[Experience and thinking on the normalization stage of prevention and control of COVID-19 in China]

Epidemiological feature analysis of SVEIR model with control strategy and variant evolution

The complex interactions were performed among non-pharmaceutical interventions, vaccinations, and hosts for all epidemics in mainland China during the spread of COVID-19. Specially, the small-scale epidemic in the city described by SVEIR model was less found in the current studies. The SVEIR model with control was established to analyze the dynamical and epidemiological features of two epidemics in Jinzhou City led by Omicron variants before and after Twenty Measures. In this study, the total population (N) of Jinzhou City was divided into five compartments: the susceptible (S), the vaccinated (V), the exposed (E), the infected (I), and the recovered (R). By surveillance data and the SVEIR model, three methods (maximum likelihood method, exponential growth rate method, next generation matrix method) were governed to estimate basic reproduction number, and the results showed that an increasing tendency of basic reproduction number from Omicron BA.5.2 to Omicron BA.2.12.1. Meanwhile, the effective reproduction number for two epidemics were investigated by surveillance data, and the results showed that Jinzhou wave 1 reached the peak on November 1 and was controlled 7 days later, and that Jinzhou wave 2 reached the peak on November 28 and was controlled 5 days later. Moreover, the impacts of non-pharmaceutical interventions (awareness delay, peak delay, control intensity) were discussed extensively, the variations of infection scales for Omicron variant and EG.5 variant were also discussed. Furthermore, the investigations on peaks and infection scales for two epidemics in dynamic zero-COVID policy were operated by the SVEIR model with control. The investigations on public medical requirements of Jinzhou City and Liaoning Province were analyzed by using SVEIR model without control, which provided a possible perspective on variant evolution in the future.

Relationship Between Sleep Problems and Memory Impairment Among Nurses

BACKGROUND

Sleep problems are common among nurses and can lead to various health problems. Further, the relationship between multiple sleep problems and memory impairment in clinical nurses remains unknown. Therefore, in this study, we aimed to explore the relationship between sleep problems and memory impairment among nurses.

METHODS

Multistage cluster-stratified random sampling was performed from tertiary hospitals in Shandong, China. Overall, a total of 1833 nurses were included in the final analysis. The Chinese version of the Pittsburgh Sleep Quality Index and prospective and retrospective memory questionnaire were administered to the participants.

RESULTS

The sleep quality of the nurses decreased during the normal epidemic prevention and control period compared with that before the epidemic in terms of sleep duration, sleep efficiency, and sleep disturbances. Nurses who reported cumulative or specific sleep problems (e.g., high sleep latency, sleep disturbances, and daytime dysfunction) and those in the "daily disturbances" and "poor sleep quality" groups had a higher risk of memory impairment than the others.

CONCLUSION

Sleep problems might be important for memory impairment among nurses. These findings may help identify nurses at considerable risk of memory impairment in clinical practice.

Interpersonal distance perception during the normalization of an pandemic situation: Effects of mask-wearing and vaccination

This study aimed to evaluate the effect of anti-pandemic measures, including wearing a face mask and receiving vaccinations, on interpersonal distance (IPD) during the normalization stage of the COVID-19 pandemic. Virtual reality (VR) technology was used to simulate the experimental environment and a confederate in different conditions. Thirty-one participants were asked to approach the virtual confederate, who could exhibit three vaccination states and two mask-wearing conditions, actively and passively in both indoor and outdoor environments. ANOVA results showed that the participants kept a smaller IPD from the confederate wearing a face mask (IPD = 125.6 cm) than from the one without a face mask (IPD = 154.2 cm). The effects of vaccination states were significant, with the largest distance for an unvaccinated confederate (IPD = 182.3 cm) and the smallest distance for the confederate who had received a booster vaccine (IPD = 111.5 cm). Significant effects of environment were also found, with the participants maintaining a larger IPD in an outdoor environment (IPD = 143.4 cm) than in an indoor room (IPD = 136.4 cm). Additionally, the IPD collected when the participants were passively approached (IPD = 149.6 cm) was significantly larger than that obtained when they actively approached the confederate (IPD = 130.3 cm). Moreover, when the participants faced a confederate who had received a booster vaccine and wore a mask, the IPD was not significantly different from that collected before the COVID-19 pandemic in both the active and passive patterns. These findings help us to better understand the nature of IPD and human behaviors during the normalization stage of the pandemic and provide scientific suggestions for policymakers to develop pandemic-prevention measures.

Reflections on the dynamic zero-COVID policy in China

The coronavirus disease 2019 (COVID-19) pandemic has posed a serious threat to global healthcare and economy. In order to curb its spread, China adopted the dynamic zero-COVID policy, aiming to diagnose and isolate cases and close contacts as soon as possible. However, there is a controversy about the impact of isolation measures on social order, including the economy, personal employment and public mental health. Therefore, this review discusses and analyzes in detail the advantages and challenges of implementing dynamic zero-COVID policy. Although this public health policy might cause a shock to the economy in the short term, China still achieved a continued healthy economic performance with stable unemployment and strong export growth. Moreover, the rates of infection and mortality in China were lower than those in the United States and the European Union. However, due to the high transmissibility and low pathogenicity of the Omicron variant and prolonged lockdown-induced psychological damage, people questioned the effectiveness and necessity of this policy. Now that China has adjusted its policy in a timely manner, but many problems still remain unsolved. Some practical suggestions in terms of mental health, vaccine development, drugs supply, and economic recovery are put forward at the end of our paper to minimize negative impacts and provide a reference for future efforts.

Antiviral Treatment in Older Chinese Patient with SARS-CoV-2 and Influenza A Virus Co-Infection: A Case Series

Coronavirus disease 2019 (COVID-19) emergence in late 2019, and wide spread quickly in the world. In China, the COVID-19 epidemic situation entered a low level now. With the arrival of flu season, the number of patients with respiratory symptoms is increasing. We reported three cases of patients who co-infected with SARS-CoV-2 and influenza A virus (IAV), and they were all treated with nirmatrelvir-ritonavir (NMV/r) and baloxavir marboxil. Due to the overlapping clinical features between the two diseases, it is important to identified them and gave the antiviral therapy timely.

Comparative analysis of prevention and control measures toward COVID-19 epidemic between Shanghai and Beijing

Purpose

By serving and providing a guide for other regional places, this study aims to advance and guide the epidemic prevention and control methods, and practices and strengthen people's ability to respond to COVID-19 and other future potential public health risks.

Design/methodology/approach

A comparative analysis was conducted that the COVID-19 epidemic development trend and prevention and control effects both in Beijing and Shanghai. In fact, regarding the COVID-19 policy and strategic areas, the differences between governmental, social, and professional management were discussed and explored. To prevent and be ready for potential pandemics, experience and knowledge were used and summarized.

Findings

The strong attack of the Omicron variant in early 2022 has posed challenges to epidemic prevention and control practices in many Chinese cities. Shanghai, which had achieved relatively good performance in the fight against the epidemic, has exposed limitations in its epidemic prevention and control system in the face of Omicron. In fact, the city of Beijing has undertaken prompt and severe lockdown measures and achieved rather good results in epidemic prevention and control because of learning from Shanghai's experience and lessons; adhering to the overall concept of "dynamic clearing," implementing precise prevention and monitoring, enhancing community control, and making emergency plans and preparations. All these actions and measures are still essential in the shift from pandemic response to pandemic control.

Research limitations/implications

Different places have introduced different urgent policies to control the spread of the pandemic. Strategies to control COVID-19 have often been based on preliminary and limited data and have tended to be slow to evolve as new evidence emerges. Hence, the effects of these anti-epidemic policies need to be further tested.

The Impact of COVID-19-Related Work Stress on the Mental Health of Primary Healthcare Workers: The Mediating Effects of Social Support and Resilience

Objective

The psychological condition of healthcare workers since the COVID-19 pandemic has attracted the attention of many studies. However, few have reported on psychosocial problems of primary healthcare workers in the COVID-19 pandemic. This study aimed to examine the mediating roles of social support and resilience in COVID-19-related work stress and symptoms of anxiety and depression.

Methods

A total of 840 primary healthcare workers in 17 community health centers in Guangzhou, China, were recruited from May to July 2021. Data on demographic characteristics, COVID-19-related work stress, social support, resilience, anxiety and depression were collected. A structural equation model was used for mediation analysis.

Results

More than half of participants reported mild or more severe (at least borderline abnormal) symptoms of anxiety (68.1%) and depression (55.6%). Social support and resilience mediate the association between COVID-19-related work stress and symptoms of anxiety and depression, respectively. Furthermore, the association between work stress and symptoms of anxiety and depression was also mediated by an accumulation of social support and resilience. The indirect effect of COVID-19-related work stress on anxiety and depression through resilience was much greater than other indirect effects.

Conclusion

Anxiety and depression were prevalent among primary healthcare workers. This study highlights the psychological impact of the COVID-19-related psychosocial work environment on primary healthcare workers. There is an urgent need to improve working conditions for primary healthcare workers in the COVID-19 and to implement intervention strategies aimed at increasing individual resilience alongside the establishment of external supportive work environments.

Acceptance of a COVID-19 vaccine and associated factors among pregnant women in China: a multi-center cross-sectional study based on health belief model

Background: Vaccine hesitancy has been recognized as an urgent public health issue. We aimed to explore the acceptance of a COVID-19 vaccine and related factors among pregnant women, a vulnerable population for vaccine-preventable diseases.Methods: A multi-center cross-sectional study among pregnant women was conducted in five provinces of mainland China from November 13 to 27, 2020. We collected sociodemographic characteristics, attitude, knowledge, and health beliefs on COVID-19 vaccination. Locally weighted scatterplot smoothing regression analysis was used to assess the trends of vaccination acceptance. Multivariable logistic regression was performed to identify factors related to vaccination acceptance.Results: Among the 1392 pregnant women, the acceptance rate of a COVID-19 vaccine were 77.4% (95%CI 75.1-79.5%). In the multivariable regression model, the acceptance rate was associated with young age (aOR = 1.87, 95% CI: 1.20-2.93), western region (aOR = 2.73, 95% CI: 1.72-4.32), low level of education (aOR = 2.49, 95% CI: 1.13-5.51), late pregnancy (aOR = 1.49, 95% CI: 1.03-2.16), high knowledge score on COVID-19 (aOR = 1.05, 95% CI: 1.01-1.10), high level of perceived susceptibility (aOR = 2.18, 95% CI: 1.36-3.49), low level of perceived barriers (aOR = 4.76, 95% CI: 2.23-10.18), high level of perceived benefit (aOR = 2.18, 95% CI: 1.36-3.49), and high level of perceived cues to action (aOR = 15.70, 95% CI: 8.28-29.80).Conclusions: About one quarters of pregnant women have vaccine hesitancy. Our findings highlight that targeted and multipronged efforts are needed to build vaccine literacy and confidence to increase the acceptance of a COVID-19 vaccine during the COVID-19 pandemic, especially for vulnerable populations.

Prevalence of and Factors Associated With Depressive Symptoms Among College Students in Wuhan, China During the Normalization Stage of COVID-19 Prevention and Control

Objectives: The 2019 coronavirus disease (COVID-19) epidemic has led to persistent negative psychological effects on the general public, especially on college students, who are highly susceptible to psychological difficulties, such as fear, anxiety, and depression. Little information is known about depressive symptoms among college students during the normalization stage of COVID-19 prevention and control in China. This study aimed to understand the prevalence of and factors associated with depressive symptoms after a long quarantine time and online learning at home among college students in Wuhan, China. Materials and Methods: A web-based survey was conducted from July to August 2020 during the Chinese summer holiday to collect data on sociodemographic variables, depressive symptoms, and their potential associated factors using an electronic questionnaire among college students in Wuhan, China. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depressive symptoms. Binary logistic regression was used to explore the factors associated with depressive symptoms. Results: A total of 9,383 college students were included in the analysis. The prevalence of depressive symptoms was 15.8% (1,486/9,383) among college students. The binary logistic regression showed that the experience of being quarantined for observation or treatment, family members or friends dying of COVID-19, rarely or never seeking help from others, fewer supportive relatives or friends, less support from family in the past month, a worse relationship with parents at home, a longer time spent daily on electronic devices except for online learning, and feeling anxious in the face of returning to school were independently associated with a higher risk of depressive symptoms. Academic stress and concern about the epidemic were the main reasons for their anxiety. Conclusions: Targeted psychological intervention measures are recommended for college students to improve their mental health during the normalization stage of COVID-19 prevention and control.