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Soo JC, Portnoff L, Bickson J, Fisher EM. Development of an experimental technique to determine the barrier performance of medical gloves when stretched. Ann Work Expo Health 2024; 68:811-819. [PMID: 39011929 DOI: 10.1093/annweh/wxae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 06/28/2024] [Indexed: 07/17/2024] Open
Abstract
Protective clothing standards, such as test methods published by ASTM International, play an integral role in ensuring the performance of personal protective equipment. The standard tests are not without limitations and are periodically reviewed and often updated. Some tests may not be reflective of in-use conditions. A new test cell was designed using sanitary fixtures to evaluate the effect of glove stretch on barrier performance using fluorescein solution as the challenge agent for enhanced visualization and fluorometer detection. Domed-shaped and flat screens were developed to permit and limit glove stretch within the test cell. The barrier performance of glove swatches was evaluated for both stretched and unstretched states. Latex, nitrile, and vinyl glove models of various thicknesses were evaluated. The tests were conducted following pressure and time parameters specified in ASTM F903, ASTM F1670, and ASTM F1671. Fluorescein solution movement, which may occur through penetration, was measured using a fluorometer. Glove stretch caused a reduction in glove thickness ranging from 16% to 40%. Overall, 21 sample failures were found (16.7%; n = 126) regardless of test condition. Nitrile gloves provided better barrier efficacy with the lowest failure rates (2.38%; 1 failure out of 42) compared to latex (19.4%; 7 failures out of 36) and vinyl gloves (27.1%; 13 failures out of 48). Differences in failure rates between stretched and unstretched gloves were insignificant; however, the latex material showed a 2.5 times increase in failures when stretched compared to unstretched. The new test apparatus was able to differentiate between the barrier performance of different glove materials. The use of a domed screen allowed the gloves to stretch, a condition that better represents the state of gloves when in use. Analysis of samples collected from the glove surface opposite to the exposure may provide a way to assess chemical permeation in addition to penetration.
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Affiliation(s)
- Jhy-Charm Soo
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College Public Health, Georgia Southern University, Statesboro, GA 30460, United States
| | - Lee Portnoff
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Pittsburgh, PA 15236, United States
| | - Joseph Bickson
- Pittsburgh Mining Research Division, NIOSH, CDC, Pittsburgh, PA 15236, United States
| | - Edward M Fisher
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Pittsburgh, PA 15236, United States
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Mehrotra P, Desai A. Resource sustainability and challenges in the supply chain: implications for infection prevention. Curr Opin Infect Dis 2024; 37:277-281. [PMID: 38843441 DOI: 10.1097/qco.0000000000001033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
PURPOSE OF REVIEW Infection prevention and control practices remain the bedrock of healthcare associated infection prevention and outbreak and epidemic control efforts. However, issues in supply chain management can hinder these efforts, as exemplified by various public health emergencies. This review explores the key role of supply chains in infection prevention and explores specific challenges. RECENT FINDINGS In all of the critical components of infection prevention and control - hand hygiene, personal protective equipment, sterile supplies, environmental disinfection, and waste management - disruptions in supply chains have led to limited availability and dissemination. SUMMARY Strategies to mitigate these resource constraints in the inter-epidemic period will also be highlighted. The infection prevention workforce is well poised to inform supply chain dynamics. Without robust and adequate supply chains, infection prevention and control efforts suffer which perpetuates healthcare-associated infections, clusters, and epidemics.
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Affiliation(s)
- Preeti Mehrotra
- Beth Israel Deaconess Medical Center, Division of Infectious Diseases, Boston, Massachusetts
| | - Angel Desai
- University of California, Davis, Division of Infectious Diseases, Sacramento, California, USA
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Lane M, Pompeii L, Rios J, Benavides E, Kasbaum M, Patlovich S, Ostrosky-Zeichner L, Hornbeck A, McClain C, Fernando R, Sietsema M, Kraft C. Provider experiences with daily use of elastomeric half-mask respirators in health care. Am J Infect Control 2024; 52:745-750. [PMID: 38278304 DOI: 10.1016/j.ajic.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND During public health emergencies, demand for N95 filtering facepiece respirators (N95 FFRs) can outpace supply. Elastomeric half-mask respirators (EHMRs) are a potential alternative that are reusable and provide the same or higher levels of protection. This study sought to examine the practical aspects of EHMR use among health care personnel (HCP). METHODS Between September and December 2021, 183 HCPs at 2 tertiary referral centers participated in this 3-month EHMR deployment, wearing the EHMR whenever respiratory protection was required according to hospital protocols (ie, when an N95 FFR would typically be worn) and responding to surveys about their experience. RESULTS Participants wore EHMRs typically 1 to 3 hours per shift, reported disinfecting the respirator after 85% of the removals, and reported high confidence in using the EHMR following the study. EHMRs caused minimal interference with patient care tasks, though they did inhibit communication. DISCUSSION HCP who had not previously worn an EHMR were able to wear it as an alternative to an N95 FFR without much-reported interference with their job tasks and with high disinfection compliance. CONCLUSIONS This study highlights the feasibility of the deployment of EHMRs during a public health emergency when an alternative respirator option is necessary.
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Affiliation(s)
- Morgan Lane
- Department of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA.
| | - Lisa Pompeii
- Department of Epidemiology, Genetics, and Environmental Sciences, University of Texas Health Sciences Center, School of Public Health, Houston, TX; Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Janelle Rios
- Department of Epidemiology, Genetics, and Environmental Sciences, University of Texas Health Sciences Center, School of Public Health, Houston, TX
| | - Elisa Benavides
- Department of Epidemiology, Genetics, and Environmental Sciences, University of Texas Health Sciences Center, School of Public Health, Houston, TX
| | - Marie Kasbaum
- Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Scott Patlovich
- Department of Epidemiology, Genetics, and Environmental Sciences, University of Texas Health Sciences Center, School of Public Health, Houston, TX
| | - Luis Ostrosky-Zeichner
- Department of Epidemiology, Genetics, and Environmental Sciences, University of Texas Health Sciences Center, School of Public Health, Houston, TX
| | - Adam Hornbeck
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA
| | - Caitlin McClain
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA
| | - Rohan Fernando
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA
| | - Margaret Sietsema
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA
| | - Colleen Kraft
- Department of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA
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Rickert S, Chi D, Gerber M, Roy S, Sidell D, Sobol SE, Wei J. COVID related tracheostomy tube supply shortage and mitigation strategies for safe tracheotomy care in children. Int J Pediatr Otorhinolaryngol 2024; 180:111943. [PMID: 38593716 DOI: 10.1016/j.ijporl.2024.111943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/04/2024] [Indexed: 04/11/2024]
Affiliation(s)
- Scott Rickert
- Deparment of Otolaryngology, NYU Langone Health, New York, NY, USA.
| | - David Chi
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mark Gerber
- Deparment of Otolaryngology, Phoenix Childrens Hospital, Phoenix, AZ, USA
| | - Soham Roy
- Department of Otolaryngology, Children's Hospital Colorado, Denver, CO, USA
| | - Doug Sidell
- Deparment of Otolaryngology, Stanford University Medical Center, Palo Alto, CA, USA
| | - Steven E Sobol
- Department of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Julie Wei
- Deparment of Otolaryngology, Akron Children's Hospital, Akron, OH, USA
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5
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Smith ED. Sustaining Preparedness in Hospitals. Adv Health Care Manag 2024; 22:161-178. [PMID: 38262015 DOI: 10.1108/s1474-823120240000022008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
PURPOSE The years following the 9/11/2001 terrorists attacks saw a marked increase in community and hospital emergency preparedness, from communications across community networks, development of policies and procedures, to attainment and training in the use of biological warfare resources. Regular drills ensured emergency and health care personnel were trained and prepared to address the next large-scale crisis, especially from terrorist and bioterrorist attacks. This chapter looks at some of the more familiar global health issues over the past two decades and the lessons learned from hospital responses to inform hospital management in preparation for future incidents. SEARCH METHODS This study is a narrative review of the literature related to lessons learned from four major events in the time period from 2002 to 2023 - SARS, MERS, Ebola, and COVID-19. SEARCH RESULTS The initial search yielded 25,913 articles; 57 articles were selected for inclusion in the study. DISCUSSION AND CONCLUSIONS Comparison of key issues and lessons learned among the four major events described in this article - SARS, MERS, Ebola, and COVID-19 - highlight that several lessons are "relearned" with each event. Other key issues, such as supply shortages, staffing availability, and hospital capacity to simultaneously provide care to noninfectious patients came to the forefront during the COVID-19 pandemic. A primary, ongoing concern for hospitals is how to maintain their preparedness given competing priorities, resources, and staff time. This concern remains post-COVID-19.
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Götz P, Auping WL, Hinrichs-Krapels S. Contributing to health system resilience during pandemics via purchasing and supply strategies: an exploratory system dynamics approach. BMC Health Serv Res 2024; 24:130. [PMID: 38267945 PMCID: PMC10807148 DOI: 10.1186/s12913-023-10487-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 12/16/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Health systems worldwide struggled to obtain sufficient personal protective equipment (PPE) and ventilators during the COVID-19 pandemic due to global supply chain disruptions. Our study's aim was to create a proof-of-concept model that would simulate the effects of supply strategies under various scenarios, to ultimately help decision-makers decide on alternative supply strategies for future similar health system related crises. METHODS We developed a system dynamics model that linked a disease transmission model structure (susceptible, exposed, infectious, recovered (SEIR)) with a model for the availability of critical supplies in hospitals; thereby connecting care demand (patients' critical care in hospitals), with care supply (available critical equipment and supplies). To inform the model structure, we used data on critical decisions and events taking place surrounding purchase, supply, and availability of PPE and ventilators during the first phase of the COVID-19 pandemic within the English national health system. We used exploratory modelling and analysis to assess the effects of uncertainties on different supply strategies in the English health system under different scenarios. Strategies analysed were: (i) purchasing from the world market or (ii) through direct tender, (iii) stockpiling, (iv) domestic production, (v) supporting innovative supply strategies, or (vi) loaning ventilators from the private sector. RESULTS We found through our exploratory analysis that a long-lasting shortage in PPE and ventilators is likely to be apparent in various scenarios. When considering the worst-case scenario, our proof-of-concept model shows that purchasing PPE and ventilators from the world market or through direct tender have the greatest influence on reducing supply shortages, compared to producing domestically or through supporting innovative supply strategies. However, these supply strategies are affected most by delays in their shipment time or set-up. CONCLUSION We demonstrated that using a system dynamics and exploratory modelling approach can be helpful in identifying the purchasing and supply chain strategies that contribute to the preparedness and responsiveness of health systems during crises. Our results suggest that to improve health systems' resilience during pandemics or similar resource-constrained situations, purchasing and supply chain decision-makers can develop crisis frameworks that propose a plan of action and consequently accelerate and improve procurement processes and other governance processes during health-related crises; implement diverse supplier frameworks; and (re)consider stockpiling. This proof-of-concept model demonstrates the importance of including critical supply chain strategies as part of the preparedness and response activities to contribute to health system resilience.
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Affiliation(s)
- Paula Götz
- Faculty of Technology, Policy and Management, Delft University of Technology, Jaffalaan 5, 2628 BX, Delft, The Netherlands
| | - Willem L Auping
- Faculty of Technology, Policy and Management, Delft University of Technology, Jaffalaan 5, 2628 BX, Delft, The Netherlands
| | - Saba Hinrichs-Krapels
- Faculty of Technology, Policy and Management, Delft University of Technology, Jaffalaan 5, 2628 BX, Delft, The Netherlands.
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Berthelot S, Longtin Y, Margni M, Guertin JR, LeBlanc A, Marx T, Mangou K, Bluteau A, Mantovani D, Mikhaylin S, Bergeron F, Dancause V, Desjardins A, Lahrichi N, Martin D, Sossa CJ, Lachapelle P, Genest I, Schaal S, Gignac A, Tremblay S, Hufty É, Bélanger L, Beatty E. Postpandemic Evaluation of the Eco-Efficiency of Personal Protective Equipment Against COVID-19 in Emergency Departments: Proposal for a Mixed Methods Study. JMIR Res Protoc 2023; 12:e50682. [PMID: 38060296 PMCID: PMC10739239 DOI: 10.2196/50682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 07/21/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a profound impact on emergency department (ED) care in Canada and around the world. To prevent transmission of COVID-19, personal protective equipment (PPE) was required for all ED care providers in contact with suspected cases. With mass vaccination and improvements in several infection prevention components, our hypothesis is that the risks of transmission of COVID-19 will be significantly reduced and that current PPE use will have economic and ecological consequences that exceed its anticipated benefits. Evidence is needed to evaluate PPE use so that recommendations can ensure the clinical, economic, and environmental efficiency (ie, eco-efficiency) of its use. OBJECTIVE To support the development of recommendations for the eco-efficient use of PPE, our research objectives are to (1) estimate the clinical effectiveness (reduced transmission, hospitalizations, mortality, and work absenteeism) of PPE against COVID-19 for health care workers; (2) estimate the financial cost of using PPE in the ED for the management of suspected or confirmed COVID-19 patients; and (3) estimate the ecological footprint of PPE use against COVID-19 in the ED. METHODS We will conduct a mixed method study to evaluate the eco-efficiency of PPE use in the 5 EDs of the CHU de Québec-Université Laval (Québec, Canada). To achieve our goals, the project will include four phases: systematic review of the literature to assess the clinical effectiveness of PPE (objective 1; phase 1); cost estimation of PPE use in the ED using a time-driven activity-based costing method (objective 2; phase 2); ecological footprint estimation of PPE use using a life cycle assessment approach (objective 3; phase 3); and cost-consequence analysis and focus groups (integration of objectives 1 to 3; phase 4). RESULTS The first 3 phases have started. The results of these phases will be available in 2023. Phase 4 will begin in 2023 and results will be available in 2024. CONCLUSIONS While the benefits of PPE use are likely to diminish as health care workers' immunity increases, it is important to assess its economic and ecological impacts to develop recommendations to guide its eco-efficient use. TRIAL REGISTRATION PROSPERO CRD42022302598; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=302598. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50682.
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Affiliation(s)
- Simon Berthelot
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche, CHU de Québec-Université Laval, Québec, QC, Canada
- Département de médecine de famille et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, QC, Canada
| | | | - Manuele Margni
- Ecole Polytechnique, Université de Montréal, Montréal, QC, Canada
| | - Jason Robert Guertin
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche, CHU de Québec-Université Laval, Québec, QC, Canada
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, QC, Canada
| | - Annie LeBlanc
- Département de médecine de famille et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, QC, Canada
| | - Tania Marx
- Services des urgences, Centre hospitalier universitaire de Besançon, Besançon, France
| | - Khadidiatou Mangou
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche, CHU de Québec-Université Laval, Québec, QC, Canada
| | - Ariane Bluteau
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche, CHU de Québec-Université Laval, Québec, QC, Canada
| | - Diego Mantovani
- Axe Médecine régénératrice, Centre de recherche, CHU de Québec-Université Laval, Québec, QC, Canada
| | - Sergey Mikhaylin
- EcoFoodLab, Département des sciences de aliments, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Québec, QC, Canada
| | | | | | | | - Nadia Lahrichi
- Ecole Polytechnique, Université de Montréal, Montréal, QC, Canada
| | - Danielle Martin
- Fashion Design and Creative Direction, Toronto Metropolitan University, Toronto, ON, Canada
| | | | | | | | | | - Anne Gignac
- CHU de Québec-Université Laval, Québec, QC, Canada
| | | | - Éric Hufty
- CHU de Québec-Université Laval, Québec, QC, Canada
| | | | - Erica Beatty
- Département de médecine d'urgence, Hôpital Montfort, Ottawa, ON, Canada
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Rosen M, Weinstock D, Rockafellow-Baldoni M, Freeman K, Remington J. Responding to Disasters: Training Can Overcome Issues in Disaster Response. New Solut 2023; 33:104-112. [PMID: 37312508 PMCID: PMC10993054 DOI: 10.1177/10482911231179916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Training can assist in overcoming gaps in disaster response. The National Institute of Environmental Health Sciences (NIEHS) Worker Training Program (WTP) funds a network of nonprofit organizations, or grantees, that deliver peer-reviewed safety and health training curricula to workers across a variety of occupational sectors. Grantees' experiences providing training for recovery workers after numerous disasters show the following issues need to be addressed to better protect the safety and health of recovery workers: (1) regulations and guidance documents not sufficient to protect workers; (2) protecting responders' health and safety which is a core value; (3) improving communication between responders and communities to assist in decision-making and guiding safety and health planning; (4) partnerships critical for disaster response; and (5) greater attention to protecting communities disproportionately affected by disasters. This article provides insight into addressing these recurring issues and utilizes them as part of a continuous quality improvement process for disaster responders that may help to reduce responder injuries, illness, and death during future disasters.
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Affiliation(s)
- Mitchel Rosen
- School of Public Health, Rutgers, The State University of New Jersey, Somerset, NJ, USA
| | | | | | | | - Jim Remington
- National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
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Akhtar S, Pranay K, Kumari K. Personal protective equipment and micro-nano plastics: A review of an unavoidable interrelation for a global well-being hazard. HYGIENE AND ENVIRONMENTAL HEALTH ADVANCES 2023; 6:100055. [PMID: 37102160 PMCID: PMC10089666 DOI: 10.1016/j.heha.2023.100055] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 04/07/2023] [Accepted: 04/10/2023] [Indexed: 04/28/2023]
Abstract
The usage and the demand for personal protective equipments (PPEs) for our day-to-day survival in this pandemic period of COVID-19 have seen a steep rise which has consequently led to improper disposal and littering. Fragmentation of these PPE units has eventually given way to micro-nano plastics (MNPs) emission in the various environmental matrices and exposure of living organisms to these MNPs has proven to be severely toxic. Numerous factors contribute to the toxicity imparted by these MNPs that mainly include their shape, size, functional groups and their chemical diversity. Even though multiple studies on the impacts of MNPs toxicity are available for other organisms, human cell line studies for various plastic polymers, other than the most common ones namely polyethylene (PE), polystyrene (PS) and polypropylene (PP), are still at their nascent stage and need to be explored more. In this article, we cover a concise review of the literature on the impact of these MNPs in biotic and human systems focusing on the constituents of the PPE units and the additives that are essentially used for their manufacturing. This review will subsequently identify the need to gather scientific evidence at the smaller level to help combat this microplastic pollution and induce a more in-depth understanding of its adverse effect on our existence.
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Affiliation(s)
- Shaheen Akhtar
- Kolkata Zonal Centre, CSIR-National Environmental Engineering Research Institute (NEERI), Kolkata 700107, West Bengal, India
| | - Kumar Pranay
- Department of Biochemistry, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna 800014, Bihar, India
| | - Kanchan Kumari
- Kolkata Zonal Centre, CSIR-National Environmental Engineering Research Institute (NEERI), Kolkata 700107, West Bengal, India
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10
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Rehman AU, Mian SH, Usmani YS, Abidi MH, Mohammed MK. Modelling and Analysis of Hospital Inventory Policies during COVID-19 Pandemic. Processes (Basel) 2023. [DOI: 10.3390/pr11041062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
The global coronavirus pandemic (COVID-19) started in 2020 and is still ongoing today. Among the numerous insights the community has learned from the COVID-19 pandemic is the value of robust healthcare inventory management. The main cause of many casualties around the world is the lack of medical resources for those who need them. To inhibit the spread of COVID-19, it is therefore imperative to simulate the demand for desirable medical goods at the proper time. The estimation of the incidence of infections using the right epidemiological criteria has a significant impact on the number of medical supplies required. Modeling susceptibility, exposure, infection, hospitalization, isolation, and recovery in relation to the COVID-19 pandemic is indeed crucial for the management of healthcare inventories. The goal of this research is to examine the various inventory policies such as reorder point, periodic order, and just-in-time in order to minimize the inventory management cost for medical commodities. To accomplish this, a SEIHIsRS model has been employed to comprehend the dynamics of COVID-19 and determine the hospitalized percentage of infected people. Based on this information, various situations are developed, considering the lockdown, social awareness, etc., and an appropriate inventory policy is recommended to reduce inventory management costs. It is observed that the just-in-time inventory policy is found to be the most cost-effective when there is no lockdown or only a partial lockdown. When there is a complete lockdown, the periodic order policy is the best inventory policy. The periodic order and reorder policies are cost-effective strategies to apply when social awareness is high. It has also been noticed that periodic order and reorder policies are the best inventory strategies for uncertain vaccination efficacy. This effort will assist in developing the best healthcare inventory management strategies to ensure that the right healthcare requirements are available at a minimal cost.
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Affiliation(s)
- Ateekh Ur Rehman
- Department of Industrial Engineering, College of Engineering, King Saud University, Riyadh 11421, Saudi Arabia
| | - Syed Hammad Mian
- Advanced Manufacturing Institute, King Saud University, Riyadh 11421, Saudi Arabia
| | - Yusuf Siraj Usmani
- Department of Industrial Engineering, College of Engineering, King Saud University, Riyadh 11421, Saudi Arabia
| | - Mustufa Haider Abidi
- Advanced Manufacturing Institute, King Saud University, Riyadh 11421, Saudi Arabia
| | - Muneer Khan Mohammed
- Advanced Manufacturing Institute, King Saud University, Riyadh 11421, Saudi Arabia
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11
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Moradian ST, Mahmoudi H. Experience of frontline nurses who managed the COVID-19 crisis: A qualitative study. Front Public Health 2023; 11:1070916. [PMID: 37006526 PMCID: PMC10060550 DOI: 10.3389/fpubh.2023.1070916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 02/13/2023] [Indexed: 03/18/2023] Open
Abstract
BackgroundThe health system was challenged during the COVID-19 pandemic. Nurses, as part of the health system, were expected to manage themselves in a situation where everyone was in crisis and to be able to do their work quietly and calmly. This study was conducted to show how Iranian nurses faced the COVID-19 crisis.MethodsIn a qualitative content analysis study, 16 participants, including eight nurses, five supervisors, and three head nurses of a university hospital in Tehran, Iran, were interviewed between February and December 2020. Using purposive sampling, nurses who were working with patients with COVID-19 were selected to be involved. Data were analyzed using MAXQDA 10 software, and codes were categorized based on similarities and differences.FindingData analysis revealed 212 codes. These codes were classified based on similarities and differences in 16 categories, and four main themes emerged: unpreparedness, positive adaptation, negative coping, and reorganization.ConclusionSince nurses are on the frontline in times of biological disaster, the COVID-19 pandemic provided an opportunity to demonstrate the role of nurses in reducing the burden of disease, identifying problems and opportunities, and planning appropriate interventions.
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Affiliation(s)
- Seyed Tayeb Moradian
- Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hosein Mahmoudi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
- *Correspondence: Hosein Mahmoudi
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12
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Morales IDG, Macusi ED, Jondonero MAP, Guihawan JQ, Bacosa HP, Amparado RF. Facemask: Protection or threat? MARINE POLLUTION BULLETIN 2023; 188:114681. [PMID: 36758311 PMCID: PMC9902895 DOI: 10.1016/j.marpolbul.2023.114681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/10/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
Facemasks were widely used as a protection against SARS-COV-2, which significantly reduced COVID-19 transmission during the pandemic. However, concerns have been raised regarding its adverse impacts on human health due to intense use and mismanagement. Although rampant plastic littering was the norm before the pandemic, the magnitude of the problem is worsening as potentially COVID-19-infected facemasks are thrown along the shoreline. This study assessed the discarded facemasks on the most popular beach destinations in Mati City, Davao Oriental, Philippines. A total of N = 284 discarded facemasks were found in a cumulative area of 22,500 m2, with an average density of 8.4 × 10-4 items/m2. The surgical facemask (82 %; n = 234) was the most abundant type of facemask found in the areas, followed by KF94 (16 %; n = 45) and KN95 (2 %; n = 5). The Analysis of Variance (ANOVA) showed significant differences in the visual counts of facemasks on the three beaches (p < 0.05).
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Affiliation(s)
- Ilah Dianne G Morales
- Environmental Science Graduate Program, College of Science and Mathematics, Mindanao State University-Iligan Institute of Technology (MSU-IIT), Iligan City, Lanao del Norte, Philippines.
| | - Edison D Macusi
- Institute of Agriculture and Life Sciences (IALS), Davao Oriental State University (DOrSU), Mati City, Davao Oriental, Philippines
| | | | - Jaime Q Guihawan
- Environmental Science Graduate Program, College of Science and Mathematics, Mindanao State University-Iligan Institute of Technology (MSU-IIT), Iligan City, Lanao del Norte, Philippines
| | - Hernando P Bacosa
- Environmental Science Graduate Program, College of Science and Mathematics, Mindanao State University-Iligan Institute of Technology (MSU-IIT), Iligan City, Lanao del Norte, Philippines
| | - Ruben F Amparado
- Environmental Science Graduate Program, College of Science and Mathematics, Mindanao State University-Iligan Institute of Technology (MSU-IIT), Iligan City, Lanao del Norte, Philippines
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Thiel CL, Sreedhar P, Silva GS, Greene HC, Seetharaman M, Durr M, Roberts T, Vedanthan R, Lee PH, Andrade G, El-Shahawy O, Hochman SE. Conservation Practices for Personal Protective Equipment: A Systematic Review with Focus on Lower-Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2575. [PMID: 36767940 PMCID: PMC9915410 DOI: 10.3390/ijerph20032575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/18/2023]
Abstract
During the start of the COVID-19 pandemic, shortages of personal protective equipment (PPE) necessitated unprecedented and non-validated approaches to conserve PPE at healthcare facilities, especially in high income countries where single-use disposable PPE was ubiquitous. Our team conducted a systematic literature review to evaluate historic approaches for conserving single-use PPE, expecting that lower-income countries or developing contexts may already be uniquely conserving PPE. However, of the 50 included studies, only 3 originated from middle-income countries and none originated from low-income countries. Data from the included studies suggest PPE remained effective with extended use and with multiple or repeated use in clinical settings, as long as donning and doffing were performed in a standard manner. Multiple decontamination techniques were effective in disinfecting single use PPE for repeated use. These findings can inform healthcare facilities and providers in establishing protocols for safe conservation of PPE supplies and updating existing protocols to improve sustainability and overall resilience. Future studies should evaluate conservation practices in low-resource settings during non-pandemic times to develop strategies for more sustainable and resilient healthcare worldwide.
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Affiliation(s)
- Cassandra L. Thiel
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | | | - Genevieve S. Silva
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hannah C. Greene
- Social Science Division, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates
| | - Meenakshi Seetharaman
- College of Literature, Science, and Arts, University of Michigan, Ann Arbor, MI 48109, USA
| | - Meghan Durr
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Timothy Roberts
- Health Sciences Library, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Rajesh Vedanthan
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Paul H. Lee
- Department of Oral and Maxillofacial Surgery, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Gizely Andrade
- Department of Emergency Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Omar El-Shahawy
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Sarah E. Hochman
- Department of Medicine, Division of Infectious Diseases and Immunology, NYU Grossman School of Medicine, New York, NY 10016, USA
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14
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Jimoh JO, Rahmah S, Mazelan S, Jalilah M, Olasunkanmi JB, Lim LS, Ghaffar MA, Chang YM, Bhubalan K, Liew HJ. Impact of face mask microplastics pollution on the aquatic environment and aquaculture organisms. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 317:120769. [PMID: 36455766 DOI: 10.1016/j.envpol.2022.120769] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/10/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
Microplastic pollution in our environment, especially water bodies is an emerging threat to food security and human health. Inevitably, the outbreak of Covid-19 has necessitated the constant use of face masks made from polymers such as polypropylene, polyurethane, polyacrylonitrile, polystyrene, polycarbonate, polyethylene, or polyester which eventually will disintegrate into microplastic particles. They can be broken down into microplastics by the weathering action of UV radiation from the sun, heat, or ocean wave-current and precipitate in natural environments. The global adoption of face masks as a preventive measure to curb the spread of Covid-19 has made the safe management of wastes from it cumbersome. Microplastics gain access into aquaculture facilities through water sources and food including planktons. The negative impacts of microplastics on aquaculture cannot be overemphasized. The impacts includes low growth rates of animals, hindered reproductive functions, neurotoxicity, low feeding habit, oxidative stress, reduced metabolic rate, and increased mortality rate among aquatic organisms. With these, there is every tendency of microplastic pollution to negatively impact fish production through aquaculture if the menace is not curbed. It is therefore recommended that biodegradable materials rather than plastics to be considered in the production of face mask while recycle of already produced ones should be encouraged to reduce waste.
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Affiliation(s)
- Jeremiah Olanipekun Jimoh
- Higher Institution Centre of Excellence (HICOE), Institute of Tropical Aquaculture and Fisheries, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia; Department of Fisheries and Aquaculture, Federal University, Oye Ekiti, Ekiti State, Nigeria
| | - Sharifah Rahmah
- Higher Institution Centre of Excellence (HICOE), Institute of Tropical Aquaculture and Fisheries, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia; Faculty of Fisheries and Food Science, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | - Suhairi Mazelan
- Higher Institution Centre of Excellence (HICOE), Institute of Tropical Aquaculture and Fisheries, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | - Mohamad Jalilah
- Higher Institution Centre of Excellence (HICOE), Institute of Tropical Aquaculture and Fisheries, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | - John Bunmi Olasunkanmi
- Department of Fisheries and Aquaculture, Federal University, Oye Ekiti, Ekiti State, Nigeria
| | - Leong-Seng Lim
- Borneo Marine Research Institute, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Mazlan Abd Ghaffar
- Higher Institution Centre of Excellence (HICOE), Institute of Tropical Aquaculture and Fisheries, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia; Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia; Institute of Marine Biotechnology, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | - Yu Mei Chang
- Heilongjiang River Fisheries Research Institute, Chinese Academy of Fishery Science, Harbin, China
| | - Kesaven Bhubalan
- Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia; Institute of Marine Biotechnology, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia
| | - Hon Jung Liew
- Higher Institution Centre of Excellence (HICOE), Institute of Tropical Aquaculture and Fisheries, Universiti Malaysia Terengganu, Kuala Nerus, Terengganu, Malaysia; Heilongjiang River Fisheries Research Institute, Chinese Academy of Fishery Science, Harbin, China.
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15
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Javid F, Xin X, Anderson WA, Derraik JG, Anderson YC, Baroutian S. Deconstruction and valorisation of a mixture of personal protective equipment using hydrothermal processing. J IND ENG CHEM 2022. [DOI: 10.1016/j.jiec.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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16
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Rathinamoorthy R, Raja Balasaraswathi S. Impact of coronavirus pandemic litters on microfiber pollution-effect of personal protective equipment and disposable face masks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL SCIENCE AND TECHNOLOGY : IJEST 2022; 20:1-20. [PMID: 36035637 PMCID: PMC9391648 DOI: 10.1007/s13762-022-04462-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/08/2022] [Accepted: 08/03/2022] [Indexed: 05/25/2023]
Abstract
Coronavirus Pandemic is the current biggest challenge against humanity. Apart from the personal health issues and higher mortality by the coronavirus, recent research works have also reported the environmental impacts of the pandemic. The review aims to analyze the current status of face masks and personal protective equipment littering and subsequent environmental impact in terms of microplastic and microfiber pollution. Recent researches in this domain are collected from the leading databases with relevant keywords and critically analyzed. The review results report a multi-fold increment in the usage of personal protective equipment, particularly face masks after the pandemic. Mismanagement of these items leads them to reach the marine environment through a variety of transportation. The results show a significant amount of increment in plastic and pandemic-related littering after the pandemic. The systematic review shows that the use of synthetic fibers in disposable personal protective equipment and masks leads to release of fibers that can add-on to microfiber pollution. The results are also true in the case of reusable masks as the repeated laundry and disinfection methods release a significantly higher amount of microfibers. Only very few studies have addressed the release of microfiber from the mask, and no studies have reported the impact of personal protective equipment. The worldwide mass adaptation and improper disposal of these materials increase the seriousness of the problem multiple folds. These findings suggest the immediate requirement of critical analysis of the pandemic-related littering and microfiber release characteristics. The research also urges the need for the implementation of an environmental management plan as a mitigation strategy around the globe.
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Affiliation(s)
- R. Rathinamoorthy
- Department of Fashion Technology, PSG College of Technology, Coimbatore, 641004 India
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17
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Sawyerr E, Harrison C. Resilience in healthcare supply chains: a review of the UK’s response to the COVID19 pandemic. INTERNATIONAL JOURNAL OF PHYSICAL DISTRIBUTION & LOGISTICS MANAGEMENT 2022. [DOI: 10.1108/ijpdlm-09-2021-0403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this explorative research is to analyse the resilience of the United Kingdom's (UK) healthcare supply chains from a customer’s perspective in the light of the coronavirus pandemic.Design/methodology/approachUsing the capabilities of preparedness, robustness, recovery and adaptability as the foundational percept for supply chain resilience, 22 healthcare professionals in 17 of the UK's National Health Scheme (NHS) Trusts were interviewed to explore their personal and organisational approaches adopted relative to the provision of eye protection, gloves, gowns, aprons, masks and respirators. The Dynamic Capabilities View is mapped to the resilience capabilities and used to analyse the data from a transformational supply chain research perspective.FindingsThe supply chains were largely unprepared, which was not particularly surprising even though the availability of gloves was significantly better compared to the other personal protective equipment (PPE). Techniques adopted to ensure robustness and recovery revealed the use of unsanctioned methods such as extended use of PPE beyond recommended use, redefinition of guidelines, protocols and procedures by infection control and the use of expired PPE – all of which compromised customer well-being.Research limitations/implicationsAs the paper views resilience through the lens of customers, it does not provide the perspectives of the supply chain practitioners as to the reasons for the findings and the challenges within these supply chains.Practical implicationsThe compromise of the well-being of healthcare workers due to the vulnerabilities of healthcare supply chains is highlighted to managers and prescriptions for post-disruption adaptability are made.Originality/valueThis paper introduces transformative research to supply chain resilience research by uniquely looking at resilience from the customers' well-being perspective.
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18
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Mitigating personal protective equipment (PPE) supply chain disruptions in pandemics – a system dynamics approach. INTERNATIONAL JOURNAL OF OPERATIONS & PRODUCTION MANAGEMENT 2022. [DOI: 10.1108/ijopm-09-2021-0608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe coronavirus disease (COVID-19) pandemic has emerged as an unprecedented health crisis worldwide and heavily disrupted the healthcare supply chain. This study focuses on analysing the different types of disruptions occurring in personal protective equipment (PPE) supply chains during the COVID-19 pandemic and on proposing mitigation strategies that are fit to the global scale and many interdependencies that are characteristic for this pandemic. The authors construct a conceptual system dynamics model (SD) based on the literature and adjusted with the use of empirical data (interviews) to capture the complexity of a global supply chain and identify leverage points (mitigation strategies).Design/methodology/approachThis research follows a mix-methods approach. First, the authors developed a conceptual framework based on four types of disruptions that usually occur during health emergencies (direct effect, policy, supply chain strategy, and behaviourally induced disruptions). Second, the authors collected and analysed data from interviews with experts in the PPE supply chain. Based on the interviews data, the authors developed a conceptual system dynamics (SD) model that allows to capture the complex and dynamic interplay between the elements of the global supply chain system, by highlighting key feedback loops, delays, and the way the mitigation strategies can impact on them. From this analysis, the authors developed four propositions for supply chain risk management (SCRM) in global health emergencies and four recommendations for the policy and decision makers.FindingsThe SD model highlights that without a combination of mitigation measures, it is impossible to overcome all disruptions. As such, a co-ordinated effort across the different countries and sectors that experience the disruptions is needed. The SD model also shows that there are important feedback loops, by which initial disruptions create delays and shortages that propagate through the supply chain network. If the co-ordinated mitigation measures are not implemented early at the onset of the pandemic, these disruptions will be persistent, creating potential shortages of PPE and other critical equipment at the onset of a pandemic – when they are most urgently needed.Originality/valueThis research enriches the understanding of the disruptions of PPE supply chains on the systems level and proposes mitigation strategies based on empirical data and the existing literature.
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19
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Galán MI, Velasco M, Casas ML, Goyanes MJ, Rodríguez-Caravaca G, Losa-García JE, Noguera C, Castilla V. Hospital-Wide SARS-CoV-2 seroprevalence in health care workers in a Spanish teaching hospital. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:302-309. [PMID: 35680348 PMCID: PMC9168001 DOI: 10.1016/j.eimce.2020.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/27/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Hospital-wide SARS-CoV-2 seroprevalence is rarely explored and can identify areas of unexpected risk. We determined the seroprevalence against SARS-CoV-2 in all health care workers (HCW) at a hospital. METHODS Cross-sectional study (14-27/04/2020). We determined SARS-CoV-2 IgG by ELISA in all HCW including external workers of a teaching hospital in Madrid. They were classified by professional category, working area, and risk for SARS-CoV-2 exposure. RESULTS Among 2919 HCW, 2590 (88,7%) were evaluated. The mean age was 43.8 years (SD 11.1), and 73.9% were females. Globally, 818 (31.6%) workers were IgG positive with no differences for age, sex or previous diseases. Of these, 48.5% did not report previous symptoms. Seropositivity was more frequent in high- (33.1%) and medium- (33.8%) than in low-risk areas (25.8%, p=0.007), but not for hospitalization areas attending COVID-19 and non-COVID-19 patients (35.5 vs 38.3% p>0.05). HWC with a previous SARS-CoV2 PCR-positive test were IgG seropositive in 90.8%. By multivariate logistic regression analysis seropositivity was significantly associated with being physicians (OR 2.37, CI95% 1.61-3.49), nurses (OR 1.67, CI95% 1.14-2.46), nurse assistants (OR 1.84, CI95% 1.24-2.73), HCW working at COVID-19 hospitalization areas (OR 1.71, CI95% 1.22-2.40), non-COVID-19 hospitalization areas (OR 1.88, CI95% 1.30-2.73), and at the Emergency Room (OR 1.51, CI95% 1.01-2.27). CONCLUSIONS Seroprevalence uncovered a high rate of infection previously unnoticed among HCW. Patients not suspected of having COVID-19 as well as asymptomatic HCW may be a relevant source for nosocomial SARS-CoV-2 transmission.
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Affiliation(s)
- Mª Isabel Galán
- Occupational Health Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - María Velasco
- Infectious Diseases and Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
| | - Mª Luisa Casas
- Laboratory Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Mª José Goyanes
- Microbiology Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Juan E Losa-García
- Infectious Diseases Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Carmen Noguera
- Nurse Subdirector, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Virgilio Castilla
- Medical Director, Hospital Universitario Fundación Alcorcón, Madrid, Spain
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20
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Abedin MJ, Khandaker MU, Uddin MR, Karim MR, Uddin Ahamad MS, Islam MA, Arif AM, Minhaz Hossain SM, Sulieman A, Idris AM. Amassing the Covid-19 driven PPE wastes in the dwelling environment of Chittagong Metropolis and associated implications. CHEMOSPHERE 2022; 297:134022. [PMID: 35202672 PMCID: PMC8859812 DOI: 10.1016/j.chemosphere.2022.134022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 05/22/2023]
Abstract
This study investigates the Covid-19 driven indiscriminate disposal of PPE wastes (mostly face mask and medical wastes) in Chittagong metropolitan area (CMA), Bangladesh. Based on the field monitoring, the mean PPE density (PPE/m2± SD) was calculated to be 0.0226 ± 0.0145, 0.0164 ± 0.0122, and 0.0110 ± 0.00863 for July, August, and September 2021, respectively (during the peak time of Covid-19 in Bangladesh). Moreover, gross information on PPE waste generation in the city was calculated using several parameters such as population density, face mask acceptance rate by urban population, total Covid-19 confirmed cases, quarantined and isolated patients, corresponding medical waste generation rate (kg/bed/day), etc. Moreover, the waste generated due to face mask and other PPEs in the CMA during the whole Covid-19 period (April 4, 2020 to September 5, 2021) were calculated to be 64183.03 and 128695.75 tons, respectively. It has been observed that the negligence of general people, lack of awareness about environmental pollution, and poor municipal waste management practices are the root causes for the contamination of the dwelling environment by PPE wastes. As a result, new challenges have emerged in solid waste management, which necessitates the development of an appropriate waste management strategy. The ultimate policies and strategies may help to achieve the SDG goals 3, 6, 11, 12, 13, and 15, and increase public perception on the use and subsequent disposal of PPEs, especially face masks.
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Affiliation(s)
- Md Jainal Abedin
- Faculty of Public Health, Thammasat University, Pathum Thani, 12121, Thailand
| | - Mayeen Uddin Khandaker
- Centre for Applied Physics and Radiation Technologies, School of Engineering and Technology, Sunway University, 47500, Bandar Sunway, Selangor, Malaysia.
| | - Md Ripaj Uddin
- Institute of National Analytical Research and Service (INARS), BCSIR, Dhanmondi, Dhaka, 1205, Bangladesh
| | - Md Rezaul Karim
- Department of Chemistry, Chittagong University of Engineering and Technology, Chattogram, 4349, Bangladesh
| | | | - Md Ariful Islam
- Department of Chemistry, Chittagong University of Engineering and Technology, Chattogram, 4349, Bangladesh
| | - Abu Mohammad Arif
- One Health Institute, Chattogram Veterinary and Animal Sciences University, Chattogram, 4225, Bangladesh
| | - Syed Md Minhaz Hossain
- Department of Computer Science and Engineering, Premier University, Chattogram, 4000, Bangladesh
| | - A Sulieman
- Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, P.O. Box 422, Alkharj, 11942, Saudi Arabia
| | - Abubakr M Idris
- Department of Chemistry, College of Science, King Khalid University, 62529, Abha, Saudi Arabia; Research Center for Advanced Materials Science (RCAMS), King Khalid University, 62529, Abha, Saudi Arabia
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21
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Wei H, Daniels S, Whitfield CA, Han Y, Denning DW, Hall I, Regan M, Verma A, van Tongeren M. Agility and Sustainability: A Qualitative Evaluation of COVID-19 Non-pharmaceutical Interventions in the UK Logistics Sector. Front Public Health 2022; 10:864506. [PMID: 35719658 PMCID: PMC9198245 DOI: 10.3389/fpubh.2022.864506] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/10/2022] [Indexed: 11/16/2022] Open
Abstract
Background The emergence of SARS-CoV-2 triggered a chain of public health responses that radically changed our way of living and working. Non-healthcare sectors, such as the logistics sector, play a key role in such responses. This research aims to qualitatively evaluate the non-pharmaceutical interventions (NPIs) implemented in the UK logistics sector during the COVID-19 pandemic. Methods We conducted nine semi-structured interviews in July-August 2020 and May-June 2021. In total 11 interviewees represented six companies occupying a range of positions in the UK's logistics sector, including takeaway food delivery, large and small goods delivery and home appliance installation, and logistics technology providers. Thematic analysis was completed using NVivo12. Codes relevant to NPIs were grouped into themes and mapped deductively onto an adapted Hierarchy of Control (HoC) framework, focusing on delivery workers. Codes relevant to the implementation process of NPIs were grouped into themes/subthemes to identify key characteristics of rapid responses, and barriers and facilitators. Results HoC analysis suggests the sector has implemented a wide range of risk mitigation measures, with each company developing their own portfolio of measures. Contact-free delivery was the most commonly implemented measure and perceived effective. The other implemented measures included social distancing, internal contact tracing, communication and collaboration with other key stakeholders of the sector. Process evaluation identified facilitators of rapid responses including capacity to develop interventions internally, localized government support, strong external mandates, effective communication, leadership support and financial support for self-isolation, while barriers included unclear government guidance, shortage of testing capacity and supply, high costs and diversified language and cultural backgrounds. Main sustainability issues included compliance fatigue, and the possible mental health impacts of a prolonged rapid response. Conclusions This research identified drivers and obstacles of rapid implementation of NPIs in response to a respiratory infection pandemic. Existing implementation process models do not consider speed to respond and the absence or lack of guidance in emergency situations such as the COVID-19. We recommend the development of a rapid response model to inform the design of effective and sustainable infection prevention and control policies and to focus future research priorities.
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Affiliation(s)
- Hua Wei
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Sarah Daniels
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Carl A. Whitfield
- Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
| | - Yang Han
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
| | - David W. Denning
- Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Division of Evolution, Infection & Genomics, School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - Ian Hall
- Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
- Public Health, Advice, Guidance and Expertise, UK Health Security Agency, London, United Kingdom
| | - Martyn Regan
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- National COVID-19 Response Centre, UK Health Security Agency, London, United Kingdom
| | - Arpana Verma
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Martie van Tongeren
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
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22
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Witek TJ, Schwartz R. The Evolution of Vigilance and Its Atrophy Preceding the COVID-19 Global Pandemic. Front Public Health 2022; 10:789527. [PMID: 35664126 PMCID: PMC9157789 DOI: 10.3389/fpubh.2022.789527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 03/25/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Recent infectious outbreaks preceding the COVID-19 crisis resulted in the evolution of vigilance for preparedness against the next pandemic. This vigilance was maintained to varying degrees in different jurisdictions. Objective To evaluate the evolution of vigilance following previous epidemics and pandemics and the subsequent atrophy of vigilance prior to the COVID-19 global pandemic. Methods We evaluated documentation discussing US, Canada, and South Korea from March 2002 to October 2021. Our policy search strategy was rooted in academic literature, government documents and media reports. Results In the US, there were examples of atrophy of vigilance; however, there was clear understanding of pandemic readiness actions that were simply not executed amongst political chaos. In Canada, political mishaps were less evident at the time the pandemic unfolded. Nevertheless, atrophy was evident with erosion in preparedness programs following SARS. South Korea appeared least subjected to atrophy of vigilance. The more recent MERS outbreak prompted evolution of sustained vigilance and compliance with basic public health measures such as mask wearing. Recommendations Policy options need to be explored and instituted that increase protection of preparedness programs through institutional safeguards and accountability measure.
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Affiliation(s)
- Theodore J. Witek
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Robert Schwartz
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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23
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Brown GW, Bridge G, Martini J, Um J, Williams OD, Choupe LBT, Rhodes N, Ho ZJM, Chungong S, Kandel N. The role of health systems for health security: a scoping review revealing the need for improved conceptual and practical linkages. Global Health 2022; 18:51. [PMID: 35570269 PMCID: PMC9107590 DOI: 10.1186/s12992-022-00840-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/19/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Practical links between health systems and health security are historically prevalent, but the conceptual links between these fields remain under explored, with little on health system strengthening. The need to address this gap gains relevance in light of the COVID-19 pandemic as it demonstrated a crucial relationship between health system capacities and effective health security response. Acknowledging the importance of developing stronger and more resilient health systems globally for health emergency preparedness, the WHO developed a Health Systems for Health Security framework that aims to promote a common understanding of what health systems for health security entails whilst identifying key capacities required. METHODS/ RESULTS To further explore and analyse the conceptual and practical links between health systems and health security within the peer reviewed literature, a rapid scoping review was carried out to provide an overview of the type, extent and quantity of research available. Studies were included if they had been peer-reviewed and were published in English (seven databases 2000 to 2020). 343 articles were identified, of those 204 discussed health systems and health security (high and medium relevance), 101 discussed just health systems and 47 discussed only health security (low relevance). Within the high and medium relevance articles, several concepts emerged, including the prioritization of health security over health systems, the tendency to treat health security as exceptionalism focusing on acute health emergencies, and a conceptualisation of security as 'state security' not 'human security' or population health. CONCLUSION Examples of literature exploring links between health systems and health security are provided. We also present recommendations for further research, offering several investments and/or programmes that could reliably lead to maximal gains from both a health system and a health security perspective, and why these should be explored further. This paper could help researchers and funders when deciding upon the scope, nature and design of future research in this area. Additionally, the paper legitimises the necessity of the Health Systems for Health Security framework, with the findings of this paper providing useful insights and evidentiary examples for effective implementation of the framework.
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Affiliation(s)
- Garrett Wallace Brown
- grid.9909.90000 0004 1936 8403School of Politics and International Studies (POLIS), University of Leeds, Leeds, LS2 9JT UK
| | - Gemma Bridge
- grid.4868.20000 0001 2171 1133Institute of Population Health Sciences, Centre for Clinical Trials & Methodology, Queen Mary University London, London, E1 2AD UK
| | - Jessica Martini
- grid.4989.c0000 0001 2348 0746School of Public Health, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Jimyong Um
- grid.1013.30000 0004 1936 834XDepartment of Government and International Relations, The University of Sydney, Sydney, Australia
| | - Owain D. Williams
- grid.9909.90000 0004 1936 8403School of Politics and International Studies (POLIS), University of Leeds, Leeds, LS2 9JT UK
| | | | - Natalie Rhodes
- grid.9909.90000 0004 1936 8403School of Politics and International Studies (POLIS), University of Leeds, Leeds, LS2 9JT UK
| | - Zheng Jie Marc Ho
- grid.3575.40000000121633745World Health Organisation, WHO Health Emergencies Program, 1211 Geneva, Switzerland
| | - Stella Chungong
- grid.3575.40000000121633745World Health Organisation, WHO Health Emergencies Program, 1211 Geneva, Switzerland
| | - Nirmal Kandel
- grid.3575.40000000121633745World Health Organisation, WHO Health Emergencies Program, 1211 Geneva, Switzerland
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Namdar P, Shafiekhani S, Teymori F, Abdollahzade S, Maleki A, Rafiei S. Predicting COVID-19 Cases Among Nurses Using Artificial Neural Network Approach. Comput Inform Nurs 2022; 40:341-349. [PMID: 35470304 PMCID: PMC9093222 DOI: 10.1097/cin.0000000000000907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We designed a forecasting model to determine which frontline health workers are most likely to be infected by COVID-19 among 220 nurses. We used multivariate regression analysis and different classification algorithms to assess the effect of several covariates, including exposure to COVID-19 patients, access to personal protective equipment, proper use of personal protective equipment, adherence to hand hygiene principles, stressfulness, and training on the risk of a nurse being infected. Access to personal protective equipment and training were associated with a 0.19- and 1.66-point lower score in being infected by COVID-19. Exposure to COVID-19 cases and being stressed of COVID-19 infection were associated with a 0.016- and 9.3-point higher probability of being infected by COVID-19. Furthermore, an artificial neural network with 75.8% (95% confidence interval, 72.1-78.9) validation accuracy and 76.6% (95% confidence interval, 73.1-78.6) overall accuracy could classify normal and infected nurses. The neural network can help managers and policymakers determine which frontline health workers are most likely to be infected by COVID-19.
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Affiliation(s)
- Peyman Namdar
- Author Affiliations: School of Medicine (Drs Namdar and Abdollahzade), Qazvin University of Medical Sciences (Ms Teymori); Department of Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (Dr Shafiekhani); and Student Research Center, School of Public Health (Mrs Maleki), and Social Determinants of Health Research Center (Dr Rafiei), Qazvin University of Medical Sciences, Iran
| | - Sajad Shafiekhani
- Author Affiliations: School of Medicine (Drs Namdar and Abdollahzade), Qazvin University of Medical Sciences (Ms Teymori); Department of Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (Dr Shafiekhani); and Student Research Center, School of Public Health (Mrs Maleki), and Social Determinants of Health Research Center (Dr Rafiei), Qazvin University of Medical Sciences, Iran
| | - Fatemeh Teymori
- Author Affiliations: School of Medicine (Drs Namdar and Abdollahzade), Qazvin University of Medical Sciences (Ms Teymori); Department of Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (Dr Shafiekhani); and Student Research Center, School of Public Health (Mrs Maleki), and Social Determinants of Health Research Center (Dr Rafiei), Qazvin University of Medical Sciences, Iran
| | - Sina Abdollahzade
- Author Affiliations: School of Medicine (Drs Namdar and Abdollahzade), Qazvin University of Medical Sciences (Ms Teymori); Department of Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (Dr Shafiekhani); and Student Research Center, School of Public Health (Mrs Maleki), and Social Determinants of Health Research Center (Dr Rafiei), Qazvin University of Medical Sciences, Iran
| | - Aisa Maleki
- Author Affiliations: School of Medicine (Drs Namdar and Abdollahzade), Qazvin University of Medical Sciences (Ms Teymori); Department of Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (Dr Shafiekhani); and Student Research Center, School of Public Health (Mrs Maleki), and Social Determinants of Health Research Center (Dr Rafiei), Qazvin University of Medical Sciences, Iran
| | - Sima Rafiei
- Author Affiliations: School of Medicine (Drs Namdar and Abdollahzade), Qazvin University of Medical Sciences (Ms Teymori); Department of Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences (Dr Shafiekhani); and Student Research Center, School of Public Health (Mrs Maleki), and Social Determinants of Health Research Center (Dr Rafiei), Qazvin University of Medical Sciences, Iran
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25
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Wagner SM, Tabaklar T, Seifert L. HumOSCM for pandemic response. INTERNATIONAL JOURNAL OF LOGISTICS MANAGEMENT 2022. [DOI: 10.1108/ijlm-06-2021-0345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose Humanitarian organizations have faced the unprecedented consequences of the coronavirus disease 2019 (COVID-19) pandemic. In this article, the authors therefore discuss how epidemics and pandemics, specifically Ebola and COVID-19, have affected humanitarian operations and supply chain management (HumOSCM), and how HumOSCM has contributed to preparedness for and response to epidemics and pandemics. The authors present lessons learned from responses to Ebola and COVID-19.Design/methodology/approach For this study, the authors review the scholarly HumOSCM literature, use documentary evidence from practitioner literature and apply a theory synthesis approach to derive recommendations on how HumOSCM could strengthen future responses to epidemics and pandemics.Findings The conceptualizations highlight the importance of strengthening collaboration, capability and capacity for the response to epidemics and pandemics. Furthermore, the components that can enhance the degree of collaboration, and hence, response formation, are discussed.Research limitations/implications As a non-empirical article, it suffers from the limitations of conceptual research. Hence, empirical testing of the proposed framework is recommended. The framework and propositions can serve as a basis for future studies.Practical implications The conceptual framework can help humanitarian organizations and other actors in the humanitarian sector to better understand how to prepare for future responses to epidemics and pandemics, in particular by considering the components that enhance the degree of collaboration, as well as through capability development and capacity building.Originality/value This article begins a discussion of how HumOSCM should evolve to better respond to future epidemics and pandemics.
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26
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Molina A, Vyas P, Khlystov N, Kumar S, Kothari A, Deriso D, Liu Z, Banavar S, Flaum E, Prakash M. Low cost centrifugal melt spinning for distributed manufacturing of non-woven media. PLoS One 2022; 17:e0264933. [PMID: 35439249 PMCID: PMC9017944 DOI: 10.1371/journal.pone.0264933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 02/18/2022] [Indexed: 11/19/2022] Open
Abstract
Centralized manufacturing and global supply chains have emerged as an efficient strategy for large-scale production of goods throughout the 20th century. However, while this system of production is highly efficient, it is not resilient. The COVID-19 pandemic has seen numerous supply chains fail to adapt to sudden changes in supply and demand, including those for goods critical to the pandemic response such as personal protective equipment. Here, we consider the production of the non-woven polypropylene filtration media used in face filtering respirators (FFRs). The FFR supply chain's reliance on non-woven media sourced from large, centralized manufacturing facilities led to a supply chain failure. In this study, we present an alternative manufacturing strategy that allows us to move towards a more distributed manufacturing practice that is both scalable and robust. Specifically, we demonstrate that a fiber production technique known as centrifugal melt spinning can be implemented with modified, commercially-available cotton candy machines to produce nano- and microscale non-woven fibers. We evaluate several post processing strategies to transform the produced material into viable filtration media and then characterize these materials by measuring filtration efficiency and breathability, comparing them against equivalent materials used in commercially-available FFRs. Additionally, we demonstrate that waste plastic can be processed with this technique, enabling the development of distributed recycling strategies to address the growing plastic waste crisis. Since this method can be employed at small scales, it allows for the development of an adaptable and rapidly deployable distributed manufacturing network for non-woven materials that is financially accessible to more people than is currently possible.
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Affiliation(s)
- Anton Molina
- Department of Materials Science and Engineering, Stanford University, Stanford, California, United States of America
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
| | - Pranav Vyas
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
| | - Nikita Khlystov
- Department of Chemical Engineering, Stanford University, Stanford, California, United States of America
| | - Shailabh Kumar
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
| | - Anesta Kothari
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
| | - Dave Deriso
- Department of Electrical Engineering, Stanford University, Stanford, California, United States of America
| | - Zhiru Liu
- Department of Applied Physics, Stanford University, Stanford, California, United States of America
| | - Samhita Banavar
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
| | - Eliott Flaum
- Program in Biophysics, Stanford University, Stanford, California, United States of America
| | - Manu Prakash
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
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27
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Abedin MJ, Khandaker MU, Uddin MR, Karim MR, Ahamad MSU, Islam MA, Arif AM, Sulieman A, Idris AM. PPE pollution in the terrestrial and aquatic environment of the Chittagong city area associated with the COVID-19 pandemic and concomitant health implications. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:27521-27533. [PMID: 34981371 PMCID: PMC8723821 DOI: 10.1007/s11356-021-17859-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/26/2021] [Indexed: 05/05/2023]
Abstract
The present study focuses on the indiscriminate disposal of personal protective equipment (PPEs) and resulting environmental contamination during the 3rd wave of COVID-19-driven global pandemic in the Chittagong metropolitan area, Bangladesh. Because of the very high rate of infection by the delta variant of this virus, the use of PPEs by the public is increased significantly to protect the ingestion/inhalation of respiratory droplets in the air. However, it is a matter of solicitude that general people throw away the PPEs to the dwelling environment unconsciously. With the increase of inappropriate disposal of PPEs (i.e., mostly the disposable face masks made from plastic microfibers), the possibility of transmission of the virus to the general public cannot be neglected completely. This is because this virus can survive for several days on the inanimate matter like plastics and fibers. At the same time, the result of environmental contamination by microplastic/microfiber has been widespread which eventually creates the worst impact on ecosystems and organisms. The present results may help to increase public perception of the use and subsequent disposal of PPEs, especially the face masks.
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Affiliation(s)
- Md Jainal Abedin
- Faculty of Public Health, Thammasat University, Bangkok, 10200, Thailand
| | - Mayeen Uddin Khandaker
- Centre for Applied Physics and Radiation Technologies, School of Engineering and Technology, Sunway University, 47500, Bandar Sunway, Selangor, Malaysia.
| | - Md Ripaj Uddin
- Institute of National Analytical Research and Service (INARS), BCSIR, Dhanmondi, Dhaka, 1205, Bangladesh
| | - Md Rezaul Karim
- Department of Chemistry, Chittagong University of Engineering and Technology, Chattogram, 4349, Bangladesh
| | | | - Md Ariful Islam
- Department of Chemistry, Chittagong University of Engineering and Technology, Chattogram, 4349, Bangladesh
| | - Abu Mohammad Arif
- One Health Institute, Chattogram Veterinary and Animal Sciences University, Chattogram, 4225, Bangladesh
| | - Abdelmoneim Sulieman
- Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, P.O. Box 422, Alkharj, 11942, Saudi Arabia
| | - Abubakr M Idris
- Department of Chemistry, College of Science, King Khalid University, Abha, Saudi Arabia
- Research Center for Advanced Materials Science (RCAMS), King Khalid University, Abha, Saudi Arabia
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28
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Sharma N, Gupta A, Killedar M, Bindra A, Patil A, Gupta S, Gopathoti P, Kumar P. One for Everyone: A Study of User Satisfaction Among Health-Care Providers Regarding Extended Use of N95 Masks During the COVID-19 Pandemic. Disaster Med Public Health Prep 2022; 16:619-626. [PMID: 33040770 PMCID: PMC7737120 DOI: 10.1017/dmp.2020.380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE This study was conducted to assess the feasibility of extended use of N95 masks in our hospital during the coronavirus disease 2019 (COVID-19) pandemic. We also studied the use pattern, user satisfaction, and issues faced during extended use of the mask. METHODS This cross-sectional study was conducted among health-care providers in a large tertiary care teaching hospital in northern India from April 1 to May 31, 2020. A list was prepared from the institute's register, and participants were chosen by random sampling. The data collected from the physical forms were transferred to excel sheets. RESULTS A total of 1121 responses were received. The most common problem stated with reuse of N95 masks was loss of fit followed by damage to the slings, highlighted by 44.6% and 44.4% of the participants, respectively. A total of 476 (42.5%) participants responded that they would prefer "cup-shaped N95 mask with respirator". The median scores regarding the satisfaction with the quality of masks and their fit was also 4 each. CONCLUSIONS It was concluded that the extended use of N95 masks was acceptable, with more than 96% of the participants using these masks.
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Affiliation(s)
- Nishant Sharma
- Department of Hospital Administration, AIIMS, New Delhi, India
| | - Anant Gupta
- Department of Hospital Administration, AIIMS, New Delhi, India
| | | | - Ashish Bindra
- Department of Neuroanaesthesiology and Critical Care, AIIMS, New Delhi, India
| | - Asmita Patil
- Department of Physiology, AIIMS, New Delhi, India
| | - Surabhi Gupta
- Department of Reproductive Biology, AIIMS, New Delhi, India
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29
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Griffin L, Yu M, Cloet A, Arnold S, Carlson N, Hillmyer M, Ou Q, Pei C, Cao Q, Pui D, Franklin R, Durfee W. Protective Masks Utilizing Nonendangered Components. J Med Device 2022; 16:015001. [PMID: 35280214 PMCID: PMC8905092 DOI: 10.1115/1.4053720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/08/2021] [Indexed: 11/08/2022] Open
Abstract
At the beginning of the COVID-19 pandemic when traditional N95 respirators were in short supply in the United States, there was a need for alternative products that did not rely on traditional avenues of sourcing and manufacturing. The purpose of this research was to develop and test alternatives to N95 respirators that could be produced locally without specialized materials and processes. Through an interdisciplinary team of experts, new mask designs that use repurposed filtration media and commercially available components were developed and tested for filtration and fit against current N95 standards. Filtration efficiency test results showed that the filtration media can be used for high-quality facemasks and quantitative fit testing demonstrated that the new mask designs could be viable alternatives to traditional N95 facemasks when those masks are in short supply. Manufacturing viability was tested utilizing a workforce to create 6000 masks over 10 days. The ability to quickly produce masks at scale using a workforce without specialized skills demonstrated the feasibility of the mask designs and manufacturing approach to address shortages of critical healthcare equipment, mitigate risk for healthcare and essential workers, and minimize the transmission and spread of disease.
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Affiliation(s)
- Linsey Griffin
- College of Design, University of Minnesota, 1985 Buford Avenue, 240 McNeal Hall, Saint Paul, MN 55108,Corresponding author. e-mail:
| | - Minji Yu
- College of Design, University of Minnesota, 1985 Buford Avenue, 240 McNeal Hall, Saint Paul, MN 55108,e-mail:
| | - Alison Cloet
- College of Design, University of Minnesota, 1985 Buford Avenue, 240 McNeal Hall, Saint Paul, MN 55108,e-mail:
| | - Susan Arnold
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455,e-mail:
| | - Neil Carlson
- Department of Environmental Health & Safety, University of Minnesota, Thompson Center for Environmental Management, 501 23rd Avenue SE, Minneapolis, MN 55455,e-mail:
| | - Marc Hillmyer
- Department of Chemistry, University of Minnesota, 207 Pleasant St SE, Minneapolis, MN 55455,e-mail:
| | - Qisheng Ou
- Department of Mechanical Engineering, University of Minnesota, 111 Church Street SE, Minneapolis, MN 55455,e-mail:
| | - Chenxing Pei
- Department of Mechanical Engineering, University of Minnesota, 111 Church Street SE, Minneapolis, MN 55455,e-mail:
| | - Qingfeng Cao
- Department of Mechanical Engineering, University of Minnesota, 111 Church Street SE, Minneapolis, MN 55455,e-mail:
| | - David Pui
- Department of Mechanical Engineering, University of Minnesota, 111 Church Street SE, Minneapolis, MN 55455,e-mail:
| | - Rhonda Franklin
- Department of Electrical and Computer Engineering, University of Minnesota, 200 Union Street SE, Minneapolis, MN 55455,e-mail:
| | - William Durfee
- Department of Mechanical Engineering, University of Minnesota, 111 Church Street SE, Minneapolis, MN 55455,e-mail:
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Uddin MA, Afroj S, Hasan T, Carr C, Novoselov KS, Karim N. Environmental Impacts of Personal Protective Clothing Used to Combat COVID- 19. ADVANCED SUSTAINABLE SYSTEMS 2022; 6:2100176. [PMID: 34901387 PMCID: PMC8646872 DOI: 10.1002/adsu.202100176] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/15/2021] [Indexed: 05/16/2023]
Abstract
Personal protective clothing is critical to shield users from highly infectious diseases including COVID-19. Such clothing is predominantly single-use, made of plastic-based synthetic fibers such as polypropylene and polyester, low cost and able to provide protection against pathogens. However, the environmental impacts of synthetic fiber-based clothing are significant and well-documented. Despite growing environmental concerns with single-use plastic-based protective clothing, the recent COVID-19 pandemic has seen a significant increase in their use, which could result in a further surge of oceanic plastic pollution, adding to the mass of plastic waste that already threatens marine life. In this review, the nature of the raw materials involved in the production of such clothing, as well as manufacturing techniques and the personal protective equipment supply chain are briefly discussed. The environmental impacts at critical points in the protective clothing value chain are identified from production to consumption, focusing on water use, chemical pollution, CO2 emissions, and waste. On the basis of these environmental impacts, the need for fundamental changes in the business model is outlined, including increased usage of reusable protective clothing, addressing supply chain "bottlenecks", establishing better waste management, and the use of sustainable materials and processes without associated environmental problems.
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Affiliation(s)
- Mohammad Abbas Uddin
- Department of Dyes and Chemical EngineeringBangladesh University of TextilesTejgaonDhaka1208Bangladesh
| | - Shaila Afroj
- Centre for Print Research (CFPR)The University of West of EnglandFrenchay CampusBristolBS16 1QYUK
| | - Tahmid Hasan
- Department of Environmental Science and EngineeringBangladesh University of TextilesTejgaonDhaka1208Bangladesh
| | - Chris Carr
- Clothworkers’ Centre for Textile Materials Innovation for HealthcareSchool of DesignUniversity of LeedsLeedsLS2 9JTUK
| | - Kostya S Novoselov
- Department of Materials Science and EngineeringNational University of Singapore9 Engineering Drive 1Singapore117575Singapore
- Institute for Functional Intelligent MaterialsNational University of Singapore9 Engineering Drive 1Singapore117575Singapore
- Chongqing 2D Materials InstituteLiangjiang New AreaChongqing400714China
| | - Nazmul Karim
- Centre for Print Research (CFPR)The University of West of EnglandFrenchay CampusBristolBS16 1QYUK
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Best S, Williams SJ. What Have We Learnt About the Sourcing of Personal Protective Equipment During Pandemics? Leadership and Management in Healthcare Supply Chain Management: A Scoping Review. Front Public Health 2021; 9:765501. [PMID: 34957018 PMCID: PMC8695796 DOI: 10.3389/fpubh.2021.765501] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/01/2021] [Indexed: 01/03/2023] Open
Abstract
Introduction: During the ongoing COVID-19 pandemic there have been much publicised shortages in Personal Protective Equipment for frontline health care workers, from masks to gowns. Recent previous airborne pandemics provide an opportunity to learn how to effectively lead and manage supply chains during crisis situations. Identifying and plotting this learning against time will reveal what has been learnt, when and, significantly, what can be learnt for the future. Aims: (i) To identify the temporal trajectory of leadership and management learning in health supply chain management through pandemics and (ii) to identify leadership and management lessons to enable the resilient supply of key items such as PPE in future pandemics. Methods: We undertook a scoping review in line with PRISMA (scoping review extension) searching Business Source Premier, Health Business Elite, Medline, ProQuest Business Collection and PubMed. Search terms were focused on recent airborne pandemics (SARS; Ebola; Zika virus; H1N1 swine flu, COVID-19), supply chain management, PPE, leadership, learning, inhibitors and facilitators and resilience e.g., SARS AND supply chain* AND ("personal protective equipment" OR PPE) (leaders* OR manage*) Titles and abstracts were downloaded to Endnote and duplicates removed. Two authors independently screened all of the titles and abstracts. Inclusion criteria focused on leadership and management in health supply chains during pandemics, peer reviewed or grey literature (either from business journals or reports): exclusion criteria included not in English and not focused on a named pandemic. Once interrater reliability was assured, authors completed a title and abstract screening independently. Ten percent of the resultant full text articles were screened by both authors, once agreement was reached the full text articles were screened independently noting reasons for exclusion. A data extraction tool was designed to capture findings from the final articles included in the review. Results/Discussion: We found 92 articles and, after screening, included 30 full text articles. The majority were focused on COVID-19 (N = 27) and most were from the USA (N = 13). We identified four themes related to leadership and management of pandemic PPE supply chains, (i) Leadership and management learning for pandemic PPE supply chain management, (ii) Inhibitors of PPE supply chain resilience during a pandemic, (iii) Facilitators employed to manage the immediate impacts of PPE supply chain demands during a pandemic,and (iv) Facilitators proposed to ensure longer term resilience of PPE supply chains during pandemics Our study suggests there has been limited leadership and management learning for PPE supply chains from previous pandemics, however there has been extensive learning through the COVID-19 pandemic. Lessons included the importance of planning, the significance of collaboration and relationship building. Resilience of PPE supply chains was reported to be dependent on multiple levels from individuals to organisation level and also interdependent on (i) sustainability, (ii) the practise of PPE and (iii) long term environmental impact of PPE suggesting the need, long term, to move to a circular economy approach.
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Affiliation(s)
- Stephanie Best
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Sharon J Williams
- School of Health and Social Care, Swansea University, Swansea, United Kingdom
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32
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Ma J, Chen F, Xu H, Jiang H, Liu J, Li P, Chen CC, Pan K. Face masks as a source of nanoplastics and microplastics in the environment: Quantification, characterization, and potential for bioaccumulation. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 288:117748. [PMID: 34265560 DOI: 10.1016/j.envpol.2021.117748] [Citation(s) in RCA: 114] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/03/2021] [Accepted: 07/05/2021] [Indexed: 05/19/2023]
Abstract
Billions of disposable face masks are consumed daily due to the COVID-19 pandemic. The role of these masks as a source of nanoplastics (NPs) and microplastics (MPs) in the environment has not been studied in previous studies. We quantified and characterized face mask released particles and evaluated their potential for accumulation in humans and marine organisms. More than one billion of NPs and MPs were released from each surgical or N95 face mask. These irregularly-shaped particles sized from c. 5 nm to c. 600 μm. But most of them were nano scale sized <1 μm. The middle layers of the masks had released more particles than the outer and inner layers. That MPs were detected in the nasal mucus of mask wearers suggests they can be inhaled while wearing a mask. Mask released particles also adsorbed onto diatom surfaces and were ingested by marine organisms of different trophic levels. This data is useful for assessing the health and environmental risks of face masks.
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Affiliation(s)
- Jie Ma
- Shenzhen Key Laboratory of Marine Microbiome Engineering, Institute for Advanced Study, Shenzhen University, Shenzhen, 518060, China
| | - Fengyuan Chen
- Shenzhen Key Laboratory of Marine Microbiome Engineering, Institute for Advanced Study, Shenzhen University, Shenzhen, 518060, China; Department of Ocean Science, The Hong Kong University of Science and Technology, Hong Kong, SAR, China
| | - Huo Xu
- Shenzhen Key Laboratory of Marine Microbiome Engineering, Institute for Advanced Study, Shenzhen University, Shenzhen, 518060, China; Department of Ocean Science, The Hong Kong University of Science and Technology, Hong Kong, SAR, China
| | - Hao Jiang
- Shenzhen Key Laboratory of Marine Microbiome Engineering, Institute for Advanced Study, Shenzhen University, Shenzhen, 518060, China
| | - Jingli Liu
- Shenzhen Key Laboratory of Marine Microbiome Engineering, Institute for Advanced Study, Shenzhen University, Shenzhen, 518060, China
| | - Ping Li
- Shenzhen Key Laboratory of Marine Microbiome Engineering, Institute for Advanced Study, Shenzhen University, Shenzhen, 518060, China
| | - Ciara Chun Chen
- Shenzhen Key Laboratory of Marine Microbiome Engineering, Institute for Advanced Study, Shenzhen University, Shenzhen, 518060, China
| | - Ke Pan
- Shenzhen Key Laboratory of Marine Microbiome Engineering, Institute for Advanced Study, Shenzhen University, Shenzhen, 518060, China.
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Morales-Contreras MF, Leporati M, Fratocchi L. The impact of COVID-19 on supply decision-makers: the case of personal protective equipment in Spanish hospitals. BMC Health Serv Res 2021; 21:1170. [PMID: 34711231 PMCID: PMC8552980 DOI: 10.1186/s12913-021-07202-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/19/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has been recognized as a trigger for redefining supply chains at the global level, and has created an intense debate within the academic community and among policy-makers and practitioners. Among other industries, health care has been dramatically hit by the scarcity of "medical products," specifically for personal protective equipment (PPE-like), due to supply chain disruptions coupled with dramatically increased demand. We aimed to analyze how the scarcity of PPE-like during the COVID-19 pandemic has modified the behavior of decision-makers in the PPE-like supply chain at the hospital level, and to explore what changes could be implemented to cope with future PPE-like shortages. METHODS We used an explorative approach based on semi-structured interviews with key informants in the Spanish health care industry. More specifically, we held interviews to industry experts at three hospitals in three Spanish regions to map the consequences of the COVID-19 pandemic onto the buying decision-making process. RESULTS Different strategies were developed by decision-makers at hospitals before, during, and after the first wave of the COVID-19 pandemic in Spain. Our paper offers two main findings: a) decision-makers changed their purchasing behavior from a cost main driver to guaranteeing the availability of supplies; b) they supported the idea of giving more "strategic autonomy" to Spain or Europe through back and nearshoring decisions. CONCLUSIONS This paper could be of interest to health care management at the national, regional, and hospital levels, as well as for policy-makers, since it could help to establish and configure policies to support the sourcing of medical products (specifically PPE-like) to anticipate potential supply disruptions. Our paper contributes to the limited existing literature on how purchasing strategies at the decision-maker level and supply vary in the health care industry when a public health crisis appears, and what potential solutions might be for policy-makers and practitioners involved in the health care industry.
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Affiliation(s)
- Manuel F. Morales-Contreras
- Faculty of Business Management and Economics, ICADE, Universidad Pontificia Comillas, Madrid, Spain
- Institute for Research in Technology (IIT), ICAI School of Engineering, Universidad Pontificia Comillas, Madrid, Spain
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De Vito D, Fusco A, Benincasa C, Laghi L, Ceruso FM. Healthcare Management During a Pandemic: The Other Side of the Coin for the Treatment of Covid-19 Infection. Endocr Metab Immune Disord Drug Targets 2021; 22:383-394. [PMID: 34635046 DOI: 10.2174/1871530321666211011102038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/07/2021] [Accepted: 08/25/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND World Health Organization (WHO) has increasingly improved the guidelines to tackle the spread of Coronavirus Disease 2019 (COVID-19) among the worldwide population. In this context, each country has introduced specific social, healthcare, political and macroeconomic measures to face COVID pandemic locally. OBJECTIVE The general aim of this comparative overview is to highlight the most significant effects of COVID-19 pandemic on the main healthcare systems. Also, we critically analyzed the macroeconomic variables and the most promising solutions to improve both healthcare system and its related risk management, taking into specific consideration the most industrialized countries. METHOD The main strategy has been built on a renewed concept of the hospital, rebuilding the old concepts of "triage" and "intensive care". Recently, COVID-19 hospitals have allowed to cater the patients affected by COVID-19. Moreover, the reshaping of several healthcare policies and requirements has led to several positive effects, such as the recruitment of a huge number of human resources in the healthcare systems. Nevertheless, several negative effects have also impacted the communities mostly subjected to infections. CONCLUSION Undoubtedly, the national healthcare systems have somehow addressed the people's needs, trying not to neglect the social, healthcare, economic and political aspects. In our overview, we have reported how the different actions taken in the last months, have resulted in different outcomes.
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Affiliation(s)
- Danila De Vito
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari "Aldo Moro". Italy
| | | | - Caterina Benincasa
- Marrelli Health - Tecnologica Research Institute, Biomedical Section, Street E. Fermi 1, Crotone. Italy
| | - Luca Laghi
- Queen Elisabeth hospital, Birmingham . United Kingdom
| | - Francesco M Ceruso
- Department of Dentistry "Fra G.B. Orsenigo - Ospedale San Pietro F.B.F.", Rome. Italy
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De-la-Torre GE, Pizarro-Ortega CI, Dioses-Salinas DC, Ammendolia J, Okoffo ED. Investigating the current status of COVID-19 related plastics and their potential impact on human health. CURRENT OPINION IN TOXICOLOGY 2021; 27:47-53. [PMID: 34541428 PMCID: PMC8441111 DOI: 10.1016/j.cotox.2021.08.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The COVID-19 pandemic led to a sudden global increase in the production, consumption, and mismanagement of personal protective equipment (PPE). As plastic-based PPE such as disposable face masks and gloves have become widely used, human exposure to PPE-derived pollutants may occur through indirect and direct pathways. This review explores the potential health impacts related to plastic-based PPE through these pathways. Face masks release microplastics, which are directly inhaled during use or transported through the environment. The latter can adsorb chemical contaminants and harbor pathogenic microbiota, and once consumed by organisms, they can translocate to multiple organs upon intake, potentially causing detrimental and cytotoxic effects. However, more research is required to have a comprehensive overview of the human health effects.
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Affiliation(s)
| | | | | | - Justine Ammendolia
- Department of Integrative Biology, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - Elvis D Okoffo
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD, 4102, Australia
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Salam A, Hassan T, Jabri T, Riaz S, Khan A, Iqbal KM, Khan SU, Wasim M, Shah MR, Khan MQ, Kim IS. Electrospun Nanofiber-Based Viroblock/ZnO/PAN Hybrid Antiviral Nanocomposite for Personal Protective Applications. NANOMATERIALS 2021; 11:nano11092208. [PMID: 34578527 PMCID: PMC8465428 DOI: 10.3390/nano11092208] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/17/2021] [Accepted: 08/24/2021] [Indexed: 11/24/2022]
Abstract
Designing novel antiviral personal protective equipment (PPE) is crucial for preventing viral infections such as COVID-19 in humans. Here, we fabricate an electrospun nanofiber-based Viroblock (VB)-loaded polyacrylonitrile (PAN)/zinc oxide (ZnO) hybrid nanocomposite for PPE applications. Five different concentrations of Viroblock (0.5%, 1.5%, 2.5%, 3.5%, and 5%) were added to PAN/ZnO solution and loaded for electrospinning. The developed samples reflected antibacterial activity of 92.59% and 88.64% against Staphylococcus aureus and Pseudomonas aeruginosa bacteria, respectively, with 5% VB loading. Moreover, a significant reduction in virus titer (37%) was observed with the 5% VB/PAN/ZnO nanofiber sheet. Hence, VB-loaded PAN/ZnO nanofibers have great potential to kill enveloped viruses such as influenzas and coronaviruses and could be the ideal candidate for the development of nanofiber-based PPE, such as facemasks and surgical gowns, which can play a key role in the protection of frontline health workers and the general public in the COVID-19 pandemic.
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Affiliation(s)
- Abdul Salam
- Nanotechnology Research Group, Department of Textile and Clothing, Faculty of Engineering and Technology, National Textile University Karachi Campus, Industrial Area Korangi, Karachi 74900, Pakistan; (A.S.); (T.H.)
| | - Tufail Hassan
- Nanotechnology Research Group, Department of Textile and Clothing, Faculty of Engineering and Technology, National Textile University Karachi Campus, Industrial Area Korangi, Karachi 74900, Pakistan; (A.S.); (T.H.)
| | - Tooba Jabri
- International Center for Chemical and Biological Sciences, H.E.J. Research Institute of Chemistry, University of Karachi, Karachi 75270, Pakistan; (T.J.); (K.M.I.); (M.R.S.)
| | - Shagufta Riaz
- Functional Textile Research Group, Department of Textile Engineering, National Textile University, Faisalabad 37610, Pakistan;
| | - Amina Khan
- Department of Chemistry, National Textile University, Faisalabad 37610, Pakistan;
| | - Kanwal Muhammad Iqbal
- International Center for Chemical and Biological Sciences, H.E.J. Research Institute of Chemistry, University of Karachi, Karachi 75270, Pakistan; (T.J.); (K.M.I.); (M.R.S.)
| | - Saif ullah Khan
- Department of Textile Engineering, Balochistan University of Information Technology Engineering and Management Sciences, Quetta 87100, Pakistan;
| | - Muhammad Wasim
- Key Laboratory of New Materials and Modification of Liaoning Province, School of Textile and Materials Engineering, Dalian Polytechnic University, Dalian 116034, China;
| | - Muhammad Raza Shah
- International Center for Chemical and Biological Sciences, H.E.J. Research Institute of Chemistry, University of Karachi, Karachi 75270, Pakistan; (T.J.); (K.M.I.); (M.R.S.)
| | - Muhammad Qamar Khan
- Nanotechnology Research Group, Department of Textile and Clothing, Faculty of Engineering and Technology, National Textile University Karachi Campus, Industrial Area Korangi, Karachi 74900, Pakistan; (A.S.); (T.H.)
- Correspondence: (M.Q.K.); (I.-S.K.); Tel.: +92-314-6300683 (M.Q.K.)
| | - Ick-Soo Kim
- Division of Frontier Fiber, Institute of Fiber Engineering, Interdisciplinary Cluster for Cutting Edge Research (ICCER), Faculty of Textile Sciences, Shinshu University, Tokida 3151, Ueda, Nagano 386 8567, Japan
- Correspondence: (M.Q.K.); (I.-S.K.); Tel.: +92-314-6300683 (M.Q.K.)
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Taylor RCR. The global governance of pandemics. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:1540-1553. [PMID: 34286858 PMCID: PMC8441821 DOI: 10.1111/1467-9566.13293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/10/2021] [Accepted: 04/11/2021] [Indexed: 06/13/2023]
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Goodloe JM, Topjian A, Hsu A, Dunne R, Panchal AR, Levy M, McEvoy M, Vaillancourt C, Cabanas JG, Eisenberg MS, Rea TD, Kudenchuk PJ, Gienapp A, Flores GE, Fuchs S, Adelgais KM, Owusu-Ansah S, Terry M, Sawyer KN, Fromm P, Panczyk M, Kurz M, Lindbeck G, Tan DK, Edelson DP, Sayre MR. Interim Guidance for Emergency Medical Services Management of Out-of-Hospital Cardiac Arrest During the COVID-19 Pandemic. Circ Cardiovasc Qual Outcomes 2021; 14:e007666. [PMID: 34157848 PMCID: PMC8288195 DOI: 10.1161/circoutcomes.120.007666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jeffrey M Goodloe
- Department of Emergency Medicine, University of Oklahoma School of Community Medicine, Tulsa (J.M.G.)
| | - Alexis Topjian
- Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania (A.T.)
| | - Antony Hsu
- St Joseph Mercy Hospital, Ann Arbor, MI (A.H.)
| | - Robert Dunne
- Department of Emergency Medicine, St John Hospital, Detroit, MI (R.D.)
| | - Ashish R Panchal
- The Ohio State University Wexner Medical Center, Columbus (A.R.P.)
| | - Michael Levy
- University of Alaska Anchorage, Anchorage Areawide EMS (M.L.)
| | - Mike McEvoy
- EMS Coordinator - Saratoga County, NY (M.M.)
| | - Christian Vaillancourt
- Department of Emergency Medicine, Ottawa Hospital Research Institute, University of Ottawa, ON, Canada (C.V.)
| | - Jose G Cabanas
- Wake County Department of Emergency Medical Services, University of North Carolina at Chapel Hill (J.G.C.)
| | - Mickey S Eisenberg
- Department of Emergency Medicine (M.S.E., M.R.S.).,University of Washington, Seattle. King County Emergency Medical Services, Seattle, WA (M.S.E., T.D.R., P.J.K.)
| | - Thomas D Rea
- Department of Medicine (T.D.R.).,University of Washington, Seattle. King County Emergency Medical Services, Seattle, WA (M.S.E., T.D.R., P.J.K.)
| | - Peter J Kudenchuk
- Division of Cardiology (P.J.K.).,University of Washington, Seattle. King County Emergency Medical Services, Seattle, WA (M.S.E., T.D.R., P.J.K.)
| | - Andy Gienapp
- Office of Emergency Medical Services, Wyoming Department of Health, Cheyenne (A.G.)
| | - Gustavo E Flores
- Emergency and Critical Care Trainings, San Juan, Puerto Rico (G.E.F.)
| | - Susan Fuchs
- Feinberg School of Medicine, Northwestern University, Ann and Robert H. Lurie Children's Hospital, Chicago, IL (S.F.)
| | - Kathleen M Adelgais
- Department of Pediatrics, Section of Pediatric Emergency Medicine, University of Colorado School of Medicine, Aurora (K.M.A.)
| | - Sylvia Owusu-Ansah
- Division of Pediatric Emergency Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh (S.O.-A.), University of Pittsburgh School of Medicine, PA
| | - Mark Terry
- National Registry of Emergency Medical Technicians, Columbus, OH (M.T.)
| | - Kelly N Sawyer
- Department of Emergency Medicine (K.N.S.), University of Pittsburgh School of Medicine, PA
| | - Peter Fromm
- Mount Sinai South Nassau Hospital, Oceanside, NY (P.F.)
| | - Micah Panczyk
- University of Texas Health Science Center, Houston (M.P.)
| | | | - George Lindbeck
- Office of Emergency Medical Services, Virginia Department of Health, Richmond (G.L.)
| | - David K Tan
- Washington University School of Medicine, St Louis, MO (D.K.T.)
| | | | - Michael R Sayre
- Department of Emergency Medicine (M.S.E., M.R.S.).,Seattle Fire Department, WA (M.R.S.)
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Padula WV, Cuddigan J, Ruotsi L, Black JM, Brienza D, Capasso V, Cox J, Delmore B, Holden‐Mount S, Munoz N, Nie AM, Pittman J, Sonenblum SE, Tescher A. Best-practices for preventing skin injury beneath personal protective equipment during the COVID-19 pandemic: A position paper from the National Pressure Injury Advisory Panel. J Clin Nurs 2021; 32:625-632. [PMID: 33534939 PMCID: PMC8013459 DOI: 10.1111/jocn.15682] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/11/2020] [Accepted: 01/07/2021] [Indexed: 02/02/2023]
Abstract
COVID-19 has infected millions of patients and impacted healthcare workers worldwide. Personal Protective Equipment (PPE) is a key component of protecting frontline clinicians against infection. The benefits of PPE far outweigh the risks, nonetheless, many clinicians are exhibiting skin injury caused by PPE worn incorrectly. These skin injuries, ranging from lesions to open wounds are concerning because they increase the susceptibility of viral infection and transmission to other individuals. Early into the COVID-19 pandemic (April 2020), the U. S. National Pressure Injury Advisory Panel (NPIAP) developed a series of position statements to improve wear-ability of PPE and protect healthcare professionals and their patients as safe from harm as possible under the circumstances. The NPIAP positions, which were formed by conducting a systematic review of what was known at the time, include: (a) Prepare skin before and after wearing PPE with skin sealants, barrier creams and moisturisers; (b) Frequent PPE offloading to relieve pressure and shear applied to skin; (c) treat visible skin injuries immediately caused by PPE to minimise future infection; (d) non-porous dressings may provide additional skin protection, but lack evidence; (e) health systems should take care to educate clinicians about placement and personal hygiene related to handling PPE. Throughout all of these practices, handwashing remains a top priority to handle PPE. These NPIAP positions provided early guidance to reduce the risk of skin injury caused by PPE based on available research regarding PPE injuries, a cautious application of evidence-based recommendations on prevention of device-related pressure injuries in patients and the expert opinion of the NPIAP Board of Directors. Clinicians who adhere to these recommendations reduce the prospects of skin damage and long-term effects (e.g. scarring). These simple steps to minimise the risk of skin injury and reduce the risk of coronavirus infection from PPE can help.
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Affiliation(s)
- William V. Padula
- Leonard D. Schaeffer Center for Health Policy & EconomicsDepartment of Pharmaceutical & Health EconomicsSchool of PharmacyUniversity of Southern CaliforniaLos AngelesCAUSA,Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA
| | - Janet Cuddigan
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,College of NursingUniversity of Nebraska Medical CenterOmahaNEUSA
| | - Lee Ruotsi
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,Saratoga Hospital Medical GroupSaratoga SpringsNYUSA
| | - Joyce M. Black
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,College of NursingUniversity of Nebraska Medical CenterOmahaNEUSA
| | - David Brienza
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,School of Health and Rehabilitation ScienceUniversity of PittsburghPittsburghPAUSA
| | - Virginia Capasso
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,Massachusetts General Hospital and Harvard Medical SchoolBostonMAUSA
| | - Jill Cox
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,School of NursingRutgers UniversityNewarkNJUSA
| | - Barbara Delmore
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,NYU Langone HealthNew YorkNYUSA
| | - Sarah Holden‐Mount
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,American Medical TechnologiesIrvineCAUSA
| | - Nancy Munoz
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,Southern Nevada VA Health SystemLas VegasNVUSA
| | - Ann Marie Nie
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,Children’s Hospitals and Clinics of MinnesotaMinneapolisMNUSA
| | - Joyce Pittman
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,College of NursingUniversity of South AlabamaMobileALUSA
| | - Sharon E. Sonenblum
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,The George W. Woodruff School of Mechanical EngineeringGeorgia Institute of TechnologyAtlantaGAUSA
| | - Ann Tescher
- Board of DirectorsThe National Pressure Injury Advisory Panel (NPIAPBostonMAUSA,Mayo Clinic HospitalRochesterMNUSA
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Warrington JS, Crothers JW, Goodwin A, Coulombe L, Hong T, Bryan L, Wojewoda C, Fung M, Warrington G, Clark V, Risley L, Lewis M. All Hands-On Deck and All Decks on Hand: Surmounting Supply Chain Limitations During the COVID-19 Pandemic. Acad Pathol 2021; 8:23742895211011928. [PMID: 34027053 PMCID: PMC8120534 DOI: 10.1177/23742895211011928] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/06/2021] [Accepted: 03/21/2021] [Indexed: 12/24/2022] Open
Abstract
Testing during the COVID-19 pandemic has been crucial to public health surveillance and clinical care. Supply chain constraints—spanning limitations in testing kits, reagents, pipet tips, and swabs availability—have challenged the ability to scale COVID-19 testing. During the early months, sample collection kits shortages constrained planned testing expansions. In response, the University of Vermont Medical Center, University of Vermont College of Medicine, Vermont Department of Health Laboratory, Aspenti Health, and providers across Vermont including 16 area hospitals partnered to surmount these barriers. The primary objectives were to increase supply availability and manage utilization. Within the first month of Vermont’s stay-at-home order, the University of Vermont Medical Center laboratory partnered with College of Medicine to create in-house collection kits, producing 5000 per week. University of Vermont Medical Center reassigned 4 phlebotomists, laboratory educators, and other laboratory staff, who had reduced workloads, to participate (requiring a total of 5.3-7.6 full-time equivalent (FTE) during the period of study). By August, automation at a local commercial laboratory produced 22,000 vials of media in one week (reducing the required personnel by 1.2 FTE). A multisite, cross-institutional approach was used to manage specimen collection kit utilization across Vermont. Hospital laboratory directors, managers, and providers agreed to order only as needed to avoid supply stockpiles and supported operational constraints through ongoing validations and kit assembly. Throughout this pandemic, Vermont has ranked highly in number of tests per million people, demonstrating the value of local collaboration to surmount obstacles during disease outbreaks and the importance of creative allocation of resources to address statewide needs.
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Affiliation(s)
- Jill S. Warrington
- Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Robert Larner College of Medicine, Burlington, VT, USA
- Aspenti Health, South Burlington, VT, USA
- Jill S. Warrington, MD, PhD, Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT 05401, USA.
| | - Jessica W. Crothers
- Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Robert Larner College of Medicine, Burlington, VT, USA
| | - Andrew Goodwin
- Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Robert Larner College of Medicine, Burlington, VT, USA
| | - Linda Coulombe
- University of Vermont Health Network, Supply Chain Department, Burlington, VT, USA
| | - Tania Hong
- Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Robert Larner College of Medicine, Burlington, VT, USA
| | - Lynn Bryan
- Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Robert Larner College of Medicine, Burlington, VT, USA
| | - Christina Wojewoda
- Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Robert Larner College of Medicine, Burlington, VT, USA
| | - Mark Fung
- Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Robert Larner College of Medicine, Burlington, VT, USA
| | | | | | | | - Michael Lewis
- Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Robert Larner College of Medicine, Burlington, VT, USA
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Bath J, Aziz F, Smeds MR. Progression of Changes in Vascular Surgery Practices during the Novel Corona Virus SARS-CoV-2 Pandemic. Ann Vasc Surg 2021; 76:1-9. [PMID: 33836228 PMCID: PMC8023786 DOI: 10.1016/j.avsg.2021.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 12/02/2022]
Abstract
Introduction The novel coronavirus SARS-CoV-2 (COVID-19) has spread rapidly since it was identified. We sought to understand its effects on vascular surgery practices stratified by VASCON surgical readiness level and determine how these effects have changed during the course of the pandemic. Methods All members of the Vascular and Endovascular Surgery Society were sent electronic surveys questioning the effects of COVID-19 on their practices in the early pandemic in April (EP) and four months later in the pandemic in August (LP) 2020. Results Response rates were 206/731 (28%) in the EP group and 108/731 (15%) in the LP group (P < 0.0001). Most EP respondents reported VASCON levels less than 3 (168/206,82%), indicating increased hospital limitations while 6/108 (6%) in the LP group reported this level (P < 0.0001). The EP group was more likely to report a lower VASCON level (increased resource limitations), and decreased clinic, hospital and emergency room consults. Despite an increase of average cases/week to pre-COVID-19 levels, 46/108 (43%) of LP report continued decreased compensation, with 57% reporting more than 10% decrease. Respondents in the decreased compensation group were more likely to have reported a VASCON level 3 or lower earlier in the pandemic (P = 0.018). 91/108(84%) of LP group have treated COVID-19 patients for thromboembolic events, most commonly acute limb ischemia (76/108) and acute DVT (76/108). While the majority of respondents are no longer delaying the vascular surgery cases, 76/108 (70%) feel that vascular patient care has suffered due to earlier delays, and 36/108 (33%) report a backlog of cases caused by the pandemic. Conclusions COVID-19 had a profound effect on vascular surgery practices earlier in the pandemic, resulting in continued detrimental effects on the provision of vascular care as well as compensation received by vascular surgeons.
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Affiliation(s)
- Jonathan Bath
- Division of Vascular Surgery, University of Missouri, Columbia, MO
| | - Faisal Aziz
- Division of Vascular Surgery, Pennsylvania State University, Hershey, PA
| | - Matthew R Smeds
- Division of Vascular and Endovscular Surgery, Department of Surgery, Saint Louis University, St. Louis, MO.
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Jafree SR, Momina AU, Malik N, Naqi SA, Fischer F. Challenges in providing surgical procedures during the COVID-19 pandemic: Qualitative study among Operating Department Practitioners in Pakistan. Sci Prog 2021; 104:368504211023282. [PMID: 34152874 PMCID: PMC10454979 DOI: 10.1177/00368504211023282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The surgical theatre is associated with the highest mortality rates since the onslaught of the COVID-19 pandemic. However, Operating Department Practitioners (ODPs) are neglected human resources for health in regards to both professional development and research for patient safety; even though they are key practitioners with respect to infection control during surgeries. Therefore, this study aims to describe challenges faced by ODPs during the pandemic. The secondary aim is to use empirical evidence to inform the public health sector management about both ODP professional development and improvement in surgical procedures, with a specific focus on pandemics. A qualitative study has been conducted. Data collection was based on an interview guide with open-ended questions. Interviews with 39 ODPs in public sector teaching hospitals of Pakistan who have been working during the COVID-19 pandemic were part of the analysis. Content analysis was used to generate themes. Ten themes related to challenges faced by ODPs in delivering services during the pandemic for securing patient safety were identified: (i) Disparity in training for prevention of COVID-19; (ii) Shortcomings in COVID-19 testing; (iii) Supply shortages of personal protective equipment; (iv) Challenges in maintaining physical distance and prevention protocols; (v) Human resource shortages and role burden; (vi) Problems with hospital administration; (vii) Exclusion and hierarchy; (viii) Teamwork limitations and other communication issues; (ix) Error Management; and (x) Anxiety and fear. The public health sector, in Pakistan and other developing regions, needs to invest in the professional development of ODPs and improve resources and structures for surgical procedures, during pandemics and otherwise.
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Affiliation(s)
- Sara Rizvi Jafree
- Department of Sociology, Forman Christian College University, Lahore, Punjab, Pakistan
| | - Ain ul Momina
- Institute of Public Health, King Edward Medical University, Lahore, Pakistan
| | - Nudra Malik
- Department of Applied Psychology, Lahore College for Women University, Lahore, Pakistan
| | - Syed Asghar Naqi
- Department of Surgery, King Edward Medical University, Lahore, Pakistan
| | - Florian Fischer
- Institute of Public Health, Charité– Universitätsmedizin Berlin, Berlin, Germany
- Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
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Stamps DC, Foley SM, Gales J, Lovetro C, Alley R, Opett K, Glessner T, Faggiano S. Nurse Leaders Advocate for Nurses Across a Health Care System: COVID-19. NURSE LEADER 2021; 19:159-164. [PMID: 32837355 PMCID: PMC7386289 DOI: 10.1016/j.mnl.2020.07.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 07/22/2020] [Indexed: 12/20/2022]
Abstract
The COVID-19 pandemic emphasizes the importance of nursing care globally. Nurses are the frontline staff in the care of individuals stricken with this highly infectious and deadly illness. Nurse leaders must advocate for nursing staff when staff are immersed in often overwhelming conditions. Through a case study, this article outlines how one healthcare system's Chief Nursing Officer council worked collaboratively, jointly and with the Emergency Incident Command Structure, to operationalize CDC guidelines and support, protect, educate, and empower staff. These initiatives resulted in creative solutions, technological advances for the system, and nursing staff and leaders rising to the challenge.
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Anwari V, Ng WCK, Mbadjeu Hondjeu AR, Xiao Z, Afenu E, Trac J, Kazlovich K, Hiansen J, Mashari A. Development, manufacturing, and preliminary validation of a reusable half-face respirator during the COVID-19 pandemic. PLoS One 2021; 16:e0247575. [PMID: 33730106 PMCID: PMC7968700 DOI: 10.1371/journal.pone.0247575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 02/09/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction The COVID-19 pandemic has led to widespread shortages of N95 respirators and other personal protective equipment (PPE). An effective, reusable, locally-manufactured respirator can mitigate this problem. We describe the development, manufacture, and preliminary testing of an open-hardware-licensed device, the “simple silicone mask” (SSM). Methods A multidisciplinary team developed a reusable silicone half facepiece respirator over 9 prototype iterations. The manufacturing process consisted of 3D printing and silicone casting. Prototypes were assessed for comfort and breathability. Filtration was assessed by user seal checks and quantitative fit-testing according to CSA Z94.4–18. Results The respirator originally included a cartridge for holding filter material; this was modified to connect to standard heat-moisture exchange (HME) filters (N95 or greater) after the cartridge showed poor filtration performance due to flow acceleration around the filter edges, which was exacerbated by high filter resistance. All 8 HME-based iterations provided an adequate seal by user seal checks and achieved a pass rate of 87.5% (N = 8) on quantitative testing, with all failures occurring in the first iteration. The overall median fit-factor was 1662 (100 = pass). Estimated unit cost for a production run of 1000 using distributed manufacturing techniques is CAD $15 in materials and 20 minutes of labor. Conclusion Small-scale manufacturing of an effective, reusable N95 respirator during a pandemic is feasible and cost-effective. Required quantities of reusables are more predictable and less vulnerable to supply chain disruption than disposables. With further evaluation, such devices may be an alternative to disposable respirators during public health emergencies. The respirator described above is an investigational device and requires further evaluation and regulatory requirements before clinical deployment. The authors and affiliates do not endorse the use of this device at present.
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Affiliation(s)
- Vahid Anwari
- Joint Department of Medical Imaging, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- The Lynn and Arnold Irwin Advanced Perioperative Imaging Lab, Department of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - William C. K. Ng
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- Department of Anaesthesia and Pain Management, The Hospital for Sick Children, Toronto, Ontario, Canada
- * E-mail:
| | - Arnaud Romeo Mbadjeu Hondjeu
- Department of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Zixuan Xiao
- Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Edem Afenu
- School of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jessica Trac
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kate Kazlovich
- The Lynn and Arnold Irwin Advanced Perioperative Imaging Lab, Department of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Ontario, Canada
| | - Joshua Hiansen
- The Lynn and Arnold Irwin Advanced Perioperative Imaging Lab, Department of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Azad Mashari
- The Lynn and Arnold Irwin Advanced Perioperative Imaging Lab, Department of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
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Moseley TW, Conners AL, He H, Barth JE, Lightfoote JB, Parikh JR, Whitman GJ. Mitigating the Transmission of COVID-19 with the Appropriate Usage of Personal Protective Protocols and Equipment in Breast Imaging and Intervention. JOURNAL OF BREAST IMAGING 2021; 3:215-220. [PMID: 33778489 PMCID: PMC7928886 DOI: 10.1093/jbi/wbab007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Indexed: 01/13/2023]
Abstract
The integration of personal protective equipment (PPE) and procedures into breast imaging and intervention practices will mitigate the risk of transmission of COVID-19 during the pandemic. Although supply chain shortages have improved, understanding the proper use of PPE and protocols to mitigate overconsumption are important to ensure efficacious utilization of PPE. Protocols and best practices are reviewed, and guidelines and resource materials are referenced in order to support breast imaging healthcare professionals.
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Affiliation(s)
- Tanya W Moseley
- The University of Texas MD Anderson Cancer Center, Department of Breast Imaging, Houston, TX, USA
| | - Amy L Conners
- Mayo Clinic, Department of Radiology, Rochester, MN, USA
| | - Hongying He
- The University of Texas Health Science Center at Houston, Department of Diagnostic and Interventional Imaging, Houston, TX, USA
| | - Jean E Barth
- Mayo Clinic, Department of Infection Prevention and Control, Rochester, MN, USA
| | | | - Jay R Parikh
- The University of Texas MD Anderson Cancer Center, Department of Breast Imaging, Houston, TX, USA
| | - Gary J Whitman
- The University of Texas MD Anderson Cancer Center, Department of Breast Imaging, Houston, TX, USA
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Bedi JS, Vijay D, Dhaka P, Singh Gill JP, Barbuddhe SB. Emergency preparedness for public health threats, surveillance, modelling & forecasting. Indian J Med Res 2021; 153:287-298. [PMID: 33906991 PMCID: PMC8204835 DOI: 10.4103/ijmr.ijmr_653_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Indexed: 11/04/2022] Open
Abstract
In the interconnected world, safeguarding global health security is vital for maintaining public health and economic upliftment of any nation. Emergency preparedness is considered as the key to control the emerging public health challenges at both national as well as international levels. Further, the predictive information systems based on routine surveillance, disease modelling and forecasting play a pivotal role in both policy building and community participation to detect, prevent and respond to potential health threats. Therefore, reliable and timely forecasts of these untoward events could mobilize swift and effective public health responses and mitigation efforts. The present review focuses on the various aspects of emergency preparedness with special emphasis on public health surveillance, epidemiological modelling and capacity building approaches. Global coordination and capacity building, funding and commitment at the national and international levels, under the One Health framework, are crucial in combating global public health threats in a holistic manner.
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Affiliation(s)
- Jasbir Singh Bedi
- Centre for One Health, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Deepthi Vijay
- Centre for One Health, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Pankaj Dhaka
- Centre for One Health, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Jatinder Paul Singh Gill
- Centre for One Health, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, India
| | - Sukhadeo B. Barbuddhe
- Department of Meat Safety, ICAR-National Research Centre on Meat, Chengicherla, Hyderabad, Telangana, India
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Rivard L, Pester J, McMahon K, Check R, Kelly B, Balakrishnan V, Jeanmonod D, Jeanmonod R. The efficacy of continuous use disposable N95 masks in clinical practice in the emergency department. Am J Emerg Med 2021; 44:124-127. [PMID: 33607588 PMCID: PMC7863752 DOI: 10.1016/j.ajem.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022] Open
Abstract
During the SARS-CoV-2 pandemic, many emergency departments (EDs) initiated continuous use of N95 disposable respirators (N95s) rather than discarding them after each use to conserve respirators. This study investigates the efficacy of wearing disposable N95s continuously during clinical work. Methods This is a prospective cohort study of ED staff required to wear N95s continuously throughout their shifts. Subjects were doctors, nurses, and technicians who were previously fitted for their assigned N95 by employee health. Subjects were fit tested periodically throughout their shifts. Investigators filled out a questionnaire for each subject noting the hours of continuous N95 wear. Data were analyzed using descriptive statistics. Results One hundred thirteen N95s were evaluated, with 23 failures at first testing. These were not retested. Twenty-seven N95s passed at the start of a shift and did not have repeat testing during the course of the shift. These were excluded from further analysis. Seventeen N95s passed testing after several hours of continuous wear, but only had a single fit test done partway or at the end of a shift. These were assumed to have passed if tested at shift start, and were assigned as “passes” for continuous use. Forty-six N95s had an initial pass and were evaluated for continuous use, of which 6 subsequently failed later in the shift, giving a fail rate with continuous use of 9.5%. Conclusion Continuous use of disposable N95s throughout an ED shift is reasonable during a PPE shortage if wearers are assured of fit at the start of their shift.
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Affiliation(s)
- Leah Rivard
- St. Luke's University Hospital and Health Network, Department of Emergency Medicine, Bethlehem, PA, United States of America
| | - Jonathan Pester
- St. Luke's University Hospital and Health Network, Department of Emergency Medicine, Bethlehem, PA, United States of America
| | - Kathleen McMahon
- St. Luke's University Hospital and Health Network, Department of Emergency Medicine, Bethlehem, PA, United States of America
| | - Ronald Check
- St. Luke's University Hospital and Health Network, Department of Emergency Medicine, Bethlehem, PA, United States of America
| | - Brian Kelly
- St. Luke's University Hospital and Health Network, Department of Emergency Medicine, Bethlehem, PA, United States of America
| | - Vamsi Balakrishnan
- St. Luke's University Hospital and Health Network, Department of Emergency Medicine, Bethlehem, PA, United States of America
| | - Donald Jeanmonod
- St. Luke's University Hospital and Health Network, Department of Emergency Medicine, Bethlehem, PA, United States of America
| | - Rebecca Jeanmonod
- St. Luke's University Hospital and Health Network, Department of Emergency Medicine, Bethlehem, PA, United States of America.
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Greenawald LA, Moore SM, Wizner K, Yorio PL. Developing a methodology to collect empirical data that informs policy and practices for stockpiling personal protective equipment. Am J Infect Control 2021; 49:166-173. [PMID: 32659415 DOI: 10.1016/j.ajic.2020.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Personal protective equipment (PPE) are stockpiled across the nation to offset supply depletion during public health emergencies. Stockpiled PPE inventories vary across the United States by type, model, quantity, and the conditions in which they are stored. Over the past decade, federal, state, and local stockpile managers have had concerns for the viability of aging PPE. METHODS To understand factors that may affect stockpiled PPE, we explored the breadth of stockpile storage conditions and respirator and surgical gown inventories through collaboration with the national PPE community, qualitative observations collected at 10 different US stockpiles, and by compiling stockpile PPE inventories and climate data from a convenience sample of US stockpiles. RESULTS The aggregated inventory from 20 stockpiles is reported, accounting for approximately 53 million respirators. Most respirators (69% or 35.8 million) have been stored between 5 and 10 years. Upon visiting 10 stockpile facilities, we report on the storage conditions observed and summarize the storage environment data collected. CONCLUSIONS This is the first study to identify common PPE types, inventories, and storage conditions across federal, state, and local government stockpile facilities as well as health care organization-managed caches. These findings will be leveraged to guide the development of sampling protocols for air-purifying respirators and surgical gowns in US stockpiles to understand the performance viability after long-term storage.
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Hoernke K, Djellouli N, Andrews L, Lewis-Jackson S, Manby L, Martin S, Vanderslott S, Vindrola-Padros C. Frontline healthcare workers' experiences with personal protective equipment during the COVID-19 pandemic in the UK: a rapid qualitative appraisal. BMJ Open 2021; 11:e046199. [PMID: 33472794 PMCID: PMC7818840 DOI: 10.1136/bmjopen-2020-046199] [Citation(s) in RCA: 147] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To report frontline healthcare workers' (HCWs) experiences with personal protective equipment (PPE) during the COVID-19 pandemic in the UK. To understand HCWs' fears and concerns surrounding PPE, their experiences following its guidance and how these affected their perceived ability to deliver care during the COVID-19 pandemic. DESIGN A rapid qualitative appraisal study combining three sources of data: semistructured in-depth telephone interviews with frontline HCWs (n=46), media reports (n=39 newspaper articles and 145 000 social media posts) and government PPE policies (n=25). PARTICIPANTS Interview participants were HCWs purposively sampled from critical care, emergency and respiratory departments as well as redeployed HCWs from primary, secondary and tertiary care centres across the UK. RESULTS A major concern was running out of PPE, putting HCWs and patients at risk of infection. Following national level guidance was often not feasible when there were shortages, leading to reuse and improvisation of PPE. Frequently changing guidelines generated confusion and distrust. PPE was reserved for high-risk secondary care settings and this translated into HCWs outside these settings feeling inadequately protected. Participants were concerned about differential access to adequate PPE, particularly for women and Black, Asian and Minority Ethnic HCWs. Participants continued delivering care despite the physical discomfort, practical problems and communication barriers associated with PPE use. CONCLUSION This study found that frontline HCWs persisted in caring for their patients despite multiple challenges including inappropriate provision of PPE, inadequate training and inconsistent guidance. In order to effectively care for patients during the COVID-19 pandemic, frontline HCWs need appropriate provision of PPE, training in its use as well as comprehensive and consistent guidance. These needs must be addressed in order to protect the health and well-being of the most valuable healthcare resource in the COVID-19 pandemic: our HCWs.
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Affiliation(s)
- Katarina Hoernke
- Institute for Global Health, University College London, London, UK
| | - Nehla Djellouli
- Institute for Global Health, University College London, London, UK
| | - Lily Andrews
- Institute of Epidemiology and Health Care, University College London, London, UK
| | | | - Louisa Manby
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Sam Martin
- Oxford Vaccine Group, University of Oxford, Oxford, UK
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Kovács G, Falagara Sigala I. Lessons learned from humanitarian logistics to manage supply chain disruptions. JOURNAL OF SUPPLY CHAIN MANAGEMENT 2021. [DOI: 10.1111/jscm.12253] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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