Since the onset of the COVID-19 pandemic in 2019, the role of weather conditions in influencing transmission has been unclear, with results varying across different studies. Given the changes in border policies and the higher vaccination rates compared to earlier conditions, this study aimed to reassess the impact of weather on COVID-19, focusing on local climate effects. We analyzed daily COVID-19 case data and weather factors such as temperature, humidity, wind speed, and a diurnal temperature range from 1 March to 15 August 2022 across six regions in Taiwan. This study found a positive correlation between maximum daily temperature and relative humidity with new COVID-19 cases, whereas wind speed and diurnal temperature range were negatively correlated. Additionally, a significant positive correlation was identified between the unease environmental condition factor (UECF, calculated as RH*Tmax/WS), the kind of Climate Factor Complex (CFC), and confirmed cases. The findings highlight the influence of local weather conditions on COVID-19 transmission, suggesting that such factors can alter environmental comfort and human behavior, thereby affecting disease spread. We also introduced the Fire-Qi Period concept to explain the cyclic climatic variations influencing infectious disease outbreaks globally. This study emphasizes the necessity of considering both local and global climatic effects on infectious diseases.

Background and Objectives: Effective pain and soft tissue management in conservatively treated upper extremity fractures remains challenging. Despite widespread use of traditional Chinese medicine (TCM) topicals for musculoskeletal injuries, robust evidence remains limited. This pilot study evaluated the safety and efficacy of two established TCM formulations during the acute phase of injury. Patients and Methods: In this single-center, four-arm randomized controlled trial (NCT04593849), 24 adults with conservatively managed upper extremity fractures and Tscherne C0 or C1 tissue injuries were allocated to one of four groups: Wan-Yin-Gao-Jia-Jean-Wey (WYGJJW), Ru-Yih-Jin-Huang-Saan (RYJHS), TCM placebo, or control. Treatments were applied daily for 7 days. Feasibility (adherence, compliance) and primary outcomes (limb swelling, adverse skin reactions) were assessed by a blinded evaluator. Pain (VAS) and function (QuickDASH) were secondary outcomes. Non-parametric tests were used for analysis. Results: A total of 24 participants were equally randomized into four study groups, achieving 100% adherence, with no missed doses or clinic visits [retention rate: 100%; drug compliance rate: 100%]. Both WYGJJW and RYJHS groups showed statistical significance in swelling reduction [WYGJJW: 0.95 cm (IQR: 0.9– 1.9); RYJHS: 1.05 cm (0.5– 5.35)], pain relief [WYGJJW: 2 points (0.88– 4.5); RYJHS: 2 (1– 2.25)], and functional improvement [WYGJJW: 7.96 points (2.95– 16.48); RYJHS: 4.39 (2.27– 14.72)]. The WYGJJW group reported fewer skin rashes (16.7%) compared to RYJHS (50.0%), suggesting a more favorable safety profile. When compared to the TCM placebo and control groups, WYGJJW demonstrated significantly greater swelling reduction, and marginally greater functional improvement compared to the TCM placebo group. Conclusion: This study supports the safety, feasibility, and therapeutic potential of integrative TCM medicine for patients with upper extremity fractures and acute musculoskeletal injuries when surgical intervention is not recommended. A larger clinical trial is warranted to confirm these preliminary findings and to further assess long-term clinical effectiveness and safety. Clinicaltrials.gov.id: NCT04593849 was registered on October 9, 2020.