Emergency Preparedness and Management of Mobile Cabin Hospitals in China During the COVID-19 Pandemic

The healthcare systems in China and globally have faced serious challenges during the coronavirus disease (COVID-19) pandemic. The shortage of beds in traditional hospitals has exacerbated the threat of COVID-19. To increase the number of available beds, China implemented a special public health measure of opening mobile cabin hospitals. Mobile cabin hospitals, also called Fangcang shelter hospitals, refer to large-scale public venues such as indoor stadiums and exhibition centers converted to temporary hospitals. This study is a mini review of the practice of mobile cabin hospitals in China. The first part is regarding emergency preparedness, including site selection, conversion, layout, and zoning before opening the hospital, and the second is on hospital management, including organization management, management of nosocomial infections, information technology support, and material supply. This review provides some practical recommendations for countries that need mobile cabin hospitals to relieve the pressure of the pandemic on the healthcare systems.

Vaccines provide disproportional protection to the increased hospitalisation risk posed by the Delta variant of SARS-CoV2: a meta-analysis

Variants of SARS-CoV2 that achieved global dominance (Alpha and Delta) have been associated with increased hospitalisation risk. A quantification of this risk across studies is currently lacking for Delta. Furthermore, how risk for severe disease changes in both vaccinated and unvaccinated individuals is important as the underlying risks determine public health impact. The surplus risk of Delta versus Alpha on hospitalisation was determined using random-effects meta-analysis. Infection with the Delta compared to the Alpha variant increased hospitalisation risk (unvaccinated: log HR 0.62, CI: 0.41 -- 0.84, P < 0.0001; linear HR 1.87). This finding should inform our response to future variants of concern, currently Omicron. SARS-CoV2 variants that achieve dominance, have achieved this through a higher rate of infection and this evolutionary trajectory has also come with a correlated higher risk of severe disease. The surplus risk posed by Delta was significantly lower however in the vaccinated (model estimate -0.40, CI: -0.73 -- -0.07, P = 0.017). Vaccination thus provided a disproportionate level of protection to hospitalisation with the Delta variant and provides further rationale for vaccination for SARS-CoV2 as a durable public health measure.

Impact of school closures and re-openings on COVID-19 transmission

Background: Globally, the education of students at primary and secondary schools has been severely disrupted by the implementation of school closures to reduce the spread of coronavirus disease 2019 (COVID-19). The effectiveness of school closures in reducing transmission of COVID-19 and the impact of re-opening schools are unclear. Methods: Research criteria for this rapid review included empirical studies, published or pre-published worldwide before January 25, 2021, that assessed the effectiveness of school closures in reducing the spread of COVID-19 and the impact of school re-openings on COVID-19 transmission. Results: Twenty-four studies on the impact of school closures and re-openings on COVID-19 transmission were identified through the seven databases that were searched. Overall the evidence from these studies was mixed and varied due to several factors such as the time of implementation of public health measures, research design of included studies and variability among the levels of schooling examined. Conclusion: Preliminary findings suggest that school closures have limited impact on reducing COVID-19 transmission, with other non-pharmaceutical interventions considered much more effective. However, due to the limitations of the studies, further research is needed to support the use of this public health measure in response to the COVID-19 pandemic.

Vaccination against SARS-CoV-2: a human enhancement story

Background Vaccination is an essential strategy for mitigating the COVID-19 pandemic. Besides its significance as a public health measure, vaccination is a sophisticated example of modern biotechnology. Since vaccination gives the human body an ability that it does not naturally possess, the question arises as to its classification as Human Enhancement. Main Body Exemplified on a selection of different definitions, we conclude that vaccinations may indeed be classified and treated as a form of Human Enhancement. This raises some ethical issues that are notorious in the broad field of Human Enhancement. A study with N = 67 participants revealed that vaccinations are perceived neither as a clear nor poor example of Human Enhancement. Conclusion We argue that qualifying vaccination technology as Human Enhancement does not provide convincing arguments to reject vaccination. By examining the Human Enhancement debate and the similarities to the issue of vaccination shown here, policymakers can learn valuable lessons regarding mass vaccination programs’ current and future handling.

Managing essential healthcare services during the first nationwide lockdown: experiences from a Regional Referral Hospital in Bhutan

The current COVID -19 pandemic has brought unprecedented burden on healthcare system throughout the world. While the pandemic has hijacked all attention and priorities, there is a significant concern that non-COVID essential healthcare services may be negleccted. Lockdowns have become an important public health measure to contain local outbreaks. We describe our experiences in ensuring the provision of essential healthcare services during the first nationwide lockdown. Adequate preparations with a well-thought of contingency plan , identification of roles, good communication system, 24 -hour hotline and a mobile clinic with the most essential services, form important components of essential healthcare services.

Ecotourism in Times of Covid-19: A Systematic Review from the Five Continents on How This Activity is Being Carried Out and What Proposals They Have for the Near Future

The emergence of the covid-19 virus has prompted governments in several countries to close their international borders, close transportation routes and decree quarantines as a public health measure to prevent the spread of the virus among the population. Globally, essential businesses have continued to operate, while others such as tourism must wait. Ecotourism is a sustainable activity that attracts tourists concerned about the environment and local culture, which generates income for the locals. In order to have a broader picture of how the ecotourism sector is dealing with covid-19, a systematic review was conducted to identify Scopus records detailing such evidence disclosed from 2020 to the first quarter of 2021. As results, records were identified in the five continents, which agree that the pandemic has negatively affected the income of local people, who have been forced to close their businesses and even perform illegal acts; however, there are also encouraging proposals of economic reactivation plans presented by villagers, who expect the opening of this activity to operate keeping all the health safety measures decreed by their governments. Received: 6 May 2021 / Accepted: 27 September 2021 / Published: 5 November 2021

Analysis of COVID-19 vaccine non-intent by essential vs non-essential worker, demographic, and socioeconomic status among 101,048 US adults

As of May 2021, over 286 million coronavirus 2019 (COVID-19) vaccine doses have been administered across the country. This data is promising, however there are still populations that, despite availability, are declining vaccination. We reviewed vaccine likelihood and receptiveness to recommendation from a doctor or nurse survey responses from 101,048 adults (≥18 years old) presenting to 442 primary care clinics in 8 states and the District of Columbia. Occupation was self-reported and demographic information extracted from the medical record, with 58.3% (n = 58,873) responding they were likely to receive the vaccine, 23.6% (n = 23,845) unlikely, and 18.1% (n = 18,330) uncertain. We found that essential workers were 18% less likely to receive the COVID-19 vaccination. Of those who indicated they were not already “very likely” to receive the vaccine, a recommendation from a nurse or doctor resulted in 16% of respondents becoming more likely to receive the vaccine, although certain occupations were less likely than others to be receptive to recommendations. To our knowledge, this is the first study to look at vaccine intent and receptiveness to recommendations from a doctor or nurse across specific essential worker occupations, and may help inform future early phase, vaccine rollouts and public health measure implementations.

Evaluation of the Effectiveness and Safety of the BNT162b2 COVID-19 Vaccine in the Vaccination Campaign among the Health Workers of Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Health workers, especially those in patient-facing roles, had a significantly increased risk of COVID-19 infection, having serious outcomes, and risking spreading the virus to patients and staff. Vaccination campaign planning suggests allocating initial supplies of BNT162b2 vaccine to health workers given the importance of early protection to safeguard the continuity of care to patients. The aim of the study is to assess the effectiveness and safety of BNT162b2 vaccine among the health workers of Fondazione Policlinico Universitario Agostino Gemelli IRCCS (FPG). The retrospective cohort study was conducted among health staff working at the FPG. Vaccination data were collected from hospital records. The primary end points were vaccine effectiveness and safety. A total of 6649 health workers were included, of whom 5162 received injections. There were 14 cases of COVID-19 with onset at least 14 days after the second dose among vaccinated health workers and 45 cases among unvaccinated ones. BNT162b2 was 91.5% effective against COVID-19 (95% credible interval, 84.7% to 95.3%). The safety profile of BNT162b2 vaccine consisted of short-term, non-serious events. The promotion and boost of the COVID-19 vaccination campaign represents a key public health measure useful to curb the spread of the pandemic especially in vulnerable contexts, such as hospitals, where health workers carry out a paramount role for the entire community, and requires further protection with a possible booster dose in view of autumn-winter 2021.

Modelling the impact of travel restrictions on COVID-19 cases in Hong Kong in early 2020

Background Coronavirus Disease 2019 (COVID-19) led to pandemic that affected almost all countries in the world. Many countries have implemented border restriction as a public health measure to limit local outbreak. However, there is inadequate scientific data to support such a practice, especially in the presence of an established local transmission of the disease. Objective To apply a metapopulation Susceptible-Exposed-Infectious-Recovered (SEIR) model with inspected migration to investigate the effect of border restriction as a public health measure to limit outbreak of coronavirus disease 2019. Methods We apply a modified metapopulation SEIR model with inspected migration with simulating population migration, and incorporating parameters such as efficiency of custom inspection in blocking infected travelers in the model. The population sizes were retrieved from government reports, while the number of COVID-19 patients were retrieved from Hong Kong Department of Health and China Centre for Disease Control (CDC) data. The R0 was obtained from previous clinical studies. Results Complete border closure can help to reduce the cumulative COVID-19 case number and mortality in Hong Kong by 13.99% and 13.98% respectively. To prevent full occupancy of isolation facilities in Hong Kong; effective public health measures to reduce local R0 to below 1.6 was necessary, apart from having complete border closure. Conclusions Early complete travel restriction is effective in reducing cumulative cases and mortality. However, additional anti-COVID-19 measures to reduce local R0 to below 1.6 are necessary to prevent COVID-19 cases from overwhelming hospital isolation facilities.