Risk factors and strategies for prevention of depression, anxiety and eating disorders among adolescents during the coronavirus disease 2019 (COVID-19) pandemic: a review

The purpose of this review is to identify prevalent trends and risk factors in depression,anxiety,and eating disorders in the adolescent population in the post coronavirus disease 2019(COvID-19)scenario.We examined the literature published on adolescent mental health since the COVID-19 pandemic.We chose to summarize studies published from 2019 to 2022,using bibliographic search tools.We developed criteria for selecting articles for our review using diagnostic indicators and keywords.Mental health conditions such as depression,anxiety and eating disorders are commonly prevalent in this population and have shown increasing rates in the past three years.Some risk factors associated with these diagnoses include reduction in social interaction,increased workloads,routine shifts,sleep quality,social media usage and parental involvement.Routines,sleep cycles,physical activity,and social media should all be considered as a part of prevention in this population.Approaches that seem to be successful include maintaining social ties and avoiding negative social media usage with harmful content.Increased global public awareness,as well as parental awareness,through media campaigns,is critical to slowing the spread of mental health challenges in adolescents and teenagers in the post-COvID-19 era.

Prediction System for Diagnosis and Detection of Coronavirus Disease-2019(COVID-19):A Fuzzy-Soft Expert System

In early December 2019,a new virus named“2019 novel coronavirus(2019-nCoV)”appeared in Wuhan,China.The disease quickly spread worldwide,resulting in the COVID-19 pandemic.In the currentwork,we will propose a novel fuzzy softmodal(i.e.,fuzzy-soft expert system)for early detection of COVID-19.Themain construction of the fuzzy-soft expert systemconsists of five portions.The exploratory study includes sixty patients(i.e.,fortymales and twenty females)with symptoms similar to COVID-19 in(Nanjing Chest Hospital,Department of Respiratory,China).The proposed fuzzy-soft expert systemdepended on five symptoms of COVID-19(i.e.,shortness of breath,sore throat,cough,fever,and age).We will use the algorithm proposed by Kong et al.to detect these patients who may suffer from COVID-19.In this way,the present system is beneficial to help the physician decide if there is any patient who has COVID-19 or not.Finally,we present the comparison between the present system and the fuzzy expert system.

Global pattern and determinants of coronavirus disease 2019(COVID-19)vaccine coverage and progression:a global ecological study

Background:Understanding and minimizing existing global coronavirus disease 2019(COVID-19)vaccination disparities is critical to global population health and eliminating health inequities.The study aims to investigate the disparities of vaccination coverage and progression and the associated economic and educational determinants to inform global COVID-19 vaccination strategies.Methods:COVID-19 vaccination coverage data from 206 countries used in the study were derived from“Our World in Data”website.After obtaining the vaccination coverage indicators,we fitted the progression indicators for vaccination.Correlation and multiple linear regression analysis were used to examine the effects of gross domestic product(GDP)per capita,Gini index,education,and their interactions on the coverage and progression of the COVID-19 vaccination.Results:The coverage of COVID-19 vaccination ranged from less than 30 doses to more than 150 doses per hun­dred people,from less than 15%to more than 75%for proportion of people vaccinated,from less than 15%to more than 60%for proportion of people fully vaccinated.Similarly,the progression of vaccination ranged from less than 0.1 to more than 0.6 for progression of total number of doses,from less than 0.1 to more than 0.3 for progression of proportion of people vaccinated,and from less than 0.1 to more than 0.4 for progression of propor­tion of people fully vaccinated.GDP per capita and education were positively associated with the coverage and progression,while Gini index was negatively associated with the coverage and progression.Negative interaction between GDP per capita and education was also observed for coverage(0=-0.012 to-0.011,P<0.05)and progression(0=-0.012 to-0.011,P<0.05).Conclusions:Substantial geographic disparities existed for the coverage and progression of COVID-19 vaccination.

A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV) infected pneumonia(standard version)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

Hepatobiliary system and intestinal injury in new coronavirus infection(COVID-19):A retrospective study

BACKGROUND An important area of effective control of the coronavirus disease 19(COVID-19)pandemic is the study of the pathogenic features of severe acute respiratory syndrome coronavirus 2 infection,including those based on assessing the state of the intestinal microbiota and permeability.AIM To study the clinical features of the new COVID-19 in patients with mild and moderate severity at the stage of hospitalization,to determine the role of hepatobiliary injury,intestinal permeability disorders,and changes in the qualitative and quantitative composition of the microbiota in the development of systemic inflammation in patients with COVID-19.METHODS The study was performed in 80 patients with COVID-19,with an average age of 45 years,19 of whom had mild disease,and 61 had moderate disease severity.The scope of the examination included traditional clinical,laboratory,biochemical,instrumental,and radiation studies,as well as original methods for studying microbiota and intestinal permeability.RESULTS The clinical course of COVID-19 was studied,and the clinical and biochemical features,manifestations of systemic inflammation,and intestinal microbiome changes in patients with mild and moderate severity were identified.Intestinal permeability characteristics against the background of COVID-19 were evaluated by measuring levels of proinflammatory cytokines,insulin,faecal calprotectin,and zonulin.CONCLUSION This study highlights the role of intestinal permeability and microbiota as the main drivers of gastroenterological manifestations and increased COVID-19 severity.

The origin, transmission and clinical therapies on coronavirus disease 2019(COVID-19) outbreak——an update on the status

An acute respiratory disease,caused by a novel coronavirus(SARS-CoV-2,previously known as 2019-nCoV),the coronavirus disease 2019(COVID-19)has spread throughout China and received worldwide attention.On 30 January 2020,World Health Organization(WHO)officially declared the COVID-19 epidemic as a public health emergency of international concern.The emergence of SARS-CoV-2,since the severe acute respiratory syndrome coronavirus(SARSCoV)in 2002 and Middle East respiratory syndrome coronavirus(MERS-CoV)in 2012,marked the third introduction of a highly pathogenic and large-scale epidemic coronavirus into the human population in the twenty-first century.As of 1 March 2020,a total of 87,137 confirmed cases globally,79,968 confirmed in China and 7169 outside of China,with 2977 deaths(3.4%)had been reported by WHO.Meanwhile,several independent research groups have identified that SARS-CoV-2 belongs toβ-coronavirus,with highly identical genome to bat coronavirus,pointing to bat as the natural host.The novel coronavirus uses the same receptor,angiotensin-converting enzyme 2(ACE2)as that for SARS-CoV,and mainly spreads through the respiratory tract.Importantly,increasingly evidence showed sustained human-tohuman transmission,along with many exported cases across the globe.The clinical symptoms of COVID-19 patients include fever,cough,fatigue and a small population of patients appeared gastrointestinal infection symptoms.The elderly and people with underlying diseases are susceptible to infection and prone to serious outcomes,which may be associated with acute respiratory distress syndrome(ARDS)and cytokine storm.Currently,there are few specific antiviral strategies,but several potent candidates of antivirals and repurposed drugs are under urgent investigation.In this review,we summarized the latest research progress of the epidemiology,pathogenesis,and clinical characteristics of COVID-19,and discussed the current treatment and scientific advancements to combat the epidemic novel coronavirus.

Decoding the evolution and transmissions of the novel pneumonia coronavirus(SARS-CoV-2/HCoV-19)using whole genomic data

The outbreak of COVID-19 started in mid-December2019 in Wuhan, China. Up to 29 February 2020,SARS-CoV-2(HCoV-19/2019-nCoV) had infected more than 85 000 people in the world. In this study,we used 93 complete genomes of SARS-CoV-2 from the GISAID EpiFlu TM database to investigate the evolution and human-to-human transmissions of SARS-CoV-2 in the first two months of the outbreak.We constructed haplotypes of the SARS-CoV-2 genomes, performed phylogenomic analyses and estimated the potential population size changes of the virus. The date of population expansion was calculated based on the expansion parameter tau(τ)using the formula t=τ/2 u. A total of 120 substitution sites with 119 codons, including 79 non-synonymous and 40 synonymous substitutions, were found in eight coding-regions in the SARS-CoV-2 genomes.Forty non-synonymous substitutions are potentially associated with virus adaptation. No combinations were detected. The 58 haplotypes(31 found in samples from China and 31 from outside China)were identified in 93 viral genomes under study and could be classified into five groups. By applying the reported bat coronavirus genome(bat-RaTG13-CoV)as the outgroup, we found that haplotypes H13 and H38 might be considered as ancestral haplotypes,and later H1 was derived from the intermediate haplotype H3. The population size of the SARS-CoV-2 was estimated to have undergone a recent expansion on 06 January 2020, and an early expansion on 08 December 2019. Furthermore,phyloepidemiologic approaches have recovered specific directions of human-to-human transmissions and the potential sources for international infected cases.

Electron beam irradiation on novel coronavirus(COVID-19):A Monte-Carlo simulation

The novel coronavirus pneumonia triggered by COVID-19 is now raging the whole world.As a rapid and reliable killing COVID-19 method in industry,electron beam irradiation can interact with virus molecules and destroy their activity.With the unexpected appearance and quickly spreading of the virus,it is urgently necessary to figure out the mechanism of electron beam irradiation on COVID-19.In this study,we establish a virus structure and molecule model based on the detected gene sequence of Wuhan patient,and calculate irradiated electron interaction with virus atoms via a Monte Carlo simulation that track each elastic and inelastic collision of all electrons.The characteristics of irradiation damage on COVID-19,atoms’ionizations and electron energy losses are calculated and analyzed with regions.We simulate the different situations of incident electron energy for evaluating the influence of incident energy on virus damage.It is found that under the major protecting of an envelope protein layer,the inner RNA suffers the minimal damage.The damage for a^100-nm-diameter virus molecule is not always enhanced by irradiation energy monotonicity,for COVID-19,the irradiation electron energy of the strongest energy loss damage is 2 keV.

低频脉冲磁场诱导TRPC1改善COVID-19患者康复期下肢的肌肉无力症状

背景:肌肉无力是新型冠状病毒(COVID-19)感染后的常见症状,影响康复期人体日常活动能力。在强度1.5 mT,频率3300 Hz的低频脉冲磁场刺激下可通过诱导和激活经典瞬时感受器电位通1(classical transient receptor potential channel 1,TRPC1),提升人体骨骼肌的最大自主收缩力与力量耐力,对肌肉组织产生一系列生理支持效应,该手段是否会改善新型冠状病毒肺炎患者康复期的肌无力症状尚无研究。目的:选用低频脉冲磁场对新型冠状病毒肺炎患者下肢肌群进行磁刺激,以观察该刺激对新型冠状病毒肺炎患者康复期下肢肌群肌无力改善的影响。方法:招募胶体金法抗原检测试剂(COVID-19)为阳性并伴有肌肉无力症状的新型冠状病毒(奥密克戎毒株)感染患者14例,将所有受试者随机分成2组,分别为接受磁场刺激的试验组和接受假治疗的对照组。试验总时长3周,试验组每隔48 h对腿部进行低频脉冲磁刺激,对照组与试验组干预流程一致但给予假刺激,两组患者均不被告知磁刺激仪器是否运行,两组患者共进行9次操作,随后观察两组患者下肢局部肌群最大自主收缩力、腿部爆发力与力量耐力的变化情况。结果与结论:①在采集的8个局部肌群中,试验组患者7个局部肌群在经过3周的低频脉冲磁场刺激,最大自主收缩力值均增长。对照组除3个肌群最大自主收缩力自行增长改善以外,其他肌群肌力无提升。②试验组的左腿前群与双腿后群提升率显著高于对照组。③两组的纵跳摸高高度与膝关节峰值角速度相比试验前测均提升,试验组摸高高度提升率高于对照组。④在疲劳状态下,试验组膝关节峰值角速度下降率显著下降,对照组膝关节峰值角速度下降率无显著性变化;试验组摸高高度下降率显著下降,而对照组摸高高度下降率无显著性变化。⑤上述数据证实,在强度1.5 mT,频率3300 Hz的低频脉冲磁场刺激方案下,新型冠状病毒肺炎患者在康复期经过3周的低频脉冲磁场刺激相比人体自愈过程可使更多的下肢局部肌群肌力获得提升,对基于腿部爆发力的全身协调发力能力及功能状态明显改善。因此,低频脉冲磁场刺激可作为一种改善新冠感染患者下肢肌肉无力症状的有效、非运动的康复手段。

Coronavirus disease 2019 (COVID-19) and global mental health

The mental health effects of the coronavirus disease 2019(COVID-19)pandemic may shape population health for many years to come.Failure to address the mental health issues stemming from the pandemic is likely to prolong its impact.The COVID-19 pandemic has created a significant global challenge and,in lower-income countries,even a disruption of mental health services.Given our experience with previous pandemics,the present COVID-19 crisis can be expected to cause psychological trauma,and steps are needed to address this issue proactively.Policies focusing on the long-term mental health consequences of COVID-19 may equal the importance of those currently seeking to mitigate its physical effects.The implications of the GOVID-19 pandemic for mental health call for a greater focus on the needs of those with mental disorders and on mental health issues affecting health care workers and the general public.Timely preventive and therapeutic mental health care is essential in addressing the psychosocial needs of populations exposed to the pandemic.In addition to specialist care,"task-shifting"and digital technologies may provide cost-effective means of providing mental health care in lower-income countries worldwide as well as in higher-income countries with mental health services overwhelmed by the effects of the COVID-19 pandemic.In view of the ever-increasing pressure on global health systems resulting from the COVID-19 pandemic,adopting and adapting"task-shifting",i.e.,the delegation of psychotherapeutic interventions to trained non-specialists,as an element of the provision of mental health services,is overdue.Digital technologies can be used to enhance social support and facilitate resilience to the detrimental mental health effects of the pandemic;they may also offer an efficient and cost-effective way to provide easy access to mentalhealth care.

Coronavirus disease 2019 (COVID-19) pandemic: how countries shouldbuild more resilient health systems for preparedness and response

Objective: A resilient health system plays a crucial role in pandemic preparedness and response. Althoughthe World Health Organization (WHO) has required all states parties to strengthen core capacities to respondto public health emergencies under the International Health Regulations (2005), the actions of most countriesto combating coronavirus disease 2019 (COVID-19) has showed that they are not well-prepared. This crosssectionalstudy aimed to examine the health system resilience of selected countries and analyze their strategiesand measures in response to the COVID-19 pandemic.Methods: This study selected five countries including the Iran, Japan, Republic of Korea (South Korea), the U.K.,and the U.S., based on the severity of the national epidemic, the geographical location, and the developmentlevel. Cumulative number of death cases derived from WHO COVID-19 dashboard was used to measure theseverity of the impact of the pandemic in each country;WHO State Parties Self-Assessment Annual Reporting (SPAR)Scores and Global Health Security (GHS) Index were applied to measure the national health system resilience;and research articles and press materials were summarized to identify the strategies and measures adopted bycountries during response to COVID-19. This study applied the resilient health systems framework to analyzehealth system resilience in the selected countries from five dimensions, including awareness, diversity, selfregulation,integration and adaptation.Results: The SPAR Scores and GHS Index of the four developed countries, Japan, South Korea, the U.K. and theU.S. were above the global and regional averages;the SPAR Scores of Iran were above the global average whilethe GHI Index lain below the global average. In terms of response strategies, Japan, the U.K. and the U.S. investedmore health resources in the treatment of severe patients, while South Korea and Iran had adopted a strategyof extensive testing and identification of suspected patients. In terms of specific measures, all the five countriesadopted measures such as restrictions on entry and international travel, closure of schools and industries,lockdown and quarantine. Nevertheless, the effectiveness of implementing these measures varied acrosscountries, based on the response strategies.Conclusion: Although SPAR Scores and GHS Index have evaluated the national core capacities for preparednessand response, the actions to cope with the COVID-19 pandemic has revealed the fact that most countries stilldo not build resilient health systems in response to public health emergencies. Health system strengtheningand health security efforts should be pursued in tandem, as part of the same mutually reinforcing approach todeveloping resilient health systems.

Early stage risk communication and community engagement(RCCE)strategies and measures against the coronavirus disease 2019(COVID-19)pandemic crisi

Coronavirus disease 2019(COVID-19)pandemic has proven to be tenacious and shows that the global commu nity is still poorly prepared to handling such emerging pandemics.Enhancing global solidarity in emergency preparedness and response,and the mobilization of conscience and cooperation,can serve as an excellent source of ideas and measures in a timely manner.The article provides an overview of the key components of risk communication and community engagement(RCCE)strategies at the early stages in vulnerable nations and populations,and highlight contextual recommendations for strengthening coordinated and sustainable RCCE preventive and emergency response strategies against COVID-19 pandemic.Global solidarity calls for firming govemance,abundant community participation and enough trust to boost early pandemic preparedness and response.Promoting public RCCE response interventions needs crucially improving government health systems and security proactiveness,community to individual confinement,trust and resilience solutions.To better understand population risk and vulnerability,as well as COVID-19 transmission dynamics,it is important to build intelligent systems for monitoring isolation/quarantine and tracking by use of artificial intelligence and machine learning systems algorithms.Experiences and lessons learned from the international community is crucial for emerging pandemics prevention and control programs,especially in promoting evidence-based decision-making,integrating data and models to inform effective and sustainable RCCE strategies,such as local and global safe and effective COVID-19 vaccines and mass immunization programs.

Occupational health protection for health workers during the coronavirus disease 2019(COVID-19)pandemic:6P-approach in China

Health workers(HW)are on the frontline fighting against the COVID-19 pandemic,they are exposed to multiple occupational hazards.This article analyzed the comprehensive measures of protecting HWs during the COVID-19 response in China.Occupational health protection of HWs was one of the key strategies of the public health measures adopted against the COVID-19 outbreak from the earliest stage in China.This prioritization of HWs health protection was based on the technical and policy guidance of WHO and International Labor Organization as well as the experiences from previous outbreaks in China.The comprehensive measures in China can be summarized as‘6P-approach’:public health emergency response,prompt learning from lessons,proactive measures of occupational health,precaution strategies against occupational hazards,personal protective equipment and medical devices supply,and professional networking.Through this 6P-approach,China was able to minimize the incidence of COVID-19 infection among HWs,while successfully containing the outbreak dxuing the first quarter of 2020.Although the COVID-19 vaccines have been rolled out,however,the COVID-19 pandemic is still under rapidly evolving situation.Experiences from China may provide other countries with an example of prioritizing and incorporating occupational health protection of HWs in their public health measures responding to the COVID-19 pandemic.

Virtual healthcare services and digital health technologies deployed during coronavirus disease 2019(COVID-19)pandemic in South Africa:a systematic review

Aims:To identify virtual healthcare services and digital health technologies deployed in South Africa during coronavirus disease 2019(COVID-19)and the challenges associated with their use.Metiiods:To determine the status of digital health utilization during COVID-19 in South Africa,the preferred reporting items for systematic reviews and meta-analyses model was used to perform a systematic and in-depth critical analysis of previously published studies in well-known and trusted online electronic databases using specific search keywords words that are relevant to this study.We selected published peer-reviewed articles available from the onset of COVID-19 to July 2021.Results:Total of 24 articles were included into this study.This study revealed that South Africa adopted digital technologies such as SMS-based solutions,mobile health applications,telemedicine and telehealth,WhatsApp-based systems,artificial intelligence and chatbots and robotics to provide healthcare services during COVID-19 pandemic.These innovative technologies have been used for various purposes including screening infectious and non-infectious diseases,disease surveillance and monitoring,medication and treatment compliance,creating awareness and communication.The study also revealed that teleconsultation and e-prescription,telelaboratory and telepharmacy,teleeducation and teletraining,teledermatology,teleradiology,telecardiology,teleophthalmology,teleneurology,telerehabilitation,teleoncology and telepsychiatry are among virtual healthcare services delivered through digital health technologies during COVID-19 in South Africa.However,these smart digital health technologies face several impediments such as infrastructural and technological barriers,organization and financial barriers,policy and regulatory barriers as well as cultural barriers.Conclusion:Although COVID-19 has invigorated the use of digital health technologies,there are still some shortcomings.The outbreak of pandemics like COVID-19 in the future is not inevitable.Therefore,we recommend increasing community networks in rural areas to bridge the digital divide and the modification of mHealth policy to advocate for the effective use of innovative technologies in healthcare and the development of sustainable strategies for resources mobilization through private-public partnerships as well as joining available international initiatives advocating for smart digital health.

Expanding telemedicine to reduce the burden on the healthcare systems and poverty in Africa for a post-coronavirus disease 2019 (COVID-19) pandemic reformation

The coronavirus disease 2019(COVID-19)global public health emergency,has exposed the fragility of health systems.Access to healthcare became a scarce commodity as healthcare providers and resource-poor popula­tions became victims of the novel corona virus.Therefore,this study focuses on Africa’s readiness to integrate telemedicine into the weak health systems and its adoption may help alleviate poor healthcare and poverty after COVID-19.We conducted a narrative review through different search strategies in Scopus on January 20,2021,to identify available literature reporting implementation of various telemedicine modes in Africa from January 1,2011 to December 31,2020.We summarized 54 studies according to geographies,field,and implementation methods.The results show a willingness to adopt telemedicine in the resource-poor settings and hard-to-reach populations,which will bring relief to the inadequate healthcare systems and alleviate poverty of those who feel the burden of healthcare cost the most.With adequate government financing,telemedicine promises to enhance the treating of communicable and non-communicable diseases as well as support health infrastructure.It can also alleviate poverty among vulnerable groups and hard-to-reach communities in Africa with adequate government financing.However,given the lack of funding in Africa,the challenges in implementing telemedicine require global and national strategies before it can yield promising results.This is especially true in regards to alleviating the multidimensionality of poverty in post-COVID-19 Africa.

Global health governance for travel health: lessons learned from thecoronavirus disease 2019 (COVID-19) outbreaks in large cruise ships

Background: The outbreak and global pandemic of coronavirus disease 2019 (COVID-19) attracts a great deal ofattentions to the problem of travel health. Cruise tourism is increasingly popular, with an estimated 30 millionpassengers transported on cruise ships worldwide each year. Safeguarding the health of cruise travelers duringthe entire travel is of ultimate importance for both the industry and global public health.Objective: This study aimed to explore the challenges and opportunities in travel health from the perspective ofglobal health governance.Methods: The global governance framework including problems, values, tools or regulations, and actors relatedto travel health were used to analyze the issues involved.Results: Up to April 2020, nearly thirty cruise ship voyages reported COVID-19 cases. The Diamond Princess,Grand Princess and Ruby Princess cruise ship had over 1,400 total reported COVID-19 cases, and more than 30deaths. A community with a common future in travel health is the core value of global health governance fortravel health. The travel-related international regulations, including the International Health Regulation (IHR[2005]), United Nations Convention on the Law of the Sea (UNCLOS) and the International Maritime Organization(IMO) conventions should be further updated to deal with the travel health problems. The roles andresponsibilities and the cooperation mechanisms of different actors are not clear in relation to the public healthemergencies during the travel.Conclusion: Travel health transcends national borders and involves multilevel actors, thus needs globalcooperation and governance. Regulations and legislation at global and country level are required to preventlarge-scale humanitarian crisis on travel health. Multilateral coordination, cooperation and collaborationmechanisms between governments, intergovernmental organizations, non-governmental organizations andindustry are needed to build a better community of common destiny for travel health.

Public health preparedness and responses to the coronavirus disease 2019(COVID-19)pandemic in South Asia:a situation and policy analysis

Like rest of the world,the South Asian region is facing enormous challenges with the coronavirus disease 2019(COVID-19)pandemic.The socio-economic context of the eight South Asian countries is averse to any longterm lockdown program,but the region still observed stringent lockdown close to two months.This paper analyzed major measures in public health preparedness and responses in those countries in the pandemic.The research was based on a situation analysis to discuss appropriate plan for epidemic preparedness,strategies for prevention and control measures,and adequate response management mechanism.Based on the data from March 21 to June 26,2020,it appeared lockdown program along with other control measures were not as effective to arrest the exponential growth of fortnightly COVID-19 cases in Afghanistan,Bangladesh,India,Nepal and Pakistan.However,Bhutan,Maldives and Sri Lanka have been successfully limiting the spread of the disease.The in-depth analysis of prevention and control measures espoused densely populated context of South Asia needs community-led intervention strategy,such as case containment,in order to reverse the growing trend,and adopt the policy of mitigation instead of suppression to formulate COVID-19 action plan.On the other hand,mechanism for response management encompassed a four-tier approach of governance to weave community-led local bodies with state,national and international governance actors for enhancing the countries’emergency operation system.It is concluded resource-crunch countries in South Asia are unable to cope with the disproportionate demand of capital and skilled health care workforce at the time of the pandemic.Hence,response management needs an approach of governance maximization instead of resource maximization.The epidemiologic management of population coupled with suitable public health prevention and control measures may be a more appropriate strategy to strike a balance between economy and population health during the time of pandemic.

Levels of economic developement and the spread of coronavirus disease 2019(COVID-19)in 50 U.S.states and territories and 28 European countries:an association analysis of aggregated data

Background:The coronavirus disease 2019(COVID-19)became a global pandemic within several months after it was first reported at the end of December,2019.Countries in the Northern Hemisphere have been affected the most,including the United States and European countries.Contrary to the common knowledge that infectious diseases are more prevalent in low-and middle-income countries,COVID-19 appears to affect wealthy countries more.This paper attempts to quantify the relationship between COVID-19 infections and levels of economic development with data from the U.S.and Europe.Methods:Public domain data on the confirmed COVID-19 cases during January 1 and May 31,2020 by states and territories in the U.S.and by countries in Europe were included.Incidence rate was estimated using the 2019 total population.COVID-19 cases were associated with 2019 gross domestic product(GDP)using regression models after a logarithmic transformation of the data.The U.S.data and European data were analyzed separately,considering significant heterogeneity between the two.Results:A total of 2451691 COVID-19 cases during a 5-month period were analyzed,including 1787414 from 50 U.S.states and territories and 664277 from 28 European countries.The overall incidence rate was 5.393/1000 for the U.S.and 1.411/1000 for European countries with large variations.Lg(total cases)was significantly associated with lg(GDP)for U.S.states(=1.2579,P<0.001)and European countries(=0.7156,P<0.001),respectively.Conclusion:This study demonstrated a positive correlation between COVID-19 case incidence and GDP in the United States and 28 European countries.Study findings suggest a potential role of high-level development in facilitating infectious disease spread,such as more advanced transportation system,large metropolitan cities with high population density,better domestic and international travel for businesses,leisure,and more group activities.These factors must be considered in controlling the COVID-19 epidemic.This study focuses on the impact of economic development,many other factors might also have contributed to the rapid spread of COVID-19 in these countries and states,such as differences in national and statewide anti-epidemic strategies,people's behavior,and healthcare systems.Besides,low-and middle-income countries may have an artificially low COVID-19 case count just due to lack of diagnostic capabilities.Findings of this study also encourage future research with individual-level data to detect risk factors at the personal level to understand the risk of COVID-19.

Discussion on application of food-medicine homologous traditional Chinese medicine in prevention prescriptions for Coronavirus Disease 2019 (COVID-19)

From sorting out and statistical analysis of 172 prevention prescriptions for Coronavirus Disease 2019 (COVID-19) put forward by government departments, medical institutions and TCM clinical experts in various provinces, municipalities and autonomous regions, the results showed that food-medicine homologous traditional Chinese medicine (abbreviated as"food-medicine materials") such as honeysuckle, licorice, agastache, tangerine peel, fresh reed rhizome, perilla and platycodon are used most frequently. Combined with TCM theory and modern pharmacology analysis, not only deeper understandin/g of the application value of food-medicine materials, but also reference value of their daily use and development of related products reference in the future is expected to be acquired.

Fragility and challenges of health systems in pandemic: lessons from India's second wave of coronavirus disease 2019 (COVID-19)

The unprecedented healthcare demand due to sudden outbreak of coronavirus disease 2019 (COVID-19) pandemic has almost collapsed the health care systems especially in the developing world. Given the disastrous outbreak of COVID-19 second wave in India, the health system of country was virtually at the brink of collapse. Therefore, to identify the factors that resulted into breakdown and the challenges, Indian healthcare system faced during the second wave of COVID-19 pandemic, this paper analysed the health system challenges in India and the way forward in accordance with the six building blocks of world health organization (WHO). Applying integrated review approach, we found that the factors such as poor infrastructure, inadequate financing, lack of transparency and poor healthcare management resulted into the overstretching of healthcare system in India. Although health system in India faced these challenges from the very beginning, but early lessons from first wave should have been capitalized to avert the much deeper crisis in the second wave of the pandemic. To sum-up given the likely future challenges of pandemic, while healthcare should be prioritized with adequate financing, strong capacity-building measures and integration of public and private sectors in India. Likewise fiscal stimulus, risk assessment, data availability and building of human resources chain are other key factors to be strengthened for mitigating the future healthcare crisis in country.