新型冠状病毒肺炎（COVID - 19）与SARS的流行病学特征分析及防控建议

目的 了解新型冠状病毒肺炎（COVID - 19）与严重急性呼吸综合征（SARS）两种传染病,为完善新型冠状病毒肺炎疫情防控策略提供科学依据。方法 通过查阅相关文献及报道,比较分析两种传染病在临床表现、流行病学和病原学特征上的相似和不同之处。结果 两种传染病均是由β冠状病毒感染而引起的新型人类呼吸系统疾病,在全球多个国家出现,与SARS比较,COVID - 19传染源除了患者之外,隐性感染者也是COVID - 19的主要传染源。此外,COVID - 19的传染性更强,但病情严重程度不及SARS。结论 消除传染源、切断传播途径及保护易感人群是控制传染病流行的基本手段。结合SARS疫情的防控经验,完善疫情信息监测、提高病毒检测技术及加强联防联控是优化新型冠状病毒肺炎疫情防控的重点。     

Reassessing Reported Deaths and Estimated Infection Attack Rate during the First 6 Months of the COVID-19 Epidemic,Delhi, India

India reported >10 million coronavirus disease (COVID-19) cases and 149,000 deaths in 2020. To reassess reported deaths and estimate incidence rates during the first 6 months of the epidemic, we used a severe acute respiratory syndrome coronavirus 2 transmission model fit to data from 3 serosurveys in Delhi and time-series documentation of reported deaths. We estimated 48.7% (95% credible interval 22.1%–76.8%) cumulative infection in the population through the end of September 2020. Using an age-adjusted overall infection fatality ratio based on age-specific estimates from mostly high-income countries, we estimated that just 15.0% (95% credible interval 9.3%–34.0%) of COVID-19 deaths had been reported, indicating either substantial underreporting or lower age-specific infection-fatality ratios in India than in high-income countries. Despite the estimated high attack rate, additional epidemic waves occurred in late 2020 and April–May 2021. Future dynamics will depend on the duration of natural and vaccine-induced immunity and their effectiveness against new variants.     

Prevention Measures for COVID-19 and Changes in Kawasaki Disease Incidence

BackgroundKawasaki disease is suspected to be triggered by previous infection. The prevention measures for coronavirus disease 2019 (COVID-19) have reportedly reduced transmission of certain infectious diseases. Under these circumstances, the prevention measures for COVID-19 may reduce the incidence of Kawasaki disease.MethodsWe conducted a retrospective study using registration datasets of patients with Kawasaki disease who were diagnosed in all 11 inpatient pediatric facilities in Yamanashi Prefecture. The eligible cases were 595 cases that were diagnosed before the COVID-19 pandemic (from January 2015 through February 2020) and 38 cases that were diagnosed during the COVID-19 pandemic (from March through November 2020). Incidence of several infectious disease were evaluated using data from the Infectious Disease Weekly Report conducted by the National Institute of Infectious Diseases.ResultsEpidemics of various infectious diseases generally remained at low levels during the first 9 months (March through November 2020) of the COVID-19 pandemic. Moreover, the incidence of COVID-19 was 50–80 times lower than the incidence in European countries and the United States. The total number of 38 cases with Kawasaki disease for the 9 months during the COVID-19 pandemic was 46.3% (−3.5 standard deviations [SDs] of the average [82.0; SD, 12.7 cases] for the corresponding 9 months of the previous 5 years. None of the 38 cases was determined to be triggered by COVID-19 based on their medical histories and negative results of severe acute respiratory syndrome coronavirus 2 testing at admission.ConclusionThese observations provide a new epidemiological evidence for the notion that Kawasaki disease is triggered by major infectious diseases in children.Key words: COVID-19, Kawasaki disease, retrospective database, infectious disease     

我国女性职业健康与职业发展之路——写在中国共产党建党100周年

儿童多系统炎症综合征（multisystem inflammatory syndrome in children, MIS-C）是一种以发热、消化道症状、心脏损害及休克等多系统受累为特征的疾病，伴炎症及心肌损伤标志物明显升高，同时存在严重急性呼吸综合征冠状病毒-2（severe acute respiratory syndrome-associated coronavirus, SARS-CoV-2）感染证据或2019新型冠状病毒病（coronavirus disease 2019, COVID-19）接触史。MIS-C的发病机制尚未明确，可能与SARS-CoV-2感染后继发的免疫失调有关，目前多在欧美国家报道。MIS-C与川崎病临床表现相似，主要不同是该病与SARS-CoV-2感染相关。60%的MIS-C患儿需要重症监护，大多接受抗炎和免疫调节为主的综合治疗，病死率为0.9%～2.0%。目前全球COVID-19疫情防控仍面临严峻挑战，儿科医生应提高识别MIS-C的能力。     

新型冠状病毒肺炎防控疾控人员个人防护规范团体标准解读

新型冠状病毒肺炎是一种新发的传染病，CDC工作人员作为防控新型冠状病毒肺炎疫情的专业人员，直接面对感染威胁。北京预防医学会组织北京市疾病预防控制中心撰写的《新型冠状病毒肺炎防控疾控人员个人防护规范（T/BPMA 0002-2020）》团体标准，以多年的个人防护研究为基础，以科学、规范、安全为原则，提出CDC工作人员合理选择和正确使用个人防护装备，确定个人防护装备使用程序。在接触、处置有明确风险的新型冠状病毒肺炎疫情时，为确保CDC工作人员个人防护的安全，提供标准化依据。     

COVID-19疫情给其它传染病防治带来的挑战与机遇

COVID-19大流行对人类健康造成巨大威胁的同时也给全世界公共卫生系统带来前所未有的挑战和机遇。为迅速控制疫情,世界各国采取保持社交距离、重新分配医疗资源、调整医疗策略等应急措施,原有医疗服务秩序遭到破坏,有限医疗资源受到再挤压,其它传染病防治最佳时机被错过,导致结核病、肝炎、麻疹、艾滋病等多种传染病发病率和死亡率快速上升,给人类健康和社会经济都造成严重损害。但是也有一些意外收获,如改变了人们对旅行安全常态的定义、完善了中低收入国家被忽视的传染病防控关键内容、暴露出医疗体系中传染病医生匮乏问题、降低严重复杂性流感和侵袭性肺炎球菌等疾病发病率等。年初,COVID-19大流行给全世界敲响了警钟,让各国看清自身公共卫生系统在应对传染病暴发上的不足。年末,COVID-19和其它传染病或将同时暴发,各国公共卫生系统将面临更为严峻的大考,亟待各国政府高度重视并做好充分准备。     

新冠疫苗犹豫及其影响因素研究进展

2020年暴发的新型冠状病毒肺炎疫情推动了新型冠状病毒疫苗(简称新冠疫苗)的研发和应用,但疫苗犹豫阻碍了新冠疫苗的普及接种。本文横向对比不同国家的新冠疫苗犹豫情况,结合已有的相关模型剖析影响新冠疫苗犹豫的因素,从而提出针对新冠疫苗犹豫的干预措施,以期为改善新冠疫苗犹豫提供参考。     

Risk of COVID-19 and major adverse clinical outcomes among people with disabilities in South Korea

BackgroundEvidence regarding the risk of coronavirus disease (COVID-19) and the major adverse clinical outcomes of COVID-19 among people with disabilities (PwDs) is scarce.ObjectiveThis study investigated the association of disability status with the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test positivity and the risk of major adverse clinical outcomes among participants who tested positive for SARS-CoV-2.MethodsThis study included all patients (n = 8070) who tested positive for SARS-CoV-2 and individuals without COVID-19 (n = 121,050) in South Korea from January 1 to May 30, 2020. The study variables included officially registered disability status from the government, SARS-CoV-2 test positivity, and major adverse clinical outcomes of COVID-19 (admission to the intensive care unit, invasive ventilation, or death).ResultsThe study participants included 129,120 individuals (including 7261 PwDs), of whom 8070 (6.3%) tested positive for SARS-CoV-2. After adjusting for potential confounding factors, PwDs had an increased risk of SARS-CoV-2 test positivity compared with people without disabilities (odds ratio [OR]: 1.36, 95% confidence interval [CI]: 1.24–1.48). Among participants who tested positive for SARS-CoV-2, PwDs were associated with an increased risk of major adverse clinical outcomes from COVID-19 compared to those without disabilities (OR: 1.43, 95% CI: 1.11–1.86).ConclusionsPwDs had an increased risk of COVID-19 and major adverse clinical outcomes of COVID-19 compared with people without disabilities. Given the higher vulnerability of PwDs to COVID-19, tailored policy and management to protect against the risk of COVID-19 are required.     

New Insights into Potential Beneficial Effects of Bioactive Compounds of Bee Products in Boosting Immunity to Fight COVID-19 Pandemic: Focus on Zinc and Polyphenols

The coronavirus disease 2019 (COVID-19) is an epidemic caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Populations at risk as well as those who can develop serious complications are people with chronic diseases such as diabetes, hypertension, and the elderly. Severe symptoms of SARS-CoV-2 infection are associated with immune failure and dysfunction. The approach of strengthening immunity may be the right choice in order to save lives. This review aimed to provide an overview of current information revealing the importance of bee products in strengthening the immune system against COVID-19. We highlighted the immunomodulatory and the antiviral effects of zinc and polyphenols, which may actively contribute to improving symptoms and preventing complications caused by COVID-19 and can counteract viral infections. Thus, this review will pave the way for conducting advanced experimental research to evaluate zinc and polyphenols-rich bee products to prevent and reduce the severity of COVID-19 symptoms.     

Characteristics of COVID-19 infection clusters occurring among workers in several Asia-Pacific countries

The types of workplaces and occupations with coronavirus 2019 (COVID-19) clusters vary between countries and periods. We aimed to characterize major occupational groups with mass outbreaks of COVID-19 infections in several Asia-Pacific countries. Data on the major occupations or workplaces reporting COVID-19 cases in workplaces from January 2020 to July 2021 was collected from industrial hygiene professionals in nine countries. The proportion of workers accounted for 39.1 to 56.6% of the population in each country. The number of workers covered in the national statistics varies among nations based on their definition of a worker. None of the countries examined here have systematically collected occupational data on COVID-19 illnesses and deaths classified by type of industry, occupation, or job. Most countries experienced COVID-19 clusters among health and social care workers (HSCW) in hospitals or long-term care facilities. The types of occupations or workplaces with virus clusters in some participating countries included prisons, call centers, workplaces employing immigrants, garment facilities, grocery stores, and the military, which differed among countries, except for a few common occupations such as HSCW and those populated by immigrants. Further study is necessary in order to seek ways to control infection risks, including revisions to industrial-health-related laws.     

Considerations for Establishing Successful Coronavirus Disease Vaccination Programs in Africa

The accelerated development of coronavirus disease (COVID-19) candidate vaccines is intended to achieve worldwide immunity. Ensuring COVID-19 vaccination is crucial to stemming the pandemic, reclaiming everyday life, and helping restore economies. However, challenges exist to deploying these vaccines, especially in resource-limited sub-Saharan Africa. In this article, we highlight lessons learned from previous efforts to scale up vaccine distribution and offer considerations for policymakers and key stakeholders to use for successful COVID-19 vaccination rollout in Africa. These considerations range from improving weak infrastructure for managing data and identifying adverse events after immunization to considering financing options for overcoming the logistical challenges of vaccination campaigns and generating demand for vaccine uptake. In addition, providing COVID-19 vaccination can be used to promote the adoption of universal healthcare, especially in sub-Saharan Africa countries.     

Micronutrients Deficiency,Supplementation and Novel Coronavirus Infections—A Systematic Review and Meta-Analysis

Background: Micronutrients play roles in strengthening and maintaining immune function, but their supplementation and/or deficiency effects on respiratory tract infections are inconclusive. This review aims to systematically assess the associations between micronutrient supplementation or deficiency, with novel coronavirus incidence and disease severity. Methods: Systematic literature searches conducted in five electronic databases identified 751 unique studies, of which 33 studies (five supplementation studies, one supplementation and deficiency study, and 27 deficiency studies) were eventually included in this review. Proportions of incidence and severity outcomes in each group, and adjusted summary statistics with their relevant 95% confidence intervaIs (CI) were extracted. Data from 19 studies were pooled in meta-analysis using the generic inverse variance method. Findings: A total of 360,346 patients across 16 countries, with a mean age between 32 and 87.7 years, were involved across 33 studies. All studies were on COVID-19 infections. In individuals without micronutrient deficiency, there was a significant reduction on odds of COVID-19 incidence (pooled OR: 0.37, 95% CI: 0.18, 0.78), and ICU admissions or severe/critical disease onset when combined as a severity outcome (pooled OR: 0.26, 95% CI: 0.08, 0.89). Insignificant protective effects were observed on other outcome measures, namely mortality, ICU admission, progression to respiratory-related complications, severe/critical disease onset or requiring respiratory support and hospitalization rate. Conclusion: The absence of micronutrient deficiency significantly reduced COVID-19 incidence and clinical deterioration in hospitalized patients. Usage of micronutrients as prophylaxis and complementary supplement in therapeutic management of COVID-19 patients may be a promising and cost-effective approach warranting in-depth investigation.     

Mouth shield to minimize airborne transmission risk of COVID-19 and other infectious diseases in the dental office

Transmission of coronavirus disease (COVID-19) and other infectious diseases is a significant risk during dental procedures because most dental interventions involve aerosols or droplets that could contaminate the surrounding environment. Current protection guidelines to address the high risk of droplets, aerosols, and airborne particle transmission of COVID-19 in the dental office recommend minimizing aerosol-generating procedures. In this paper, an innovative mouth shield is presented that should minimize water backsplash from the air-water syringe during dental treatment. The mouth shield can be added to the personal protective equipment to provide the dental team with extra protection. It can be made of different materials, is straightforward, inexpensive, and safe to fabricate, and is easy to use.     

Infection Control Measures and Prevalence of SARS-CoV-2 IgG among 4,554 University Hospital Employees,Munich, Germany

Hospital staff are at high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during the coronavirus disease (COVID-19) pandemic. This cross-sectional study aimed to determine the prevalence of SARS-CoV-2 infection in hospital staff at the University Hospital rechts der Isar in Munich, Germany, and identify modulating factors. Overall seroprevalence of SARS-CoV-2-IgG in 4,554 participants was 2.4%. Staff engaged in direct patient care, including those working in COVID-19 units, had a similar probability of being seropositive as non–patient-facing staff. Increased probability of infection was observed in staff reporting interactions with SARS-CoV-2‒infected coworkers or private contacts or exposure to COVID-19 patients without appropriate personal protective equipment. Analysis of spatiotemporal trajectories identified that distinct hotspots for SARS-CoV-2‒positive staff and patients only partially overlap. Patient-facing work in a healthcare facility during the SARS-CoV-2 pandemic might be safe as long as adequate personal protective equipment is used and infection prevention practices are followed inside and outside the hospital     

新型冠状病毒(SARS-CoV-2)实验室检测策略

由严重急性呼吸综合征冠状病毒-2（SARS-CoV-2）感染引起的2019冠状病毒疾病（COVID-19）为全球性流行病和公共卫生威胁。人们付出了巨大的努力去认识和治疗COVID-19,更可取的是防止感染及临床疾病形成。COVID-19疫苗包括灭活疫苗、腺病毒载体疫苗、mRNA疫苗和亚单位疫苗接种都可诱导绝大多数受试成人产生强体液免疫应答和细胞免疫应答,形成高滴度S蛋白特异性抗体、中和抗体及强Th1细胞因子应答,疫苗对成人COVID-19的保护效力 > 70 %。多个因素会影响疫苗保护效力。     

孕妇新型冠状病毒肺炎及疫苗的流行病学研究进展

新型冠状病毒肺炎（COVID-19）是一种由新型冠状病毒（新冠病毒）引起的急性呼吸道传染性疾病。由于妊娠期间的生理变化,孕妇易感COVID-19,尤其是新冠病毒变异株流行期间,孕妇不良妊娠结局的发生风险可能更高。目前尚缺乏孕妇接种新冠病毒疫苗（新冠疫苗）的随机临床试验证据,各国关于孕妇接种新冠疫苗的推荐存在差异,这给孕妇COVID-19的防控带来了一定挑战。本文回顾了国内外妊娠期感染新冠病毒的重要研究进展,论述了妊娠期患COVID-19对孕妇、胎儿及婴儿的危害,以及真实世界研究中妊娠期接种新冠疫苗的有效性和安全性等,以期为今后开展孕妇相关研究,制定防控措施提供参考。     

Covid 19: Diet Composition and Health

The virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the disease coronavirus disease 2019 (COVID-19). The cumulative number of cases reported globally is now nearly 197 million and the number of cumulative deaths is 4.2 million (26 July to 1 August 2021). Currently we are focusing primarily on keeping a safe distance from others, washing our hands, and wearing masks, and the question of the effects of diet and diet-dependent risk factors remains outside the center of attention. Nevertheless, numerous studies indicate that diet can play an important role in the course of COVID-19. In this paper, based on select scientific reports, we discuss the structure and replication cycle of SARS-CoV-2, risk factors, dietary standards for sick patients, and the roles of the microbiome and dietary components supporting the immune system in preventing COVID-19.     

Priming with social benefit information of vaccination to increase acceptance of COVID-19 vaccines

Vaccine hesitancy can be heightened due to increasing negative reports about vaccines. Emphasizing the social benefits of vaccination may shift individual attention from individual to social benefit of vaccination and hence promote prosocial vaccination. In six rounds of a population-based survey conducted over one major community epidemic of coronavirus disease 2019 (COVID-19) in Hong Kong from June to November 2020, we manipulated the question asking about acceptance of a COVID-19 vaccine with or without emphasizing the social benefit of vaccination against COVID-19 (prosocial priming) and monitored the changes of vaccine confidence by news media sentiment on vaccines. Population-weighted percentages of accepting COVID-19 vaccines by priming condition and vaccine confidence were compared across survey rounds. Logit regression models assessed the main effect of prosocial priming and the modification effects of vaccine confidence and perceived personal risk from COVID-19 on acceptance of COVID-19 vaccines. We found that prosocial priming significantly increased acceptance of COVID-19 vaccines across all survey rounds except for Round 3 when incidence of COVID-19 reached a peak. Vaccine confidence significantly declined in Round 6 when news media sentiment on vaccines became predominantly negative. The effect of prosocial priming on promoting vaccine acceptance was significantly greater in participants with low vaccine confidence and those perceiving the severity of COVID-19 to be mild/very mild. Our study suggests that packaging vaccination against COVID-19 as a prosocial behaviour can help overcome low vaccine confidence and promote prosocial vaccination particularly when disease incidence temporarily declines and the public perceive low severity of COVID-19.     

新型冠状病毒肺炎病人营养中添加谷氨酰胺双肽可行性分析

研究新型冠状病毒肺炎(COVID-19)疫情中,对于感染2019新型冠状病毒(SARS-Co V-2)的病人,是否应该在营养制剂中添加谷氨酰胺双肽。本文通过资料整理、文献回顾,综述了谷氨酰胺双肽的作用,探讨了其对COVID-19的潜在风险和临床获益。得出结论:(1)对于轻中症COVID-19病人,可视病人免疫状态决定是否添加谷氨酰胺。(2)对于COVID-19合并ARDS的病人,若病情稳定且无肝肾功能衰竭,可考虑补充谷氨酰胺。(3)对于重症恢复期的病人,应考虑肠内补充谷氨酰胺。(4)对于儿科病人,目前尚缺乏明确谷氨酰胺补充使病人获益的证据,应谨慎使用。营养制剂中添加谷氨酰胺双肽对COVID-19病人病情的影响需要进一步的临床研究。     

Protecting health during COVID-19 and beyond: A global examination of paid sick leave design in 193 countries*

ABSTRACT

Well-designed paid sick leave is critical to ensure workers stay home when sick to prevent the spread of SARS-CoV-2 and other infectious pathogens, both when the economy is open and during an economic shutdown. To assess whether paid sick leave is available in countries around the world, we created and analysed a database of legislative guarantees of paid leave for personal illness in 193 UN member states. Original labour and social security legislation and global information on social security systems for each country were obtained and analysed by a multilingual research team using a common coding framework. While strong models exist across low- middle- and high-income countries, critical gaps that jeopardise health and economic security remain. 27% of countries do not guarantee paid sick leave from the first day of illness, essential to encouraging workers to stay home when they are sick and prevent spread. 58% of countries do not have explicit provisions to ensure self-employed and gig economy workers have access to paid sick leave benefits. Comprehensive paid sick leave policies that cover all workers are urgently needed if we are to reduce the spread of COVID-19, and be ready to respond to threats from new pathogens.