Analysis of the Current Status of Routine Emergency Management of Public Health Emergencies in Primary and Secondary Schools: A Sampling Study Based on 399 Schools in Beijing, China

Analysis of the Current Status of Routine Emergency Management of Public Health Emergencies in Primary and Secondary Schools: A Sampling Study Based on 399 Schools in Beijing, China | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Analysis of the Current Status of Routine Emergency Management of Public Health Emergencies in Primary and Secondary Schools: A Sampling Study Based on 399 Schools in Beijing, China Xinyu HOU, Mei GU, Jingxuan ZHAO, Jia YANG This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6819081/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Objective To analyze the current status of public health emergency management in primary and secondary schools in Beijing through cross-regional and cross-educational-stage comparisons, providing a scientific basis for optimizing the schools' routine emergency prevention and control systems. Method A multi-stage stratified cluster random sampling method was employed to select 399 primary and secondary schools in Beijing for a questionnaire survey. Result In terms of policy implementation, 99.75% of schools achieved near-universal coverage of the "Two Plans and Nine Systems" framework; however, environmental health inspection reporting (16.29%) and student health management/vaccination systems (15.04%) emerged as weak points. The emergency plan formulation rate reached 99.25%, while 67.92% of schools conducted emergency drills once per semester. Regarding resource allocation, basic protective supplies and disinfection materials were well-equipped, though Chi-square tests (χ²) revealed structural disparities in first-aid equipment: suburban areas demonstrated the highest Automated External Defibrillator(AED) configuration rate (99.32%), fixed AEDs showed optimal coverage in primary schools (77.30%), and portable AED availability led in integrated schools (52.00%). Conclusion Beijing's primary and secondary schools have established a public health emergency prevention and control system featuring the "Two Plans and Nine Systems" framework as its top-level design, routine emergency drills as its implementation pathway, and first-aid facility reserves as its foundation. However, three key shortcomings persist: weak implementation of environmental health inspections, insufficiently refined health monitoring, and uneven distribution of emergency medical resources (particularly AEDs). Recommendations include establishing diversified funding mechanisms, optimizing resource allocation pathways, and strengthening inter-departmental collaboration to systematically enhance school emergency management efficacy. Primary and secondary schools school health Public health emergencies Emergency management Figures Figure 1 1. Background Since the late 1980s, the World Health Organization (WHO) has consistently emphasized the central role of schools in health promotion [ 1 ] . As densely populated settings, schools are high-risk environments for the rapid transmission and spread of public health emergencies. In 1996, WHO first published “Promoting Health Through Schools”. Although it did not explicitly use the term "public health emergencies," this document laid a forward-looking foundation for school-based infectious disease control policies. It established comprehensive prevention measures—including environmental health management, disease surveillance, and reporting systems—creating the groundwork for schools to respond to public health crises. In June 2021, WHO and United Nations Educational, Scientific and Cultural Organization (UNESCO) jointly released “Making Every School a Health Promoting School Global Standards and Indicators”, while the 2024 WHO publication “Making Every School a Health-Promoting School”: Implementation Guidance further underscores schools' critical function in managing public health emergencies. Schools serve not only as frontlines for preventing and controlling such emergencies but also as vital venues for cultivating students' health literacy and emergency response capabilities. The United Nations Sustainable Development Goals (SDGs) explicitly call to "ensure healthy lives and promote well-being for all at all ages," schools are a key link in achieving this goal. Against the backdrop of the global COVID-19 pandemic, governments worldwide have strengthened school public health emergency management systems. For instance: France established a school epidemic response framework under the direct leadership of the Prime Minister, coordinated by the Ministry of the Interior and Ministry of Health. The UK government issued interim guidance, Coronavirus(COVID-19):safeguarding in schools, colleges and other providers [ 2 ] . Through measures such as enhancing legal frameworks, intensifying emergency drills, and optimizing resource allocation, countries continue to bolster schools' capacity to respond to public health emergencies. Statistics indicate approximately 75% of China's public health emergencies occur in schools [ 3 ] , typically comprising sudden infectious disease outbreaks, clusters of undiagnosed illnesses, and food/occupational poisoning incidents that pose severe health threats to students and staff due to their abrupt onset, high-risk impact, and public nature [ 4 ] . Infectious diseases dominate these emergencies, accounting for 94.52% of school incidents in Beijing (2010–2020) [ 5 ] . To effectively respond, China promulgated the "Regulations on Public Health in Schools" as early as April 1990, clearly listing strengthening the prevention and treatment of infectious diseases as one of the core tasks of school health work. Since then, the relevant policy system has been continuously improved at the national level: In 2017, the General Office of the Ministry of Education issued the "Notice on Further Improving the Prevention and Control of Infectious Diseases and Food Safety in Schools". In 2021, five departments including the Ministry of Education jointly issued documents such as the "Opinions on Comprehensively Strengthening and Improving School Health and Health Education in the New Era", all emphasizing the establishment of a long-term prevention and control mechanism and the improvement of a disease prevention system, in order to comprehensively enhance schools' emergency response and health management capabilities in dealing with public health emergencies. In recent years, China has achieved certain results in responding to public health emergencies in schools, especially demonstrating strong institutional advantages in the prevention and control of the novel coronavirus pneumonia. The National Health Commission, in collaboration with the education department, promptly formulated the "Notice on Issuing the Technical Plan for COVID-19 Prevention and Control in Higher Education Institutions, Primary and Secondary Schools, and Kindergartens (Fifth Edition)", and through the establishment of a "two plans and nine systems" prevention and control system, continuously improved the regular epidemic prevention and control mechanism on campus. This system takes the "two plans" (the infectious disease epidemic prevention and control plan and the emergency response plan) as the guiding documents and establishes nine core systems as supporting measures: The reporting system for infectious disease outbreaks, morning and afternoon health checks for teachers and students, tracking of students' absences, verification of certificates for resumption of classes, health management, vaccination, health education, disinfection of venues and environmental inspection systems have been established, forming a three-dimensional prevention and control network covering prevention and monitoring, emergency response and health management. However, in the practice of COVID-19 prevention and control, the emergency management system of schools still exposed several key problems that urgently need to be improved: The emergency plans for public health emergencies in schools lack pertinence and operability; Emergency material reserves have not yet established a scientific and dynamic management mechanism, and the types, quantities and update frequencies of material reserves cannot meet the actual demands. The implementation of the infectious disease prevention and control system is insufficient. When implementing prevention and control measures, there are problems such as being formalistic and inadequate supervision [ 6 – 9 ] . The top-level design of school emergency management, prevention and control capabilities, and the allocation of health resources directly affect the effectiveness of its emergency management for public health emergencies [ 4 ] . The existence of the above-mentioned problems indicates that the school's public health emergency management system still needs to be further optimized and improved from institutional design to practical implementation. Research on public health emergencies in schools mostly focuses on the epidemic characteristics such as the types and outbreak times of infectious diseases, while investigations on the emergency management system, the allocation of emergency resources, and the implementation of infectious disease prevention and control systems are relatively scarce [ 10 – 12 ] . As the capital of China, Beijing assumes a leading role in formulating policies for managing public health emergencies in primary and secondary schools. Given the large number of such institutions, disparities in geographical location, school system types, and resource allocation across Beijing's schools result in varying levels of capacity to address public health emergencies, similar to other regions nationwide. By examining the current state of emergency system construction in Beijing's primary and secondary schools, a more comprehensive understanding can be achieved regarding the differences and commonalities in schools' emergency management capabilities, as well as their existing strengths and challenges. This study employs a multi-stage stratified random sampling method to investigate primary and secondary schools across different regions and school systems in Beijing, analyzing the current status and issues related to school-based public health emergency management, and offering recommendations for enhancing the level of emergency management in this domain. 2. Data and Method 2.1 Investigation Method The sample size was calculated using a cross-sectional study formula: ​ , Z = 1.96 (95% confidence level), E = 0.05 (margin of error), and P = 38.98% (proportion of primary and secondary schools among all Beijing schools in 2023–2024). This yielded a minimum requirement of 365 schools. Accounting for questionnaire validity and return rates, 400 schools were targeted. A multi-stage stratified random sampling approach was implemented: First, districts were allocated proportional sampling quotas based on their school distributions per 2023–2024 Beijing Education Statistics [ 13 ] ; Second, schools within districts were randomly selected via random number tables; Finally, one school physician per school was randomly chosen by lot-drawing to complete the survey (Fig. 1 ). Of 400 distributed questionnaires, 399 valid responses were returned (99.75% validity rate). The study received ethical approval from Capital Medical University (No. Z2023SY093) and was conducted during April-May 2024. 2.2 Composition of the Questionnaire Based on a comprehensive review of literature and expert consultations, guided by the "Guiding Opinions on Strengthening the Public Health System Construction in Schools in Beijing," and in accordance with relevant policies such as the "Opinions on Comprehensively Strengthening and Improving School Health and Health Education in the New Era" and the "Regulations on School Health," our research team developed a specialized questionnaire to examine the routine emergency management of public health incidents in primary and secondary schools in Beijing. The reliability and validity of the questionnaire were evaluated through a pre-survey, and subsequent optimizations and improvements were made based on the pre-survey results. The questionnaire utilized in this study was specifically designed for this research (for detailed content, please refer to the supplementary file). It is structured into three sections: The first part is the basic information of the school, including the area where the school is located, the academic system, the number of campuses and the boarding system situation; The second part focuses on the infectious disease prevention and control system, with an emphasis on assessing the implementation and difficulties of the "Two Plans and Nine Systems". The third part examines the emergency management mechanism for public health emergencies in schools, mainly covering core elements such as the formulation of emergency plans, the frequency of emergency drills, the configuration of first aid facilities and equipment (including whether they are equipped and the number of fixed and portable AEDs), the types of emergency material reserves, and the organizational structure of emergency management (including the person in charge of the emergency leadership group). The selected variables mentioned above strictly follow the policy orientation to ensure that the research content is effectively connected with the current institutional norms, and the data collection has policy adaptability and practical guiding value. 2.3 Quality Control Before the questionnaire officially begins, a small-scale pre-survey is conducted to focus on verifying the appropriateness of the item expressions and the feasibility of the survey process, thereby optimizing the questionnaire structure and option Settings. During the formal investigation stage, a standardized data collection process was adopted: Members of the research team sent an electronic letter of the " Questionnaire on the Current Situation of Routine Emergency Management of Public Health Emergencies in Primary and Secondary Schools in Beijing " to the school doctor via WeChat, along with a standardized operation guide including the research background, filling norms and confidentiality declaration. To ensure the quality of data collection, a dedicated person is arranged to track the progress of the filling and implement dynamic Q&A. Before entering the questionnaires, informed consent was obtained from all respondents. A unified database was established during the entry process. EpiData 3.1 software was used for double entry and real-time logical verification to ensure the accuracy, completeness and authenticity of the data. 2.4 Statistical Analysis Methods The statistics of the data were conducted using SPSS version 26.0 software. Frequency, composition ratio and chi-square test were adopted to describe and analyze the basic situation of the school, the emergency prevention and control ability of public health emergencies of the school and the allocation of school health resources. 3 Result 3.1 Basic Information of the School Among the 399 schools surveyed, there are 189 urban schools, 146 schools in the near suburbs and 64 schools in the far suburbs. Among them, there were 185 primary schools (46.37%), 139 middle schools (34.84%), and 75 continuous schools (including nine-year and twelve-year continuous schools) (18.80%). The number of campuses is mainly 1 (63.41%). 76.94% are non-boarding schools. 3.2 Current Situation of Infectious Disease Prevention and Control in Schools The survey results (Table 1 ) show that 99.75% of schools can effectively implement the "Two Plans and Nine Systems". Among them, the top three infectious disease prevention and control systems that are difficult to implement are: the environmental hygiene inspection and notification system (16.29%), the student health management system, and the vaccination system (each accounting for 15.04%). Table 1 Implementation and Existing Difficulties of the School's "Two Plans and Nine Systems" Variable Region n (%) Educational stage n (%) Total n(%) Urban District Inner Suburb Outer Suburb Primary School Secondary School Integrated School Implementation status of the "Two Plans and Nine Systems" framework Fully implement 175(92.59) 127(86.99) 58(90.63) 171(92.43) 124(89.21) 65(86.67) 360(90.23) Relatively fully implemented 11(5.82) 19(13.01) 6(9.38) 14(7.57) 12(8.63) 10(13.33) 36(9.02) General 2(1.06) 0(0.00) 0(0.00) 0(0.00) 2(1.44) 0(0.00) 2(0.50) Difficult to fully implement 1(0.53) 0(0.00) 0(0.00) 0(0.00) 1(0.72) 0(0.00) 1(0.25) Difficult-to-implement infectious disease prevention and control systems (multiple choices) Infectious disease prevention and control plan 23(12.17) 22(15.07) 9(14.06) 24(12.97) 21(15.11) 9(12.00) 54(13.53) Infectious Disease Epidemic response plan 24(12.70) 26(17.81) 9(14.06) 22(11.89) 25(17.99) 12(16.00) 59(14.79) Reporting system for infectious disease epidemics and public health emergencies 24(12.70) 22(15.07) 12(18.75) 28(15.14) 18(12.95) 12(16.00) 58(14.54) Morning and noon health check system 32(16.93) 16(10.96) 6(9.38) 20(10.81) 17(12.23) 17(22.67) 54(13.53) The registration system for students' absence from school due to illness 29(15.34) 18(12.33) 7(10.94) 23(12.43) 19(13.67) 12(16.00) 54(13.53) Verification system for resumption of classes certificates 23(12.17) 18(12.33) 9(14.06) 21(11.35) 18(12.95) 11(14.67) 50(12.53) Student health management system 32(16.93) 22(15.07) 6(0.38) 27(14.59) 21(15.11) 12(16.00) 60(15.04) Vaccination system 32(16.93) 20(13.70) 8(12.50) 31(16.76) 17(12.23) 12(16.00) 60(15.04) Health education system for infectious disease prevention and control 23(12.17) 12(8.22) 5(7.81) 14(7.57) 16(11.51) 10(13.33) 40(10.03) Ventilation and disinfection system 25(13.23) 13(8.90) 6(9.38) 16(8.65) 20(14.39) 8(10.57) 44(11.03) Environmental sanitation inspection notification system 28(14.81) 25(17.12) 12(18.75) 29(15.68) 25(15.83) 14(18.67) 65(16.29) Note: " Difficult-to-implement infectious disease prevention and control systems " is a multiple-choice question, so the total percentage is not 1. 3.3 Current Situation of School Emergency Management for Public Health Incidents (1) Emergency Plans and Emergency Drills The survey results (Table 2 ) show that almost all schools (99.25%) have formulated emergency plans for public health incidents. Regarding the frequency of emergency drills, 67.92% of the schools conduct one drill per semester, 15.79% conduct one drill per quarter, and 9.27% conduct one drill per year. Table 2 School Emergency Plans and Emergency Drills Situation Variable Region n (%) Educational stage n (%) Total n (%) Urban District Inner Suburb Outer Suburb Primary School Secondary School Integrated School Whether an emergency response plan for public health emergencies has been formulated Yes 189(100.00) 144(98.63) 63(98.44) 184(99.46) 138(99.28) 74(98.67) 396(99.25) No 0(0.00) 2(1.37) 1(1.56) 1(0.54) 1(0.72) 1(1.33) 3(0.75) Frequency of emergency drills Never 1(0.53) 0(0.00) 0(0.00) 0(0.00) 1(0.72) 0(0.00) 1(0.25) Once every quarter 27(14.29) 25(17.12) 11(17.19) 32(17.30) 20(14.39) 11(14.67) 63(15.79) Once a semester 135(71.43) 93(63.70) 43(67.19) 126(68.11) 94(67.63) 51(68.00) 271(67.92) Once a year 16(8.47) 15(10.27) 6(9.38) 13(7.03) 16(11.51) 8(10.67) 37(9.27) Other 10(5.29) 13(8.90) 4(6.25) 14(7.57) 8(5.76) 5(6.67) 27(6.77) (2) Current Status of Emergency Preparedness and Material Allocation The survey results (Tables 3 and 4 ) indicate that, in terms of emergency material allocation, the provision rates for temperature detection supplies (e.g., mercury thermometers, forehead thermometers, etc.) and personal protective equipment (e.g., disposable medical masks, etc.) exceed 99%. The allocation rate for surface disinfection supplies (e.g., chlorine-based disinfectants, 75% ethanol disinfectant, etc.) is as high as 98.25%, while the allocation rates for air disinfection supplies (e.g., ultraviolet lamps, air disinfection machines, disinfectants, etc.) (96.49%) and vomit/excrement disinfection supplies (e.g., vomiting emergency disposal kits, etc.) (96.74%) are slightly lower. Regarding emergency medical supplies, 96.49% of schools have equipped automated external defibrillators (AEDs) and other emergency facilities, with a higher allocation rate for fixed AEDs (71.93%) compared to portable AEDs (42.86%). Comparisons of regional and school educational stage factors reveal variations in schools' emergency response capabilities. Chi-square test results demonstrate statistically significant differences in AED and other emergency equipment allocation across regions (χ² = 6.449, P = 0.04). The allocation rate is highest in near suburban areas (99.32%), followed by far suburban areas (96.88%) and urban areas (94.18%). In terms of fixed and portable AED allocation, there are statistically significant differences among school systems for both fixed AEDs (χ² = 10.982, P = 0.027) and portable AEDs (χ² = 11.771, P = 0.019). Specifically, primary schools exhibit a higher allocation rate for fixed AEDs (77.30%) compared to middle schools (69.78%) and all-round schools (62.67%), whereas all-round schools show a higher allocation rate for portable AEDs (52.00%) compared to middle schools (46.76%) and primary schools (36.22%). Table 3 Current Status of School Emergency Material Preparation Variable Region n (%) Educational stage n (%) Total n (%) Urban District Inner Suburb Outer Suburb Primary School Secondary School Integrated School Types of emergency supplies (multiple choices) Temperature measurement supplies 189(100.00) 145(99.32) 64(100.00) 185(100.00) 138(99.28) 75(100.00) 398(99.75) Personal protective equipment 188(99.47) 144(98.63) 63(98.44) 184(99.46) 137(98.56) 74(98.67) 395(99.00) Air disinfection supplies 180(95.24) 142(97.26) 63(98.44) 178(96.22) 136(97.84) 71(94.67) 385(96.49) Surface disinfection supplies 187(98.94) 143(97.95) 62(96.88) 183(98.92) 135(97.12) 74(98.67) 392(98.25) Disinfection supplies for vomit and excrement 187(98.94) 141(96.58) 58(90.63) 180(97.30) 132(94.96) 74(98.67) 386(96.74) Hand disinfection supplies 185(97.88) 140(95.89) 63(98.44) 182(98.38) 136(97.84) 70(93.33) 388(97.24) Note: "Types of emergency supplies" is a multiple-choice question, so the percentages do not add up to 1. Table 4 Current Status of School Emergency Supplies Preparation 变量 Region n (%) χ2 P Educational stage n (%) χ2 P Total n(%) Urban District Inner Suburb Outer Suburb Primary School Secondary School Integrated School Whether it is equipped with emergency equipment and facilities such as AED 6.449 0.040 3.476 0.176 Yes 178(94.18) 145(99.32) 62(96.88) 180(97.30) 131(94.24) 74(98.67) 385(96.49) No 11(5.82) 1(0.68) 2(3.13) 5(2.70) 8(5.76) 1(1.33) 14(3.51) The number of fixed AEDs 4.174 0.383 10.982 0.027 Zero 57 (30.16) 33(22.60) 22(34.38) 42(22.70) 42(30.22) 28(37.33) 112(28.07) One 96 (50.79) 79(54.11) 31(48.44) 111(60.00) 64(46.04) 31(41.33) 206(51.63) More than one 36 (19.05) 34(23.29) 11(17.19) 32(17.30) 33(23.74) 16(21.33) 81(20.30) Number of portable AEDs 8.609 0.072 11.771 0.019 Zero 105(55.56) 94(64.38) 29(45.31) 118(63.78) 74(53.24) 36(48.00) 228(57.14) One 58(30.69) 41(28.08) 24(37.50) 50(27.03) 50(35.97) 23(30.67) 123(30.83) More than one 26(13.76) 11(7.53) 11(17.19) 17(9.19) 15(10.79) 16(21.33) 48(12.03) 4 Discussion 4.1 The overall implementation of the "Two Plans and Nine Systems" has been satisfactory; however, the execution of certain systems warrants further attention and improvement. In April 2020, the National Health Commission of the People's Republic of China issued the "Notice on Further Strengthening the Prevention and Control of Key Infectious Diseases in Autumn and Winter", requiring local authorities to guide schools in establishing an infectious disease prevention and control system of "two plans and nine systems". At present, 99.75% of primary and secondary schools in Beijing have largely implemented the "two plans and nine systems" framework. However, challenges remain more pronounced in the implementation of specific systems, such as the environmental hygiene inspection and notification system (16.29%), the student health management system, and the vaccination system (each accounting for 15.04%). Firstly, there is the reporting system for hygiene inspections. Environmental hygiene conditions in primary and secondary schools across China exhibit variations based on region and school educational stage. The qualification rates for teaching environmental hygiene are highest in urban areas and primary schools, whereas environmental hygiene management in rural schools, particularly concerning drinking water and toilet hygiene, requires further strengthening [ 14 , 15 ] . This urban-rural disparity (between urban areas and far suburbs) is particularly pronounced in the suburban regions of Beijing. For instance, in Miyun District, the issue of unregulated domestic sewage discharge is significant. Approximately one-quarter of the residents dispose of sewage in non-compliant manners. Furthermore, numerous garbage disposal sites are located in environmentally sensitive areas, such as farmland and river courses, creating persistent pollution sources [ 16 , 17 ] . Such environmental issues are transmitted to campuses through various pathways: sewage seepage compromises the safety of groundwater, potentially impacting the quality of drinking water in school; uncontrolled garbage accumulation exacerbates the risk of disease vector transmission, posing significant hazards for the spread of infectious diseases. These challenges are further exacerbated by the structural constraints commonly encountered by rural schools, including inadequate educational resources, limited financial support, and insufficient decision-making autonomy [ 18 , 19 ] . In this context, the effectiveness of implementing the school hygiene inspection and notification system may be constrained by the following factors: First, governance measures aimed at upgrading infrastructure such as water supply systems, construction of sanitary toilets, and garbage and sewage treatment require sustained financial investment. However, rural and suburban schools typically face rigid constraints due to insufficient financial resources. Second, while the introduction of socialized services (e.g., outsourcing daily campus cleaning and toilet maintenance to professional cleaning companies or entrusting the operation and maintenance of water purification equipment to specialized institutions) can alleviate management pressure and enhance the efficiency of school hygiene management, the quality of service delivery depends heavily on the level of financial support available. Third, the continuous input of external environmental risks combined with systemic shortages in school hygiene management resources creates a cumulative effect, which results in the difficulty of effectively implementing preventive and control measures within the school hygiene inspection and notification system, even when it is established, due to inadequate foundational support. The United States Environmental Protection Agency (EPA) offers theoretical guidance and practical tools to support schools in developing and implementing environmental health plans. However, given the non-mandatory nature of these measures, the level of enforcement varies significantly across states. Many schools face challenges in effectively managing their environmental hygiene due to insufficient infrastructure, a shortage of dedicated personnel, limited funding, and inadequate training resources [ 20 ] . In Brazil, the operational nature of a school (whether it is public or private) and its geographical location (specifically, whether it is situated in a state capital) also influence the sanitary conditions of the school environment [ 21 ] . Owing to economic limitations and the inadequate enforcement of relevant policies, schools typically lack designated personnel responsible for environmental hygiene inspections and notifications. This, in turn, exacerbates the challenges associated with implementing the hygiene inspection and notification system. The second is the student health management system. Currently, the process of student health management in Chinese primary and secondary schools remains relatively coarse, with inadequate emphasis on health management. The phenomenon of "testing without managing" regarding students' health information is prevalent, and there is a significant shortage of professional health management personnel. These factors substantially impede the effective implementation of student health management systems in schools [ 22 – 24 ] . Health management occupies a significant position within the framework of school health in Japan. All primary and secondary schools in Japan are staffed with dedicated nursing teachers who are responsible for overseeing school health and safety management. These professionals provide personalized health guidance to students, with an emphasis on fostering students' ability and attitude toward identifying and addressing health and safety issues [ 25 ] . The objective of school health management is to systematically collect students' health information, predict the trajectory of their health conditions, provide timely intervention and guidance, and ultimately foster students' proactive adoption of a health-conscious mindset. The third aspect is the vaccination system. Vaccination serves as an effective measure to prevent infectious diseases, mitigate the severity of illness, and decrease the risk of transmission [ 26 ] . The school collaborates with the community health service center to jointly facilitate vaccination efforts. In this partnership, the school is responsible for organizing and coordinating vaccination activities while not imposing mandatory requirements regarding students' vaccination status. For students who are willing to receive vaccination but are unable to do so within the prescribed timeframe due to special circumstances, the school can offer personalized appointment services. It can also assist students and their parents in liaising with the community health service center, flexibly adjust the vaccination schedule, and provide options such as weekend vaccinations or extended vaccination cycles. Currently, countries such as Canada, the United Kingdom, Australia, and the United States have established school-based vaccination programs, offering free vaccination services within schools to enhance the vaccination coverage among school-aged children [ 27 ] . Following the implementation of the school vaccination program, the vaccination rate among students has shown an increase. However, concerns raised by parents regarding the safety of vaccines and the adequacy of the vaccination environment within schools have impacted the further advancement of the school vaccination program [ 27 – 29 ] . Consequently, schools should fully utilize the home-school cooperation mechanism to deliver targeted health education to parents. This can be accomplished through organizing lectures, distributing health handbooks, and disseminating scientific information via social media platforms. These efforts aim to educate parents about vaccines, enhance their confidence in the safety and efficacy of vaccines, transform their behavioral parent lectures, distributing health handbooks, and disseminating scientific information via social media platforms. These efforts aim to enhance parents' understanding of vaccines, strengthen their confidence in vaccine safety and efficacy, modify their attitudes, facilitate the effective implementation of the vaccination system in schools, and ultimately increase the vaccination rate among primary and secondary school students [ 30 – 32 ] . 4.2 The coverage rate of emergency drills for public health incidents in schools is relatively high, and the configuration of relevant materials is gradually being optimized. In 2014, the Ministry of Education issued the "Guidelines for Emergency Evacuation Drills in Primary and Secondary Schools and Kindergartens," explicitly requiring all levels of schools to develop their own emergency drill plans and conduct at least one emergency evacuation drill per month. In China, 98.43% of primary and secondary schools have conducted emergency drills for public health incidents. By contrast, only 64% of schools in the United States have established designated emergency action plans, which underscores the institutional advantages of China's top-level design in emergency management [ 10 , 33 ] . Among these regions, Beijing performs exceptionally well, with 99.25% of schools having formulated emergency response plans. Nevertheless, there remains room for improvement in the dynamic management of these plans, as the updates to emergency plans need to align more closely with the requirements of higher-level documents, particularly to address the evolving nature of new public health risks. Currently, 83.71% of primary and secondary schools in Beijing have established a routine emergency drill mechanism, with no significant variation observed across regions or school educational stage. Nevertheless, 0.25% of schools have never organized any emergency drills, revealing potential blind spots in emergency management. Further guidance and oversight are therefore required. In the process of developing emergency drill plans and conducting routine drills, schools not only evaluate the effectiveness of their emergency response plans but also identify deficiencies in the provision of emergency supplies. In Beijing's primary and secondary schools, a diverse range of emergency supplies is available; however, the availability rate of air disinfection products and disinfection products for vomit and excrement (approximately 96%) is slightly lower compared to other types of emergency supplies. This, to some extent, diminishes the material support for school environmental hygiene inspections and constrains the school's capacity to address and report environmental inspection issues. According to the "Standards for School Health (Medical) Rooms" issued by the National Health Commission in 2024, school health (medical) rooms must be equipped not only with basic first aid equipment such as first aid kits and tourniquets but also, in accordance with the school's emergency response plans, maintain an adequate stock of disinfection products, masks, gloves, non-contact thermometers, hand sanitizers, and other medical supplies. Additionally, expired or damaged hygiene supplies must be updated promptly through regular inspections.To ensure the efficacy of materials and the standardization of management, schools must establish a comprehensive material management system. First, a detailed material inventory should be developed, which at a minimum includes critical information such as the name, specification, quantity, and expiration date of the materials. Second, to further enhance material management, schools can collaborate with procurement platforms to establish a dual-purpose material reserve mechanism that accommodates both routine and emergency scenarios. This mechanism will clarify and refine processes related to material renewal, procurement, storage, and utilization. Through these management measures, it is ensured that emergency and other health-related materials in schools are updated promptly, thereby preventing the use of expired or damaged items and safeguarding the health and safety of faculty and students. While standardizing the storage of emergency materials, the provision of first-aid facilities must also be prioritized. In 2022, the China Education Equipment Industry Association released the "Standard for the Provision of Campus First Aid Facilities and Equipment (Trial)" which specifies that schools at the compulsory education stage must be equipped with one automated external defibrillator (AED) unit. Currently, 96.49% of primary and secondary schools in Beijing have been equipped with automated external defibrillators (AEDs) and other first-aid facilities and equipment. This significant achievement can be largely attributed to the "Notice on Properly Implementing the Configuration of Automated External Defibrillators (AEDs) in Schools" previously issued by Beijing authorities. The notice explicitly stipulates that the procurement costs for AEDs in primary and secondary schools shall be coordinated and resolved by the education commissions of each district, thereby providing a robust financial guarantee for the configuration process. With this policy support, the implementation in Beijing's near suburbs stands out notably, with the equipment rate of first-aid facilities and equipment in schools reaching 99.32%. This has effectively facilitated the widespread adoption of first-aid facilities and equipment in schools and established effective emergency preparedness to mitigate potential school emergencies in suburban areas. In terms of the AED deployment strategy, primary school students generally experience relatively lower academic pressure, engage in more frequent physical education classes and recess activities, and exhibit higher levels of physical activity intensity. Consequently, when deploying AEDs, it is essential to prioritize addressing various potential emergencies. Fixed AEDs, due to their advantages such as conspicuous installation locations, robust stability, and reduced likelihood of being moved or damaged, have been more extensively adopted in primary schools, achieving a configuration rate of 77.30%, which is the highest among all educational systems. Integrated schools, given their broad range of educational stages and large student populations, demonstrate a greater need for portable AEDs, leading to a higher configuration rate of portable AEDs (52.00%). Considering that the current AED configuration in schools has achieved certain outcomes, the next step should focus on enhancing first aid training. In the United States, 76% of teachers, 68% of administrative staff, and 28% of students have undergone CPR training [ 34 ] . In 2021, the Education Office issued the "Notice on Further Promoting School Emergency Rescue Work," emphasizing the implementation of emergency rescue training and the dissemination of emergency rescue knowledge and skills as critical components of school health education and youth quality education. The popularization of emergency rescue knowledge and the practical application skills on campus can be promoted by engaging professional first-aid personnel to deliver training on the use of AEDs and other equipment to teachers and senior students, as well as by integrating first-aid courses into the student health education curriculum. 5. Conclusion The prevention and control system for public health emergencies in primary and secondary schools in Beijing demonstrates a complex characteristic encompassing "a complete institutional framework, a gradient of implementation efficiency, and an imbalance in guarantee levels." The city has constructed a three-dimensional prevention and control framework, with the "two plans and nine systems" institutional network (achieving a coverage rate of 99.75%) serving as the top-level design, the regular emergency drill mechanism (with a popularization rate of 83.71%) functioning as the implementation pathway, and the first-aid facility configuration system (with an AED coverage rate of 96.49%) providing hardware support. Notably, the near suburbs have attained an ultra-high configuration rate of 99.32% for first-aid facilities, underscoring the systematic integration capability of public health governance in the capital. However, the phenomenon of gradient attenuation in prevention and control effectiveness merits attention, primarily manifesting in the following aspects: (1) The enforcement of environmental hygiene management is inadequate. The implementation rate of the environmental hygiene inspection and notification system remains relatively low (only 16.29%), reflecting the combined impact of delayed risk management in off-campus environmental governance and insufficient allocation of on-campus hygiene management resources. To address these challenges, a comprehensive governance framework integrating "financial guarantee - diversified fundraising - school and local collaboration" should be established: Firstly, enhance government special allocations with a focus on prioritizing the renovation of water supply and toilet facilities in rural schools; secondly, establish a diversified funding mechanism combining "government subsidies, social donations, and user fees," encouraging enterprises and public welfare organizations to participate in school environmental hygiene services, thereby alleviating financial burdens and ensuring sustainable funding for socialized services; finally, collaborate with environmental protection departments to address sewage and garbage issues surrounding schools, mitigating the adverse effects of off-campus pollution on campus environments. Through multi-stakeholder cooperation, the issues of insufficient funding and resource scarcity can be progressively resolved. (2) There is a notable deficiency in the provision of refined guidance within health monitoring systems. Presently, health monitoring predominantly emphasizes information collection, significantly lagging behind Japan's sophisticated management approach, which incorporates professional nursing teachers to provide trend-based health guidance and proactive intervention strategies. To address the issue of insufficiently detailed health monitoring, it is recommended to integrate Japan's advanced health management model with cutting-edge digital technologies, establish a district-level school health big data center, and develop an electronic health record system equipped with trend warning functionalities. Each school should appoint a clinically qualified health manager. By leveraging big data technology, critical data such as student absenteeism rates and abnormal physical examination values can be systematically collected and analyzed to construct an early warning model for infectious diseases. (3) There exists a structural imbalance in the allocation of emergency resources. The scarcity of disinfection supplies (4%) and the fact that 0.25% of schools lack emergency management plans create a compounded risk, underscoring the delay in constructing intelligent material monitoring systems. It is recommended to establish a three-tier material network comprising "municipal reserve centers - district-level transfer stations - school intelligent cabinets" and optimize the material allocation pathway through the application of a dynamic demand prediction model. (4) The development of first aid capabilities exhibits a tendency of being "hardware-focused while neglecting software." Despite the leading rate of first aid material provision, the training of first aid skills requires further enhancement. To address the lag in skills training, it is proposed to construct a three-pronged improvement mechanism integrating "qualification certification - course development - practical drills": incorporate first aid skills into supplementary criteria for teacher title evaluation, develop a tiered first aid course system; emphasize cultivating emergency awareness in primary schools and implement CPR/AED practical training in middle schools; collaborate with tertiary hospitals to establish first aid training bases within schools and conduct comprehensive drills covering school public health emergencies on a semester basis. Declarations Ethical Approval and Consent to participate: This study was approved by the Research Ethics Committee of Capital Medical University (Approval Number: Z2023SY093). The respondents of the questionnaire in this study were school doctors from primary and secondary schools in the sampled areas of Beijing. When distributing the questionnaires, their informed consent was obtained, and they were informed that the information filled in the questionnaires would only be used for the collection of basic data and would be strictly confidential. Therefore, this study complies with the Declaration of Helsinki. Ethical approval was obtained from the ethics committee before the start of the study; and the privacy of the research participants was protected, and informed consent was also obtained from the participants. Consent for publication ： Not applicable. This study does not involve human data. Availability of data and materials: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. All data generated or analysed during this study are included in this published article [and its supplementary information files]. Competing interests: The authors declare that they have no competing interests. Funding: The funding for this research was provided by the Open Research Project of the Capital Institute of Health Management and Policy. The project proposal is uploaded to the system as an attachment. This study does not involve the use of datasets, so this item is not applicable. Author Contributions: HXY was the primary contributor to the manuscript. GM and ZhJX were responsible for literature search and organization. YJ was in charge of the overall article structure, outline, and revision. All authors read and approved the final manuscript. Acknowledgements: Not applicable. Author Information: First Author: Hou Xinyu, is a current master's student. Research interests: School Health. Corresponding Author: Yang Jia, Associate Professor. 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Investigation on the Current Situation of Infectious Disease Prevention and Control Management in Primary and Secondary Schools in Luoyang City, Henan Province in 2022 [J]. Mod Disease Control Prev. 2024;35(9):705–8. Zhang X. Emerging infectious diseases are an eternal challenge for school health [J]. Chin J School Health. 2020;41(5):641–4. Beijing Municipal Education Commission. Statistical Overview of Beijing's Education Development in the 2023–2024 Academic Year [EB/OL]. (2024-03-22)[2025-05-01]. https://jw.beijing.gov.cn/xxgk/shujufab/tongjigaikuang/202403/t20240321_3596738.html Cha YE, Fu YZ, Yao W. Environmental hygiene conditions of rural schools in five western provinces of China [J]. Chin J School Health. 2021;42(7):1083–7. Wu Y, Li M, Huang Z, et al. The Current Status of Teaching and Learning Environmental Hygiene in Primary and Secondary Schools in China in 2018 [J]. Chin J School Health. 2019;40(5):745–8. Teng KQ, Zheng DS, Feng YM. Analysis of the Current Situation of Rural Domestic Sewage in Miyun District, Beijing in 2016 [J]. China Health Ind. 2017;14(26):1–3. Teng KQ, Zheng DS, Feng YM. Analysis of the Current Situation of Rural Domestic Waste in Miyun District, Beijing in 2016 [J/OL]. China Health Ind. 2017;14(29):14–6. Zhang J. Research on the Operation Guarantee of Small-scale Rural Schools in J City [D]. Nanchong: China West Normal University; 2023. Zhang X. Research on the Current Situation and Optimization of Rural Compulsory Education Resource Allocation in Laiyang City [D]. Yantai: Yantai University; 2023. GOUGE D H, LAME M L, STOCK T W, et al. Improving Environmental Health in Schools[J]. Curr Probl Pediatr Adolesc Health Care. 2023;53(4):101407. HORTA R L, ANDERSEN C S, PINTO R O, et al. Health promotion in school environment in Brazil[J]. Volume 51. Revista de Saúde Pública; 2017. p. 27. Cao PJ, Pan YP. Discussion on the Importance of Health Management for Teenage Students [J]. 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Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children[J]. BMC Health Serv Res. 2019;19(1):407. Mai YZ, Li JL, Xie S, et al. Analysis of the Protective Effect and Influencing Factors of Varicella Vaccination on School Outbreaks [J]. Chin J School Health. 2023;44(2):278–81. Huang YD, Li JY, Lv HY. Analysis of the awareness of varicella vaccination among parents of school-age children and its influencing factors [J]. Chin J Public Health Manage. 2020;36(6):848–52. Qin Y, Liu LJ, Liu YQ, et al. Evaluation of the Health Education Effect on Influenza Vaccine Vaccination among Parents of School Students in Mianyang City during 2021–2022 [J]. J Prev Med Inform. 2024;40(9):1111–9. Liang HN, Zhou Q. Comprehensive Quality Management Evaluation of Emergency Response Plans in American Schools Based on the QuEP Framework [J]. J Chengdu Normal Univ. 2022;38(3):101–10. OLYMPIA RP, AVNER WANE. The preparedness of schools to respond to emergencies in children: a national survey of school nurses[J]. Pediatrics. 2005;116(6):e738–45. Additional Declarations No competing interests reported. Supplementary Files file.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 21 Jul, 2025 Reviewers agreed at journal 11 Jul, 2025 Reviewers invited by journal 09 Jul, 2025 Editor assigned by journal 16 Jun, 2025 Editor invited by journal 10 Jun, 2025 Submission checks completed at journal 09 Jun, 2025 First submitted to journal 09 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6819081","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":484406838,"identity":"fd43911b-8572-44de-a0ec-dddb94edc4c5","order_by":0,"name":"Xinyu HOU","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Xinyu","middleName":"","lastName":"HOU","suffix":""},{"id":484406839,"identity":"43f96650-eebd-4108-8cb9-83194958e9a9","order_by":1,"name":"Mei GU","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Mei","middleName":"","lastName":"GU","suffix":""},{"id":484406842,"identity":"0addd47f-9167-41ac-9595-4cad9585db27","order_by":2,"name":"Jingxuan ZHAO","email":"","orcid":"","institution":"Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jingxuan","middleName":"","lastName":"ZHAO","suffix":""},{"id":484406843,"identity":"7719feda-c07f-42c7-b38d-5b7deb528b9f","order_by":3,"name":"Jia YANG","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzUlEQVRIiWNgGAWjYLACCQMGAwb2xsaHH0jTwnO42ViCFIsMGCTS2wR4iFJ6/OzhFxYFdsa6Mx+2MUgw2MnpNhDSciYvzULCINnM7HZi24MChmRjswOEtBzIMTOQMGC2AWppN5BgOJC4jaCW829AWuptzG4ebJPgIUrLjRzjBxIGh83MbjASqUXyxhszYCAfNzY7kwgMZAMi/MJ3Psf4s8SfasNtx48/fPihwk6OoBaFAwxs0ogYNCCgHATkGxiYPxKfTkbBKBgFo2BEAgApy0Pn0rUuvQAAAABJRU5ErkJggg==","orcid":"","institution":"Capital Medical University","correspondingAuthor":true,"prefix":"","firstName":"Jia","middleName":"","lastName":"YANG","suffix":""}],"badges":[],"createdAt":"2025-06-04 09:53:32","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6819081/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6819081/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86781664,"identity":"9946e422-b73b-4203-8b6e-5a1983381569","added_by":"auto","created_at":"2025-07-15 13:33:54","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":319666,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSampling flowchart\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6819081/v1/5f80d75923190f18bd0f4df0.jpeg"},{"id":86783070,"identity":"862f4ba9-1cf8-4c1d-8a91-04465eae89a1","added_by":"auto","created_at":"2025-07-15 13:49:55","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2039013,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6819081/v1/b4489415-3457-420d-81a1-8fe40e9e62ed.pdf"},{"id":86781663,"identity":"2834c460-15f3-4793-a333-27d520b2394a","added_by":"auto","created_at":"2025-07-15 13:33:54","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":18745,"visible":true,"origin":"","legend":"","description":"","filename":"file.docx","url":"https://assets-eu.researchsquare.com/files/rs-6819081/v1/0116e2755d8ac316370f0f58.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Analysis of the Current Status of Routine Emergency Management of Public Health Emergencies in Primary and Secondary Schools: A Sampling Study Based on 399 Schools in Beijing, China","fulltext":[{"header":"1. Background","content":"\u003cp\u003eSince the late 1980s, the World Health Organization (WHO) has consistently emphasized the central role of schools in health promotion \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. As densely populated settings, schools are high-risk environments for the rapid transmission and spread of public health emergencies. In 1996, WHO first published \u0026ldquo;Promoting Health Through Schools\u0026rdquo;. Although it did not explicitly use the term \"public health emergencies,\" this document laid a forward-looking foundation for school-based infectious disease control policies. It established comprehensive prevention measures\u0026mdash;including environmental health management, disease surveillance, and reporting systems\u0026mdash;creating the groundwork for schools to respond to public health crises. In June 2021, WHO and United Nations Educational, Scientific and Cultural Organization (UNESCO) jointly released \u0026ldquo;Making Every School a Health Promoting School Global Standards and Indicators\u0026rdquo;, while the 2024 WHO publication \u0026ldquo;Making Every School a Health-Promoting School\u0026rdquo;: Implementation Guidance further underscores schools' critical function in managing public health emergencies. Schools serve not only as frontlines for preventing and controlling such emergencies but also as vital venues for cultivating students' health literacy and emergency response capabilities. The United Nations Sustainable Development Goals (SDGs) explicitly call to \"ensure healthy lives and promote well-being for all at all ages,\" schools are a key link in achieving this goal. Against the backdrop of the global COVID-19 pandemic, governments worldwide have strengthened school public health emergency management systems. For instance: France established a school epidemic response framework under the direct leadership of the Prime Minister, coordinated by the Ministry of the Interior and Ministry of Health. The UK government issued interim guidance, Coronavirus(COVID-19):safeguarding in schools, colleges and other providers \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. Through measures such as enhancing legal frameworks, intensifying emergency drills, and optimizing resource allocation, countries continue to bolster schools' capacity to respond to public health emergencies.\u003c/p\u003e\u003cp\u003eStatistics indicate approximately 75% of China's public health emergencies occur in schools \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e, typically comprising sudden infectious disease outbreaks, clusters of undiagnosed illnesses, and food/occupational poisoning incidents that pose severe health threats to students and staff due to their abrupt onset, high-risk impact, and public nature \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. Infectious diseases dominate these emergencies, accounting for 94.52% of school incidents in Beijing (2010\u0026ndash;2020) \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. To effectively respond, China promulgated the \"Regulations on Public Health in Schools\" as early as April 1990, clearly listing strengthening the prevention and treatment of infectious diseases as one of the core tasks of school health work. Since then, the relevant policy system has been continuously improved at the national level: In 2017, the General Office of the Ministry of Education issued the \"Notice on Further Improving the Prevention and Control of Infectious Diseases and Food Safety in Schools\". In 2021, five departments including the Ministry of Education jointly issued documents such as the \"Opinions on Comprehensively Strengthening and Improving School Health and Health Education in the New Era\", all emphasizing the establishment of a long-term prevention and control mechanism and the improvement of a disease prevention system, in order to comprehensively enhance schools' emergency response and health management capabilities in dealing with public health emergencies. In recent years, China has achieved certain results in responding to public health emergencies in schools, especially demonstrating strong institutional advantages in the prevention and control of the novel coronavirus pneumonia. The National Health Commission, in collaboration with the education department, promptly formulated the \"Notice on Issuing the Technical Plan for COVID-19 Prevention and Control in Higher Education Institutions, Primary and Secondary Schools, and Kindergartens (Fifth Edition)\", and through the establishment of a \"two plans and nine systems\" prevention and control system, continuously improved the regular epidemic prevention and control mechanism on campus. This system takes the \"two plans\" (the infectious disease epidemic prevention and control plan and the emergency response plan) as the guiding documents and establishes nine core systems as supporting measures: The reporting system for infectious disease outbreaks, morning and afternoon health checks for teachers and students, tracking of students' absences, verification of certificates for resumption of classes, health management, vaccination, health education, disinfection of venues and environmental inspection systems have been established, forming a three-dimensional prevention and control network covering prevention and monitoring, emergency response and health management. However, in the practice of COVID-19 prevention and control, the emergency management system of schools still exposed several key problems that urgently need to be improved: The emergency plans for public health emergencies in schools lack pertinence and operability; Emergency material reserves have not yet established a scientific and dynamic management mechanism, and the types, quantities and update frequencies of material reserves cannot meet the actual demands. The implementation of the infectious disease prevention and control system is insufficient. When implementing prevention and control measures, there are problems such as being formalistic and inadequate supervision \u003csup\u003e[\u003cspan additionalcitationids=\"CR7 CR8\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e. The top-level design of school emergency management, prevention and control capabilities, and the allocation of health resources directly affect the effectiveness of its emergency management for public health emergencies \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. The existence of the above-mentioned problems indicates that the school's public health emergency management system still needs to be further optimized and improved from institutional design to practical implementation. Research on public health emergencies in schools mostly focuses on the epidemic characteristics such as the types and outbreak times of infectious diseases, while investigations on the emergency management system, the allocation of emergency resources, and the implementation of infectious disease prevention and control systems are relatively scarce \u003csup\u003e[\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eAs the capital of China, Beijing assumes a leading role in formulating policies for managing public health emergencies in primary and secondary schools. Given the large number of such institutions, disparities in geographical location, school system types, and resource allocation across Beijing's schools result in varying levels of capacity to address public health emergencies, similar to other regions nationwide. By examining the current state of emergency system construction in Beijing's primary and secondary schools, a more comprehensive understanding can be achieved regarding the differences and commonalities in schools' emergency management capabilities, as well as their existing strengths and challenges. This study employs a multi-stage stratified random sampling method to investigate primary and secondary schools across different regions and school systems in Beijing, analyzing the current status and issues related to school-based public health emergency management, and offering recommendations for enhancing the level of emergency management in this domain.\u003c/p\u003e"},{"header":"2. Data and Method","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Investigation Method\u003c/h2\u003e\u003cp\u003eThe sample size was calculated using a cross-sectional study formula: ​\u003c/p\u003e\u003cp\u003e\u003cimg src=\"data:image/png;base64,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\"\u003e\u003c/p\u003e\u003cp\u003e, Z\u0026thinsp;=\u0026thinsp;1.96 (95% confidence level), E\u0026thinsp;=\u0026thinsp;0.05 (margin of error), and \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;38.98% (proportion of primary and secondary schools among all Beijing schools in 2023\u0026ndash;2024). This yielded a minimum requirement of 365 schools. Accounting for questionnaire validity and return rates, 400 schools were targeted. A multi-stage stratified random sampling approach was implemented: First, districts were allocated proportional sampling quotas based on their school distributions per 2023\u0026ndash;2024 Beijing Education Statistics \u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e; Second, schools within districts were randomly selected via random number tables; Finally, one school physician per school was randomly chosen by lot-drawing to complete the survey (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Of 400 distributed questionnaires, 399 valid responses were returned (99.75% validity rate). The study received ethical approval from Capital Medical University (No. Z2023SY093) and was conducted during April-May 2024.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Composition of the Questionnaire\u003c/h2\u003e\u003cp\u003eBased on a comprehensive review of literature and expert consultations, guided by the \"Guiding Opinions on Strengthening the Public Health System Construction in Schools in Beijing,\" and in accordance with relevant policies such as the \"Opinions on Comprehensively Strengthening and Improving School Health and Health Education in the New Era\" and the \"Regulations on School Health,\" our research team developed a specialized questionnaire to examine the routine emergency management of public health incidents in primary and secondary schools in Beijing. The reliability and validity of the questionnaire were evaluated through a pre-survey, and subsequent optimizations and improvements were made based on the pre-survey results. The questionnaire utilized in this study was specifically designed for this research (for detailed content, please refer to the supplementary file). It is structured into three sections: The first part is the basic information of the school, including the area where the school is located, the academic system, the number of campuses and the boarding system situation; The second part focuses on the infectious disease prevention and control system, with an emphasis on assessing the implementation and difficulties of the \"Two Plans and Nine Systems\". The third part examines the emergency management mechanism for public health emergencies in schools, mainly covering core elements such as the formulation of emergency plans, the frequency of emergency drills, the configuration of first aid facilities and equipment (including whether they are equipped and the number of fixed and portable AEDs), the types of emergency material reserves, and the organizational structure of emergency management (including the person in charge of the emergency leadership group). The selected variables mentioned above strictly follow the policy orientation to ensure that the research content is effectively connected with the current institutional norms, and the data collection has policy adaptability and practical guiding value.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Quality Control\u003c/h2\u003e\u003cp\u003eBefore the questionnaire officially begins, a small-scale pre-survey is conducted to focus on verifying the appropriateness of the item expressions and the feasibility of the survey process, thereby optimizing the questionnaire structure and option Settings. During the formal investigation stage, a standardized data collection process was adopted: Members of the research team sent an electronic letter of the \" Questionnaire on the Current Situation of Routine Emergency Management of Public Health Emergencies in Primary and Secondary Schools in Beijing \" to the school doctor via WeChat, along with a standardized operation guide including the research background, filling norms and confidentiality declaration. To ensure the quality of data collection, a dedicated person is arranged to track the progress of the filling and implement dynamic Q\u0026amp;A. Before entering the questionnaires, informed consent was obtained from all respondents. A unified database was established during the entry process. EpiData 3.1 software was used for double entry and real-time logical verification to ensure the accuracy, completeness and authenticity of the data.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Statistical Analysis Methods\u003c/h2\u003e\u003cp\u003eThe statistics of the data were conducted using SPSS version 26.0 software. Frequency, composition ratio and chi-square test were adopted to describe and analyze the basic situation of the school, the emergency prevention and control ability of public health emergencies of the school and the allocation of school health resources.\u003c/p\u003e\u003c/div\u003e"},{"header":"3 Result","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Basic Information of the School\u003c/h2\u003e\u003cp\u003eAmong the 399 schools surveyed, there are 189 urban schools, 146 schools in the near suburbs and 64 schools in the far suburbs. Among them, there were 185 primary schools (46.37%), 139 middle schools (34.84%), and 75 continuous schools (including nine-year and twelve-year continuous schools) (18.80%). The number of campuses is mainly 1 (63.41%). 76.94% are non-boarding schools.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Current Situation of Infectious Disease Prevention and Control in Schools\u003c/h2\u003e\u003cp\u003eThe survey results (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) show that 99.75% of schools can effectively implement the \"Two Plans and Nine Systems\". Among them, the top three infectious disease prevention and control systems that are difficult to implement are: the environmental hygiene inspection and notification system (16.29%), the student health management system, and the vaccination system (each accounting for 15.04%).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eImplementation and Existing Difficulties of the School's \"Two Plans and Nine Systems\"\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eRegion n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\u003cp\u003eEducational stage n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eTotal n(%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban District\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eInner Suburb\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eOuter\u003c/p\u003e\u003cp\u003eSuburb\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePrimary School\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSecondary School\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eIntegrated School\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eImplementation status of the \"Two Plans and Nine Systems\" framework\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFully implement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e175(92.59)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e127(86.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e58(90.63)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e171(92.43)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e124(89.21)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e65(86.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e360(90.23)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelatively fully implemented\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11(5.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e19(13.01)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6(9.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14(7.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e12(8.63)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e10(13.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e36(9.02)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGeneral\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2(1.06)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2(1.44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e2(0.50)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDifficult to fully implement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1(0.53)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1(0.72)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1(0.25)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDifficult-to-implement infectious disease prevention and control systems (multiple choices)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInfectious disease prevention and control plan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e23(12.17)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22(15.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9(14.06)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e24(12.97)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e21(15.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e9(12.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e54(13.53)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInfectious Disease Epidemic response plan\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24(12.70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26(17.81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9(14.06)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e22(11.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e25(17.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e12(16.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e59(14.79)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eReporting system for infectious disease epidemics and public health emergencies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24(12.70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22(15.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12(18.75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e28(15.14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e18(12.95)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e12(16.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e58(14.54)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMorning and noon health check system\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32(16.93)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16(10.96)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6(9.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e20(10.81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e17(12.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e17(22.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e54(13.53)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eThe registration system for students' absence from school due to illness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e29(15.34)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18(12.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7(10.94)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e23(12.43)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e19(13.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e12(16.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e54(13.53)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVerification system for resumption of classes certificates\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e23(12.17)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18(12.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9(14.06)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e21(11.35)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e18(12.95)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e11(14.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e50(12.53)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStudent health management system\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32(16.93)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22(15.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6(0.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e27(14.59)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e21(15.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e12(16.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e60(15.04)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVaccination system\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32(16.93)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20(13.70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8(12.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e31(16.76)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e17(12.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e12(16.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e60(15.04)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHealth education system for infectious disease prevention and control\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e23(12.17)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12(8.22)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5(7.81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14(7.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e16(11.51)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e10(13.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e40(10.03)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVentilation and disinfection system\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e25(13.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13(8.90)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6(9.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e16(8.65)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e20(14.39)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e8(10.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e44(11.03)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEnvironmental sanitation inspection notification system\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e28(14.81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25(17.12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12(18.75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e29(15.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e25(15.83)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e14(18.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e65(16.29)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cb\u003eNote: \" Difficult-to-implement infectious disease prevention and control systems \" is a multiple-choice question, so the total percentage is not 1.\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Current Situation of School Emergency Management for Public Health Incidents\u003c/h2\u003e\u003cp\u003e\u003cb\u003e(1) Emergency Plans and Emergency Drills\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe survey results (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) show that almost all schools (99.25%) have formulated emergency plans for public health incidents. Regarding the frequency of emergency drills, 67.92% of the schools conduct one drill per semester, 15.79% conduct one drill per quarter, and 9.27% conduct one drill per year.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSchool Emergency Plans and Emergency Drills Situation\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eRegion n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\u003cp\u003eEducational stage n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eTotal n (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban\u003c/p\u003e\u003cp\u003eDistrict\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eInner\u003c/p\u003e\u003cp\u003eSuburb\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eOuter\u003c/p\u003e\u003cp\u003eSuburb\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePrimary\u003c/p\u003e\u003cp\u003eSchool\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSecondary School\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eIntegrated School\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWhether an emergency response plan for public health emergencies has been formulated\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e189(100.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e144(98.63)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e63(98.44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e184(99.46)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e138(99.28)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e74(98.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e396(99.25)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2(1.37)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1(1.56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1(0.54)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1(0.72)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1(1.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e3(0.75)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFrequency of emergency drills\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1(0.53)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e1(0.72)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0(0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1(0.25)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOnce every quarter\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e27(14.29)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25(17.12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11(17.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e32(17.30)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e20(14.39)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e11(14.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e63(15.79)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOnce a semester\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e135(71.43)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e93(63.70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e43(67.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e126(68.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e94(67.63)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e51(68.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e271(67.92)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOnce a year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e16(8.47)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15(10.27)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6(9.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e13(7.03)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e16(11.51)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e8(10.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e37(9.27)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10(5.29)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13(8.90)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4(6.25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14(7.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e8(5.76)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e5(6.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e27(6.77)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e(2) Current Status of Emergency Preparedness and Material Allocation\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe survey results (Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e) indicate that, in terms of emergency material allocation, the provision rates for temperature detection supplies (e.g., mercury thermometers, forehead thermometers, etc.) and personal protective equipment (e.g., disposable medical masks, etc.) exceed 99%. The allocation rate for surface disinfection supplies (e.g., chlorine-based disinfectants, 75% ethanol disinfectant, etc.) is as high as 98.25%, while the allocation rates for air disinfection supplies (e.g., ultraviolet lamps, air disinfection machines, disinfectants, etc.) (96.49%) and vomit/excrement disinfection supplies (e.g., vomiting emergency disposal kits, etc.) (96.74%) are slightly lower. Regarding emergency medical supplies, 96.49% of schools have equipped automated external defibrillators (AEDs) and other emergency facilities, with a higher allocation rate for fixed AEDs (71.93%) compared to portable AEDs (42.86%).\u003c/p\u003e\u003cp\u003eComparisons of regional and school educational stage factors reveal variations in schools' emergency response capabilities. Chi-square test results demonstrate statistically significant differences in AED and other emergency equipment allocation across regions (χ\u0026sup2; = 6.449, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.04). The allocation rate is highest in near suburban areas (99.32%), followed by far suburban areas (96.88%) and urban areas (94.18%). In terms of fixed and portable AED allocation, there are statistically significant differences among school systems for both fixed AEDs (χ\u0026sup2; = 10.982, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.027) and portable AEDs (χ\u0026sup2; = 11.771, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.019). Specifically, primary schools exhibit a higher allocation rate for fixed AEDs (77.30%) compared to middle schools (69.78%) and all-round schools (62.67%), whereas all-round schools show a higher allocation rate for portable AEDs (52.00%) compared to middle schools (46.76%) and primary schools (36.22%).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCurrent Status of School Emergency Material Preparation\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eRegion n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c8\" namest=\"c5\"\u003e\u003cp\u003eEducational stage n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eTotal n (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban District\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eInner Suburb\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eOuter Suburb\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePrimary\u003c/p\u003e\u003cp\u003eSchool\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSecondary School\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eIntegrated School\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTypes of emergency supplies\u003c/p\u003e\u003cp\u003e(multiple choices)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTemperature measurement supplies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e189(100.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e145(99.32)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e64(100.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e185(100.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e138(99.28)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e75(100.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e398(99.75)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePersonal protective equipment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e188(99.47)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e144(98.63)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e63(98.44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e184(99.46)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e137(98.56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e74(98.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e395(99.00)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAir disinfection supplies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e180(95.24)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e142(97.26)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e63(98.44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e178(96.22)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e136(97.84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e71(94.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e385(96.49)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurface disinfection supplies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e187(98.94)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e143(97.95)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e62(96.88)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e183(98.92)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e135(97.12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e74(98.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e392(98.25)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDisinfection supplies for vomit and excrement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e187(98.94)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e141(96.58)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e58(90.63)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e180(97.30)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e132(94.96)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e74(98.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e386(96.74)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHand disinfection supplies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e185(97.88)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e140(95.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e63(98.44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e182(98.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e136(97.84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e70(93.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e388(97.24)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"9\"\u003e\u003cb\u003eNote: \"Types of emergency supplies\" is a multiple-choice question, so the percentages do not add up to 1.\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCurrent Status of School Emergency Supplies Preparation\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"16\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e变量\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e\u003cp\u003eRegion n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eχ2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"5\" nameend=\"c13\" namest=\"c9\"\u003e\u003cp\u003eEducational stage n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eχ2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c15\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c16\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eTotal n(%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUrban District\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eInner Suburb\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eOuter Suburb\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003ePrimary\u003c/p\u003e\u003cp\u003eSchool\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e\u003cp\u003eSecondary School\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c13\" namest=\"c12\"\u003e\u003cp\u003eIntegrated School\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWhether it is equipped with emergency equipment and facilities such as AED\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e6.449\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0.040\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e3.476\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e0.176\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e178(94.18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e145(99.32)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e62(96.88)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003e180(97.30)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u003cp\u003e131(94.24)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e74(98.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e385(96.49)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e11(5.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e1(0.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2(3.13)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003e5(2.70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u003cp\u003e8(5.76)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e1(1.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e14(3.51)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThe number of fixed AEDs\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e4.174\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.383\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e10.982\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u003cb\u003e0.027\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eZero\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e57 (30.16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e33(22.60)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e22(34.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003e42(22.70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u003cp\u003e42(30.22)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e28(37.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e112(28.07)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOne\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e96 (50.79)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e79(54.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e31(48.44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003e111(60.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u003cp\u003e64(46.04)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e31(41.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e206(51.63)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMore than one\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e36 (19.05)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e34(23.29)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e11(17.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003e32(17.30)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u003cp\u003e33(23.74)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e16(21.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e81(20.30)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of portable AEDs\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e8.609\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e11.771\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e\u003cb\u003e0.019\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eZero\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e105(55.56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e94(64.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e29(45.31)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003e118(63.78)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u003cp\u003e74(53.24)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e36(48.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e228(57.14)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOne\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e58(30.69)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e41(28.08)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e24(37.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003e50(27.03)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u003cp\u003e50(35.97)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e23(30.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e123(30.83)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMore than one\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e26(13.76)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e11(7.53)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e11(17.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003e17(9.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u003cp\u003e15(10.79)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e16(21.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e48(12.03)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"4 Discussion","content":"\u003cp\u003e\u003cb\u003e4.1 The overall implementation of the \"Two Plans and Nine Systems\" has been satisfactory; however, the execution of certain systems warrants further attention and improvement.\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIn April 2020, the National Health Commission of the People's Republic of China issued the \"Notice on Further Strengthening the Prevention and Control of Key Infectious Diseases in Autumn and Winter\", requiring local authorities to guide schools in establishing an infectious disease prevention and control system of \"two plans and nine systems\". At present, 99.75% of primary and secondary schools in Beijing have largely implemented the \"two plans and nine systems\" framework. However, challenges remain more pronounced in the implementation of specific systems, such as the environmental hygiene inspection and notification system (16.29%), the student health management system, and the vaccination system (each accounting for 15.04%). Firstly, there is the reporting system for hygiene inspections. Environmental hygiene conditions in primary and secondary schools across China exhibit variations based on region and school educational stage. The qualification rates for teaching environmental hygiene are highest in urban areas and primary schools, whereas environmental hygiene management in rural schools, particularly concerning drinking water and toilet hygiene, requires further strengthening \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. This urban-rural disparity (between urban areas and far suburbs) is particularly pronounced in the suburban regions of Beijing. For instance, in Miyun District, the issue of unregulated domestic sewage discharge is significant. Approximately one-quarter of the residents dispose of sewage in non-compliant manners. Furthermore, numerous garbage disposal sites are located in environmentally sensitive areas, such as farmland and river courses, creating persistent pollution sources \u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. Such environmental issues are transmitted to campuses through various pathways: sewage seepage compromises the safety of groundwater, potentially impacting the quality of drinking water in school; uncontrolled garbage accumulation exacerbates the risk of disease vector transmission, posing significant hazards for the spread of infectious diseases. These challenges are further exacerbated by the structural constraints commonly encountered by rural schools, including inadequate educational resources, limited financial support, and insufficient decision-making autonomy \u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e. In this context, the effectiveness of implementing the school hygiene inspection and notification system may be constrained by the following factors: First, governance measures aimed at upgrading infrastructure such as water supply systems, construction of sanitary toilets, and garbage and sewage treatment require sustained financial investment. However, rural and suburban schools typically face rigid constraints due to insufficient financial resources. Second, while the introduction of socialized services (e.g., outsourcing daily campus cleaning and toilet maintenance to professional cleaning companies or entrusting the operation and maintenance of water purification equipment to specialized institutions) can alleviate management pressure and enhance the efficiency of school hygiene management, the quality of service delivery depends heavily on the level of financial support available. Third, the continuous input of external environmental risks combined with systemic shortages in school hygiene management resources creates a cumulative effect, which results in the difficulty of effectively implementing preventive and control measures within the school hygiene inspection and notification system, even when it is established, due to inadequate foundational support. The United States Environmental Protection Agency (EPA) offers theoretical guidance and practical tools to support schools in developing and implementing environmental health plans. However, given the non-mandatory nature of these measures, the level of enforcement varies significantly across states. Many schools face challenges in effectively managing their environmental hygiene due to insufficient infrastructure, a shortage of dedicated personnel, limited funding, and inadequate training resources \u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e. In Brazil, the operational nature of a school (whether it is public or private) and its geographical location (specifically, whether it is situated in a state capital) also influence the sanitary conditions of the school environment \u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. Owing to economic limitations and the inadequate enforcement of relevant policies, schools typically lack designated personnel responsible for environmental hygiene inspections and notifications. This, in turn, exacerbates the challenges associated with implementing the hygiene inspection and notification system. The second is the student health management system. Currently, the process of student health management in Chinese primary and secondary schools remains relatively coarse, with inadequate emphasis on health management. The phenomenon of \"testing without managing\" regarding students' health information is prevalent, and there is a significant shortage of professional health management personnel. These factors substantially impede the effective implementation of student health management systems in schools \u003csup\u003e[\u003cspan additionalcitationids=\"CR23\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e. Health management occupies a significant position within the framework of school health in Japan. All primary and secondary schools in Japan are staffed with dedicated nursing teachers who are responsible for overseeing school health and safety management. These professionals provide personalized health guidance to students, with an emphasis on fostering students' ability and attitude toward identifying and addressing health and safety issues\u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e. The objective of school health management is to systematically collect students' health information, predict the trajectory of their health conditions, provide timely intervention and guidance, and ultimately foster students' proactive adoption of a health-conscious mindset. The third aspect is the vaccination system. Vaccination serves as an effective measure to prevent infectious diseases, mitigate the severity of illness, and decrease the risk of transmission \u003csup\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e. The school collaborates with the community health service center to jointly facilitate vaccination efforts. In this partnership, the school is responsible for organizing and coordinating vaccination activities while not imposing mandatory requirements regarding students' vaccination status. For students who are willing to receive vaccination but are unable to do so within the prescribed timeframe due to special circumstances, the school can offer personalized appointment services. It can also assist students and their parents in liaising with the community health service center, flexibly adjust the vaccination schedule, and provide options such as weekend vaccinations or extended vaccination cycles. Currently, countries such as Canada, the United Kingdom, Australia, and the United States have established school-based vaccination programs, offering free vaccination services within schools to enhance the vaccination coverage among school-aged children \u003csup\u003e[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e. Following the implementation of the school vaccination program, the vaccination rate among students has shown an increase. However, concerns raised by parents regarding the safety of vaccines and the adequacy of the vaccination environment within schools have impacted the further advancement of the school vaccination program \u003csup\u003e[\u003cspan additionalcitationids=\"CR28\" citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/sup\u003e. Consequently, schools should fully utilize the home-school cooperation mechanism to deliver targeted health education to parents. This can be accomplished through organizing lectures, distributing health handbooks, and disseminating scientific information via social media platforms. These efforts aim to educate parents about vaccines, enhance their confidence in the safety and efficacy of vaccines, transform their behavioral parent lectures, distributing health handbooks, and disseminating scientific information via social media platforms. These efforts aim to enhance parents' understanding of vaccines, strengthen their confidence in vaccine safety and efficacy, modify their attitudes, facilitate the effective implementation of the vaccination system in schools, and ultimately increase the vaccination rate among primary and secondary school students \u003csup\u003e[\u003cspan additionalcitationids=\"CR31\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003e\u003cb\u003e4.2 The coverage rate of emergency drills for public health incidents in schools is relatively high, and the configuration of relevant materials is gradually being optimized.\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIn 2014, the Ministry of Education issued the \"Guidelines for Emergency Evacuation Drills in Primary and Secondary Schools and Kindergartens,\" explicitly requiring all levels of schools to develop their own emergency drill plans and conduct at least one emergency evacuation drill per month. In China, 98.43% of primary and secondary schools have conducted emergency drills for public health incidents. By contrast, only 64% of schools in the United States have established designated emergency action plans, which underscores the institutional advantages of China's top-level design in emergency management \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/sup\u003e. Among these regions, Beijing performs exceptionally well, with 99.25% of schools having formulated emergency response plans. Nevertheless, there remains room for improvement in the dynamic management of these plans, as the updates to emergency plans need to align more closely with the requirements of higher-level documents, particularly to address the evolving nature of new public health risks. Currently, 83.71% of primary and secondary schools in Beijing have established a routine emergency drill mechanism, with no significant variation observed across regions or school educational stage. Nevertheless, 0.25% of schools have never organized any emergency drills, revealing potential blind spots in emergency management. Further guidance and oversight are therefore required. In the process of developing emergency drill plans and conducting routine drills, schools not only evaluate the effectiveness of their emergency response plans but also identify deficiencies in the provision of emergency supplies. In Beijing's primary and secondary schools, a diverse range of emergency supplies is available; however, the availability rate of air disinfection products and disinfection products for vomit and excrement (approximately 96%) is slightly lower compared to other types of emergency supplies. This, to some extent, diminishes the material support for school environmental hygiene inspections and constrains the school's capacity to address and report environmental inspection issues. According to the \"Standards for School Health (Medical) Rooms\" issued by the National Health Commission in 2024, school health (medical) rooms must be equipped not only with basic first aid equipment such as first aid kits and tourniquets but also, in accordance with the school's emergency response plans, maintain an adequate stock of disinfection products, masks, gloves, non-contact thermometers, hand sanitizers, and other medical supplies. Additionally, expired or damaged hygiene supplies must be updated promptly through regular inspections.To ensure the efficacy of materials and the standardization of management, schools must establish a comprehensive material management system. First, a detailed material inventory should be developed, which at a minimum includes critical information such as the name, specification, quantity, and expiration date of the materials. Second, to further enhance material management, schools can collaborate with procurement platforms to establish a dual-purpose material reserve mechanism that accommodates both routine and emergency scenarios. This mechanism will clarify and refine processes related to material renewal, procurement, storage, and utilization. Through these management measures, it is ensured that emergency and other health-related materials in schools are updated promptly, thereby preventing the use of expired or damaged items and safeguarding the health and safety of faculty and students. While standardizing the storage of emergency materials, the provision of first-aid facilities must also be prioritized. In 2022, the China Education Equipment Industry Association released the \"Standard for the Provision of Campus First Aid Facilities and Equipment (Trial)\" which specifies that schools at the compulsory education stage must be equipped with one automated external defibrillator (AED) unit. Currently, 96.49% of primary and secondary schools in Beijing have been equipped with automated external defibrillators (AEDs) and other first-aid facilities and equipment. This significant achievement can be largely attributed to the \"Notice on Properly Implementing the Configuration of Automated External Defibrillators (AEDs) in Schools\" previously issued by Beijing authorities. The notice explicitly stipulates that the procurement costs for AEDs in primary and secondary schools shall be coordinated and resolved by the education commissions of each district, thereby providing a robust financial guarantee for the configuration process. With this policy support, the implementation in Beijing's near suburbs stands out notably, with the equipment rate of first-aid facilities and equipment in schools reaching 99.32%. This has effectively facilitated the widespread adoption of first-aid facilities and equipment in schools and established effective emergency preparedness to mitigate potential school emergencies in suburban areas. In terms of the AED deployment strategy, primary school students generally experience relatively lower academic pressure, engage in more frequent physical education classes and recess activities, and exhibit higher levels of physical activity intensity. Consequently, when deploying AEDs, it is essential to prioritize addressing various potential emergencies. Fixed AEDs, due to their advantages such as conspicuous installation locations, robust stability, and reduced likelihood of being moved or damaged, have been more extensively adopted in primary schools, achieving a configuration rate of 77.30%, which is the highest among all educational systems. Integrated schools, given their broad range of educational stages and large student populations, demonstrate a greater need for portable AEDs, leading to a higher configuration rate of portable AEDs (52.00%). Considering that the current AED configuration in schools has achieved certain outcomes, the next step should focus on enhancing first aid training. In the United States, 76% of teachers, 68% of administrative staff, and 28% of students have undergone CPR training \u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e. In 2021, the Education Office issued the \"Notice on Further Promoting School Emergency Rescue Work,\" emphasizing the implementation of emergency rescue training and the dissemination of emergency rescue knowledge and skills as critical components of school health education and youth quality education. The popularization of emergency rescue knowledge and the practical application skills on campus can be promoted by engaging professional first-aid personnel to deliver training on the use of AEDs and other equipment to teachers and senior students, as well as by integrating first-aid courses into the student health education curriculum.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThe prevention and control system for public health emergencies in primary and secondary schools in Beijing demonstrates a complex characteristic encompassing \"a complete institutional framework, a gradient of implementation efficiency, and an imbalance in guarantee levels.\" The city has constructed a three-dimensional prevention and control framework, with the \"two plans and nine systems\" institutional network (achieving a coverage rate of 99.75%) serving as the top-level design, the regular emergency drill mechanism (with a popularization rate of 83.71%) functioning as the implementation pathway, and the first-aid facility configuration system (with an AED coverage rate of 96.49%) providing hardware support. Notably, the near suburbs have attained an ultra-high configuration rate of 99.32% for first-aid facilities, underscoring the systematic integration capability of public health governance in the capital.\u003c/p\u003e\u003cp\u003eHowever, the phenomenon of gradient attenuation in prevention and control effectiveness merits attention, primarily manifesting in the following aspects:\u003c/p\u003e\u003cp\u003e\u003cb\u003e(1) The enforcement of environmental hygiene management is inadequate.\u003c/b\u003e The implementation rate of the environmental hygiene inspection and notification system remains relatively low (only 16.29%), reflecting the combined impact of delayed risk management in off-campus environmental governance and insufficient allocation of on-campus hygiene management resources. To address these challenges, a comprehensive governance framework integrating \"financial guarantee - diversified fundraising - school and local collaboration\" should be established: Firstly, enhance government special allocations with a focus on prioritizing the renovation of water supply and toilet facilities in rural schools; secondly, establish a diversified funding mechanism combining \"government subsidies, social donations, and user fees,\" encouraging enterprises and public welfare organizations to participate in school environmental hygiene services, thereby alleviating financial burdens and ensuring sustainable funding for socialized services; finally, collaborate with environmental protection departments to address sewage and garbage issues surrounding schools, mitigating the adverse effects of off-campus pollution on campus environments. Through multi-stakeholder cooperation, the issues of insufficient funding and resource scarcity can be progressively resolved.\u003c/p\u003e\u003cp\u003e\u003cb\u003e(2) There is a notable deficiency in the provision of refined guidance within health monitoring systems.\u003c/b\u003e Presently, health monitoring predominantly emphasizes information collection, significantly lagging behind Japan's sophisticated management approach, which incorporates professional nursing teachers to provide trend-based health guidance and proactive intervention strategies. To address the issue of insufficiently detailed health monitoring, it is recommended to integrate Japan's advanced health management model with cutting-edge digital technologies, establish a district-level school health big data center, and develop an electronic health record system equipped with trend warning functionalities. Each school should appoint a clinically qualified health manager. By leveraging big data technology, critical data such as student absenteeism rates and abnormal physical examination values can be systematically collected and analyzed to construct an early warning model for infectious diseases.\u003c/p\u003e\u003cp\u003e\u003cb\u003e(3) There exists a structural imbalance in the allocation of emergency resources.\u003c/b\u003e The scarcity of disinfection supplies (4%) and the fact that 0.25% of schools lack emergency management plans create a compounded risk, underscoring the delay in constructing intelligent material monitoring systems. It is recommended to establish a three-tier material network comprising \"municipal reserve centers - district-level transfer stations - school intelligent cabinets\" and optimize the material allocation pathway through the application of a dynamic demand prediction model.\u003c/p\u003e\u003cp\u003e\u003cb\u003e(4) The development of first aid capabilities exhibits a tendency of being \"hardware-focused while neglecting software.\"\u003c/b\u003e Despite the leading rate of first aid material provision, the training of first aid skills requires further enhancement. To address the lag in skills training, it is proposed to construct a three-pronged improvement mechanism integrating \"qualification certification - course development - practical drills\": incorporate first aid skills into supplementary criteria for teacher title evaluation, develop a tiered first aid course system; emphasize cultivating emergency awareness in primary schools and implement CPR/AED practical training in middle schools; collaborate with tertiary hospitals to establish first aid training bases within schools and conduct comprehensive drills covering school public health emergencies on a semester basis.\u003c/p\u003e"},{"header":"Declarations","content":"\u003col\u003e\n\u003cli\u003e\u003cstrong\u003e Ethical Approval and Consent to participate:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eThis study was approved by the Research Ethics Committee of Capital Medical University (Approval Number: Z2023SY093). The respondents of the questionnaire in this study were school doctors from primary and secondary schools in the sampled areas of Beijing. When distributing the questionnaires, their informed consent was obtained, and they were informed that the information filled in the questionnaires would only be used for the collection of basic data and would be strictly confidential. Therefore, this study complies with the Declaration of Helsinki. Ethical approval was obtained from the ethics committee before the start of the study; and the privacy of the research participants was protected, and informed consent was also obtained from the participants.\u003c/p\u003e\n\u003col start=\"2\"\u003e\n\u003cli\u003e\u003cstrong\u003e Consent for publication\u003c/strong\u003e\u003cstrong\u003e：\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eNot applicable. This study does not involve human data.\u003c/p\u003e\n\u003col start=\"3\"\u003e\n\u003cli\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. All data generated or analysed during this study are included in this published article [and its supplementary information files].\u003c/p\u003e\n\u003col start=\"4\"\u003e\n\u003cli\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u0026nbsp;The authors declare that they have no competing interests.\u003c/p\u003e\n\u003col start=\"5\"\u003e\n\u003cli\u003e\u003cstrong\u003e Funding:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eThe funding for this research was provided by the Open Research Project of the Capital Institute of Health Management and Policy. The project proposal is uploaded to the system as an attachment. This study does not involve the use of datasets, so this item is not applicable.\u003c/p\u003e\n\u003col start=\"6\"\u003e\n\u003cli\u003e\u003cstrong\u003e Author Contributions:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eHXY was the primary contributor to the manuscript. GM and ZhJX were responsible for literature search and organization. YJ was in charge of the overall article structure, outline, and revision. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003col start=\"7\"\u003e\n\u003cli\u003e\u003cstrong\u003e Acknowledgements:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003col start=\"8\"\u003e\n\u003cli\u003e\u003cstrong\u003e Author Information:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eFirst Author: Hou Xinyu, is a current master's student. Research interests: School Health.\u003c/p\u003e\n\u003cp\u003eCorresponding Author: Yang Jia, Associate Professor. Research interests: Health Policy, School Health, etc.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHERLITZ L, MACINTYRE H, OSBORN T, et al. The sustainability of public health interventions in schools: a systematic review[J]. Implement Sci. 2020;15(1):4.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLiu LF, Fan ZM, Liu LJ. Insights from the Models of Infectious Disease Prevention and Control in Primary and Secondary Schools in France, the United Kingdom and the United States [J]. Chin J School Health. 2020;41(12):1767\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWeng XJ, Wang Y, Wang XH, et al. Analysis of the Epidemiological Characteristics of Infectious Public Health Emergencies in Schools (Kindergartens and Nurseries) across China from 2014 to 2016 [J]. Disease Surveillance. 2019;34(5):446\u0026ndash;50.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOu QX, Liu FG. 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Mod Disease Control Prev. 2024;35(9):705\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhang X. Emerging infectious diseases are an eternal challenge for school health [J]. Chin J School Health. 2020;41(5):641\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBeijing Municipal Education Commission. Statistical Overview of Beijing's Education Development in the 2023\u0026ndash;2024 Academic Year [EB/OL]. (2024-03-22)[2025-05-01]. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://jw.beijing.gov.cn/xxgk/shujufab/tongjigaikuang/202403/t20240321_3596738.html\u003c/span\u003e\u003cspan address=\"https://jw.beijing.gov.cn/xxgk/shujufab/tongjigaikuang/202403/t20240321_3596738.html\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCha YE, Fu YZ, Yao W. 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Research on the Operation Guarantee of Small-scale Rural Schools in J City [D]. Nanchong: China West Normal University; 2023.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhang X. Research on the Current Situation and Optimization of Rural Compulsory Education Resource Allocation in Laiyang City [D]. Yantai: Yantai University; 2023.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGOUGE D H, LAME M L, STOCK T W, et al. Improving Environmental Health in Schools[J]. Curr Probl Pediatr Adolesc Health Care. 2023;53(4):101407.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHORTA R L, ANDERSEN C S, PINTO R O, et al. Health promotion in school environment in Brazil[J]. Volume 51. Revista de Sa\u0026uacute;de P\u0026uacute;blica; 2017. p. 27.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCao PJ, Pan YP. Discussion on the Importance of Health Management for Teenage Students [J]. Chin J School Doctor. 2009;23(6):713.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhao Y. Research on the Implementation of a New Strategy for Student Health Management in Chinese Schools [J]. J Nanjing Sport Inst (Social Sci Edition), 2007(4): 13\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eXu Y, Zhu H. The Current Situation and Countermeasures of School Health Management in China [J]. Chin J School Health. 2016;37(2):164\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTOMOKAWA S, SHIRAKAWA Y, MIYAKE K, et al. Lessons learned from health education in Japanese schools[J]. Pediatr Int. 2021;63(6):619\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eQin JM. The Current Situation and Response Measures of Public Health Emergencies in Schools in China [J]. J Appl Prev Med. 2021;27(4):382\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKANG GJ, CULP R K, ABBAS KM. Facilitators and Barriers of Parental Attitudes and Beliefs toward School-Located Influenza Vaccination in the United States. Syst Review[J] Vaccine. 2017;35(16):1987\u0026ndash;95.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKELLY D A, MACEY D J. MAK D B. Annual influenza vaccination[J]. Hum Vaccines Immunotherapeutics. 2014;10(7):1930\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYOO B K, SCHAFFER S J, HUMISTON S G, 等. Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children[J]. BMC Health Serv Res. 2019;19(1):407.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMai YZ, Li JL, Xie S, et al. Analysis of the Protective Effect and Influencing Factors of Varicella Vaccination on School Outbreaks [J]. Chin J School Health. 2023;44(2):278\u0026ndash;81.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHuang YD, Li JY, Lv HY. Analysis of the awareness of varicella vaccination among parents of school-age children and its influencing factors [J]. Chin J Public Health Manage. 2020;36(6):848\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eQin Y, Liu LJ, Liu YQ, et al. Evaluation of the Health Education Effect on Influenza Vaccine Vaccination among Parents of School Students in Mianyang City during 2021\u0026ndash;2022 [J]. J Prev Med Inform. 2024;40(9):1111\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLiang HN, Zhou Q. Comprehensive Quality Management Evaluation of Emergency Response Plans in American Schools Based on the QuEP Framework [J]. J Chengdu Normal Univ. 2022;38(3):101\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOLYMPIA RP, AVNER WANE. The preparedness of schools to respond to emergencies in children: a national survey of school nurses[J]. Pediatrics. 2005;116(6):e738\u0026ndash;45.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Primary and secondary schools, school health, Public health emergencies, Emergency management","lastPublishedDoi":"10.21203/rs.3.rs-6819081/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6819081/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eTo analyze the current status of public health emergency management in primary and secondary schools in Beijing through cross-regional and cross-educational-stage comparisons, providing a scientific basis for optimizing the schools' routine emergency prevention and control systems.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e\u003cp\u003eA multi-stage stratified cluster random sampling method was employed to select 399 primary and secondary schools in Beijing for a questionnaire survey.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e\u003cp\u003eIn terms of policy implementation, 99.75% of schools achieved near-universal coverage of the \"Two Plans and Nine Systems\" framework; however, environmental health inspection reporting (16.29%) and student health management/vaccination systems (15.04%) emerged as weak points. The emergency plan formulation rate reached 99.25%, while 67.92% of schools conducted emergency drills once per semester. Regarding resource allocation, basic protective supplies and disinfection materials were well-equipped, though Chi-square tests (χ\u0026sup2;) revealed structural disparities in first-aid equipment: suburban areas demonstrated the highest Automated External Defibrillator(AED) configuration rate (99.32%), fixed AEDs showed optimal coverage in primary schools (77.30%), and portable AED availability led in integrated schools (52.00%).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eBeijing's primary and secondary schools have established a public health emergency prevention and control system featuring the \"Two Plans and Nine Systems\" framework as its top-level design, routine emergency drills as its implementation pathway, and first-aid facility reserves as its foundation. However, three key shortcomings persist: weak implementation of environmental health inspections, insufficiently refined health monitoring, and uneven distribution of emergency medical resources (particularly AEDs). Recommendations include establishing diversified funding mechanisms, optimizing resource allocation pathways, and strengthening inter-departmental collaboration to systematically enhance school emergency management efficacy.\u003c/p\u003e","manuscriptTitle":"Analysis of the Current Status of Routine Emergency Management of Public Health Emergencies in Primary and Secondary Schools: A Sampling Study Based on 399 Schools in Beijing, China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-15 13:33:50","doi":"10.21203/rs.3.rs-6819081/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-07-21T16:05:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"203574664307762823285245962213792571699","date":"2025-07-11T12:13:21+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-09T15:18:10+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-16T13:28:47+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-06-10T08:54:28+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-10T03:33:06+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-06-10T03:28:55+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"981c91da-5ca4-44a7-83cd-ab0bfc9a6d93","owner":[],"postedDate":"July 15th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-07-15T13:33:50+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-15 13:33:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6819081","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6819081","identity":"rs-6819081","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}