Response to the COVID-19 Epidemic: The Chinese Experience and Implications for Other Countries

International Journal of Environmental Research and Public Health 2020,
Volume 17, Issue 7, Page 2304

Liu, Wei; Yue, Xiao-Guang; Tchounwou, Paul B.

Abstract

The ongoing outbreak of the novel coronavirus disease (COVID-19) that occurred in China is rapidly spreading globally. China’s bond and strict containment measures have been proved (in practice) to significantly reduce the spread of the epidemic. This was obtained through the use of emergency control measures in the epidemic areas and the integration of resources from multiple systems, including business, community, technology, education, and transportation, across the country. In order to better understand how China has managed to reduce the public health and economic impacts of the COVID-19 epidemic, this editorial systematically reviews the specific measures for infection prevention and control of the disease. The best practices for COVID-19 eradication in China provide evidence-based strategies that could be replicated in other countries.

Keywords

COVID-19; epidemic, China, emergency control measures, public health

COVID-19, Rheumatic Diseases and Immunosuppressive Drugs: An Appeal For Medication Adherence

Rheumatology International 2020

Yun-Jung Kang

Dear Editor,

The novel coronavirus (SARS-CoV-2) outbreak has raised concerns among patients on chronic immunosuppressive therapy because of immune response to virus perceived to be lowered, possibly fuelling non-adherence behaviour. Indeed, high frequency of infection has been observed in patients with rheumatic diseases. Despite immunosuppressive agents and impaired immune function had been associated with increased risk of infection, it must be remembered that uncontrolled disease activity is among the most sensitive and specific independent predictors.

Keywords

Clinical Aspects, Diagnosis, Treatment

Science Education in the Era of a Pandemic

Science & Education

Erduran, Sibel.

In late February 2019, when the Covid-19 crisis began to spread across South Korea, my doctoral student Wonyong Park was there for his data collection in secondary schools. Unphased by the growing national epidemic at the time, he remarked: “As a Cambridge student, Newton once had to return home due to the plague outbreak in England, during which he made his greatest discoveries! However, as the situation develops, I promise I’ll keep healthy and make this time most useful for me.” Now, about a month later, the entire planet finds itself in the midst of a pandemic

Keywords

Epidemiology

Unprecedented Solutions for Extraordinary Times: Helping Long-Term Care Settings Deal with the COVID-19 Pandemic

Infection Control & Hospital Epidemiology

Gaur, Swati; Dumyati, Ghinwa; Nace, David A.; Jump, Robin L. P.

Our healthcare system faces an unprecedented strain as it struggles with the coronavirus disease 2019 (COVID-19) pandemic. With cases now reported in 53 states and territories, community spread is either already occurring or imminent in most localities. Most healthcare systems are experiencing limited access to diagnostic tests accompanied by delays in test results of more than 24 hours.1 Trials to assess potential treatments are underway, with mounting difficulty in acquiring agents as the demand for them increases.

Keywords

Clinical aspects, diagnosis, treatment

Roadblocks to Infection Prevention Efforts in Healthcare SARS-CoV-2/COVID-19 Response

Disaster Medicine and Public Health Preparedness

Popescu, Saskia

Abstract

The outbreak of a novel coronavirus, COVID-19, is challenging international public health and healthcare efforts. As hospitals work to acquire enough personal protective equipment and brace for potential cases, the role of infection prevention efforts and programs has become increasingly important. Lessons from the 2003 SARS-CoV outbreak in Toronto and 2015 MERS-CoV outbreak in South Korea have unveiled the critical role that hospitals play in outbreaks, especially of novel coronaviruses. Their ability to amplify the spread of disease can rapidly fuel transmission of the disease and often those failures in infection prevention and general hospital practices contribute to such events. While efforts to enhance infection prevention measures and hospital readiness are underway in the United States, it is important to understand why these programs were not able to maintain continued, sustainable levels of readiness. History has shown that infection prevention programs are primarily responsible for preparing hospitals and responding to biological events but face under-staffing and focused efforts defined by administrators. The current U.S. healthcare system though, is built upon a series of priorities that often view biopreparedness as a costly endeavor. Awareness of these competing priorities and the challenges infection prevention programs face when working to maintain biopreparedness is critical in adequately addressing this critical infrastructure in the face of an international outbreak.

Keywords

Epidemiology

A Randomized Trial Of Instructor-Led Training Versus Video Lesson In Training Health Care Providers In Proper Donning And Doffing Of Personal Protective Equipment

Disaster Medicine and Public Health Preparedness

Christensen, Liva; Rasmussen, Charlotte Schang; Benfield, Thomas; Franc, Jeffrey Michael

Abstract

Objective: This study compared live instructor-led training with video-based instruction in personal protective equipment (PPE) donning and doffing. It assessed the difference in performance between (1) attending 1 instructor-led training session in donning and doffing PPE at 1 month prior to assessment, and (2) watching training videos for 1 month.

Methods: This randomized controlled trial pilot study divided 21 medical students and junior doctors into 2 groups. Control group participants attended 1 instructor-led training session. Video group participants watched training videos demonstrating the same procedures, which they could freely watch again at home. After 1 month, a doctor performed a blind evaluation of performance using checklists.

Results: Nineteen participants were assessed after 1 month. The mean donning score was 84.8/100 for the instructor-led group and 88/100 for the video group; mean effect size was 3.2 (95% CI: -7.5 to 9.5). The mean doffing score was 79.1/100 for the instructor-led group and 73.9/100 for the video group; mean effect size was 5.2 (95% CI: -7.6 to 18).

Conclusion: Our study found no significant difference in donning and doffing scores between instructor-led and video lessons. Video training could be a fast and resource-efficient method of training in PPE donning and doffing in responding to the COVID-19 pandemic.

Keywords

personal protective equipment, coronavirus, video training, randomized trial

COVID-19 in Endoscopy: Time to do more?

Gastrointestinal Endoscopy

Thompson, Christopher C.; Shen, Lin; Lee, Linda S.

Introduction

We have read with great interest the paired articles on SARS-CoV-2/Novel Coronavirus19 (COVID-19) in this issue of Gastrointestinal Endoscopy. The first is entitled “Coronavirus (COVID-19) outbreak: what the department of endoscopy should know” by Repici et al, 1 which describes the Italian experience, and the second is “Considerations in performing endoscopy during the COVID-19 pandemic” by Soetikno et al, 2 which is drawn largely from the Hong Kong experience. We would like to congratulate the authors for their development and rigorous account of the endoscopic practices they have successfully used to minimize infection of endoscopy staff while providing essential services in this high-risk environment. We would also like to share a U.S. hospital perspective gained from our experience contending with numerous COVID-19 cases following the Biogen conference in Boston, Massachusetts.

Keywords

Clinical aspects, diagnosis, treatment

Knowledge And Attitudes Of Medical Staff In Chinese Psychiatric Hospitals Regarding COVID-19

Brain, Behavior, & Immunity - Health

Shi, Yudong; Wang, Juan; Yang, Yating; Wang, Zhiqiang; Wang, Guoqing; Hashimoto, Kenji; Zhang, Kai; Liu, Huanzhong.

Abstract

On March 11, 2020, the World Health Organization (WHO) declared the novel coronavirus COVID-19 a pandemic. There are patients in psychiatric hospitals in China who have been infected with COVID-19, however, the knowledge and attitudes of psychiatric hospital staff towards infectious diseases and their willingness to work during the COVID-19 outbreak has not yet been investigated. This study was performed to assess the knowledge and attitudes of medical staff in two Chinese mental health centers during the COVID-19 outbreak. We included 141 psychiatrists and 170 psychiatric nurses in the study. We found that during the COVID-19 epidemic, 89.51% of the medical staff of the psychiatric hospitals studied had extensive knowledge of COVID-19, and 64.63% of them received the relevant training in hospitals. Furthermore, about 77.17% of participants expressed a willingness to care for psychiatric patients suffering from COVID-19 virus infection. Independent predictors of willingness to care for patients included advanced training and experience of caring for patients with COVID-19. In conclusion, this study suggests that increased attention should be paid to the knowledge and attitudes of medical staff at psychiatric hospitals during the COVID-19 outbreak.

Keywords

COVID-19, Knowledge, Attitudes, Psychiatrists, Nurses

How could artificial intelligence aid in the fight against coronavirus?

Expert Review of Anti-infective Therapy

Yassine, Hadi M.; Shah, Zubair.

Do you believe that artificial intelligence (AI) is the key to a cure for the coronavirus?

Dr Hadi: Artificial intelligence (AI) is one of the means or avenues to understand the virus and develop preventative and control measures. This includes but is not limited to: the usage of mathematical modeling to understand virus transmission, structural biology to determine virus structure and develop vaccines, computational biology to understand virus evolution, as well as docking studies to screen for drugs and inhibitors

Keywords

COVID19, Artificial Intelligence, In-silico, Vaccines, Emerging Diseases

COVID-19, Diabetes Mellitus and ACE2: The Conundrum

Diabetes Research and Clinical Practice

Pal, Rimesh; Bhansali, Anil

Introduction

A novel coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has scourged the world since its outbreak in December 2019 at Wuhan, China resulting in the World Health Organization declaring it as a pandemic. As of March 22, 2020, COVID-19 has affected over 292,000 people in at least 185 countries worldwide with most of the cases being reported from China, Europe and the United States of America. The absolute number of deaths has already surpassed 12,750 globally and is expected to increase further as the disease spreads rapidly. The disease has also infiltrated the Indian masses and is spreading fast. India being a developing nation with more than 1.3 billion people, failure to contain the virus can lead to disastrous consequences with death toll perhaps surpassing all other nations.

Keywords

Clinical aspects, diagnosis, treatment

Herbal Medicine And Pattern Identification For Treating COVID-19: A Rapid Review Of Guidelines

Integrative Medicine Research
Volume 9, Issue 2, June 2020, 100407

Ang, Lin; Lee, Hye Won; Choi, Jun Yong; Zhang, Junhua; Lee, Myeong Soo

Introduction

Background:

Coronavirus disease 2019 (COVID-19) is pandemic and has caused illness to many people worldwide. This review aimed to summarize and analyze the herbal formulae provided by the guidelines for their pattern identifications (PIs) and compositions of herbs to treat patients with COVID-19.

Methods:

We searched 7 data sources for eligible traditional medicine guidelines up to March 6, 2020 and found a total of 28 traditional medicine guidelines that provide treatment measures for COVID-19.

Results:

Of the 28 guidelines, there were 26 government-issued Chinese guidelines and 2 Korean guidelines. After standardizing the terminology of the PIs and herbal formulae, there were 8 PIs and 23 herbal formulae for the mild stage, 11 PIs and 31 herbal formulae for the moderate stage, 8 PIs and 21 herbal formulae for the severe stage, and 6 PIs and 23 herbal formulae for the recovery stage in the Chinese guidelines. In the Korean guidelines, there were 4 PIs and 15 herbal formulae for the mild stage, 3 PIs and 3 herbal formulae for the severe stage, and 2 PIs and 2 herbal formulae for the recovery stage. In the frequency analysis of herbs, Glycyrrhizae Radix et Rhizoma was found to be the herb with the highest frequency of usage in the Chinese guidelines.

Conclusion:

This review can be used as guidance for the traditional medicine treatment of COVID-19. Clinical evidence is needed in the future to evaluate the efficacy of traditional medicine.

Keywords

Clinical aspects, diagnosis, treatment

The Cytokine Release Syndrome (CRS) Of Severe COVID-19 And Interleukin-6 Receptor (IL-6R) Antagonist Tocilizumab May Be The Key To Reduce The Mortality

International Journal of Antimicrobial Agents

Zhang, Chi; Wu, Zhao; Li, Jia-Wen; Zhao, Hong; Wang, Gui-Qiang

Abstract

Since December 2019, a viral pneumonia (COVID-19) from Wuhan, China has swept the world. Although the case fatality rate is not high, the number of people infected is large, and there are still a large number of patients dying. With the collation and publication of more and more clinical data, a large number of data suggest that there are mild or severe cytokine storms in severe patients, which is also an important cause of death. Therefore, the treatment of cytokine storm has become an important part of rescuing severe patients. Interleukin-6 (IL-6) plays an important role in cytokine release syndrome (CRS). If it can block the signal transduction pathway of IL-6, it is expected to become a new method for the treatment of severe patients. Tocilizumab is a blocker of IL-6R, which can effectively block IL-6 signal transduction pathway. So, tocilizumab is likely to become an effective drug for patients with severe COVID-19.

Keywords

COVID-19, Cytokine release syndrome, Tocilizumab

Coronavirus Disease 2019 (COVID-19): Current Status And Future Perspective

International Journal of Antimicrobial Agents

Li, Heng; Liu, Shang-Ming; Yu, Xiao-Hua; Tang, Shi-Lin; Tang, Chao-Ke

Abstract

Coronavirus disease 2019 (COVID-19) originated in the city of Wuhan, Hubei Province, Central China, and has spread quickly to 72 countries to date. COVID-19 is caused by a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [previously provisionally known as 2019 novel coronavirus (2019-nCoV)]. At present, the newly identified SARS-CoV-2 has caused a large number of deaths with tens of thousands of confirmed cases worldwide, posing a serious threat to public health. However, there are no clinically approved vaccines or specific therapeutic drugs available for COVID-19. Intensive research on the newly emerged SARS-CoV-2 is urgently needed to elucidate the pathogenic mechanisms and epidemiological characteristics and to identify potential drug targets, which will contribute to the development of effective prevention and treatment strategies. Hence, this review will focus on recent progress regarding the structure of SARS-CoV-2 and the characteristics of COVID-19, such as the aetiology, pathogenesis and epidemiological characteristics.

Keywords

COVID-19, SARS-CoV-2, 2019-nCoV, Coronavirus, Pneumonia

Recent Progress In Understanding 2019 Novel Coronavirus (SARS-Cov-2) Associated With Human Respiratory Disease: Detection, Mechanisms And Treatment

International Journal of Antimicrobial Agents

Kang, Shuntong; Peng, Wenyao; Zhu, Yuhao; Lu, Shiyao; Zhou, Min; Lin, Wei; Wu, Wenfang; Huang, Shu; Jiang, Liping; Luo, Xuan; Deng, Meichun

ABSTRACT

Viral respiratory diseases such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) always pose a severe threat to people. First identified in late December 2019, a novel coronavirus (2019-nCoV; SARS-CoV-2) has affected many provinces in China and multiple countries worldwide. The viral outbreak has aroused panic and a public-health emergency around the world, and the number of infections continues to rise. However, the causes and consequences of the pneumonia remain unknown. To effectively implement epidemic prevention, early identification and diagnosis are critical to disease control. Here we scrutinise a series of available studies by global scientists on the clinical manifestations, detection methods and treatment options for the disease caused by SARS-CoV-2, named coronavirus disease 2019 (COVID-19), and also propose potential strategies for preventing the infection.

Keywords

2019 novel coronavirus, 2019-nCoV, SARS-CoV-2, Mechanism, Treatment, Detection

Preventing bat-born viral outbreaks in future using ecological interventions

Environmental Research
Volume 185, June 2020, 109460

Nabi, Ghulam; Siddique, Rabeea; Ali, Ashaq; Khan, Suliman

Introduction

The Coronavirus Disease 2019 (COVID-19) outbreak caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was reported for the first time in December 2019, Wuhan, China (Khan et al., 2020). The COVID-19 then rapidly spread from the epicentre globally, and now characterized as a pandemic by the World Health Organization (World Health Organization, 2020). The high transmissibility of SARS-CoV-2, the lack of specific treatment and vaccines, and the unstoppable spread of infection have recently caused global health emergency, fear, and psychological stress among the public (Cohen and Kupferschmidt, 2020). Like SARS-CoV-2, other viruses including Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Marburg virus, and Ebola virus, have caused major outbreaks in history. These outbreaks caused large numbers of fatalities, morbidities, and cost billions of dollars, worldwide (Allocati et al., 2016; Fan et al., 2019). Bats are reported as a natural reservoir for these viruses, especially coronaviruses (CoVs) which constitute approximately, 31% of their virome (Allocati et al., 2016; Afelt et al., 2018). These viruses are transmitted to humans either directly or via intermediate hosts (Chan et al., 2013; Allocati et al., 2016). Furthermore, higher species diversity (over 1400), longer lifespan (over 30 years), resistance to viral infection, and migration make them a huge reservoir for pathogens and give them higher chances to transmit pathogens to other species in vast areas (Allocati et al., 2016; Frick et al., 2019; Banerjee et al., 2020). In 207 bat species, 5717 bat-associated animal viruses have been detected in 77 different countries (Allocati et al., 2016). However, the elusive and nocturnal habits make them difficult to be studied (Frick et al., 2019) therefore, there could be more deadly viruses with epidemic and pandemic potentials if other bats species are studied.

Keywords

Ethics, social science, economics

Progress and Prospects on Vaccine Development against SARS-CoV-2

Vaccines 2020
Volume 8, Issue 2, Page 153

Zhang, Jinyong; Zeng, Hao; Gu, Jiang; Li, Haibo; Zheng, Lixin; Zou, Quanming

Introduction

In December 2019, the outbreak of pneumonia caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a serious pandemic in China and other countries worldwide. So far, more than 460,000 confirmed cases were diagnosed in nearly 190 countries, causing globally over 20,000 deaths. Currently, the epidemic is still spreading and there is no effective means to prevent the infection. Vaccines are proved to be the most effective and economical means to prevent and control infectious diseases. Several countries, companies, and institutions announced their programs and progress on vaccine development against the virus. While most of the vaccines are under design and preparation, there are some that have entered efficacy evaluation in animals and initial clinical trials. This review mainly focused on the progress and our prospects on field of vaccine development against SARS-CoV-2.

Keywords

SARS-CoV-2, Vaccine, Adjuvant, Animal model

Can China return to normalcy while keeping the coronavirus in check?

Science

Normile, Dennis

.

Introduction

Life is almost back to normal in much of China. Shops, restaurants, bars, and offices are open for business. Manufacturing activity is picking up. Traffic once again jams the highways of major cities. Three quarters of China's workforce was back on the job as of 24 March, according to one company’s estimate. Wuhan, where the COVID-19 pandemic originated, is lagging, as is the rest of Hubei province but even there, the lockdown is due to lift 8 April. China has done what few believed was possible: bring a blazing epidemic of a respiratory virus to a virtual standstill. On 18 March, the country reported zero locally transmitted cases of COVID-19 for the first time. Since then, only 6 of such infections have been reported, only one of them in Wuhan. Now, the key question is: Can China keep it that way?

Keywords

Epidemiology

Iran confronts coronavirus amid a˜battle between science and conspiracy theories’

The European respiratory journal

Stone, Richard.

Introduction

When Mehdi Variji fell ill with COVID-19 in early March, he holed up in his apartment in Tehran, Iran, to ride it out. The comforts of home didn’t seem to help. As he grew short of breath and oxygen levels in his blood ebbed, Variji, a 43-year-old physician who ran Tehran’s 21st District Clinic, knew he faced a bleak prognosis. “I’m taking three medicines, but they are not working on me,” he said in a cellphone video he shot a few days before his death. A somber cellphone video shot on 20 March shows four gowned and masked workers preparing his grave in the courtyard of a shrine in his hometown, Sari. His wife and children stayed away because of the infection risk. It was just after midnight on Nowruz, the first day of the Persian new year and normally the beginning of a joyous festival.

Keywords

COVID-19, SARS-CoV-2, Treatment

Covid-19: Doctors Are Told Not To Perform CPR On Patients In Cardiac Arrest

BMJ
Volume 368, 2020, m1282-m1282

Mahase, Elisabeth; Kmietowicz, Zosia.

Introduction

Healthcare staff in the West Midlands have been told not to start chest compressions or ventilation in patients who are in cardiac arrest if they have suspected or diagnosed covid-19 unless they are in the emergency department and staff are wearing full personal protective equipment (PPE).

The guidance from the University Hospitals Birmingham NHS Foundation Trust says that patients in cardiac arrest outside the emergency department can be given defibrillator treatment if they have a “shockable” rhythm. But if this fails to restart the heart “further resuscitation is futile,” it says.

Keywords

COVID-19, SARS-CoV-2, Treatment