China National Health Commission Research Articles

Modeling outbreaks of COVID-19 in China: The impact of vaccination and other control measures on curbing the epidemic

ABSTRACT This study aims to examine the development trend of COVID-19 in China and propose a model to assess the impacts of various prevention and control measures in combating the COVID-19 pandemic. Using COVID-19 cases reported by the National Health Commission of China from January 2, 2020, to January 2, 2022, we established a Susceptible-Exposed-Infected-Asymptomatic-Quarantined-Vaccinated-Hospitalized-Removed (SEIAQVHR) model to calculate the COVID-19 transmission rate and Rt effective reproduction number, and assess prevention and control measures. Additionally, we built a stochastic model to explore the development of the COVID-19 epidemic. We modeled the incidence trends in five outbreaks between 2020 and 2022. Some important features of the COVID-19 epidemic are mirrored in the estimates based on our SEIAQVHR model. Our model indicates that an infected index case entering the community has a 50%–60% chance to cause a COVID-19 outbreak. Wearing masks and getting vaccinated were the most effective measures among all the prevention and control measures. Specifically targeting asymptomatic individuals had no significant impact on the spread of COVID-19. By adjusting prevention and control parameters, we suggest that increasing the rates of effective vaccination and mask-wearing can significantly reduce COVID-19 cases in China. Our stochastic model analysis provides a useful tool for understanding the COVID-19 epidemic in China.

Prediction of cross-border spread of the COVID-19 pandemic: A predictive model for imported cases outside China.

The COVID-19 pandemic has been present globally for more than three years, and cross-border transmission has played an important role in its spread. Currently, most predictions of COVID-19 spread are limited to a country (or a region), and models for cross-border transmission risk assessment remain lacking. Information on imported COVID-19 cases reported from March 2020 to June 2022 was collected from the National Health Commission of China, and COVID-19 epidemic data of the countries of origin of the imported cases were collected on data websites such as WHO and Our World in Data. It is proposed to establish a prediction model suitable for the prevention and control of overseas importation of COVID-19. Firstly, the SIR model was used to fit the epidemic infection status of the countries where the cases were exported, and most of the r2 values of the fitted curves obtained were above 0.75, which indicated that the SIR model could well fit different countries and the infection status of the region. After fitting the epidemic infection status data of overseas exporting countries, on this basis, a SIR-multiple linear regression overseas import risk prediction combination model was established, which can predict the risk of overseas case importation, and the established overseas import risk model overall P <0.05, the adjusted R2 = 0.7, indicating that the SIR-multivariate linear regression overseas import risk prediction combination model can obtain better prediction results. Our model effectively estimates the risk of imported cases of COVID-19 from abroad.

Antimicrobial resistance of clinical bacterial isolates in China: current status and trends.

Antimicrobial resistance surveillance systems have been established in China. Two representative national surveillance networks are the China Antimicrobial Surveillance Network (CHINET) and China Antimicrobial Resistance Surveillance System (CARSS), both of which were established in 2005. For all clinical isolates collected in both of these surveillance networks, the ratio of Gram-negative bacilli to Gram-positive cocci was approximately 7:3 during the past 18 years. Generally, Gram-negative bacilli have a higher antimicrobial resistance profile in China. The prevalence of ESBLs in Escherichia coli is as high as approximately 50%. Acinetobacter baumannii-calcoaceticus complex (ABC) has a high antimicrobial resistance profile, with a carbapenem resistance rate of approximately 66%. However, the prevalence of carbapenem-resistant ABC has also shown a decreasing trend from 2018 to 2022. The prevalence of vancomycin-resistant Enterococcus was low, and the prevalence of MRSA and carbapenem-resistant Pseudomonas aeruginosa showed decreasing trends from 2005 to 2022. CHINET surveillance data demonstrated that the prevalence of carbapenem-resistant Klebsiella pneumoniae showed a remarkable increasing trend from 2.9% (imipenem resistance) in 2005 to 25.0% in 2018, and then slightly decreased to 22.6% in 2022. The decreasing trends may reflect the antimicrobial stewardship efforts in China: a professional consensus on the rational clinical use of carbapenems was issued by the National Health Commission of China and was well implemented nationally; after that, the clinical use of carbapenems decreased slightly in China.

‘Credit Is a Basket’

Abstract In 2019, the National Health Commission of China announced a nation-wide plan to incorporate blood donation into the country's emerging informational infrastructure: the social credit system (SCS). Through analysis of comments from Weibo, one of China's largest social media sites, alongside news articles and official government announcements from the time, we follow the figure of the basket, which we regard as vernacular critique. By analysing the formation of trust indicators, contestations over their commensurability, and the prospect of converting between moral deeds and financial advantage, we aim to augment understandings of the ways that quantification practices are, and become, moral projects.

A comparative analysis of vaccine lists, prices, and candidates, and the national immunization program between China and the United States

Vaccines have an essential role in preventing infectious diseases and reducing the burden of disease. The differences in vaccine lists and prices, and the National Immunization Program (NIP) and vaccine development between China and the United States (US) in conjunction with epidemiologic data on infectious diseases were systematically compared. The epidemiologic data of infectious diseases in 2019 were extracted from the China National Health Commission and the US Centers for Disease Control and Prevention (CDC). The vaccine list was identified from the China National Medical Products Administration and US Food and Drug Administration databases. Vaccine prices were obtained via the China government procurement platform and the US CDC. The NIP vaccines for China and the US were obtained from the China and US CDCs. Vaccine candidates investigated in 2015-2022 were identified from the China Clinical Trial Registry Platform and the US clinicaltrials.gov database. Differences in the incidence of infectious diseases between China and the US were detected with both countries facing a lack of available vaccines for prevention of many diseases. The number of listed vaccines and preventable diseases in China was 59 and 36, respectively, which was higher than the US (45 and 31, respectively). The median price of NIP vaccines in China was significantly lower than the price in the US (median: $3.8 vs. $20; P&lt;0.001); however, there was no significant difference in the price of non-NIP vaccines (median: $68 vs. $86; P=0.498). Vaccines developed by local manufacturers were less expensive than imported products despite the absence of significant differences (median: $16 vs. $31; P=0.180). The number and types of NIP vaccines used to prevent infectious diseases in China were lower than the US. The majority of vaccine candidates in China were not novel compared to the US. Vaccines marketed in China for infectious diseases were comparable to the US. Our findings suggest that China should further expand NIP vaccines and incentive research and development on novel vaccines to improve accessibility based on infectious disease epidemiology.

Factors influencing public engagement in government TikTok during the COVID-19 crisis

PurposeAlthough governments have used social media platforms to interact with the public in an attempt to minimize anxiety and provide a forum for public discussion during the pandemic, governments require sufficient crisis communication skills to engage citizens in taking appropriate action effectively. This study aims to examine how the National Health Commission of China (NHCC) has used TikTok, the leading short video–based platform, to facilitate public engagement during COVID-19.Design/methodology/approachBuilding upon dual process theories, this study integrates the activation of information exposure, prosocial interaction theory and social sharing of emotion theory to explore how public engagement is related to message sensation value (MSV), media character, content theme and emotional valence. A total of 354 TikTok videos posted by NHCC were collected during the pandemic to explore the determinants of public engagement in crises.FindingsThe findings demonstrate that MSV negatively predicts public engagement with government TikTok, but that instructional information increases engagement. The presence of celebrities and health-care professionals negatively affects public engagement with government TikTok accounts. In addition, emotional valence serves a moderating role between MSV, media characters and public engagement.Originality/valueGovernment agencies must be fully aware of the different combinations of MSV and emotion use in the video title when releasing crisis-related videos. Government agencies can also leverage media characters – health professionals in particular – to enhance public engagement. Government agencies are encouraged to solicit public demand for the specific content of instructing information through data mining techniques.

Expert consensus on the management of interstitial lung disease during the COVID-19 epidemic

Expert consensus on the management of interstitial lung disease during the COVID-19 epidemic

PP132 Health Technology Assessment Agencies’ Expectations Regarding Patient Experience Data in Australia, China, And Japan

IntroductionHealth technology assessment (HTA) agencies are increasingly embracing patient experience data (PED) to support reimbursement decisions. This study aimed to review HTA agencies’ expectations with regards to utilizing PED to support drug reimbursement in Australia, Japan, and China.MethodsPublished HTA guidance documents were reviewed in 2021 to identify any PED-specific information. If available, recommendations related to the type of PED (e.g., generic vs. disease-specific clinical outcomes assessment (COA)); COA validation, analyses, endpoints and interpretation; and the interest in PED beyond COA in HTA decision-making (e.g., patient preference information) were reviewed. Literature review and semi-structured interviews with key opinion leaders (KOLs) were conducted to further explore these themes and future trends with regards to PED.ResultsAustralia’s Pharmaceutical Benefits Advisory Committee guidance document includes a dedicated section on patient-reported outcomes (PRO), providing details on preferred PRO instruments; validation expectations; and recommended methods to explore score interpretation, assess and report PRO results and handle missing data. While PED derived from non-PRO sources are not discussed in the guidance, the KOL noted that they should not be ruled out. Japan’s Center for Outcomes Research and Economic Evaluation for Health guideline includes a section dedicated to PROs without details related to instrument validation, analyses and interpretation, however, is focused on the use of PRO to inform health economic assessments. In China, the HTA center of China National Health Commission drafted two disease-specific technical guidance documents recommending the inclusion of PROs in efficacy assessments and use of instruments relevant in the Chinese population; these points were echoed by the KOL interviewed.ConclusionsThere are recommendations on PED use included in country-specific guidance documents, however their level of detail varies greatly. Knowing each agency’s expectations with regards to PED is key when submitting HTA evidence dossiers and should be considered early in clinical trial design to integrate market access perspectives and optimize drug development.

Release and impact of China's "Second List of Rare Diseases".

On September 18, 2023, the National Health Commission of China officially announced the "Second List of Rare Diseases". This list of 86 rare diseases, drafted in accordance with the "Working Procedures for Drafting the List of Rare Diseases", marks the second release of a rare disease list since the initial list was issued in May 2018. Following the release of the first batch, the Chinese Government introduced various policies to enhance the diagnosis and treatment of rare diseases, to promote the research on, development of, production of, and availability of rare disease medications in China, and to improve medication access for patients with rare diseases. Consequently, this has elevated the level of rare disease diagnosis and treatment, ensuring greater accessibility to treatment for affected individuals. The expansion of the rare disease list through the release of the "Second List of Rare Diseases" will further enhance rare disease management, increase awareness, improve diagnosis and treatment, facilitate the development and availability of more rare disease medications, establish a comprehensive support system for patients with rare diseases, and ultimately benefit a larger number of individuals affected by rare diseases. The definition of rare diseases in China should be refined by explicitly establishing corresponding criteria based on incidence, prevalence, or the number of affected individuals. Additionally, the mechanism for removal of diseases from rare disease lists should be enhanced, and prompt adjustments should be made regarding diseases that do not align with the selection principles of the list, taking into consideration environmental changes.

The impacts of meteorological factors on the incidence of hand, foot, and mouth disease in China: An interactive perspective

Hand, foot, and mouth disease (HFMD) is a contagious illness and a matter of public health concern globally. It has a widespread impact in China, where it poses a significant risk to the health of young children. Previous research has discovered that the occurrence and spread of HFMD are closely linked to meteorological factors, but the specifics of these intricate nonlinear relationships and how they interact with the incidence of HFMD are still uncertain. In the present study, we filled this gap in knowledge by first obtaining data on hand, foot, and mouth disease from the National Health Commission of China alongside real-time surveillance data from meteorological stations. We then used Spearman's correlation analysis to identify the variables significantly related to HFMD, investigating the existence of co-curvilinearity among the contributing factors by using the independent effects model in the generalized additive model to analyze both the contribution of individual factors and their combined effects on the incidence of HFMD. The interactions between meteorological factors were then modeled to investigate their influence on HFMD. The results showed that, in descending order of effect size, air temperature (AT), sunshine duration (SD), wind speed (WS), and barometric pressure (BP) had a significant nonlinear impact on the incidence of HFMD, which displayed a fluctuating increase in line with rising temperatures. The interactions of (1) high temperature and low air pressure and (2) low wind speed and poor sunshine had the largest influence on HFMD. In descending order, the strengths of the interaction effects between factors were as follows: AT ∼ SD > AT ∼ WS > AT ∼ BP > WS ∼ BP > WS ∼ SD > BP ∼ SD. Our findings will inform policy initiatives contributing to the Healthy China strategy and assist in the prevention and control of HFMD by enabling the prediction and early warning of disease outbreaks.

Associations of long-term fine particulate matter exposure with all-cause and cause-specific mortality: results from the ChinaHEART project

The chronic effects of fine particulate matter (PM2.5) at high concentrations remains uncertain. We aimed to examine the relationship of long-term PM2.5 exposure with all-cause and the top three causes of death (cardiovascular disease [CVD], cancer, and respiratory disease), and to analyze their concentration-response functions over a wide range of concentrations. We enrolled community residents aged 35-75 years from 2014 to 2017 from all 31 provinces of the Chinese Mainland, and followed them up until 2021. We used a long-term estimation dataset for both PM2.5 and O3 concentrations with a high spatiotemporal resolution to assess the individual exposure, and used Cox proportional hazards models to estimate the associations between PM2.5 and mortalities. We included 1,910,923 participants, whose mean age was 55.6±9.8 years and 59.4% were female. A 10μg/m3 increment in PM2.5 exposure was associated with increased risk for all-cause death (hazard ratio 1.02 [95% confidence interval 1.012-1.028]), CVD death (1.024 [1.011-1.037]), cancer death (1.037 [1.023-1.052]), and respiratory disease death (1.083 [1.049-1.117]), respectively. Long-term PM2.5 exposure nonlinearly related with all-cause, CVD, and cancer mortalities, while linearly related with respiratory disease mortality. The overall effects of long-term PM2.5 exposure on mortality in the high concentration settings are weaker than previous reports from settings of PM2.5 concentrations < 35μg/m³. The distinct concentration-response relationships of CVD, cancer, and respiratory disease mortalities could facilitate targeted public health efforts to prevent death caused by air pollution. The Chinese Academy of Medical Sciences Innovation Fund for Medical Science, the National High Level Hospital Clinical Research Funding, the Ministry of Finance of China and National Health Commission of China, the 111 Project from the Ministry of Education of China.

Novel herbal beverage ameliorates exercise-induced fatigue in mice by modulating oxidative stress and reshaping the gut microbiota

With the demands of enhancing exercise performance, dietary supplements are widely used in the health management of athletes and who engaged in strenuous exercise. Based on the list of edible and medicinal materials approved by China's National Health Commission, we composed an herbal beverage formula named SRB, initially identified its chemical composition, and clarified its preventive effect on exercise-induced fatigue (EIF). SRB supplementation for four weeks significantly enhanced exercise performance in mice, as reflected by exhaustive swimming test and treadmill exercise test. In mice that underwent one single exhaustive exercise, SRB supplementation markedly reduced metabolite accumulation, increased glycogen contents in the liver and muscle, promoted anti-oxidative enzyme activities, decreased hepatic malondialdehyde (MDA) level, and protected quadriceps femoris morphology, respectively. Anti-oxidative stress effect of SRB may be relevant with increased gene expressions of nuclear factor-erythroid 2-related factor 2 (Nrf2) and antioxidant response element (ARE)-dependent gene. Moreover, SRB treatment altered gut bacterial community structure, e.g., increased the relative abundance of short-chain fatty acids (SCFAs)-producing bacteria and decreased the relative abundance of sulfate-reducing bacteria. Altogether, we identified SRB as an effective anti-EIF dietary supplement with prebiotic effects in C57BL/6 mice.

Association of high-density lipoprotein cholesterol with all-cause and cause-specific mortality in a Chinese population of 3.3 million adults: a prospective cohort study

High-density lipoprotein cholesterol (HDL-C) has been inversely associated with cardiovascular disease (CVD) risk, but recent evidence suggests that extremely high levels of HDL-C are paradoxically related to increased CVD incidence and mortality. This study aimed to comprehensively examine the associations of HDL-C with all-cause and cause-specific mortality in a Chinese population. The China Health Evaluation And risk Reduction through nationwide Teamwork (ChinaHEART) project included 3,397,547 participants aged 35-75 years with a median follow-up of 3.9 years. Baseline HDL-C levels were measured, and mortality data was ascertained from the National Mortality Surveillance System and Vital Registration of Chinese Center for Disease Control and Prevention. This study found U-shaped associations of HDL-C with all-cause, cardiovascular and cancer mortality. When compared with the groups with the lowest risk, the adjusted hazard ratios (95% CIs) for HDL-C<30mg/dL was 1.23 (1.17-1.29), 1.33 (1.23-1.45) and 1.18 (1.09-1.28) for all-cause, CVD and cancer mortality, respectively. For HDL-C >90mg/dL, the corresponding HR (95% CIs) was 1.10 (1.05-1.15), 1.09 (1.01-1.18) and 1.11 (1.03-1.19). Similar U-shaped patterns were also found in associations of HDL-C with ischemic heart disease, ischemic stroke, and liver cancer. About 3.25% of all-cause mortality could be attributed to abnormal levels of HDL-C. The major contributor to mortality was ischemic heart disease (16.06 deaths per 100,000 persons, 95% UI: 10.30-22.67) for HDL-C<40mg/dL and esophageal cancer (2.29 deaths per 100,000 persons, 95% UI: 0.57-4.77) for HDL-C >70mg/dL. Both low and high HDL-C were associated with increased mortality risk. We recommended 50-79mg/dL as the optimal range of HDL-C among Chinese adults. Individuals with dyslipidemia might benefit from proper management of both low and high HDL-C. The CAMS Innovation Fund for Medical Science (2021-1-I2M-011), the National High Level Hospital Clinical Research Funding (2022-GSP-GG-4), the Ministry of Finance of China and National Health Commission of China, and the 111 Project from the Ministry of Education of China (B16005), the Program for Guangdong Introducing Innovative and Enterpreneurial Teams (2019ZT08Y481), Sanming Project of Medicine in Shenzhen (SZSM201811096), the Young Talent Program of the Academician Fund, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen (YS-2022-006) and Guangdong Basic and Applied Basic Research Foundation (2023A1515010076 & 2021A1515220173).

Analysis of Herbal Medicine in the Clinical Guidelines of Korea and China for COVID-19

COVID-19 is an acute infectious disease caused by SARS-CoV-2 that has infected more than 700 million people around the world and left many deaths. In Korea and China, Korean medicine and Traditional Chinese Medicine were used to treat COVID-19, and the key element between them was herbal medicine. Clinical guidelines for herbal medicine have been published in Korea and China. In this review, the Korean and Chinese guidelines were compared and analyzed. This review was based on the latest revised clinical guidelines. The Korean guidelines covered all three guidelines published by The Association of Korean Medicine and The KM Professor Council of Internal Medicine of the Respiratory System. The Chinese guideline was published by the China National Health Commission. Based on research trends, a comprehensive comparison was made of the suggested prescriptions for each severity of COVID-19. It is expected that this review will be used as a reference for the treatment of COVID-19 or new infectious diseases in the future.

The possibility of automatic capillary blood testing in routine blood tests: an evaluation of the automatic mode of the Mindray BC-7500 CRP Auto Hematology Analyzer for capillary blood testing.

Capillary blood is a common specimen type used for infant blood routine tests. Until now, this specimen type could only be tested with the manual mode in hematology analyzers. Manual sample mixing and loading increases the amount labor force and can be more easily affected by human factors. This study was designed to investigate the proficiency of the automatic mode of the Mindray BC-7500 CRP Auto Hematology Analyzer for capillary blood testing. The complete blood count (CBC) results for capillary blood were compared between the automatic and manual modes. Special types of samples, including samples with high or low volume, thalassemia red cells, high fibrinogen, high hematocrit (HCT), or high triglyceride levels, were compared and evaluated. The intraclass correlation coefficient (ICC) was used to define the agreement between the 2 modes. The industry standard Analytical Quality Specifications for Routine Tests in Clinical Hematology (WS/T 406-2012), published by the National Health Commission of China, was used to evaluate the correlation between the results from the 2 modes. There was good correlation between the automatic and manual modes for every type of sample, and the ICCs were all higher than 0.9. Except for high HCT or high triglyceride samples, there were no differences found between the 2 modes based on the WS/T 406-2012 standard. This new automatic mode utilized in the Mindray BC-7500 CRP Auto Hematology Analyzer for capillary blood yielded the same results as the manual mode except in the case of samples with high HCT or triglycerides. Capillary blood might be routinely tested automatically with hematology analyzers in the near future, which might reduce the labor required and improve standardization.

Evolution and major changes of the diagnosis and treatment protocol for COVID‐19 patients in China 2020–2023

AbstractSince the identification of the first case of pneumonia of unknown cause in 2019, the COVID‐19 pandemic has spread the globe for over 3 years. As the most populous country in the world, China's disease prevention policies and response plans concern the health of the country's 1.4 billion people and beyond. During the course of the pandemic, scientific research has been accumulated and given evidence‐based support to the official guidance of COVID‐19 management. The National Health Commission of China have compiled, published, and updated a total of 10 versions of the “Diagnosis and Treatment Protocol for COVID‐19 Patients” to better inform clinical practitioners and staff to effectively screen, diagnose, manage, treat, and care for cases of severe acute respiratory syndrome coronavirus 2 infection. This paper compares and summarizes each version of the protocol in terms of etiology and epidemiology, clinical manifestation and diagnosis, treatment and nursing, disease control and management, presenting detailed changes, additions, deletions, and refinement of the protocols.

The impact of COVID-19 lockdown on cases and deaths of AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C in China: an interrupted time series analysis.

China has implemented nationwide lockdown to contain COVID-19 from an early stage. Previous studies of the impact of COVID-19 on sexually transmitted diseases (STDs) and diseases caused by blood-borne viruses (BBVs) in China have yielded widely disparate results, and study on deaths attributable to STDs and BBVs are scarce. We aimed to elucidate the impact of COVID-19 lockdown on the cases, deaths, and case-fatality ratios of STDs and BBVs. We extracted the monthly cases and deaths data for AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C between January 2015 and December 2021 from the notifiable disease reporting database on the official website of the National Health Commission of China. We used descriptive statistics to summarize the number of cases and deaths, and calculated incidence and case-fatality ratios before and after implementing nationwide lockdown (January 2020). We used negative binominal segmented regression models to estimate the immediate and long-term impacts of lockdown on cases, deaths, and case-fatality ratios in January 2020 and December 2021, respectively. A total of 14,800,330 cases and 127,030 deaths of AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C were reported from January 2015 to December 2021, with an incidence of 149.11/100,000 before lockdown and 151.41/100,000 after lockdown , and a case-fatality ratio of 8.21/1000 before lockdown and 9.50/1000 after lockdown . In the negative binominal model, AIDS cases (-23.4%; 0.766, 0.626-0.939) and deaths (-23.9%; 0.761, 0.647-0.896), gonorrhea cases (-34.3%; 0.657, 0.524-0.823), syphilis cases (-15.4%; 0.846, 0.763-0.937), hepatitis B cases (-17.5%; 0.825, 0.726-0.937) and hepatitis C cases (-19.6%; 0.804, 0.693-0.933) showed significant decreases in January 2020. Gonorrhea, syphilis and hepatitis C showed small increases in the number of deaths or case-fatality ratios in January 2020. By December 2021, the cases, deaths, and case-fatality ratios for each disease had either reached or remained below expected levels. COVID-19 lockdown may have contributed to fewer reported cases of AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C, and more reported deaths or case-fatality ratios of gonorrhea, syphilis and hepatitis C in China.

Status of and perspectives on COVID-19 vaccination after lifting of the dynamic zero-COVID policy in China.

On December 7, 2022, China's National Health Commission issued the Ten New Covid Rules lifting the dynamic zero-COVID policy. In the interim, vaccination campaigns continue to be promoted. We assessed the potential impacts on the status, perceptions, and attitudes toward COVID-19 vaccines via an online self-administered questionnaire. Among 1,170 participants, 1,142 (97.6%) participants were vaccinated against COVID-19, and 51.8% (591/1,142) have already received the booster. More than half of the participants who were vaccinated were ages 31 to 50 (51.8%). Participants believed the following strategies could improve the vaccination rate: timely feedback of the vaccination data (such as safety, efficacy, and other issues of public concern) from authoritative media (95.6%), increasing the number of vaccination sites and availability of vaccines and using more convenient methods of making appointment (95.2%), recommendations from friends and relatives (94.8%), and presenting the qualifications of the staff performing vaccination (89.1%). More measures, including targeted measures for different age groups and timely feedback on the vaccination data including safety and efficacy from authoritative media, are likely to help improve vaccination rates.

Unlocking Opportunities for Migrant Workers in China: Analyzing the Impact of Health Insurance on Hukou Switching Intentions

The Chinese urban–rural binary health insurance structure has contributed to a significant urban–rural segmentation and regional fragmentation, which will affect labor mobilization and urbanization. The purpose of this research is to study whether and how urban–rural binary health insurance impacts the intentions of migrant workers to switch between rural and urban hukou. Pooled data were drawn from China Migrants Dynamic Survey, collected by the National Health Commission of China. The study applied the instrument variable model due to the existence of the endogeneity; and the IVprobit model to conduct the empirical analysis. Our findings are as follows: (1) the urban–rural binary health insurance affects migrant workers’ intentions to switch to urban hukou significantly. (2) The negative impact of originally rural health insurance on migrant workers’ intention of switching to urban hukou is relatively large for low-education-level migrant workers. (3) Compared with new generation of migrant workers, old migrant workers have higher health insurance dependency levels. Finally, our research suggested several policy implications, such as accelerating the establishment of a unified urban–rural health insurance system, increasing the urban health insurance participation rate of migrant workers in their working cities, and including migrant workers in the scope of equal access to urban public services, etc. All the policy suggestions are essential in order to accelerate the citizenization of migrant workers, improve the quality of urbanization, and promote the construction of a unified national labor market.

Prevalence of taste and smell dysfunction in mild and asymptomatic COVID-19 patients during Omicron prevalent period in Shanghai, China: a cross-sectional survey study

ObjectivesCOVID-19, which is caused by SARS-CoV-2, is a severe threat to human health and the economy globally. This study aimed to investigate the prevalence of taste and/or smell dysfunction and...