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      COVID-19 prevention and control strategies: learning from the Macau model

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          Abstract

          Background: Macau is a densely populated international tourist city. Compared to most tensely populated countries/territories, the prevalence and mortality of COVID-19 in Macau are lower. The experiences in Macau could be helpful for other areas to combat the COVID-19 pandemic. This article introduced the endeavours and achievements of Macau in combatting the COVID-19 pandemic.

          Method: Both qualitative and quantitative analysis methods were used to explore the work, measures, and achievements of Macau in dealing with the COVID-19 pandemic.

          Results: The results revealed that Macau has provided undifferentiated mask purchase reservation services, COVID-19 vaccination services to all residents and non-residents in Macau along with delivering multilingual services, in Chinese, English and Portuguese, to different groups of the population. To facilitate the travels of people, business and trades between Macau and mainland China, the Macau government launched the Macau Health Code System, which uses the health status declaration, residence history declaration, contact history declaration of the declarant to match various relevant backend databases within the health authority and provide a risk-related colour code operations. The Macau Health Code System connects to the Chinese mainland's own propriety health code system seamlessly, whilst effectively protecting the privacy of the residents. Macau has also developed the COVID-19 Vaccination Appointment system, the Nucleic Acid Test Appointment system, the Port and Entry/Exit Quarantine system, the medical and other supporting systems.

          Conclusion: The efforts in Macau have achieved remarkable results in COVID-19 prevention and control, effectively safeguarding the lives and health of the people and manifesting the core principle of “serving the public”. The measures used are sustainable and can serve as an important reference for other countries/regions.

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          Evaluation of SARS-CoV-2 RNA shedding in clinical specimens and clinical characteristics of 10 patients with COVID-19 in Macau

          As a city famous for tourism, the public healthcare system of Macau SAR has been under great pressure during the outbreak of the Coronavirus Disease 2019 (COVID-19). In this study, we report clinical and microbiological features of ten COVID-19 patients enrolled in the Centro Hospitalar Conde de São Januário (CHCSJ) between January 21 to February 16, 2020. Clinical samples from all patients including nasopharyngeal swab (NPS)/sputum, urine, and feces were collected for serial virus RNA testing by standard qRT-PCR assay. In total, seven were imported cases and three were local cases. The median duration from Macau arrival to admission in imported cases was 3 days. Four patients required oxygen therapy but none of them needed machinal ventilation. No fatal cases were noted. The most common symptoms were fever (80%) and diarrhea (80%). In the "Severe" group, there was significantly more elderly patients (p=0.045), higher lactate dehydrogenase levels (p=0.002), and elevated C-Reactive protein levels compared to the "Mild to Moderate" group (p<0.001). There were positive SARS-CoV-2 RNA signals in all patients' NPS and stool specimens but negative in all urine specimens. Based on our data on SARS-CoV-2 RNA shedding in stool and the possibility of a lag in viral detection in NPS specimens, the assessment of both fecal and respiratory specimen is recommended to enhance diagnostic sensitivity, and also to aid discharge decision before the role of viral RNA shedding in stool is clarified.
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            Physical Distancing, Face Masks, and Eye Protection to Prevent Person-to-Person Transmission of SARS-CoV-2 and COVID-19: A Systematic Review and Meta-Analysis

            Study design Systematic review and meta-analysis of 21 standard World Health Organization-specific and COVID-19-specific sources through May 3, 2020. Key findings In a review of 25,697 patients, transmission of viruses was lower with physical distancing of 1 meter or more compared with less than 1 meter. Protection was increased as distance was lengthened (absolute risk, 3% with longer distance vs 13% with shorter distance). Face mask use could result in a large reduction in risk of interaction (adjusted risk, 3% with face masks vs 17% without). There was a stronger association with protection using N95 masks compared with disposable surgical masks or reusable cotton masks. Eye protection also was associated with less infection. Conclusion These findings support physical distancing of 1 meter or more. Optimum use of face masks and eye protection in public and health care settings should be informed by these findings. Commentary Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person to person through close contact. With no effective pharmacologic interventions or vaccine expected in the near future, reducing the rate of infection (flattening the curve) is a priority. Added benefits are likely with even larger physical distances, such as 2 meters (6 feet, which we keep hearing about) or more. The use of face masks, including N95 and surgical or similar masks (12- to 16-layer cotton or gauze masks), and eye protection is clearly beneficial. For the general public, this report confirms previous recommendations that physical distancing of more than 1 meter is highly effective and that face masks are associated with protection. Other basic measures, such as hand hygiene, are still needed. I am growing more disheartened by my fellow man (and woman) as things open up during the pandemic. This past weekend, I went to a barbecue outside of Philadelphia, which was attended by many physicians, and to my older brother’s outdoor 70th birthday party in northern New Jersey, which was especially hard-hit by the virus. At both events, none of the guests wore masks but would sidle up to my wife, my son, and me as if everything were normal. I can think of four reasons that people would not follow recommendations such as maintaining at least 3- to 6-foot distancing and wearing face masks: (1) they know they don’t have the virus (even without being tested); (2) they know they won’t get sick because they’re young, or they’re older but otherwise healthy; (3) they don’t believe the science (I don’t have patience for these people); or (4) they believe we are all going to get the virus anyway, so get it over with and let’s move on (I know very intelligent people who support this last reason). I don’t want to tread political waters, but I wish these individuals would acknowledge there may be others who don’t agree with this laissez-faire reasoning. Some people may want to maintain social distancing at an outdoor event—and maybe even wear a face mask.
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              Author and article information

              Journal
              Int J Biol Sci
              Int J Biol Sci
              ijbs
              International Journal of Biological Sciences
              Ivyspring International Publisher (Sydney )
              1449-2288
              2022
              21 August 2022
              : 18
              : 14
              : 5317-5328
              Affiliations
              [1 ]The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
              [2 ]Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau SAR, China.
              [3 ]Centre for Cognitive and Brain Sciences, University of Macau, Macau SAR, China.
              [4 ]Department of Public Health and Medicinal Administration, Institute of Chinese Medical Sciences, University of Macau, Macau SAR, China.
              [5 ]Faculty of Law, University of Macau, Macau SAR, China.
              [6 ]Faculty of Science and Technology, University of Macau, Macau SAR, China.
              [7 ]United Nations University Institute in Macau, Macau SAR, China.
              Author notes
              ✉ Corresponding authors: Dr. Yu-Tao Xiang, 1/F, Building E12, Faculty of Health Sciences, University of Macau, Avenida da Universidade, Taipa, Macau SAR, China. Fax: +853-2288-2314; Phone: +853-8822-4223; E-mail: ytxiang@ 123456um.edu.mo ; or Dr. Yuan-Jia Hu, 1/F, Building E12, Faculty of Health Sciences, University of Macau, Avenida da Universidade, Taipa, Macau SAR, China. E-mail: yuanjiahu@ 123456um.edu.mo

              * These authors contributed equally to the work.

              Competing Interests: The authors have declared that no competing interest exists.

              Article
              ijbsv18p5317
              10.7150/ijbs.70177
              9461669
              36147478
              945b8f8b-bf6a-41ce-b931-9568c2fd3d76
              © The author(s)

              This is an open access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.

              History
              : 17 December 2021
              : 16 July 2022
              Categories
              Research Paper

              Life sciences
              covid-19,macau,strategy
              Life sciences
              covid-19, macau, strategy

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