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In December 2019, the coronavirus disease 2019 (COVID-19) pandemic attacked Wuhan, China. The city government soon strictly locked down the city, implemented a hierarchical diagnosis and treatment system, and took a series of unprecedented pharmaceutical and non-pharmaceutical measures. The residents’ access to the medical resources and the consequently potential demand–supply tension may determine effective diagnosis and treatment, for which travel distance and time are key indicators. Using the Application Programming Interface (API) of Baidu Map, we estimated the travel distance and time from communities to the medical facilities capable of treating COVID-19 patients, and we identified the service areas of those facilities as well. The results showed significant differences in service areas and potential loading across medical facilities. The accessibility of medical facilities in the peripheral areas was inferior to those in the central areas; there was spatial inequality of medical resources within and across districts; the amount of community healthcare centers was insufficient; some communities were underserved regarding walking distance; some medical facilities could be potentially overloaded. This study provides reference, in the context of Wuhan, for understanding the spatial aspect of medical resources and residents’ relevant mobility under the emergency regulation, and re-examining the coordination of emergency to improve future planning and utilization of medical facilities at various levels. The approach can facilitate policymakers to assess potential loading of medical facilities, identify low-accessibility areas, and deploy new medical facilities. It also implies that the accessibility analysis can be rapid and relevant even only with open-source data.

Objective The remarkable success of iodine deficiency disorders (IDD) elimination in China has been achieved through a mandatory universal salt iodization (USI) program. The study aims to estimate the relationship between urinary iodine concentration (UIC) and iodine content in edible salt to assess the current iodine nutritional status of school aged children. Methods A total of 5565 students from 26 of 39 districts/counties in Chongqing participated in the study, UIC and iodine content in table salt were measured. Thyroid volumes of 3311 students were examined by ultrasound and goiter prevalence was calculated. Results The overall median UIC of students was 222 μg/L (IQR: 150-313 μg/L). Median UIC was significantly different among groups with non-iodized salt (iodine content <5 mg/kg), inadequately iodized salt (between 5 and 21 mg/kg), adequately iodized (between 21 and 39 mg/kg) and excessively iodized (>39 mg/kg) salt (P < 0.01). The total goiter rate was 1.9% (60/3111) and 6.0% (186/3111) according to Chinese national and WHO reference values, respectively. Thyroid volume and goiter prevalence were not different within the three iodine nutritional status groups (insufficient, adequate and excessive, P > 0.05). Conclusions The efficient implementation of current USI program is able to reduce the goiter prevalence in Chongqing as a low incidence of goiter in school aged children is observed in this study. The widened UIC range of 100–299 μg/L indicating sufficient iodine intake is considered safe with a slim chance of causing goiter or thyroid dysfunction. Further researches were needed to evaluate the applicability of WHO reference in goiter diagnose in Chongqing or identifying more accurate criteria of normal thyroid volume of local students in the future.

A novel pneumonia-like coronavirus disease (COVID-19) caused by a novel coronavirus named SARS-CoV-2 has swept across China and the world. Public health measures that were effective in previous infection outbreaks (eg, wearing a face mask, quarantining) were implemented in this outbreak. Available multidimensional social network data that take advantage of the recent rapid development of information and communication technologies allow for an exploration of disease spread and control via a modernized epidemiological approach. By using spatiotemporal data and real-time information, we can provide more accurate estimates of disease spread patterns related to human activities and enable more efficient responses to the outbreak. Two real cases during the COVID-19 outbreak demonstrated the application of emerging technologies and digital data in monitoring human movements related to disease spread. Although the ethical issues related to using digital epidemiology are still under debate, the cases reported in this article may enable the identification of more effective public health measures, as well as future applications of such digitally directed epidemiological approaches in controlling infectious disease outbreaks, which offer an alternative and modern outlook on addressing the long-standing challenges in population health.

Objective:To investigate whether implementation of a universal salt iodization (USI) programme has sufficient effects on pregnant women in Chongqing, the present study evaluated the iodine nutritional status of pregnant women living in Chongqing by spot urinary iodine concentration (UIC), to provide scientific suggestions to better meet the specific iodine needs of this vulnerable group.Design:Cross-sectional design.Setting:A random spot urine sample and household table salt sample were provided by each participant.Participants:A total of 2607 pregnant women from twenty-six of thirty-nine districts/counties in Chongqing participated.Results:The overall median UIC of pregnant women was 171·80 μg/l (interquartile range (IQR) = 113·85–247·00 μg/l) and 40·97 % (n 1057) of participants were iodine insufficient. The median iodine in table salt samples was 25·40 mg/kg (IQR = 23·10–28·30 mg/kg); 93·26 % (n 2406) of samples examined were found to be adequately iodized. Iodine nutritional status was not significantly different according to table salt iodization category. Trimester was identified to be statistically associated with UIC (P < 0·01). Seven districts/counties had median UIC below 150 μg/l and one district had median UIC of 277·40 μg/l.Conclusions:The USI programme in Chongqing prevents iodine deficiency generally, but does not maintain iodine status within adequate and recommended ranges throughout pregnancy. Usage of non-iodized or unqualified iodized salt and the slight change of dietary habits of iodized salt in Chongqing may present a substantial challenge to fight iodine-deficiency disorders; more efforts are needed to ensure adequate iodine intake during pregnancy besides the USI programme.

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