions in response to future pandemics.

The Impact of COVID-19 on Food Consumption and Dietary Quality of Rural Households in China

The COVID-19 pandemic disrupted the food supply chain and thus threatened the food security of many people, while the impact of the pandemic on food consumption of people living in rural areas is still unknown. This study filled in the research gaps by employing a three-wave food consumption survey from 2019 to 2021 conducted in rural China. We adopted a random effect model and Poisson regression to quantify the short-run and long-run impacts of COVID-19 on rural households’ food consumption and dietary quality. We found that rural households increased the consumption of vegetables, aquaculture products and legumes in the short-run, and these changes in consumption behavior even lasted 1 year after lockdown was lifted. However, the positive impact was much smaller in households not engaged in agricultural production. In addition, our results showed that COVID-19 decreased dietary diversity but increased dietary quality for households still engaged in food-related agriculture production. Our study indicated that COVID-19 did not threaten the food security status of rural families in China. On the contrary, rural families, particularly those still engaged in agricultural production, increased the consumption of several foods to strengthen their resistance against the virus.

Virtual Infection Prevention and Control in Low- and Middle-Income Countries

COVID-19 brought new challenges and opportunities for infection prevention and control. Virtual infection prevention and control (VIPC), although nascent, is rapidly becoming a viable and necessary strategy for combatting the COVID-19 pandemic. Benefits of VIPC include extending the impact of globally scarce infectious disease providers and public health practitioners, allowing coordination between disparate professionals to more effectively combat infectious disease, and increasing access to and quality of healthcare. Although mainly applied in developed countries, VIPC may play its greatest role in low- and middle-income countries (LMICs) with fewer healthcare resources. We conducted a brief literature search of VIPC in LMICs and found that many studies describe solutions in developed countries or describe planned or theoretical solutions. Few studies describe actual VIPC implementation in LMICs, except for China. Literature from related fields, for example, virtual critical care, and from developed countries is more robust and provides a roadmap for future research on VIPC in LMICs. Further research into strategies and outcomes related to VIPC in LMICs is necessary.

Development and utility of a close contact information management system for the COVID-19 pandemic

BACKGROUND

Since the outbreak started in 2019, COVID-19 pandemic has a significant global impact. Due to the highly infective nature of SARS-CoV-2, the COVID-19 close contacts are at significant risk of contracting COVID-19. China's experience in successfully controlling COVID-19 emphasized the importance of managing close contacts because this strategy helps to limit potential infection sources, prevent the unconscious spread of COVID-19 and thus control this pandemic. As a result, to understand and consider the management of close contacts may be beneficial to other countries. However, managing close contacts is challenging owing to the huge number of close contacts and a lack of appropriate management tools and literature references.

METHODS

A new system called the COVID-19 Close Contact Information Management System was developed. Here we introduced the design, use, improvement and achievements of this system.

RESULTS

This system was designed from the standpoint of the Centers for Disease Control and Prevention in charge of managing close contacts. Two main functions and eight modules/themes were ultimately formed after two development stages. The system introduces what information need to be collected in the close contact management. Since the system allows information flow across cities, the geographical distance and administrative regional boundaries are no longer obstacles for managing close contacts, which promotes the management of each close contact. Moreover, when this system is used in conjunction with other data tools, it provides data assistance for understanding the COVID-19 characteristics and formulating targeted COVID-19 control policies. To date, the system has been widely used in Guangdong Province for over 1 year and has recorded tens of thousands of pieces of data. There is sufficient practical experience to suggest that the system is capable of meeting the professional work requirements for close contact management.

CONCLUSIONS

This system provides a new way to manage close contacts and restrict the spread of COVID-19 by combining information technology with disease prevention and control strategies in the realm of public health. We hope that this system will serve as an example and guide for those anticipating similar work in other countries in response to current and future public health incidents.

Perceived Stress among School Students in Distance Learning During the COVID-19 Pandemic in the Gaza Strip, Palestine

The rapid outbreak of COVID-19 is a global health problem that has a significant effect on the educational systems. Therefore, students shifted to distance learning through the digital platform. Since COVID-19 has consequences on mental health, the present study examined the perceived stress level in school students in distance learning during the COVID-19 period. A cross-sectional study of a sample consisting of 385 school students evaluated the Perceived Stress Scale (PSS) and their concerns and emotions during the COVID-19 pandemic. The results showed that the mean value of the total PSS scores was 19.50 ± 9.28. About 48.6% of students had moderate stress, 28.8% had low stress, and 22.6% had high stress. Significant associations were found between the level of stress and demographic variables: age, gender, educational level, and place of residence. Female students were significantly higher than the male students in the mean score of perceived stress level (20.14 versus 18.13; p-value = 0.018). Females were more likely (53.4%) to have moderate stress than males (38.2%) (p = 0.019). The students aged 15–18 years were significantly higher than those aged 11–14 years in the mean score of perceived stress level (22.64 versus 17.24, respectively; p-value < 0.001). The students aged 15–18 years were also more likely (n = 536, 96.4%) to had high levels of stress than the younger students (p < 0.001). The results showed that secondary school students were significantly higher than primary school students in the mean score of perceived stress level (23.75 versus 16.76, respectively; p < 0.001). Secondary students were also more likely (43.0%) to have high stress than primary students (9.4%) (p < 0.001). Students who live in the Rafah governorate had a significantly lowest mean score of perceived stress level when compared to other counterparts (p-value = 0.005). Gender (β = − 0.282, P < 0.001), age (β = − 0.379, P = 0.004), place of residence (β = − 0.096, P = 0.034), and educational level (β = 0.845, P < 0.001) were predictors of perceived stress. The results revealed moderate to high levels of stress in school students in the Gaza Strip during schools closure due to the COVID-19 pandemic. The prevalence of psychological distress attributed to suddenly shifted from traditional learning to distance learning. The incorporation of stress management programs and online counselling will minimize stress and enhance the mental health of school students during distance learning.

A quadruple protection procedure for resuming pig production in small-scale ASFV-positive farms in China

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African swine fever outbreak has caused serious economic losses in China. Pork supply in consequence faces huge demand.

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The small-scale farms in China are encountering difficulties in raising pigs.

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A comprehensive procedure was tested in 35 small pig farms that had been confirmed with African swine fever virus.

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During a one-year study, 100 percent of porkers and 98.8 percent of sows were healthy respectively.

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An effective biosafety procedure was developed for production of pigs in small-scale farms in China.

African swine fever (ASF) outbreak has caused serious economic losses in Asia since 2018. As ASF is a new emerging disease, many farmers hesitate to raise pigs before biosafety procedures were evaluated to be effective. To support small-scale farms in resuming pig production, a comprehensive procedure, called the quadruple protection procedure (QPP), was tested in 35 small farms which had been confirmed with African swine fever virus (ASFV). The QPP takes care of the farms' construction, environmental disinfection, regular immunization, and feed quality. Qualified daily management was supplemented as well. During a one-year survey four disinfectants and one piece of equipment were used in higher frequency. A 7- or 15-day empty period after the disinfection was suitable when it was combined with the rest of the protection measures from QPP. Totally 18,730 porkers and 3,006 sows were healthy by the end of the study with percentage of 100 and 98.8, respectively, indicating that QPP could protect pigs in small-scale farms from pathogens within China. This study developed an effective protective procedure system for small-scale farms to produce pigs under the risk of ASF outbreak.

COVID-19 in dental practice – An overview of challenges and preventive measures

COVID-19 was identified to be caused by a new coronavirus named as SARS-CoV-2. Since the outbreak of this disease, World Health Organization (WHO) declared a global public health emergency. SARS-CoV-2 has a high estimate rate of human-to-human transmission mainly through inhalation/ingestion/direct mucous contact with respiratory droplets. Considering this high transmission capacity, several countries have already registered cases of infection by health professionals. Even though dentists are not directly involved in the diagnosis and therapy of COVID-19 they represent undoubtedly a risk group due to high exposure and their work environment is a contagion factor for patients and staff. In this manner, the objective of this article is to approach important aspects of COVID-19 concerning dental care and provides an overview of its challenges on dental practice. For this, we used these following keywords in our research: COVID-19; dental general practice; prevention and control; infectious disease transmission; infectious disease transmission, patient to professional. Taking into account the global concern with patient care in midst of this pandemic, we address valid concerns regarding the potential means of contamination in the dental office and highlight practices and guidelines adopted in different countries to minimize risks in dental care in this global public health crisis, thus, reinforcing the challenges of dentistry in this context, highlighting the importance of rigorous preventive measures. However, there is still a lack of standardization of dental care protocols and consequently, reduce the risk of contagion.

A study of anxiety, depression and stress symptoms among Fayoum medical students during COVID-19 lockdown, Egypt

Background

The widespread pandemic of COVID-19 virus carries not only physical hazards, but also major psychological effects especially among medical students. The aim was to investigate the psychological effects of COVID-19 on medical students and the factors affecting them. The study was carried out with an online questionnaire distributed through Google Forms for medical students at Faculty of Medicine, Egypt. The questionnaire included socio-demographic questions, validated psychometric tools for the assessment of depression, anxiety and stress (Depression Anxiety Stress Scales DASS-21) and the Impact of Event Stress Scale-Revised (IES-R) were applied.

Results

The total number of participants was 282 students. Percentage of participants with clinically significant depression was 75.2%, anxiety was 56.4% and stress was 52.9%. Those showed PTSD probability was 54.3%. The multivariate regression analysis revealed that IES remained significantly associated with gender and previous road accidents, depression and anxiety remained significantly associated with personal history of psychiatric illness, while stress remained significantly associated with gender and previous road accidents.

Conclusions

Medical students were highly depressed, anxious and stressed during period of COVID-19 pandemic. Being a female, having previous history of psychiatric illness and previous road accident were highly associated with increasing the psychological impact of COVID-19.

Regional disparities in Preventive measures of COVID-19 pandemic in China. A study from international students' prior knowledge, perception and vulnerabilities

The COVID-19 pandemic needs immediate solution before inflicting more devastation. So far, China has successfully controlled transmission of COVID-19 through implementing stringent preventive measures. In this study, we analyze the effectiveness of preventive measures taken in thirteen regions of China based on the feedback provided by 1135 international students studying in China. The study uses factor analysis combined with varimax rotation of variables. It was found that awareness raising and dispersing actionable knowledge regarding trust and adapting measures remained significantly important. Therefore, recognition of information gaps, improvements in the level of alertness, and development of preventive measures in each sector are imperative. The findings of this study revealed that trust, students' health, waste disposal, and the efforts of the Chinese government/international institute of education to prevent this pandemic were significantly and positively associated with preventive measures. The results showed that prior knowledge, global pandemics, and food and grocery purchases were firmly related to the preventive measures of COVID-19. Moreover, anxiety, transportation, and economic status were negatively related to the preventive measures. During this epidemic situation, international students suffered various types of mental stresses and anxiety, especially living in most affected regions of China. The study adopted a mixed (qualitative and quantitative) approach where the findings can act as a set of guidelines for governmental authorities in formulating, assisting in the preparation, instructing, and guiding policies to prevent and control the epidemic COVID-19 at national, local, and divisional levels.

About anxiety levels and anti-anxiety drugs among quarantined undergraduate Jordanian students during COVID-19 pandemic

OBJECTIVE

This study was conducted to study the anxiety scores among undergraduate university students in Jordan during COVID-19 pandemic and to assess the relationship between quarantine and shifting to distance learning resulted from the governmental strict isolation measures and severity of anxiety among students.

METHODS

A cross-sectional design was conducted to meet the study objectives. A convenience sample of 736 undergraduate university students in Jordan was recruited, and anxiety was assessed using the Hamilton Anxiety Scale.

RESULTS

The results indicated that anxiety score was 22.76 and 40.6% of the participant experienced moderate to severe anxiety, whereas 23.5% experienced mild to moderate anxiety and 35.9% experienced mild anxiety. Factors like suffering from chronic illnesses, having chronic medications, grade point average, shifting to distance learning, quarantine during the pandemic, study duties, the newly developed evaluation methods and the experience of students towards the use of anti-anxiety drugs and herbs had significantly increased the anxiety scores.

CONCLUSION

Our findings indicate that quarantine and shifting to distance learning during COVID-19 pandemic have negatively affected the anxiety scores of the university students which should be taken in consideration by the policymakers in Jordan in order to support this vulnerable group.

The human pandemic coronaviruses on the show: The spike glycoprotein as the main actor in the coronaviruses play

Three coronaviruses (CoVs) have threatened the world population by causing outbreaks in the last two decades. In late 2019, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged and caused the coronaviruses to disease 2019 (COVID-19), leading to the ongoing global outbreak. The other pandemic coronaviruses, SARS-CoV and Middle East respiratory syndrome CoV (MERS-CoV), share a considerable level of similarities at genomic and protein levels. However, the differences between them lead to distinct behaviors. These differences result from the accumulation of mutations in the sequence and structure of spike (S) glycoprotein, which plays an essential role in coronavirus infection, pathogenicity, transmission, and evolution. In this review, we brought together many studies narrating a sequence of events and highlighting the differences among S proteins from SARS-CoV, MERS-CoV, and SARS-CoV-2. It was performed here, analysis of S protein sequences and structures from the three pandemic coronaviruses pointing out the mutations among them and what they come through. Additionally, we investigated the receptor-binding domain (RBD) from all S proteins explaining the mutation and biological importance of all of them. Finally, we discuss the mutation in the S protein from several new isolates of SARS-CoV-2, reporting their difference and importance. This review brings into detail how the variations in S protein that make SARS-CoV-2 more aggressive than its relatives coronaviruses and other differences between coronaviruses.

The Impact of COVID-19 Management Policies Tailored to Airborne SARS-CoV-2 Transmission: Policy Analysis

Background

Daily new COVID-19 cases from January to April 2020 demonstrate varying patterns of SARS-CoV-2 transmission across different geographical regions. Constant infection rates were observed in some countries, whereas China and South Korea had a very low number of daily new cases. In fact, China and South Korea successfully and quickly flattened their COVID-19 curve. To understand why this was the case, this paper investigated possible aerosol-forming patterns in the atmosphere and their relationship to the policy measures adopted by select countries.

Objective

The main research objective was to compare the outcomes of policies adopted by countries between January and April 2020. Policies included physical distancing measures that in some cases were associated with mask use and city disinfection. We investigated whether the type of social distancing framework adopted by some countries (ie, without mask use and city disinfection) led to the continual dissemination of SARS-CoV-2 (daily new cases) in the community during the study period.

Methods

We examined the policies used as a preventive framework for virus community transmission in some countries and compared them to the policies adopted by China and South Korea. Countries that used a policy of social distancing by 1-2 m were divided into two groups. The first group consisted of countries that implemented social distancing (1-2 m) only, and the second comprised China and South Korea, which implemented distancing with additional transmission/isolation measures using masks and city disinfection. Global daily case maps from Johns Hopkins University were used to provide time-series data for the analysis.

Results

The results showed that virus transmission was reduced due to policies affecting SARS-CoV-2 propagation over time. Remarkably, China and South Korea obtained substantially better results than other countries at the beginning of the epidemic due to their adoption of social distancing (1-2 m) with the additional use of masks and sanitization (city disinfection). These measures proved to be effective due to the atmosphere carrier potential of SARS-CoV-2 transmission.

Conclusions

Our findings confirm that social distancing by 1-2 m with mask use and city disinfection yields positive outcomes. These strategies should be incorporated into prevention and control policies and be adopted both globally and by individuals as a method to fight the COVID-19 pandemic.

The influence of interpersonal relationships on school adaptation among Chinese university students during COVID-19 control period: Multiple mediating roles of social support and resilience

BACKGROUND

Owing to the government's effective epidemic control measures, universities in some areas of China gradually resumed offline teaching six months after the COVID-19 outbreak. Although attention should now be paid to the experiences of students after they returned to campus, few studies have explored the factors and mechanisms that have influenced these students' school adaptation. The present study investigated the multiple roles of social support and resilience in mediating associations the relationship between Chinese university students' interpersonal relationships and their school adaptation during COVID-19 control period.

METHODS

A cross-sectional survey was conducted with 4534 Chinese university students (Mage = 19.70, SD = 1.14) at two universities in Jiangxi provinces. The independent variable was interpersonal relationships; mediating variables were social support and resilience; and the dependent variable was school adaptation. Multiple mediation analysis was performed using the MPlus software.

RESULTS

Controlling for demographic variables, the quality of students' interpersonal relationships was significantly and positively related to their school adaptation, with students' ratings of social support and resilience mediating these associations. More interestingly, social support and resilience played multiple mediating roles in the relationship between interpersonal relationships and school adaptation.

LIMITATIONS

The age stage of the sample and the methods in which the data were collected may affect the generalizability of the results.

CONCLUSIONS

During COVID-19 control period, interpersonal relationships can influence school adaptation either directly or indirectly by enhancing social support or resilience (parallel mediation) or by activating resilience via the experience of social support (serial mediation). This study's results emphasize the role of interpersonal relationships, as well as the contributions of positive external and internal factors on students' school adaptation during the epidemic control period. Accordingly, these findings may have implications for the mental health education of college students in the post-epidemic era.

Travel-related control measures to contain the COVID-19 pandemic: an evidence map

OBJECTIVES

To comprehensively map the existing evidence assessing the impact of travel-related control measures for containment of the SARS-CoV-2/COVID-19 pandemic.

DESIGN

Rapid evidence map.

DATA SOURCES

MEDLINE, Embase and Web of Science, and COVID-19 specific databases offered by the US Centers for Disease Control and Prevention and the WHO.

ELIGIBILITY CRITERIA

We included studies in human populations susceptible to SARS-CoV-2/COVID-19, SARS-CoV-1/severe acute respiratory syndrome, Middle East respiratory syndrome coronavirus/Middle East respiratory syndrome or influenza. Interventions of interest were travel-related control measures affecting travel across national or subnational borders. Outcomes of interest included infectious disease, screening, other health, economic and social outcomes. We considered all empirical studies that quantitatively evaluate impact available in Armenian, English, French, German, Italian and Russian based on the team's language capacities.

DATA EXTRACTION AND SYNTHESIS

We extracted data from included studies in a standardised manner and mapped them to a priori and (one) post hoc defined categories.

RESULTS

We included 122 studies assessing travel-related control measures. These studies were undertaken across the globe, most in the Western Pacific region (n=71). A large proportion of studies focused on COVID-19 (n=59), but a number of studies also examined SARS, MERS and influenza. We identified studies on border closures (n=3), entry/exit screening (n=31), travel-related quarantine (n=6), travel bans (n=8) and travel restrictions (n=25). Many addressed a bundle of travel-related control measures (n=49). Most studies assessed infectious disease (n=98) and/or screening-related (n=25) outcomes; we found only limited evidence on economic and social outcomes. Studies applied numerous methods, both inferential and descriptive in nature, ranging from simple observational methods to complex modelling techniques.

CONCLUSIONS

We identified a heterogeneous and complex evidence base on travel-related control measures. While this map is not sufficient to assess the effectiveness of different measures, it outlines aspects regarding interventions and outcomes, as well as study methodology and reporting that could inform future research and evidence synthesis.

Sentiment analysis and its applications in fighting COVID-19 and infectious diseases: A systematic review

The COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 occurred unexpectedly in China in December 2019. Tens of millions of confirmed cases and more than hundreds of thousands of confirmed deaths are reported worldwide according to the World Health Organisation. News about the virus is spreading all over social media websites. Consequently, these social media outlets are experiencing and presenting different views, opinions and emotions during various outbreak-related incidents. For computer scientists and researchers, big data are valuable assets for understanding people's sentiments regarding current events, especially those related to the pandemic. Therefore, analysing these sentiments will yield remarkable findings. To the best of our knowledge, previous related studies have focused on one kind of infectious disease. No previous study has examined multiple diseases via sentiment analysis. Accordingly, this research aimed to review and analyse articles about the occurrence of different types of infectious diseases, such as epidemics, pandemics, viruses or outbreaks, during the last 10 years, understand the application of sentiment analysis and obtain the most important literature findings. Articles on related topics were systematically searched in five major databases, namely, ScienceDirect, PubMed, Web of Science, IEEE Xplore and Scopus, from 1 January 2010 to 30 June 2020. These indices were considered sufficiently extensive and reliable to cover our scope of the literature. Articles were selected based on our inclusion and exclusion criteria for the systematic review, with a total of n = 28 articles selected. All these articles were formed into a coherent taxonomy to describe the corresponding current standpoints in the literature in accordance with four main categories: lexicon-based models, machine learning-based models, hybrid-based models and individuals. The obtained articles were categorised into motivations related to disease mitigation, data analysis and challenges faced by researchers with respect to data, social media platforms and community. Other aspects, such as the protocol being followed by the systematic review and demographic statistics of the literature distribution, were included in the review. Interesting patterns were observed in the literature, and the identified articles were grouped accordingly. This study emphasised the current standpoint and opportunities for research in this area and promoted additional efforts towards the understanding of this research field.

Multiplex Real-Time Reverse-Transcription Polymerase Chain Reaction Assays for Diagnostic Testing of Severe Acute Respiratory Syndrome Coronavirus 2 and Seasonal Influenza Viruses: A Challenge of the Phase 3 Pandemic Setting

BACKGROUND

Pandemic coronavirus disease 2019 (COVID-19) disease represents a challenge for healthcare structures. The molecular confirmation of samples from infected individuals is crucial and therefore guides public health decision making. Clusters and possibly increased diffuse transmission could occur in the context of the next influenza season. For this reason, a diagnostic test able to discriminate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from influenza viruses is urgently needed.

METHODS

A multiplex real-time reverse-transcription polymerase chain reaction (PCR) assay was assessed using 1 laboratory protocol with different real-time PCR instruments. Overall, 1000 clinical samples (600 from samples SARS-CoV-2-infected patients, 200 samples from influenza-infected patients, and 200 negative samples) were analyzed.

RESULTS

The assay developed was able to detect and discriminate each virus target and to intercept coinfections. The limit of quantification of each assay ranged between 5 and 10 genomic copy numbers, with a cutoff value of 37.7 and 37.8 for influenza and SARS-CoV-2 viruses, respectively. Only 2 influenza coinfections were detected in COVID-19 samples.

CONCLUSIONS

This study suggests that multiplex assay is a rapid, valid, and accurate method for the detection of SARS-CoV-2 and influenza viruses in clinical samples. The test may be an important diagnostic tool for both diagnostic and surveillance purposes during the seasonal influenza activity period.

Digital Health Solutions to Control the COVID-19 Pandemic in Countries With High Disease Prevalence: Literature Review

BACKGROUND

COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, has become a global pandemic, affecting most countries worldwide. Digital health information technologies can be applied in three aspects, namely digital patients, digital devices, and digital clinics, and could be useful in fighting the COVID-19 pandemic.

OBJECTIVE

Recent reviews have examined the role of digital health in controlling COVID-19 to identify the potential of digital health interventions to fight the disease. However, this study aims to review and analyze the digital technology that is being applied to control the COVID-19 pandemic in the 10 countries with the highest prevalence of the disease.

METHODS

For this review, the Google Scholar, PubMed, Web of Science, and Scopus databases were searched in August 2020 to retrieve publications from December 2019 to March 15, 2020. Furthermore, the Google search engine was used to identify additional applications of digital health for COVID-19 pandemic control.

RESULTS

We included 32 papers in this review that reported 37 digital health applications for COVID-19 control. The most common digital health projects to address COVID-19 were telemedicine visits (11/37, 30%). Digital learning packages for informing people about the disease, geographic information systems and quick response code applications for real-time case tracking, and cloud- or mobile-based systems for self-care and patient tracking were in the second rank of digital tool applications (all 7/37, 19%). The projects were deployed in various European countries and in the United States, Australia, and China.

CONCLUSIONS

Considering the potential of available information technologies worldwide in the 21st century, particularly in developed countries, it appears that more digital health products with a higher level of intelligence capability remain to be applied for the management of pandemics and health-related crises.

Processing Big Data with Apache Hadoop in the Current Challenging Era of COVID-19

Big data have become a global strategic issue, as increasingly large amounts of unstructured data challenge the IT infrastructure of global organizations and threaten their capacity for strategic forecasting. As experienced in former massive information issues, big data technologies, such as Hadoop, should efficiently tackle the incoming large amounts of data and provide organizations with relevant processed information that was formerly neither visible nor manageable. After having briefly recalled the strategic advantages of big data solutions in the introductory remarks, in the first part of this paper, we focus on the advantages of big data solutions in the currently difficult time of the COVID-19 pandemic. We characterize it as an endemic heterogeneous data context; we then outline the advantages of technologies such as Hadoop and its IT suitability in this context. In the second part, we identify two specific advantages of Hadoop solutions, globality combined with flexibility, and we notice that they are at work with a “Hadoop Fusion Approach” that we describe as an optimal response to the context. In the third part, we justify selected qualifications of globality and flexibility by the fact that Hadoop solutions enable comparable returns in opposite contexts of models of partial submodels and of models of final exact systems. In part four, we remark that in both these opposite contexts, Hadoop’s solutions allow a large range of needs to be fulfilled, which fits with requirements previously identified as the current heterogeneous data structure of COVID-19 information. In the final part, we propose a framework of strategic data processing conditions. To the best of our knowledge, they appear to be the most suitable to overcome COVID-19 massive information challenges.

Vision of China's future urban construction reform: In the perspective of comprehensive prevention and control for multi disasters

The COVID-19 pandemic has caused huge deaths, massive damage and losses around the world. Looking back in history, the motivation for construction and development of cities was to enhance disaster prevention capacity, while modern cities are built and developed to improve health and wellness for human beings. Each disaster would pose some new challenges to the urban planning and architectural design, such as COVID-19. Therefore, the dilemma of future multi disasters (e.g. epidemics) would lead to reflections on the revision or change of urban design regulations. For the post-epidemic era, a comprehensive and integrated prevention system should be established for multi urban disasters, which requires to be optimally formulated based on multiple objectives, i.e., on the balancing of disaster occurrence probability and stop loss cost. This will be realized thanks to the rapid development of digital alike advanced technologies. Thus, this paper aims to provide a reference for the prevention and control of future city epidemics and disasters in responding to strategies of urban planning and design by considering the reform of urban construction related regulations, further to facilitate the creation of healthy and safe urban environments.

COVID-19 Pandemic: The Influence of Culture and Lessons for Collaborative Activities

The rapid epidemiological shift from an epidemic/outbreak in Wuhan, China, to a global pandemic of COVID-19 in less than 3 months came with lessons the world's health system should learn to prepare for the future outbreaks. Since February 20, 2020, the total number of confirmed cases of COVID-19 has been increased very slowly in the countries of East Asia, including Japan, South Korea, and China, when compared with those in the Western countries. This chapter begins with an overview of the impact of COVID-19 on healthcare workers and public health facilities, followed by immediate global actions and research in response to the newly emerged pandemic. It includes an evaluation of the potential influence of culture on the implementation of different protective measures to combat the COVID-19 pandemic while at the same time offering suggestions that will make it easier for all populations to adapt protective steps against COVID-19 and other respiratory infectious diseases. Finally, the chapter provides a detailed discussion of lessons we have learned from the pandemic, leading to the conclusion that the transition from individualism to collaborative efforts is the treatment of universal pandemics.

Coronavirus disease 2019-Historical context, virology, pathogenesis, immunotherapy, and vaccine development

The current Coronavirus Disease 2019 (COVID-19) pandemic is causing great alarm around the world. The pathogen for COVID-19 - severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - is the seventh known coronavirus to cause pneumonia in humans. While much remains unknown about SARS-CoV-2, physicians and researchers have begun to publish relevant findings, and much evidence is available on coronaviruses previously circulating in human and animal populations. In this review, we situate COVID-19 in its context as a transboundary viral disease, and provide a comprehensive discussion focused on the discovery, spread, virology, pathogenesis, and clinical features of this disease, its causative coronaviral pathogen, and approaches to combating the disease through immunotherapies and other treatments and vaccine development. An epidemiological survey revealed a potentially large number of asymptomatic SARS-CoV-2 carriers within the population, which may hamper efforts against COVID-19. Finally, we emphasize that vaccines against SARS-CoV-2, which may be developed by 2021, will be essential for prevention of COVID-19.

Optimal control strategies for the transmission risk of COVID-19

In this paper, we apply optimal control theory to a novel coronavirus (COVID-19) transmission model given by a system of non-linear ordinary differential equations. Optimal control strategies are obtained by minimizing the number of exposed and infected population considering the cost of implementation. The existence of optimal controls and characterization is established using Pontryagin's Maximum Principle. An expression for the basic reproduction number is derived in terms of control variables. Then the sensitivity of basic reproduction number with respect to model parameters is also analysed. Numerical simulation results demonstrated good agreement with our analytical results. Finally, the findings of this study shows that comprehensive impacts of prevention, intensive medical care and surface disinfection strategies outperform in reducing the disease epidemic with optimum implementation cost.

Psychological Impact of Health Risk Communication and Social Media on College Students During the COVID-19 Pandemic: Cross-Sectional Study

Background

The outbreak of COVID-19 began in 2019 and is expected to impact the psychological health of college students. Few studies have investigated the associations among health risk communication, social media, and psychological symptoms during a major pandemic.

Objective

The aim of this research was to assess the prevalence of psychological symptoms among college students and explore their associations with health risk communication and social media.

Methods

A web-based survey was distributed through the Wenjuanxing platform among Chinese college students from March 3-15, 2020. In addition to demographics, information on health risk communication and social media was collected, and the Symptom Checklist 90 Phobia and Health Anxiety Inventory subscale was used to assess psychological symptoms among 1676 college students in China. Multivariable logistic regression was performed to examine these independent risk factors.

Results

The prevalence of panic and health anxiety was 17.2% (288/1676) and 24.3% (408/1676), respectively. Regarding risk communication, understanding the risk of COVID-19 (odds ratio [OR] 0.480, 95% CI 0.367-0.627) was a protective factor against panic. Knowledge of prognosis (OR 0.708, 95% CI 0.551-0.910), preventive measures (OR 0.380, 95% CI 0.195-0.742), and wearing face masks (OR 0.445, 95% CI 0.230-0.862) were shown to be protective factors in predicting health anxiety. Perceived lethality (OR 1.860, 95% CI 1.408-2.459), being affected by the global spread (OR 1.936, 95% CI 1.405-2.669), and impact on social contacts (OR 1.420, 95% CI 1.118-1.802) were identified as significant risk factors associated with health anxiety. In terms of social media, trust in mainstream media (OR 0.613, 95% CI 0.461-0.816) was considered to be a protective factor against health anxiety.

Conclusions

There was a high prevalence of psychological symptoms among college students. Health risk communication and social media use were important in predicting psychological symptoms, especially health anxiety. Scientific and evidence-based information should be reported by social media platforms. Web-based consultation and intervention measures should be the focus of future studies.

Changes in public preferences for technologically enhanced surveillance following the COVID-19 pandemic: a discrete choice experiment

OBJECTIVES

As governments attempt to navigate a path out of COVID-19 restrictions, robust evidence is essential to inform requirements for public acceptance of technologically enhanced communicable disease surveillance systems. We examined the value of core surveillance system attributes to the Australian public, before and during the early stages of the current pandemic.

DESIGN

A discrete choice experiment was conducted in Australia with a representative group of respondents, before and after the WHO declared COVID-19 a Public Health Emergency of International Concern. We identified and investigated the relative importance of seven attributes associated with technologically enhanced disease surveillance: respect for personal autonomy; privacy/confidentiality; data certainty/confidence; data security; infectious disease mortality prevention; infectious disease morbidity prevention; and attribution of (causal) responsibility. Specifically, we explored how the onset of the COVID-19 outbreak influenced participant responses.

SETTING AND PARTICIPANTS

2008 Australians (general public) completed the experiment: 793 before COVID-19 outbreak onset (mean age 45.9 years, 50.2% male) and 1215 after onset (mean age 47.2 years, 49% male).

RESULTS

All seven attributes significantly influenced respondents' preferences for communicable disease surveillance systems. After onset, participants demonstrated greater preference for a surveillance system that could prevent a higher number of illnesses and deaths, and were less concerned about their personal autonomy. However, they also increased their preference for a system with high data security.

CONCLUSIONS

Public acceptance of technology-based communicable disease surveillance is situation dependent. During an epidemic, there is likely to be greater tolerance of technologically enhanced disease surveillance systems that result in restrictions on personal activity if such systems can prevent high morbidity and mortality. However, this acceptance of lower personal autonomy comes with an increased requirement to ensure data security. These findings merit further research as the pandemic unfolds and strategies are put in place that enable individuals and societies to live with SARS-CoV-2 endemicity.

Shorter incubation period is associated with severe disease progression in patients with COVID-19

The diagnosed COVID-19 cases revealed that the incubation periods (IP) varied a lot among patients. However, few studies had emphasized on the different clinical features and prognosis of patients with different IP. A total of 330 patients with laboratory-confirmed COVID-19 were enrolled and classified into immediate onset group(IP<3 days, I group, 57 cases) and late onset group(IP>10 days, L group, 75 cases) based on IP. The difference of clinical characteristics and prognosis of the two groups were compared. There were more patients with fever in I group than in L group(P = 0.003), and counts of all the total lymphocytes, total T lymphocytes, CD4 + and CD8 + T lymphocytes were significantly different between the two groups(all P < 0.01). Besides, patients in L group had more GGOs in CT scan than I group and there were more patients in I group receiving antibiotic treatment than in L group(P < 0.001). For disease aggravation, the median CT scores were comparable between the two groups, but individually, there were more patients with increased CT score during hospitalization in I group than in L group. The aggravation incidence of CT presentation was 21.1% in I group, significantly higher than L group(8.0%, P = 0.042). Multivariable COX models suggested that IP was the only independent factors for CT aggravation. Conclusively, patients with different IP were different in clinical symptoms, laboratory tests, and CT presentations. Shorter IP was associated with the aggravation of lung involvement in CT scan.

Risk communication on behavioral responses during COVID-19 among general population in China: A rapid national study

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Exposed to risk communication messages were positively associated with engaging in preventive behaviors.

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Believing in misinformation were negatively associated with wearing masks.

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Inadequate supplies of personal protection materials were negatively associated with outdoor hygiene behaviors.

Objectives

To describe the risk perception and behavioral responses among Chinese adults and to assess the associations of risk communication, risk perception, and behavioral adherence during the COVID-19 epidemic.

Methods

A national cross-sectional survey was conducted in 31 provinces in China with a total number of 5039 effective questionnaires collected. The questionnaire included sociodemographic characteristics, COVID-19 risk communication factors, mask and soap supply, and engagement in preventive behaviors during the epidemic. Multivariable Logistic regression was used.

Results

An overwhelmingly high prevalence of Chinese people was exposed to COVID-19 related risk communication messages (86.5%) and an overwhelming majority of respondents reported engagement in preventive behaviors (88.3%). Exposed to risk communication messages were positively associated with engaging in preventive behaviors, whereas, believing in misinformation were negatively associated with wearing masks when in public (p < 0.01). Respondents encountered an inadequate supplies of personal protection materials were negatively associated with their outdoor hygiene behaviors. People who were male, in an older age group, minorities, with lower education, with lower income, and lived in rural area showed lower exposures to risk communication messages.

Conclusions

Future risk communication practices are recommended to better monitor population risk perceptions and pay attention to socio-demographically disadvantaged people.

Emotional "inflection point" in public health emergencies with the 2019 new coronavirus pneumonia (NCP) in China

BACKGROUND

The outbreak of the new coronavirus pneumonia (NCP) in Wuhan, Hubei, has caused very serious consequences and severely affected people's lives and mental health. The outbreak will cause bad emotions such as tension, anxiety, fear, and so on. College students who have returned home from school face infection, isolation, and delay in starting school, and thus, their emotional stress should be observed.

METHODS

This study used self-designed questionnaires and artificial intelligence (AI) to assess and analyze the emotional state of over 30,000 college students during the outbreak period in January (T1) and home quarantine in February (T2). This survey used online questionnaire (www.wjx.cn) to investigate the emotion information of college students.

RESULTS

In the T1 survey, the "Typhoon Eye Effect" appeared. College students in Hubei are calmer than those outside Hubei in T1. However, in T2, an emotional "infection point" appeared, there was an "Exposure Effect", the negative emotions of students in Hubei largely increased and became higher than students outside Hubei.

CONCLUSION

This survey found that there is an emotional "infection point" in February among college students, especially in the Hubei area. College students in Hubei are calmer than those outside Hubei in T1. In contrast, college students in Hubei were more nervous and scared than those outside Hubei in T2. This epidemic has caused the students to experience significant pressure and negative emotions. Therefore, universities and society should pay attention to their emotional adjustment, there are some suggestions such as establish the mental health organizations, test students' emotion status regularly.

Facing COVID-19: Early Recognition and Triage Tool for Medical Treatment Facilities With Limited Resources

INTRODUCTION

Coronavirus Disease 2019 (COVID-19) is spreading all over the world. Health systems around the globe have to deal with decreased capabilities and exhausted resources because of the surge of patients. The need to identify COVID-19 patients to achieve a timely opportunity to treat and isolate them is an ongoing challenge for health care professionals everywhere. A lack of testing capabilities forces clinicians to make the crucial initial decision on the basis of clinical findings and routine diagnostic laboratory test. This article reviews the current literature and presents a new adapted protocol for diagnosing and triaging COVID-19 patients. A special emphasis lies on the stepwise approach guiding the medical provider to a triage decision that is suitable for the individual patient and the situation of the local medical treatment facility.

MATERIALS AND METHODS

On March 30, 2020, a PubMed based literature research on COVID-19 following the preferred reporting items for systematic reviews and meta-analyses guidelines was performed. A diagnostic and triage tool for COVID-19 was designed based on the major findings in the reviewed literature.

RESULTS

After a selection process, focusing on the topics "epidemiology," "clinical characteristics," and "diagnostic tools," 119 out of a total amount of 1,241 publications were selected to get an overview of the growing evidence.

CONCLUSIONS

The designed Early Recognition and Triage Tool enables the medical provider to use the applicable modules of the protocol for capabilities of the local setting to get the most appropriate diagnostic and triage done. The tool should give guidance for the initial approach until specific testing for the COVID-19 virus is available.

Strengthening Health Systems; the Basis for Controlling Corona Virus Pandemics

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The Role of the Dental Surgeon in Controlling the Dissemination of COVID-19: A Literature Review

As early as December 2019 in the province of Hubei, China, contamination of patients with pneumonia of an unknown etiology occurred. These patients presented with symptoms such as coughing, sore throat, malaise, diarrhea, high fever, and dyspnea. This emerging disease was named COVID-19 due to being part of the group of coronaviruses (CoVs) belonging to the subfamily Orthocoronavirinae, in the Coronaviridae family and in the Nidovirales order. COVID-19 is most commonly transmitted through speech, coughing, sneezing, and salivary sputum. Because dental professionals work closely with the oral cavity, it is imperative that infection prevention controls are strictly adhered to. It is important that the dental profession treats patients while also limiting the possible contamination through the production of aerosol in the dental environment. Furthermore, the dental professional also has a key role in raising awareness and guidance amongst the population concerning COVID-19 related biosafety measures. This literature review aims to inform dental professionals about the COVID-19 pandemic and to present the implications of the virus to the dentist. Dental professionals are considered to be at high risk for contracting SARS-CoV-2.

SARS-CoV-2 and Dentistry-Review

SARS-CoV-2 (or 2019-nCoV) is the novel Coronavirus that affects humans. It originated in China at the end of 2019 due to the consumption of animals contaminated with this pathogen. SARS-CoV-2 causes the disease known as COVID-19 (coronavirus disease - 2019), and until May 21, 2020, approximately 213 countries and territories had been affected by SARS-CoV-2. The objective of this study was to review the origin and characteristics of this virus (SARS-CoV-2), symptoms and diagnosis of COVID-19, treatment of people with COVID-19, forms of transmission of the SARS-CoV-2, and precautions in dentistry. A literature search on PubMed/Medline was performed on the May 21, 2020, using the keywords (Mesh terms) "COVID-19" or "SARS-CoV-2" or "Coronavirus" associated with "dentistry" or "dental care" or "oral medicine." SARS-CoV-2 articles about the origin and characteristics of this virus (SARS-CoV-2), symptoms and diagnosis of COVID-19, treatment of people with COVID-19, forms of transmission of the SARS-CoV-2, and precautions in dentistry were included. The search was expanded according to necessity. Articles related to precautions in dentistry and SARS-CoV-1 or MERS-CoV were also selected, since precautions used in the dental clinic to avoid these viruses also apply to SARS-CoV-2. In addition, the references cited in the publications of articles included were also considered when appropriate. There was no limit in relation to the year of publication, and only articles written in English were included. In this study, suggestions for the safety of dental professionals were also included. Forty-seven articles and nine websites were included in this review.

Sleep disturbances among Chinese residents during the Coronavirus Disease 2019 outbreak and associated factors

OBJECTIVES

Sleep status can affect the body's immune status and mental health. This study aims to investigate the sleep status of Chinese residents during the outbreak of Coronavirus Disease 2019 (COVID-19) and to evaluate its related risk factors.

METHODS

This research carried out a cross-sectional survey in February 2020 (during the COVID-19 outbreak) to investigate the sleep status of residents nationwide in the form of an online questionnaire. Of the 8151 respondents, 6437 were eventually included in the analysis. Logistic regression is applied to analyze the associated factors affecting residents' sleep quality.

RESULTS

During the COVID-19 outbreak, the incidence of sleep disturbances in residents was 17.65%. Increased risk of sleep disturbances was found to be associated with older age, female gender, and poor self-reported health status. Moreover, the odds ratios (ORs) were 1.42 (95% CI: 1.1-2.64), 1.35 (95% CI: 1.16-1.59), 5.59 (95% CI: 4.32-7.23), respectively. Those residents who believed COVID-19 had caused a high number of deaths or who thought COVID-19 was not easy to cure were more likely to experience sleep disorders, and the ORs were 1.73 (95% CI: 1.43-2.09), 1.57 (95% CI: 1.29-1.91), respectively. Regular exercise was a protective factor for sleep disturbances, OR = 0.77 (95% CI: 0.63-0.93).

CONCLUSIONS

During the outbreak of COVID-19, nearly one-fifth of participants had sleep disorders. It is necessary to pay more attention to people at high risk for sleep disturbances during the outbreak, adopt effective risk communication methods, enhance residents' rational understanding of COVID-19, and develop practical indoor exercise programs for general public to improve sleep quality.

"A community system": A critical foundation for the epidemic prevention and control of SARS-CoV-2

In response to COVID‐19 that has constituted a global pandemic, countries around the world have successively adopted a myriad of prevention and control measures. As the first country with the COVID‐19 outbreak, the Chinese government has adopted a series of timely and strict prevention and control measures against the spread of the SARS‐CoV‐2, which has effectively slowed down the spread of the SARS‐CoV‐2 and created a valuable window for the international community to overcome the epidemic. China's experience in combating the COVID‐19 has shown that building a community prevention and control system is essential to control the spread of coronavirus. As the backbone of the epidemic prevention and control system, the community prevention and control system plays an important role in improving the pattern of disorderly medical treatment, screening suspected patients, preventing the input of pathogens, ensuring residents' medical needs, stabilizing public sentiment, reducing disease fear, and maintaining residents' national security. At the same time, it also exposed the problems of the community prevention and control epidemic system in terms of infrastructure, human resources, and internal systems. Based on this, this article suggests that we should improve the hardware facilities of community, improve the internal mechanism of the community, strengthen the stability of the community talent team, improve the level of linkage between the community and other departments to prevent and control the spread of SARS‐CoV‐2, effectively use information technology and actively mobilize social forces to help community prevention and control COVID‐19.

A Strategy for International Cooperation in the COVID-19 Pandemic Era: Focusing on National Scientific Funding Data

The coronavirus crisis may lead to a deeper understanding of international collaborations for developing antivirals and vaccines that are essential to protect us from current and future health security threats. Beyond technical solutions, the government of South Korea needs to establish a timely strategic investment in coronavirus-related research and development (R&D) in order to enhance the capabilities for managing this new uncertainty in regard to the domestic health crisis. Thus, this study aims to provide useful information about the status of global coronavirus-related research from the South Korean government's perspective. National funded projects stemmed from leading nations such as the United States, countries of the European Union, and Japan between 2012 and 2018. Six research fields were derived by clustering analysis and an expert-based approach, and then matched to those of South Korea. The comparative analysis among them allowed for the identification of the nations' strengths and weaknesses, thereby laying the groundwork for strategic international research collaborations.

Focus on the 2019 novel coronavirus (SARS-CoV-2)

A new coronavirus, severe acute respiratory syndrome coronavirus 2, was first discovered in Wuhan, China, in December 2019. As of 7 April 2020, the new coronavirus has spread quickly to 184 countries and aroused the attention of the entire world. No targeted drugs have yet been available for intervention and treatment of this virus. The sharing of academic information is crucial to risk assessment and control activities in outbreak countries. In this review, we summarize the epidemiological, genetic and clinical characteristics of the virus as well as laboratory testing and treatments to understand the nature of the virus. We hope this review will be helpful to prevent viral infections in outbreak countries and regions.

The social psychological impact of the COVID-19 pandemic on medical staff in China: A cross-sectional study

BACKGROUND

The COVID-19 outbreak required the significantly increased working time and intensity for health professionals in China, which may cause stress signs.

METHODS

From March 2-13 of 2020, 4,618 health professionals in China were included in an anonymous, self-rated online survey regarding their concerns on exposure to the COVID-19 outbreak. The questionnaires consisted of five parts: basic demographic information and epidemiological exposure; occupational and psychological impact; concerns during the episode; coping strategies; and the Huaxi Emotional-Distress Index (HEI).

RESULTS

About 24.2% of respondents experienced high levels of anxiety or/and depressive symptoms since the COVID-19 outbreak. Respondents who worried about their physical health and those who had COVID-19 infected friends or close relatives were more likely to have high HEI levels, than those without these characteristics. Further, family relationship was found to have an independent protective effect against high HEI levels. Their main concerns were that their families would not be cared for and that they would not be able to work properly. Compared to respondents with clear emotional problems, those with somewhat hidden emotional issues adopted more positive coping measures.

CONCLUSIONS

About a quarter of medical staff experienced psychological problems during the pandemic of COVID-19. The psychological impact of stressful events was related to worrying about their physical health, having close COVID-19 infected acquaintances and family relationship issues. Therefore, the psychological supprot for medical staff fighting in the COVID-19 pandemic may be needed.