Background Treatments for coronavirus disease 2019 (COVID-19) are limited by suboptimal efficacy. Methods From January 30, 2020 to March 23, 2020, we conducted a non-randomised controlled trial, in which all adult patients with laboratory-confirmed COVID-19 were assigned to three groups non-randomly and given supportive treatments: Group A, Lopinavir-Ritonavir; Group B,Huashi Baidu Formula(a Chinese medicineformula made by the China Academy of Chinese Medical Sciences to treatCOVID-19, which is now in the clinical trial period) and Lopinavir-Ritonavir; and Group C, Huashi Baidu Formula. The use of antibiotics, antiviruses, and corticosteroids was permitted in Group A and B. Traditional Chinese medicine injections were permitted in Group C. The primary outcomes were clinical remission time (interval from admission to the first time the patient tested negatively for novel coronavirus or an obvious improvement was observed from chest CT) and clinical remission rate (number of patients whose clinical time was within 16 days/total number of patients) Results A total of 60 adult patients with COVID-19 were enrolled at sites in Wuhan, China, and the sample size of each group was 20. In Groups A, B and C, the clinical remission rates were95.0%(19/20), 100.0%(20/20) and 100.0%(20/20), respectively. Compared with Groups A and B, the clinical remission time of Group C was significantly shorter (5.9 days vs. 10.8 days, P < 0.050; 5.9 days vs. 9.7 days, P < 0.050). There was no significant difference among Groups A, B, and C in terms of the time taken to be released from quarantine. The clinical biochemical indicators and safety indexes showed no significant differences among the three groups. Conclusions Our findings suggest that Lopinavir-Ritonavir has some efficacy in the treatment of COVID-19, and the Huashi Baidu Formula might enhance this effect to an extent. In addition, superiority was displayed in the treatment of COVID-19 through a combination of the Huashi Baidu Formula and traditional Chinese medicine injection. In future, well-designed prospective double-blinded randomised control trials are required to confirm our findings.

Objective : To evaluate the efficacy and safety of Hua Shi Bai Du Granule (Q-14) plus standard care compared with standard care alone in adults with coronavirus disease (COVID-19). Study Design : A single-center, open-label, randomized controlled trial. Setting : Wuhan Jinyintan Hospital, Wuhan, China, February 27 to March 27, 2020. Participants : A total of 204 patients with laboratory-confirmed COVID-19 were randomized into the treatment group and control group, consisting of 102 patients in each group. Interventions : In the treatment group, Q-14 was administered at 10 g (granules) twice daily for 14 days, plus standard care. In the control group, patients were provided standard care alone for 14 days. Main Outcome Measure : The primary outcome was the conversion time for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral assay. Adverse events were analyzed in the safety population. Results : Among the 204 patients, 195 were analyzed according to the intention-to-treat principle. A totalof 149 patients (71 vs. 78 in the treatment and control groups, respectively) tested negative via the SARS-CoV-2 viral assay. There was no statistical significance in the conversion time between the treatment group and control group (full analysis set: median (interquartile range): 10.00 (9.00-11.00) vs. 10.00 (9.00-11.00); mean rank: 67.92 vs. 81.44; P=0.051.). The recovery time for fever was shorter in the treatment group than in the control group. The disappearance rate of symptomslike cough, fatigue, and chest discomfort was significantly higher in the treatment group. In chest computed tomography (CT) examinations, the overall evaluation of chest CT examination after treatment compared with baseline showed that more patients showed improvement in the treatment group. There were no significant differences in the other outcomes. Conclusion : The combination of Q-14 and standard care for COVID-19 was useful for the improvement of symptoms (such as fever, cough, fatigue, and chest discomfort), but did not result in a significantly higher probability of negative conversion in the SARS-CoV-2 viral assay. No serious adverse events were observed. Trial Registration : ChiCTR2000030288

Background: Previous research suggested that Chinese Medicine (CM) Formula Huashibaidu granule might shorten the disease course in coronavirus disease 2019 (COVID-19) patients. This research aimed to investigate the early treatment effect of Huashibaidu granule in well-managed patients with mild COVID-19.Methods: An unblinded cluster-randomized clinical trial was conducted at the Dongxihu FangCang hospital. Two cabins were randomly allocated to a CM or control group, with 204 mild COVID-19 participants in each cabin. All participants received conventional treatment over a 7 day period, while the ones in CM group were additionally given Huashibaidu granule 10 g twice daily. Participants were followed up to their clinical endpoint. The primary outcome was worsening symptoms before the clinical endpoint. The secondary outcomes were cure and discharge before the clinical endpoint and alleviation of composite symptoms after the 7 days of treatment.Results: All 408 participants were followed up to their clinical endpoint and included in statistical analysis. Baseline characteristics were comparable between the two groups (P &gt; 0.05). The number of worsening patients in the CM group was 5 (2.5%), and that in the control group was 16 (7.8%) with a significant difference between groups (P = 0.014). Eight foreseeable mild adverse events occurred without statistical difference between groups (P = 0.151).Conclusion: Seven days of early treatment with Huashibaidu granule reduced the likelihood of worsening symptoms in patients with mild COVID-19. Our study supports Huashibaidu granule as an active option for early treatment of mild COVID-19 in similar well-managed medical environments.Clinical Trial Registration:www.chictr.org.cn/showproj.aspx?proj=49408, identifier: ChiCTR2000029763.

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.

The propensity for visiting urban parks is affected by the park’s attractiveness and travel convenience, where walking provides the most basic and fair access. Walking routes from residences to parks, in terms of duration and perception, have received insufficient attention in the literature, particularly in the urban form context in China. Using the case study of Xuanwu Lake Park in Nanjing, we acquire walking routes from residences to the park through open-source data scraping in order to depict the pedestrian shed and pedestrian environment reasonably along these routes. The results show that the walking routes vary significantly with regards to distance, turns, street views, and so on. Proximity to urban parks, in terms of Euclidean distance, does not necessarily correspond to actual route distance, which may have a more direct influence on travel convenience and, hence, visiting propensity. Palpable differences in green visual ratio, image elements, and points of interest along these routes may also contribute to pedestrian environmental disparity. Analyzing data obtained from an online map provides a rapid and objective approach to detect pedestrian sheds and diagnose pedestrian environments, which can facilitate urban planners and policy makers in siting new parks and assessing the service capacity of parks.

OBJECTIVETo evaluate the efficacy and safety of Chinese medicine (Q-14) plus standard care compared with standard care alone in adult with coronavirus disease 2019 (COVID-19).Study DESIGNSingle-center, open label, randomised controlled trial.SETTINGWuhan Jinyintan Hospital, Wuhan, China, February 27 to March 27, 2020.PARTICIPANTS204 patients with laboratory confirmed COVID-19 were randomised in to treatment group and control group, which was 102 patients each group.INTERVENTIONSIn treatment group, Q-14 was administrated at 10g (granules), twice daily for 14 days and plus standard care. In control group, patients were given standard care alone for 14 days.MAIN OUTCOME MEASUREThe primary outcome was conversion time of SARS-CoV-2 viral assay. Adverse events were analyzed in the safety population.RESULTSAmong 204 patients, 195 were analyzed according to the intention to treat principle. There were 149 patients (71 vs. 78 in treatment group and control group respectively) turning to negative via SARS-CoV-2 viral assay. No statistically significance showed in conversion time between treatment group and control group (FAS: Median (IQR): 10.00 (9.00-11.00) vs. 10.00 (9.00-11.00); Mean rank: 67.92 vs. 81.44; P=0.051.). Time to recovery of fever was shorter in treatment group as compared in control group. The disappearance rate of symptom in cough, fatigue, chest discomfort was significantly higher in treatment group. In chest computed tomography (Chest CT) examinations, overall evaluation of chest CT examination after treatment compared with baseline showed more patients improved in treatment group .There were no significant differences in the other outcomes.CONCLUSIONAdministration of Q-14 on standard care for COVID-19 was useful for improvement of symptoms (such as fever, cough, fatigue and chest discomfort), while did not result in a significantly higher probability of negative conversion of SARS-CoV-2 viral assay. No serious adverse events were reported.TRIAL REGISTRATIONChiCTR2000030288

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Active school commuting provides a convenient opportunity to promote physical activity for children, while also reducing car dependence and its associated environmental impacts. School–home distance is a critical factor in school commuting mode choice, and longer distances have been proven to increase the likelihood of driving. In this study, we combine open-access data acquired from Baidu Map application programming interface (API) with GIS (Geographic Information System) technology to estimate the extent to which the present school–home distances can be reduced for public middle schools in Jianye District, Nanjing, China. Based on the policies for school planning and catchment allocation, we conduct a scenario analysis of school catchment reassignment whereby residences are reassigned to the nearest school. The results show that, despite the government’s ‘attending nearby school’ policy, some students in the study area are subjected to excess school–home distances, and the overall journey-to-school trips can be reduced by 20.07%, accounting for 330.8 km. This excess distance indicates the extent to which the need for vehicle travel can be potentially reduced in favor of active school commuting and a low-carbon lifestyle. Therefore, these findings provide important insights into school siting and school catchment assignment policies seeking to facilitate active school commuting, achieve educational spatial equity and reduce car dependence.