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Thoughts on the strategy and mechanism for the regular prevention and control of COVID-19

Yinbo LUO ; Yang WU ; Man LIU ; QI CHEN ; Jiafa LIU ; Xuhua GUAN ; Yeqing TONG

Journal of Public Health and Preventive Medicine.2020;31(6):1-5. doi:10.3969/j.issn.1006-2483.2020.06.001

Since the outbreak of the COVID-19 at the end of December 2019, Hubei province has actively adopted a series of prevention and control measures such as ^“quarantine, treatment, testing, and containment^”, and have basically blocked the spread of COVID-19. However, with the development of overseas epidemics and the occurrence of case clusters in local areas, we not only face the threat of imported cases, but also face the urgent need to resume normal work and daily life. This puts forward higher requirements for regular prevention and control of COVID-19. Therefore, we should more deeply understand the significance of regular prevention and control as well as the epidemic situation in our province, summarize experience and lessons, and adhere to the prevention and control strategy of ^“government-led, group-specialist combination, and specialized-oriented^”. Meanwhile, it is necessary to implement the working requirement that combines regular prevention and control surveillance with rapid emergency response to local COVID-19 outbreaks. Furthermore, we should establish a regular multi-point trigger early warning mechanism for COVID-19, strengthen the reserve of emergency supplies and carry out training and drills on epidemic prevention and control across the province to make full preparations for the coming autumn and winter epidemics. The most important is to reform the system of disease prevention and control and public health, comprehensively improve the ability of prevention and treatment, and promote the modernization of public health governance.

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Fitting prediction of transmissibility and incidence trend of novel coronavirus pneumonia in Ningxia

Jiancai DU ; Yi YANG ; Jianhua ZHAO ; Yu ZHAO ; Yuan LIU

Journal of Public Health and Preventive Medicine.2020;31(6):6-9. doi:10.3969/j.issn.1006-2483.2020.06.002

Objective To analyze the change in transmissibility of novel coronavirus pneumonia and predict the trend of the incidence, and to provide a reference for the government to better respond to the novel coronavirus pneumonia epidemic. Methods The EpiEstimof R language software was used to estimate the change of effective basic reproduction number, and the Richards model was run by Matlab7.0 software to fit the cumulative number of confirmed cases and the number of suspected cases. The coefficient of determination and root mean squared error were used to evaluate the fitting effect of the model. Results A total of 75 confirmed cases and 107 suspected cases were reported in Ningxia. The strict implementation of various prevention and control measures gradually reduced the effective basic reproduction number from 3.82 to less than 1, indicating that the epidemic was under control. The Richards model was used to fit the cumulative confirmed cases and suspected cases, which revealed that the natural growth rates were 0.16 and 0.23, and the coefficients of determination were 0.991 and 0.998, respectively. Conclusion Combined with the effective basic reproduction number, the Richards model fitted the trend of novel coronavirus pneumonia, which can be used to predict the trend of incidence of new coronavirus pneumonia.

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Clinical characteristics of patients with malignant tumors combined with COVID-19

Mengting GAO ; Lei YUAN ; Haiyan SHAO ; Fengbo XI

Journal of Public Health and Preventive Medicine.2020;31(6):10-14. doi:10.3969/j.issn.1006-2483.2020.06.003

Objective To retrospectively analyze the clinical characteristics of patients with malignant tumors combined with new coronavirus pneumonia (COVID-19), and to provide a scientific basis for clinical treatment. Methods SPSS 20.0 was used for data analysis. The t-test was used for quantitative data, and chi-square test/Fisher-exact test was used for qualitative data. Binary logistic regression was used for multivariate analysis, and the correlation coefficient was used for multicollinearity test before regression analysis. Results A total of 61 COVID-19 infected cancer patients were included in this study. Their average age was 62.2±12.12. The most common admission symptoms were fever (54.1%), fatigue (39.3%), and cough (37.7%). The rate of the patients with severe COVID-19 was 54.1%. Having 3 or more complications (OR: 2.07, 95%CI: 3.14-2698.12), fever (OR: 12.22, 95%CI: 1.20-86.70), low percentage of lymphocytes (OR: 15.56, 95%CI: 1.78-136.24) and low serum albumin level (OR: 254.64, 95%CI: 8.56-7576.41) were risk factors for COVID-19 severity. The fatality rate of the subjects was 8.2%, and the average hospital stay was 26.7±19.69 days. Furthermore, the severity of COVID-19 had a statistically significant impact on the average hospital stay (t=-3.48, P<0.01). Conclusion Patients with malignant tumors combined with COVID-19 have a higher severity rate, fatality rate, and average hospital stay than ordinary COVID-19 patients. Underlying diseases, fever, low lymphocyte percentage, and low serum albumin levels are the factors for the increase of the illness severity in patients with malignant tumors combined with COVID-19.

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Epidemiological characteristics of 1 175 confirmed cases of COVID-19 in Xiangyang

Miao CHEN ; Wangsheng ZHANG ; Guangjiong JIANG ; Wensheng GONG

Journal of Public Health and Preventive Medicine.2020;31(6):15-18. doi:10.3969/j.issn.1006-2483.2020.06.004

Objective To investigate the epidemiological characteristics of COVID-19 outbreaks in Xiangyang, and to provide a scientific basis for curbing the development of the epidemic. Methods A retrospective epidemiological investigation was conducted to analyze the epidemiological characteristics of confirmed COVID-19 cases in the city from January 1 to April 30, 2020. Results Confirmed COVID-19 cases were reported throughout the city, and the epidemic situation decreased significantly after February. The median age of confirmed cases was 47 years old, and most of them were 25-65 years old (86.89%). The average interval time between first diagnosis and admission was 5.23 days, while the average interval time between diagnosis and confirmation was 1.69 days. As time went on, the time intervals between the first diagnosis and admission and between diagnosis and confirmation were significantly shortened. The higher the proportion of previous underlying diseases was, the more serious the COVID-19 infection was (χ²=44.40, P<0.05). Conclusion The infection of COVID-19 in Xiangyang is highly contagious, but the cluster epidemic was mainly mild. Novel coronavirus infection is closely related to occupational exposure, with young and middle-aged people being high-risk populations. Early diagnosis, early isolation, comprehensive treatment and active control of chronic underlying diseases are crucial to the control of COVID-19.

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Application of ARIMA model in the prediction of syphilis incidence in Anhui Province

Lanlan FANG ; Guixia PAN

Journal of Public Health and Preventive Medicine.2020;31(6):19-23. doi:10.3969/j.issn.1006-2483.2020.06.005

Objective To explore the application of time series autoregressive integrated moving average (ARIMA) based on seasonal difference to predict the number of syphilis cases in Anhui Province, and to provide a reference for early warning and control of syphilis. Methods Using R 3.6.2 software, the number of syphilis cases in Anhui Province from January 2004 to December 2016 was used for model fitting, and the resulting model was used to predict the incidence from January to December 2017. The difference between the predicted value and actual observed value was compared to evaluate the prediction effect of this model fitting. Results The incidence of syphilis in Anhui Province was on the rise with obvious periodicity. ARIMA(1,1,1)(0,1,2)₁₂ was the optimal model, with the AIC being -264.81 and the BIC being -249.99. Box-Pierce test showed that λ² value was 1.444(P=0.963), 10.459(P=0.576), and the difference was not statistically significant (P>0.05), indicating that the residual sequence was white noise. The model accuracy effect evaluation showed that the MAE was 0.06, the RMSE was 0.09, and the MAPE was 1.00%, indicating that the model fitting effect was good. The 2017 data was used to test the effect of the model extrapolation, and the results showed MAPE=6.09%, indicating that the model extrapolation effect was good. The actual value fell within 95% confidence interval of the predicted value, and the model prediction effect was relatively ideal. Conclusion The ARIMA(1,1,1)(0,1,2)₁₂ model could better fit and predict the number of syphilis cases in Anhui Province, which may provide a theoretical basis for early warning, prevention and control of syphilis.

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Distribution and Influencing Factors of Patients with Extra-long Hospital Stay from 128 Hospitals in Hubei Province

Yang WU ; Chuanhua YU ; Yangxu WANG ; Shuang ZHANG ; Zhong JIN ; Rongxian MA

Journal of Public Health and Preventive Medicine.2020;31(6):24-28. doi:10.3969/j.issn.1006-2483.2020.06.006

Objective Analyze the distribution and influencing factors of inpatients with extra-long hospital stay in Hubei Province. Methods Length of stay≥30 days was defined as the extra-long hospital stay, and logistic regression was used to determine the risk factors. Results There were 26 043 cases with extra-long hospital stay, which accounting for 2.88% of the total cases. Proportion of extra-long hospital stay was increased with age, the proportion of the group aged 65 and above was the highest (3.25%), and which were higher in males than that of females, the sex ratio was 1.58. Patients with extra-long hospital stay mainly had injury/poisoning and certain other consequences of external causes (16.88%), circulatory system disease (12.72%), neoplasms (11.23%), genitourinary system diseases (8.13%), mental and behavioral disorders (6.27%), and the proportion totaled up to 52.23%. Multivariate logistic regression analysis indicated that gender, age, type of disease, surgery or not and hospital grade were the influencing factors of extra-long hospital stay. Conclusions There are differences in the distribution of extra-long hospital stay in different individuals, diseases and medical treatment, targeted measures should be taken to shorten the length of stay.

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Comparative study of ARIMA model and seasonal index model in the prediction of mumps in Hubei Province

Peng ZHANG ; Jing CAI ; Shuqiong HUANG ; Wenwen YANG ; Cong XIE ; Ran WU

Journal of Public Health and Preventive Medicine.2020;31(6):29-32. doi:10.3969/j.issn.1006-2483.2020.06.007

Objective To establish an ARIMA model and a seasonal index model to predict the trend of mumps, compare the advantages and disadvantages of the two models, and to provide a scientific basis for the prevention and control of mumps. Methods ARIMA model and seasonal index model were established based on the monthly incidence of mumps in Hubei Province from 2008 to 2019. Results The average annual incidence rate from 2008 to 2019 was 28.89 / 100,000. April-July was the month of high incidence. The established ARIMA model and seasonal index model were （1-1.070B+0.441B²-0.291B³）*（1-B¹²）*X_t=（1-0.611B¹²）*Ɛ_t and X_t=（2.802-0.006t）*S_t. The average relative errors of the ARIMA model and the seasonal index model were 11.49% and 20.86%, respectively. Conclusion The ARIMA model and the seasonal index model both have good applicability in predicting the onset time characteristics and trend of mumps. However, while the ARIMA model demonstrated more advantages in fitting the annual change trend, the seasonal index model is better in fitting the monthly change trend. The two models can be used in combination to predict the trend of mumps.

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Spatiotemporal scan clustering analysis on Scarlet fever in Jinan, 2014-2019

Shang GAO ; Zhaoxia SHAN ; Qiuyan YU ; Xiuhua ZHOU

Journal of Public Health and Preventive Medicine.2020;31(6):33-36. doi:10.3969/j.issn.1006-2483.2020.06.008

Objective To analyze the epidemiological characteristics and spatiotemporal clustering of scarlet fever in Jinan, from 2014-2019, and to provide a basis for scarlet fever prevention and control. Methods The case data of scarlet fever in Jinan during 2013-2019 were extracted from the Chinese National Notifiable Infectious Disease Reporting System. Descriptive epidemiology and spatiotemporal rearrangement scanning methods were used to analyze the epidemiological characteristics and spatiotemporal distribution of scarlet fever. The RR values of scarlet fever in different towns (streets) were calculated, and the contour map of RR value was drawn. Results A total of 9 715 cases of scarlet fever were reported in Jinan from 2014 to 2019. During this period, the number of cases and the incidence rate showed a gradual increase, with two seasonal peaks in the winter and spring each year. Spatiotemporal clustering analysis detected a total of eight spatiotemporal aggregation areas, and the strongest one was in Licheng and Lixia Districts, from March 2017 to December 2019 (RR=3.45, LLR=577.88, P<0.001). The relative risk maps in each year from 2014 to 2019 were similar, and the areas with the highest risk were located in the central area of Jinan. Conclusion From 2014 to 2019, scarlet fever is highly prevalent in the central area of Jinan, with obvious spatial and temporal clustering. There are clustering areas in the central, southwest and eastern areas of Jinan, and there was a tendency for the disease to spread to Zhangqiu in the east and Pingyin in the southwest.

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Analysis of hemagglutinin gene characteristics of influenza A H3N2 virus in Changzhou, 2017 -2018

Qiong LI ; Ping YAO ; Jingyi JIANG ; Xujian MAO ; Shushu LI ; Fengming WANG

Journal of Public Health and Preventive Medicine.2020;31(6):37-41. doi:10.3969/j.issn.1006-2483.2020.06.009

Objective To understand the epidemiological characteristics and variation of H3N2 influenza virus hemagglutinin (HA) gene in Changzhou from 2017 to 2018. Methods Throat swab specimens of the influenza-like cases were collected from Changzhou Influenza Monitoring Sentinel Hospital from April 2017 to March 2018. RNA was extracted from the specimens for influenza diagnosing and genotyping using real-time RT-PCR．H3N2 positive samples were isolated, and extracted RNA was used for amplification, sequencing and phylogenetic analysis of HA gene. Results From April 2017 to March 2018, 28 strains of influenza A (H3N2) virus were isolated. After gene sequencing, a phylogenetic tree was constructed. It was found that all of the strains belonged to Group3C.2a, which was similar to the vaccine strain A/Hong Kong/4801/2014. The HA amino acid sequence difference was analyzed and compared between the H3N2 influenza virus strains isolated in Changzhou and the vaccine strain A/Hong Kong/4801/2014. It was found that the epidemic strain isolated in Changzhou was in the HA epitope (A-E) region. Ten amino acid site mutations in the HA epitope (A-E) region and two amino acid site mutations in the stem region of HA antigen were found. Conclusion From April 2017 to March 2018, the influenza virus H3N2 prevalent in Changzhou was distributed on the same evolutionary branch with the vaccine strain A/Hong Kong/4801/2014 (group 3C.2a), rendering the popular trend of one subgroup. However, some amino acid sites of the HA epitope had variations, suggesting that mutations may occur, which may affect the immune effect of the vaccine. Monitoring needs to be strengthened in the future work.

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Epidemiological characteristics of mumps in Guangxi, 2011-2019

Jiagui CHEN ; Jinfa DU ; Rencong YANG ; Qiuyun DENG ; Aihu DONG ; Jing LIU ; Sha LI ; Jianan WEI ; Weicai LU ; Gangyong PAN

Journal of Public Health and Preventive Medicine.2020;31(6):42-45. doi:10.3969/j.issn.1006-2483.2020.06.010

Objective To analyze the epidemiological characteristics of mumps in Guangxi from 2011 to 2019, and to provide a scientific basis for formulating effective prevention and control strategies. Methods Descriptive epidemiological method was used to analyze the incidence data of mumps in Guangxi from 2011 to 2019. Results From 2011 to 2019, a total of 146,132 cases of mumps were reported in Guangxi, with an average annual incidence rate of 34.23 /100 000. There were 88,919 male cases (60.85%) and 57,213 female cases (39.15%). The incidence rate decreased from 62.26/100 000 in 2011 to 16.46/100 000 in 2015, and increased from 18.60/100 000 in 2016 to 46.90/100 000 in 2019. There were seasonal variations in the incidence, with the incidence peaks occurring from April to July and from October to the following January. 85.39% of cases were under 15 years of age, and 76.82% of cases were among kindergarteners or school children. A total of 228 mumps outbreaks were reported during 2011-2019，including 5,347 cases, accounting for 3.66% of the total cases. The incidence rates of mumps in Nanning (56.09/100 000), Hechi (48.26/100 000), Liuzhou (46.77/100 000), Baise (46.34/100 000) and Fangchenggang (40.68/100,000) were relatively higher than other places. Conclusion The mumps incidence is on an upward trend in Guangxi since 2015-2019, occurring mainly in older children or students. It is suggested to adhere to the second dose of mumps containing vaccine for kindergarten and school children and strengthen the surveillance and outbreak control of mumps in schools.

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