Background: The study aimed to analyze the effectiveness of COVID-19 strategies adopted by China, Japan, Singapore, and South Korea. Methods: We extracted publicly available data from various official websites, summarized the strategies implemented in these four countries, and assessed the effectiveness of the prevention and control measures adopted by these countries. Results: As of October 28, 2020, the growth of daily new confirmed cases has stabilized in China, Singapore, and South Korea. In Japan, the daily new confirmed cases increased sharply since it lifted a state of emergency, but case-fatality maintains at a lower level. The growth of total cases is near stagnant in China and Singapore, with a case-fatality of 5.39 and 0.05% respectively. The case-fatality rate between Japan and South Korea is identical at 1.76%, however, Japan’s growth rate of cases has increased more rapidly than South Korea. Conclusion: This study found that China, Japan, Singapore, and South Korea accessed the situation within their own borders and implemented different intervention strategies to curb the spread of COVID-19 and maintain lower rates of case-fatality. China, Singapore, and South Korea adopted the containment strategy, while Japan adopted the mitigation strategy. Although Japan’s case-fatality maintained at a low level, daily new cases increased faster than the other three countries. This result indicated that a mitigation strategy could be inferior to a containment strategy.

Objective: This study aimed to examine the effectiveness of containment strategies and mitigation strategies to provide a reference for controlling the ongoing global spread of the pandemic.Methods: We extracted publicly available data from various official websites between January 1 and December 31, 2020, summarized the strategies implemented in China, South Korea, Singapore, the United States, the United Kingdom, and France, and assessed the effectiveness of the prevention and control measures adopted by these countries with the daily new cases and mortality rate per 100,000 population.Results: China, South Korea, and Singapore adopted containment strategies, which maintained a proactive approach by identifying and managing cases, tracking and isolating close contacts. China and Singapore had a similar epidemic curve and the new daily cases. As of December 31, 2020, the new daily cases of China and Singapore were below 100 with the mortality rates per 100,000 population of 0.3 and 0.5, respectively. But the new daily case of South Korea was as high as 1,029, with a mortality rate per 100,000 population of 1.8. In contrast, the United States, the United Kingdom, and France responded with mitigation strategies that focus on treating severe cases and those with underlying conditions. They had similar epidemic curves and mortality rates per 100,000 population. The United States had up to 234,133 new confirmed cases per day, and the mortality rate per 100,000 population was 107, while the United Kingdom had 56,029 new confirmed cases per day and the mortality rate per 100,000 population was 108, and France had 20,042 new cases per day, with a mortality rate per 100,000 population of 99.Conclusions: China, Korea, and Singapore, which implemented strict containment measures, had significant outbreak control. Meanwhile, the successful practices in China, Singapore, and South Korea show that the containment strategies were practices that work especially at the individual level identifying and managing the infected patients and their close contacts. In the United States, the United Kingdom, and France, which implemented the mitigation policies, the effect of epidemic prevention and control was not significant that the epidemic continued or even increased epidemic relatively quickly.

Objective: The study examined the relationship between health insurance coverage and access to needed healthcare including preventive, primary, and tertiary care among Chinese adult population. Data and methods: Data for this study came from the 2018 China Health and Retirement Longitudinal Study (CHARLS), a population-based probability sample survey. Key measures included insurance coverage (high-, moderate-, low- and no-insurance), access to care (physical examination, physician visit, office visit, inpatient care, and satisfaction with care), and personal sociodemographics. Multiple-factor generalized linear mixed model was applied to estimate the odds ratio (OR) and the 95% confidence interval (CI) of HI coverage for the four indicators of access to care, after controlling for individual characteristics and aggregation among different villages. Results: The majority of Chinese adults had some health insurance with only 3.15% uninsured. However, most had low-coverage insurance (64.82%), followed by moderate-coverage insurance (16.70%), and high-coverage insurance (15.33%). Health insurance was significantly and positively associated with access to needed healthcare (preventive, primary, and tertiary). There was also a significant gradient association between extent of insurance coverage and access to care. Conclusion: Not only health insurance mattered in enhancing access to care but that there was a significant gradient association between extent of insurance coverage and access to care with higher coverage relating to better access.

Objective: In order to provide experiences for international epidemic control, this study systematically summarized the Coronavirus disease 2019 (COVID-19) prevention and control policies in Japan, Italy, China and Singapore, and also analyzed the possible inequalities that exist in these response approaches to improve global infectious disease control. Methods: We summarized the epidemic prevention and control policies in Japan, Italy, China, and Singapore, and analyzed the policy effects of these four countries by using the data published by Johns Hopkins Coronavirus Resource Center. Results: As of May 27, 2020, the growing trend of new cases in Japan, Italy, China and Singapore has stabilized. However, the cumulative number of confirmed cases (231139) and case-fatality rate (14.3%) in Italy far exceeded those in the other three countries, and the effect of epidemic control was inferior. Singapore began to experience a domestic resurgence after April 5, with a cumulative number of confirmed cases reaching 32,876, but the case-fatality rate remained extremely low (0.1%). The growth of cumulative confirmed cases in China (84547) was almost stagnant, and the case-fatality rate was low (5.5%). The growth of cumulative confirmed cases in Japan (16661) increased slowly, and the case-fatality rate (4.8%) was slightly lower than that in China. Conclusion: This study divided the epidemic prevention and control policies of the four countries into two categories: the blocking measures adopted by China and Singapore, and the mitigation measures adopted by Japan and Italy. According to the Epidemic control results of these four countries, we can conclude that the blocking measures were generally effective. As the core strategy of blocking measures, admitting mild patients into hospital and cases tracing helped curb the spread of the outbreak in Singapore and China. Countries should choose appropriate response strategies on the premise of considering their own situation, increase investment in health resources to ensure global health equity, and eventually control the spread of infectious diseases in the world effectively.

Background: This study aims to analyze the health resource allocation efficiency in Sichuan Province from 2010 to 2018 and provide other countries with China's experience. Methods: We used the super efficiency slack based model (SBM) model and Malmquist index to analyze the super efficiency and inter-period efficiency of health resource allocation in 19 cities in Sichuan Province from 2010 to 2018 and propose the input-output optimization scheme of health resource allocation in 2018. Finally, the Tobit model was used to estimate the influencing factors of health resource allocation efficiency. Results: The total allocation of health resources in Sichuan Province was increasing in addition to the total number of visits from 2010 to 2018. The super efficiency SBM results identified that the sample's average score was between 0.651 and 3.244, with an average of 1.041, of which 15 cities had not reached data envelopment analysis effectiveness. According to the Malmquist index, the average total factor productivity index of Sichuan Province was 0.930, which showed an imbalance in resource input, and its fluctuation was mainly related to the technological progress index and scale efficiency. The efficiency score was affected by the average annual income of residents, population density and education level. Conclusions: The amount of health resource allocation in Sichuan Province had shown an overall upward trend since 2010. However, resource allocation efficiency was not high, and there were problems such as significant regional differences, insufficient technological innovation capabilities and unscientific allocation of resource scale. To optimize the resource allocation structure, we suggest that the relevant departments pay attention to the impact of natural disasters, the average annual income of residents, population density and education level on efficiency to allocate health resources scientifically.

Several observational studies suggest that coffee consumption may be associated with an increased risk of gastric cancer, but the results are inconsistent. We conducted a meta-analysis to evaluate the relationship of coffee consumption with gastric cancer risk and quantify the dose–response relationship between them. Relevant prospective studies were identified by a search of PubMed, Embase, and Web of Science to May 2015 and by reviewing the references of retrieved articles. Two independent reviewers extracted data and performed the quality assessment. A random-effects model was used to calculate the pooled risk estimates and 95 % confidence intervals (CI). The heterogeneity was assessed using the I2 statistic. Publication bias was assessed by using funnel plot, the Begg test and the Egger test. Thirteen prospective cohort studies with 20 independent reports involving 3,368 patients with gastric cancer and 1,372,811 participants during a follow-up period ranging from 4.3–8 years were included. Compared with the lowest consumption level of coffee, the pooled relative risk (RR) was 1.13 (95 % CI: 0.94–1.35). The dose–response analysis indicated that, the RR of gastric cancer was 1.03 (95 % CI; 0.95–1.11) for per 3 cups/day of coffee consumption. Any nonlinear association of gastric cancer risk with coffee consumption was not found (P for nonlinearity = 0.68). Subgroup analyses indicated that the pooled RR for participants from the United States comparing the highest with the lowest coffee consumption was 1.36 (95 % CI, 1.06–1.75, I 2 = 0 %). In addition, people with higher coffee consumption was associated with 25 % higher risk of gastric cancer in equal to or less than 10 years follow-up group (RR = 1.25; 95 % CI, 1.01–1.55, I 2 = 0 %). Visual inspection of a funnel plot and the Begg’s and the Egger’s tests did not indicate evidence of publication bias. This meta-analysis does not support the hypothesis that coffee consumption is associated with the risk of gastric cancer. The increased risk of gastric cancer for participants from the United States and equal to or less than 10 years follow-up group associated with coffee consumption warrant further studies.