Objective: We explored whether medical health workers had more psychosocial problems than nonmedical health workers during the COVID-19 outbreak. Methods

The pandemic coronavirus SARS-CoV-2 in the world has caused a large infected population suffering from COVID-19. To curb the spreading of the virus, WHO urgently demanded an extension of screening and testing; thus, a rapid and simple diagnostic method is needed. We applied a reverse transcription-loop-mediated isothermal amplification (RT-LAMP) to achieve the detection of SARS-CoV-2 in 30 min. We designed four sets of LAMP primers (6 primers in each set), targeting the viral RNA of SARS-CoV-2 in the regions of orf1ab, S gene and N gene. A colorimetric change was used to report the results, which enables the outcome of viral RNA amplification to be read by the naked eye without the need of expensive or dedicated instrument. The sensitivity can be 80 copies of viral RNA per ml in a sample. We validated the RT-LAMP method in a hospital in China, employing 16 clinic samples with 8 positives and 8 negatives. The testing results are consistent with the conventional RT-qPCR. In addition, we also show that one-step process without RNA extraction is feasible to achieve RNA amplification directly from a sample. This rapid, simple and sensitive RT-LAMP method paves a way for a large screening at public domain and hospitals, particularly regional hospitals and medical centres in rural areas.

Using interrupted time-series analysis and National Health Insurance data between January 2000 and August 2003, this study assessed the impacts of the severe acute respiratory syndrome (SARS) epidemic on medical service utilization in Taiwan. At the peak of the SARS epidemic, significant reductions in ambulatory care (23.9%), inpatient care (35.2%), and dental care (16.7%) were observed. People's fears of SARS appear to have had strong impacts on access to care. Adverse health outcomes resulting from accessibility barriers posed by the fear of SARS should not be overlooked.

ABSTRACT.Objective. In 1998, an enterovirus 71 (EV71) epidemic in Taiwan was associated with hand, foot, and mouth disease (HFMD)/herpangina and involved 78 fatal cases. We measured EV71 seroprevalence rates before and after the epidemic and investigated risk factors associated with EV71 infection and illness.Methods. Neutralizing antibodies to EV71 were assayed for 539 people before the epidemic and 4619 people of similar ages after the epidemic. Questionnaires, which were completed during household interviews after the epidemic, solicited demographic variables, exposure history, and clinical manifestations.Results. A total of 129 106 cases of HFMD were reported during the epidemic. Age-specific pre-epidemic EV71 seroprevalence rates were inversely related to agespecific periepidemic mortality rates (r ‫؍‬ ؊0.82) or severe case rates (r ‫؍‬ ؊0.93). Higher postepidemic EV71 seropositive rates among children who were younger than 3 years positively correlated with higher mortality rates in different areas (r ‫؍‬ 0.88). After the epidemic, 51 (56%) of 91 younger siblings of elder siblings who were EV71-seropositive were EV71-seropositive; otherwise, 2.2% (4 of 186) of younger siblings were EV71-seropositive (matched odds ratio [OR]: 10; 95% confidence interval [CI]: 3.4 -29). Stepwise multiple logistic regression revealed other factors associated with EV71 infection to be older age (adjusted OR: 2.5; 95% CI: 1.9 -3.4), attendance at kindergartens/child care centers (adjusted OR: 1.8; 95% CI: 1.3-2.5), contact with HFMD/herpangina (adjusted OR: 1.6; 95% CI: 1.2-2.1), greater number of children in a family (adjusted OR: 1.4; 95% CI: 1.1-1.7), and rural residence (adjusted OR: 1.4; 95% CI: 1.2-1.6). Twenty-nine percent of preschool children who were infected with EV71 developed HFMD/herpangina. Younger age and contact with HFMD/herpangina were significant factors for the development of EV71-related HFMD/herpangina in these children.Conclusions. An increased incidence of EV71 infection in young children occurred more often in geographic areas with increased mortality rates. Intrafamilial and kindergarten transmissions among preschool children were major modes of disease transmission during the widespread EV71 epidemic in Taiwan in 1998. Pediatrics 2002;109(6). URL: http://www.pediatrics.org/cgi/content/ full/109/6/e88; enterovirus 71; hand, foot, and mouth disease; seroprevalence; transmission; risk factors; symptomatic ratio; reemerging infectious disease; Taiwan.ABBREVIATIONS. EV71, enterovirus 71; HFMD, hand, foot, and mouth disease; OR, odds ratio; CI, confidence interval; SD, standard deviation. E nterovirus 71 (EV71) has been associated with outbreaks in the United States, Europe, Australia, Japan, Brazil, and Malaysia 1-10 since it was originally recognized in l969 in California. 1 Before 1998, 3 large outbreaks with dozens of fatal cases occurred in Bulgaria in 1975, Hungary in 1978, and Malaysia in 1997 However, few studies have investigated the mode of transmission, the protective effect of preexisting EV71...

In many Asian countries, physicians both prescribe and dispense drugs. This practice is hypothesized to have caused high drug expenditure and widespread prescription of antibiotics in Asia. Recently, Taiwan implemented the separation policy on an experimental basis. This paper's objective is to empirically evaluate the impact of Taiwan's reform to separate drug prescribing and dispensing on drug expenditure and total health expenditure. The research design consists of a pre/post comparison of the experimental with the control sites (difference-in-difference). Separation policy was implemented in Kaohsung and Taipei in March 1997, and expanded to Chia-yi and Taichung in March 1998. Changes in drug prescription behaviour before and after implementation in these two pairs of experimental cities were compared to Hsin-chu and Tainan (control), where separation policy was not implemented during the study period. To reduce resistance, providers in experimental sites were allowed to hire on-site pharmacists and dispense drugs through them if they chose to do so. Our study sample consists of all outpatient visits to clinics in the study sites between December 1996 and June 1998, with a total of 55.23 million claim records. The drug prescription rate, drug expenditure and total health expenditure per visit were the main outcome measures. We found that the probability of prescription and drug expenditure per visit were, respectively, 17-34% and 12-36% less among visits to clinics without on-site pharmacists, compared with the control sites. However, no difference in total health expenditure was found between these two types of visits. Hence, the separation policy could be effective in reducing drug expenditure and affecting prescription behaviour, but is less certain as a policy for reducing total health expenditure. We also found that the policy has practically no effect on clinics that have on-site pharmacists.

Although, theoretically, the impacts of a disaster are not randomly distributed across health and socioeconomic classes, empirical evidence of this claim is scarce. In a population-based cohort study, the authors identified risk factors for mortality from the September 21, 1999, Taiwan earthquake, which occurred in the middle of the night. Among 297,047 earthquake victims in central Taiwan who experienced partial or complete dwelling damage, 295,437 (noncases) survived the earthquake and 1,610 (cases) died between September 21 and October 31, 1999. Odds ratios were adjusted for both micro-level individual variables and macro-level neighborhood variables. People with mental disorders (odds ratio (OR) = 2.0, 95% confidence interval (CI): 1.1, 3.5), people with moderate physical disabilities (OR = 1.7, 95% CI: 1.2, 2.3), and people who had been hospitalized just prior to the earthquake (OR = 1.4, 95% CI: 1.2, 1.7) were the most vulnerable. The degree of vulnerability increased with decreasing monthly wage (measured in New Taiwanese dollars (NT$)) (NT$20,000 approximately NT$39,999: OR = 1.5, 95% CI: 1.1, 2.1;

No abstract

<b><i>Background:</i></b> As the fight against the COVID-19 epidemic continues, medical workers may have allostatic load. <b><i>Objective:</i></b> During the reopening of society, medical and nonmedical workers were compared in terms of allostatic load. <b><i>Methods:</i></b> An online study was performed; 3,590 Chinese subjects were analyzed. Socio-demographic variables, allostatic load, stress, abnormal illness behavior, global well-being, mental status, and social support were assessed. <b><i>Results:</i></b> There was no difference in allostatic load in medical workers compared to nonmedical workers (15.8 vs. 17.8%; <i>p</i> = 0.22). Multivariate conditional logistic regression revealed that anxiety (OR = 1.24; 95% CI 1.18–1.31; <i>p</i> &#x3c; 0.01), depression (OR = 1.23; 95% CI 1.17–1.29; <i>p</i> &#x3c; 0.01), somatization (OR = 1.20; 95% CI 1.14–1.25; <i>p</i> &#x3c; 0.01), hostility (OR = 1.24; 95% CI 1.18–1.30; <i>p</i> &#x3c; 0.01), and abnormal illness behavior (OR = 1.49; 95% CI 1.34–1.66; <i>p</i> &#x3c; 0.01) were positively associated with allostatic load, while objective support (OR = 0.84; 95% CI 0.78–0.89; <i>p</i> &#x3c; 0.01), subjective support (OR = 0.84; 95% CI 0.80–0.88; <i>p</i> &#x3c; 0.01), utilization of support (OR = 0.80; 95% CI 0.72–0.88; <i>p</i> &#x3c; 0.01), social support (OR = 0.90; 95% CI 0.87–0.93; <i>p</i> &#x3c; 0.01), and global well-being (OR = 0.30; 95% CI 0.22–0.41; <i>p</i> &#x3c; 0.01) were negatively associated. <b><i>Conclusions:</i></b> In the post-COVID-19 epidemic time, medical and nonmedical workers had similar allostatic load. Psychological distress and abnormal illness behavior were risk factors for it, while social support could relieve it.