During the first wave of COVID-19, China demonstrated a strong commitment to epidemic prevention and control. This case study focuses on Z University, which adopted closed management when the epidemic was serious, and examines the influence of COVID-19 on students\' psychology and behavior through interviews with 10 students. The research reveals that while students perceive closed management during the epidemic as enhancing safety and promoting learning engagement to some extent, the epidemic also has adverse effects on their physical health, psychology, and social life. These impacts included deteriorating physical health, feelings of rebellion and depression regarding college life, alongside concerns and aspirations regarding future job stability. In the discussion, we suggest that higher education institutions can utilize this information to shape policies and procedures, particularly concerning mental health and risk communication, not only during the current pandemic but also in future emergency or disaster scenarios.

UNASSIGNED: Syndromic surveillance represents a potentially inexpensive supplement to test-based COVID-19 surveillance. By strengthening surveillance of COVID-19-like illness (CLI), targeted and rapid interventions can be facilitated that prevent COVID-19 outbreaks without primary reliance on testing.
UNASSIGNED: This study aims to assess the temporal relationship between confirmed SARS-CoV-2 infections and self-reported and health care provider-reported CLI in university and county settings, respectively.
UNASSIGNED: We collected aggregated COVID-19 testing and symptom reporting surveillance data from Cornell University (2020-2021) and Tompkins County Health Department (2020-2022). We used negative binomial and linear regression models to correlate confirmed COVID-19 case counts and positive test rates with CLI rate time series, lagged COVID-19 cases or rates, and day of the week as independent variables. Optimal lag periods were identified using Granger causality and likelihood ratio tests.
UNASSIGNED: In modeling undergraduate student cases, the CLI rate (P=.003) and rate of exposure to CLI (P<.001) were significantly correlated with the COVID-19 test positivity rate with no lag in the linear models. At the county level, the health care provider-reported CLI rate was significantly correlated with SARS-CoV-2 test positivity with a 3-day lag in both the linear (P<.001) and negative binomial model (P=.005).
UNASSIGNED: The real-time correlation between syndromic surveillance and COVID-19 cases on a university campus suggests symptom reporting is a viable alternative or supplement to COVID-19 surveillance testing. At the county level, syndromic surveillance is also a leading indicator of COVID-19 cases, enabling quick action to reduce transmission. Further research should investigate COVID-19 risk using syndromic surveillance in other settings, such as low-resource settings like low- and middle-income countries.

Global pandemics restrict long-haul mobility and international trade. To restore air traffic, a policy named \"travel bubble\" was implemented during the recent COVID-19 pandemic, which seeks to re-establish air connections among specific countries by permitting unrestricted passenger travel without mandatory quarantine upon arrival. However, travel bubbles are prone to bursting for safety reasons, and how to develop an effective restoration plan through travel bubbles is under-explored. Thus, it is vital to learn from COVID-19 and develop a formal framework for implementing travel bubble therapy for future public health emergencies. This article conducts an analytical investigation of the air travel bubble problem from a network design standpoint. First, a link-based network design problem is established with the goal of minimizing the total infection risk during air travel. Then, based on the relationship between origin-destination pairs and international candidate links, the model is reformulated into a path-based one. A Lagrangian relaxation-based solution framework is proposed to determine the optimal restored international air routes and assign the traffic flow. Finally, computational experiments on both hypothetical data and real-world cases are conducted to examine the algorithm\'s performance. The results demonstrate the effectiveness and efficiency of the proposed model and algorithm. In addition, compared to a benchmark strategy, it is found that the infection risk under the proposed travel bubble strategy can be reduced by up to 45.2%. More importantly, this work provides practical insights into developing pandemic-induced air transport recovery schemes for both policymakers and aviation operations regulators.

UNASSIGNED: This study aims to explore the psychological reactions of medical students during the pandemic.
UNASSIGNED: A qualitative study.
UNASSIGNED: A purposive sampling technique was employed, and a qualitative approach was adopted. Semi-structured questionnaires were utilized, and online interviews were conducted. Forty medical students were selected as participants for the interviews. The interview data were analyzed using Colaizzi\'s seven-step analysis method.
UNASSIGNED: The study identified five themes related to the psychological reactions of medical students during the pandemic. Firstly, COVID-19\'s influence on medical careers was characterized by increased interest and determination in pursuing medical professions, heightened admiration for frontline workers, reinforced commitment to a medical career due to the pandemic, and recognition of the significance of medical education. Secondly, challenges and concerns in medical career pursuit were identified, including negative sentiments towards medical careers during COVID-19 and hesitations and concerns about entering the medical field amidst the pandemic. Thirdly, the impact on mental well-being encompassed diverse anxieties expressed by participants regarding control, transmission, treatment, and intentional spreading of the virus. Participants experienced an emotional progression from calmness to fear and anxiety, with heightened anxiety when relatives or acquaintances contracted COVID-19. Academic delays also contributed to anxiety among medical students. Fourthly, changes in behaviors and mindset were observed, including altered behaviors and mindset in response to the pandemic, as well as increased attention to personal hygiene and disease prevention measures. Lastly, expectations of medical students from government, public, and parents were explored.
UNASSIGNED: Understanding the psychological reactions of medical students during public health emergencies is crucial for their well-being and professional development. The findings have implications for medical education and the development of strategies to enhance the psychological well-being of medical students during similar crises.

BACKGROUND: Various trials are investigating the effect of digital and face-to-face interventions on nurse resilience; however, it remains unclear whether these interventions have immediate, short-term or long-term effects.
OBJECTIVE: The objective of the systematic review is to identify the types of interventions and assess the immediate (<3 months), short-term (3-6 months), and long-term (>6 months) effects of these interventions on nurse resilience.
METHODS: This systematic review was registered in the International Prospective Register of Systematic Reviews (Registered Number: CRD 42023434924), and results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol.
METHODS: Data were collated from the databases of CINAHL, Cochrane Library, Embase (OVID), Medline, and Scopus between March and May 2023. The research protocol was determined following the framework of population, exposure, outcomes, and type of study. The articles with full text published between 2000 and 2023 were included. Studies were included if they (1) involved the nurses who provided patient care directly, (2) utilised digital or face-to-face interventions, (3) reported resilience outcomes, and (4) were randomised controlled trials or clinical trials. The JBI critical appraisal tool was utilised to assess the risk of bias for the studies collected.
RESULTS: A total of 18 studies met the criteria and were analysed. Pooled results demonstrated that digital interventions had a statistically significant positive effect on nurse resilience at 4-5-month follow-ups (standardised mean difference [SMD] = 0.71; 95 % CI = 0.13, 1.29; P = 0.02) compared to no interventions. Additionally, pooled data showed no effect on nurse resilience at all the follow-ups, compared to no interventions. No significant results were observed in comparisons of digital or face-to-face interventions between the intervention and control groups.
CONCLUSIONS: The review assessed digital and face-to-face resilience interventions in nurses across 18 trials. Digital methods showed a short-term impact within 4-5 months, whilst face-to-face interventions had no effect during follow-ups. Realistic expectations, ongoing support, and tailored interventions are crucial for nurse resilience enhancement. Tweetable abstract It was identified digital interventions had a short-term impact on nurse resilience, whilst face-to-face interventions had no effect during follow-ups @fionayyu.

OBJECTIVE: Being front-line healthcare professionals is associated with possible severe information anxiety during the COVID-19 pandemic. Investigating signs of information anxiety is the first and key step of its targeted medical intervention. This study aims to explore the signs of front-line healthcare professionals\' information anxiety during the COVID-19 pandemic.
METHODS: This study is qualitative research. Grounded theory was used to classify information anxiety signs of front-line healthcare professionals.
METHODS: Twenty-four front-line healthcare professionals from a general hospital with over 5000 beds in Wuhan were recruited to participate in semi-structured interviews. According to the frequency and frequency variation of signs appearing in interviews, the trends of signs during the virus encounter, lockdown, flattening and second wave were compared. Based on the interviews, those signs that were conceptually related to each other were extracted to construct a conceptual model.
RESULTS: Psychological signs (emotion, worry, doubt, caution, hope), physical signs (insomnia, inattention, memory loss, appetite decreased) and behavioural signs (panic buying of goods, be at a loss, pay attention to relevant information, change habits) could be generalized from 13 subcategories of information anxiety signs. Psychological signs were the most in every period of the pandemic. Furthermore, psychological signs decreased significantly during lockdown, while behavioural and physical signs increased. Finally, severe psychological and behavioural signs were associated with physical signs.

The globe is an organically linked whole, and in the pandemic era, COVID-19 has brought heavy public safety threats and economic costs to humanity as almost all countries began to pay more attention to taking steps to minimize the risk of harm to society from sudden-onset diseases. It is worth noting that in some low- and middle-income areas, where the environment for epidemic detection is complex, the causative and comorbid factors are numerous, and where public health resources are scarce. It is often more difficult than in other areas to obtain timely and effective detection and control in the event of widespread virus transmission, which, in turn, is a constant threat to local and global public health security. Pandemics are preventable through effective disease surveillance systems, with nonpharmacological interventions (NPIs) as the mainstay of the control system, effectively controlling the spread of epidemics and preventing larger outbreaks. However, current state-of-the-art NPIs are not applicable in low- and middle-income areas and tend to be decentralized and costly. Based on a 3-year case study of SARS-CoV-2 preventive detection in low-income areas in south-central China, we explored a strategic model for enhancing disease detection efficacy in low- and middle-income areas. For the first time, we propose an integrated and comprehensive approach that covers structural, social, and personal strategies to optimize the epidemic surveillance system in low- and middle-income areas. This model can improve the local epidemic detection efficiency, ensure the health care needs of more people, reduce the public health costs in low- and middle-income areas in a coordinated manner, and ensure and strengthen local public health security sustainably.

BACKGROUND: The COVID-19 pandemic had a profound impact on the global health system and economic structure. Although the implementation of lockdown measures achieved notable success in curbing the spread of the pandemic, it concurrently incurred substantial socioeconomic costs.
OBJECTIVE: The objective of this study was to delineate an equilibrium between the economic losses and health benefits of lockdown measures, with the aim of identifying the optimal boundary conditions for implementing these measures at various pandemic phases.
METHODS: This study used a model to estimate the half-lives of the observed case fatality rates of different strains. It was based on global infection and death data collected by the World Health Organization and strain sequence time series data provided by Nextstrain. The connection between the health benefits and economic losses brought by lockdown measures was established through the calculation of disability-adjusted life years. Taking China\'s city lockdowns as an example, this study determined the cost-benefit boundary of various lockdown measures during the evolution of COVID-19.
RESULTS: The study reveals a direct proportionality between economic losses due to lockdowns and the observed case fatality rates of virus strains, a relationship that holds true irrespective of population size or per capita economic output. As SARS-CoV-2 strains evolve and population immunity shifts, there has been a notable decrease in the observed case fatality rate over time, exhibiting a half-life of roughly 8 months. This decline in fatality rates may offset the health benefits of maintaining unchanged lockdown measures, given that the resultant economic losses might exceed the health benefits.
CONCLUSIONS: The initial enforcement of lockdown in Wuhan led to significant health benefits. However, with the decline in the observed case fatality rate of the virus strains, the economic losses increasingly outweighed the health benefits. Consequently, it is essential to consistently refine and enhance lockdown strategies in accordance with the evolving fatality and infection rates of different virus strains, thereby optimizing outcomes in anticipation of future pandemics.

UNASSIGNED: After strict COVID-19-related restrictions were lifted, health systems globally were overwhelmed. Much has been discussed about how health systems could better prepare for future pandemics; however, primary health care (PHC) has been largely ignored.
UNASSIGNED: We aimed to investigate what combined policies PHC could apply to strengthen the health care system via a bottom-up approach, so as to better respond to a public health emergency.
UNASSIGNED: We developed a system dynamics model to replicate Shanghai\'s response when COVID-19-related restrictions were lifted. We then simulated an alternative PHC-based integrated health system and tested the following three interventions: first contact in PHC with telemedicine services, recommendation to secondary care, and return to PHC for recovery.
UNASSIGNED: The simulation results showed that each selected intervention could alleviate hospital overwhelm. Increasing the rate of first contact in PHC with telemedicine increased hospital bed availability by 6% to 12% and reduced the cumulative number of deaths by 35%. More precise recommendations had a limited impact on hospital overwhelm (<1%), but the simulation results showed that underrecommendation (rate: 80%) would result in a 19% increase in cumulative deaths. Increasing the rate of return to PHC from 5% to 20% improved hospital bed availability by 6% to 16% and reduced the cumulative number of deaths by 46%. Moreover, combining all 3 interventions had a multiplier effect; bed availability increased by 683%, and the cumulative number of deaths dropped by 75%.
UNASSIGNED: Rather than focusing on the allocation of medical resources in secondary care, we determined that an optimal PHC-based integrated strategy would be to have a 60% rate of first contact in PHC, a 110% recommendation rate, and a 20% rate of return to PHC. This could increase health system resilience during public health emergencies.

BACKGROUND: Various measures taken against the COVID-19 pandemic are not only effective in reducing the spread of the disease, but also lead to some unexpected results. This article regarded these measures as an intervention and explored their impact on the incidence of tuberculosis in Shantou, China.
METHODS: The incidence rate and the surveillance data of tuberculosis from January 1st, 2018 to December 31st, 2021 were provided by the Shantou Tuberculosis Prevention and Control Institute. Data were divided into pre-pandemic period (January 1st, 2018 - December 31st, 2019) and pandemic periods (January 1st, 2020 - December 31st, 2021). The Interrupted Time Series (ITS) was used to analyze the trend of tuberculosis incidence prior to and during the COVID-19 epidemic.
RESULTS: The results showed that the incidence of tuberculosis cases in Shantou decreased significantly (p < 0.05) during the pandemic as compared to that prior to the pandemic. Among them, the 45-64 age group and the 65 + age group have statistically significant declines. When patients were stratified by occupation, the unemployed and those working in agriculture reduced the most.
CONCLUSIONS: In response to the pandemic, measures like lockdowns and quarantines seem to have reduced tuberculosis incidence. However, this does not imply a true decrease. Underlying causes for the reduced true incidence need further scrutiny. Findings offer a preliminary exploration of interventions designed for one disease but functioning as unexpected results for another.