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Opportunities and challenges of traditional Chinese medicine going abroad for COVID-19 treatmentWe appreciate the work that Kai Zhang has done to highlight the treatment of COVID-19 in China via the use of Traditional Chinese Medicine (TCM) [1]. COVID-19 initially occurred in China at the end of December 2019 [2]. The Chinese government began to build many shelter hospitals in Hubei Province to treat patients with COVID-19, and medical workers from all over the country rushed to Wuhan to provide assistance [3]. Among the medical staff supporting Hubei Province, there were more than 4500 members of China's TCM system. In addition, TCM has been approved for the treatment of . As of March 23rd, among the patients with COVID-19, 74,187 patients (about 91.5%), had been treated with TCM; of these, 61,449 people were treated in Hubei Province (Fig. 1A). Clinical efficacy data has shown that the overall effective rate of TCM treatment has reached more than 90% [5].TCM is heavily involved in the fight against COVID-19, and has played an important role in the overall prevention of the disease, as well as in the treatment and rehabilitation of infected patients [6]. According to a number of US media reports, with the spread of the epidemic in the United States, the demand for TCM to treat colds and improve immunity has increased significantly. Consequently, the scale of the TCM market has grown significantly (Fig. 1B).Although TCM treatment has played an important role in this epidemic, it is also important to note that it is relatively difficult for TCM articles to be published in journals around the world. The reasons for this are believed to be as follows. First, the treatment process of TCM is individualized; not everyone's medication is exactly the same, and it is therefore difficult to evaluate the curative effect of TCM via Western medicine assessment methods. Second, there are many classifications of TCM, and the style and manner of each type of medicine are very different. Third, the origins and curative effects of TCM are different, as can be the effects of the same prescription. Fourth, Chinese doctors generally do not accept Western medical treatment processes, and the writing method of TCM practitioners is also different from that of Western medicine practitioners. Finally, TCM practitioners are trained for a long time, and foreigners have some difficulties in understanding TCM.We believe that TCM can play an important role in the prevention and treatment of COVID-19 during this epidemic. However, determining how to improve TCM on the international stage going forward remains unclear. We trust that with the joint efforts of practitioners of TCM, it will surely be highlighted by the world. FundingNo funding was received.

International cruises have drawn worldwide attention since the outbreak of coronavirus (COVID-19). This article first examines the legal issues, challenges and impact of the pandemic on large cruise ships, like the Diamond Princess, and then probes into corresponding pandemic preventive measures which port states employ. A State is obliged under the International Health Regulations 2005 (IHR) to grant foreign cruise ships free pratique , but there is an exception when public health emergencies of international concern occur. Therefore, this article argues that a port state is not obliged to allow foreign cruise ships to dock at its port at the cost of its domestic public health safety. Regarding the Diamond Princess , the Japanese government has undertaken pandemic preventive measures upon passengers on board the ship and complied with its domestic laws, including the Japanese Quarantine Act . This article further evaluates whether a port state's pandemic preventive measures concerning cruise ships are appropriate from the perspective of law. More importantly, it is necessary to consider the characteristics and specialities of international cruise ships to improve future pandemic preventive measures against large passenger ships and cruise passengers.

Introduction The significance of asymptomatic or pre-asymptomatic individuals in driving the COVID-19 epidemic in China or other countries remains uncertain. Method We collected and analyzed all the epidemiologic and virological diagnostic details of the infected individuals released by public health authorities and reiterated every episode of outbreak on a timeline. All individuals associated with the five outbreaks had tested positive for SARS-CoV-2 infection. Results In this study, all five COVID-19 outbreaks reported in China since October 2020 were analyzed. The Kashgar outbreak in Xinjiang province came into light for the first time on October 22, 2020. However, it was initiated before October 11, 2020, by a local asymptomatic import and export worker, who was infected at the working place. Subsequently, his wife caught the infection, which led to 430 more infections reported in the outbreak. The Beijing outbreak with 41 cases was noticed for the first time on December 22, 2020. However, our analysis revealed that it was initiated by an asymptomatic individual from Indonesia on December 10, 2020. The Shenyang outbreak, with 38 cases, noticed for the first time on December 23, 2020, was initiated by a pre-symptomatic individual from South Korea on December 13, 2020. Conclusion The asymptomatic or pre-symptomatic individuals during the asymptomatic period were unsuspectingly infected by SARS-CoV-2, and unintentionally transmitted the virus to a large number of people. These findings suggest that early detection of asymptomatic or pre-symptomatic individuals is of critical importance in preventing future outbreaks or epidemics.