201
|
Unoki T, Sakuramoto H, Sato R, Ouchi A, Kuribara T, Furumaya T, Tatsuno J, Wakabayashi Y, Tado A, Hashimoto N, Inagaki N, Sasaki Y. Adverse Effects of Personal Protective Equipment Among Intensive Care Unit Healthcare Professionals During the COVID-19 Pandemic: A Scoping Review. SAGE Open Nurs 2021; 7:23779608211026164. [PMID: 34212076 PMCID: PMC8216406 DOI: 10.1177/23779608211026164] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/11/2021] [Accepted: 05/28/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION To avoid exposure to SARS-COV-2, healthcare professionals use personal protective equipment (PPE) while treating COVID-19 patients. Prior studies have revealed the adverse effects (AEs) of PPE on healthcare workers (HCWs); however, no review has focused on the AEs of PPE on HCWs in intensive care units (ICUs). This review aimed to identify the AEs of PPE on HCWs working in ICUs during the COVID-19 pandemic. METHODS A scoping review was conducted. MEDLINE, CINAHL, the World Health Organization (WHO) global literature on COVID-19, and Igaku-chuo-zasshi (a Japanese medical database), Google Scholar, medRxiv, and Health Research Board (HRB) open research were searched from January 25-28, 2021. The extracted data included author(s) name, year of publication, country, language, article title, journal name, publication type, study methodology, population, outcome, and key findings. RESULTS The initial search identified 691 articles and abstracts. Twenty-five articles were included in the analysis. The analysis comprised four key topics: studies focusing on PPE-related headache, voice disorders, skin manifestations, and miscellaneous AEs of PPE. The majority of AEs for HCWs in ICUs were induced by prolonged use of masks. CONCLUSION The AEs of PPE among HCWs in ICUs included heat, headaches, skin injuries, chest discomfort, and dyspnea. Studies with a focus on specific diseases were on skin injuries. Moreover, many AEs were induced by prolonged use of masks.
Collapse
Affiliation(s)
- Takeshi Unoki
- Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Sapporo City University, Sapporo, Japan
| | - Hideaki Sakuramoto
- Department of Adult Health Nursing, College of Nursing, Ibaraki Christian University, Hitachi, Japan
| | - Ryuhei Sato
- Department of Critical Care Nursing, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Ouchi
- Department of Adult Health Nursing, College of Nursing, Ibaraki Christian University, Hitachi, Japan
| | - Tomoki Kuribara
- Department of Adult Health Nursing, School of Nursing, Sapporo City University, Sapporo, Japan
| | - Tomomi Furumaya
- High Care Unit of Advanced Emergency and Critical Care Center, Saitama Red Cross Hospital, Saitama, Japan
| | - Junko Tatsuno
- Department of Nursing, Kokura Memorial Hospital, Kitakyusyu, Japan
| | - Yuki Wakabayashi
- Department of Nursing, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Asami Tado
- Faculty of Medicine and Health Sciences, Yamaguchi University, Ube, Japan
| | - Naoya Hashimoto
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Sapporo, Japan
| | - Noriko Inagaki
- Faculty of Nursing, Setsunan University, Hirakata, Japan
| | - Yoshiko Sasaki
- Department of Disaster and Critical Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - from the Committee and working group of COVID-19 Task Force of the Japan Academy of Critical Care Nursing
- Department of Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Sapporo City University, Sapporo, Japan
- Department of Adult Health Nursing, College of Nursing, Ibaraki Christian University, Hitachi, Japan
- Department of Critical Care Nursing, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Adult Health Nursing, School of Nursing, Sapporo City University, Sapporo, Japan
- High Care Unit of Advanced Emergency and Critical Care Center, Saitama Red Cross Hospital, Saitama, Japan
- Department of Nursing, Kokura Memorial Hospital, Kitakyusyu, Japan
- Department of Nursing, Kobe City Medical Center General Hospital, Kobe, Japan
- Faculty of Medicine and Health Sciences, Yamaguchi University, Ube, Japan
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Sapporo, Japan
- Faculty of Nursing, Setsunan University, Hirakata, Japan
- Department of Disaster and Critical Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
202
|
Agarwal A, Ranjan P, Saraswat A, Kasi K, Bharadiya V, Vikram N, Singh A, Upadhyay AD, Baitha U, Klanidhi KB, Chakrawarty A. Are health care workers following preventive practices in the COVID-19 pandemic properly? - A cross-sectional survey from India. Diabetes Metab Syndr 2021; 15:69-75. [PMID: 33310264 PMCID: PMC7719197 DOI: 10.1016/j.dsx.2020.12.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/30/2020] [Accepted: 12/04/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIMS Health care workers (HCWs) are at increased risk of getting infected with Coronavirus disease 2019 (COVID-19) and suboptimal preventive practices have been identified as an important risk factor in this regard. This study was done to evaluate the preventive practices being followed by health care workers and identify reasons for suboptimal compliance. METHODS A cross-sectional survey was done in HCWs belonging to various occupational roles and socio-cultural backgrounds across India through online platforms and telephonic interviews from July 30, 2020 to August 30, 2020. A scientifically designed and pre-validated questionnaire with good validity (CVR = 0.87, S-CVI/Av = 0.978) and internal consistency (Cronbach's alpha coefficient = 0.85) was used. RESULTS The responses of 956 participants were analysed. Various suboptimal practices like touching outer surface of masks, lack of social distancing in cafeteria and duty rooms, inability to wash hands for adequate duration and properly follow steps of hand hygiene, inability to don and doff PPE properly, carrying PPE to duty rooms before completely doffing, use of personal mobile phones during duty and improper sleep were identified. Lack of knowledge, long duty hours, shortage of PPE, high patient workload, and casual attitude regarding own safety were identified as important barriers. Resident doctors and paramedical staff in the age group 18-30 years reported lower adherence. CONCLUSIONS Suboptimal compliance in preventive practices like handling PPE, distancing in cafeteria/duty rooms and hand hygiene is not uncommon in HCWs. Certain barriers are identified which should be addressed to ensure adequate safety of HCWs against COVID-19.
Collapse
Affiliation(s)
- Ayush Agarwal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Arjun Saraswat
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Keerthana Kasi
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vishwesh Bharadiya
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Naval Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Amandeep Singh
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Datt Upadhyay
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kamal Bandhu Klanidhi
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Avinash Chakrawarty
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
203
|
Setiawan HW, Pratiwi IN, Nimah L, Pawanis Z, Bakhtiar A, Fauzinigtyas R, Ramoo V. Challenges for Healthcare Workers Caring for COVID-19 Patients in Indonesia: A Qualitative Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211060291. [PMID: 34879719 PMCID: PMC8842306 DOI: 10.1177/00469580211060291] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
COVID-19 pandemic raises various challenges faced by health workers in hospitals. This study explored strategies for overcoming challenges in caring for COVID-19 patients at hospitals in Indonesia based on healthcare workers' experience. In-depth interviews were employed with 28 healthcare workers (physicians and nurses) who were purposively sampled. Data were collected via phone and analysed using the Colaizzi method. Five following challenges were found: difficulties in working with personal protective equipment (PPE), offline training for handling Covid and using PPE not being implemented evenly for all health workers, physical and psychological fatigue, difficulties in carrying out health education and assessment towards patients and families, and limited resources to cope with the COVID-19 pandemic. Meanwhile, some barriers require support from the government, public and hospital managers. The information gained from research on the strategies for caring for COVID-19 patients can contribute to better preparedness for hospitals and health workers facing the COVID-19 pandemic.
Collapse
Affiliation(s)
- Herley Windo Setiawan
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.,Airlangga University Hospital, Universitas Airlangga, Indonesia
| | - Ika Nur Pratiwi
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Lailatun Nimah
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia
| | | | - Arief Bakhtiar
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.,Airlangga University Hospital, Universitas Airlangga, Indonesia
| | - Rista Fauzinigtyas
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Vimala Ramoo
- Faculty of Medicine, University of Malaya, Kuala Lumpur', Malaysia
| |
Collapse
|
204
|
Toomey EC, Conway Y, Burton C, Smith S, Smalle M, Chan XHS, Adisesh A, Tanveer S, Ross L, Thomson I, Devane D, Greenhalgh T. Extended use or reuse of single-use surgical masks and filtering face-piece respirators during the coronavirus disease 2019 (COVID-19) pandemic: A rapid systematic review. Infect Control Hosp Epidemiol 2021; 42:75-83. [PMID: 33028441 DOI: 10.37473/fic/10.1017/ice.2020.1243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
BACKGROUND Shortages of personal protective equipment during the coronavirus disease 2019 (COVID-19) pandemic have led to the extended use or reuse of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices warrants examination. OBJECTIVES To synthesize current guidance and systematic review evidence on extended use, reuse, or reprocessing of single-use surgical masks or filtering face-piece respirators. DATA SOURCES We used the World Health Organization, the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites to identify guidance. We used Medline, PubMed, Epistemonikos, Cochrane Database, and preprint servers for systematic reviews. METHODS Two reviewers conducted screening and data extraction. The quality of included systematic reviews was appraised using AMSTAR-2. Findings were narratively synthesized. RESULTS In total, 6 guidance documents were identified. Levels of detail and consistency across documents varied. They included 4 high-quality systematic reviews: 3 focused on reprocessing (decontamination) of N95 respirators and 1 focused on reprocessing of surgical masks. Vaporized hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale. CONCLUSIONS Evidence on the impact of extended use and reuse of surgical masks and respirators is limited, and gaps and inconsistencies exist in current guidance. Where extended use or reuse is being practiced, healthcare organizations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.
Collapse
Affiliation(s)
- Elaine C Toomey
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Yvonne Conway
- Evidence Synthesis Ireland, School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Chris Burton
- Academic Unit of Primary Medical Care, University of Sheffield, Sheffield, United Kingdom
| | - Simon Smith
- Canadian Standards Biological Aerosols Working Group, Canada
| | - Michael Smalle
- James Hardiman Library, National University of Ireland, Galway, Ireland
| | - Xin-Hui S Chan
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Anil Adisesh
- Division of Occupational Medicine, Department of Medicine, University of Toronto and St Michael's Hospital, Unity Health, Toronto, Canada
| | - Sarah Tanveer
- Department of Pharmaceutical Health Services Research, University of Maryland, Baltimore, Maryland, United States
| | - Lawrence Ross
- Department of Infectious Disease, Children's Hospital of Los Angeles, Los Angeles, California, United States
| | - Iain Thomson
- Médecins Sans Frontières/Doctors without Borders, Geneva, Switzerland
| | - Declan Devane
- Evidence Synthesis Ireland, School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Trish Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
205
|
Majumder MAA, Rahman S, Cohall D, Bharatha A, Singh K, Haque M, Gittens-St Hilaire M. Antimicrobial Stewardship: Fighting Antimicrobial Resistance and Protecting Global Public Health. Infect Drug Resist 2020; 13:4713-4738. [PMID: 33402841 PMCID: PMC7778387 DOI: 10.2147/idr.s290835] [Citation(s) in RCA: 182] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/17/2020] [Indexed: 12/18/2022] Open
Abstract
Antimicrobial resistance (AMR) is a serious threat to global public health. It increases morbidity and mortality, and is associated with high economic costs due to its health care burden. Infections with multidrug-resistant (MDR) bacteria also have substantial implications on clinical and economic outcomes. Moreover, increased indiscriminate use of antibiotics during the COVID-19 pandemic will heighten bacterial resistance and ultimately lead to more deaths. This review highlights AMR's scale and consequences, the importance, and implications of an antimicrobial stewardship program (ASP) to fight resistance and protect global health. Antimicrobial stewardship (AMS), an organizational or system-wide health-care strategy, is designed to promote, improve, monitor, and evaluate the rational use of antimicrobials to preserve their future effectiveness, along with the promotion and protection of public health. ASP has been very successful in promoting antimicrobials' appropriate use by implementing evidence-based interventions. The "One Health" approach, a holistic and multisectoral approach, is also needed to address AMR's rising threat. AMS practices, principles, and interventions are critical steps towards containing and mitigating AMR. Evidence-based policies must guide the "One Health" approach, vaccination protocols, health professionals' education, and the public's awareness about AMR.
Collapse
Affiliation(s)
- Md Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Sayeeda Rahman
- School of Medicine, American University of Integrative Sciences, Bridgetown, Barbados
| | - Damian Cohall
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Ambadasu Bharatha
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Keerti Singh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Mainul Haque
- Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia
| | | |
Collapse
|
206
|
Inglis R, Barros L, Checkley W, Cizmeci EA, Lelei-Mailu F, Pattnaik R, Papali A, Schultz MJ, Ferreira JC. Pragmatic Recommendations for Safety while Caring for Hospitalized Patients with COVID-19 in Low- and Middle-Income Countries. Am J Trop Med Hyg 2020; 104:12-24. [PMID: 33355072 PMCID: PMC7957241 DOI: 10.4269/ajtmh.20-1128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/06/2020] [Indexed: 11/07/2022] Open
Abstract
Infection prevention and control measures to control the spread of COVID-19 are challenging to implement in many low- and middle-income countries (LMICs). This is compounded by the fact that most recommendations are based on evidence that mainly originates in high-income countries. There are often availability, affordability, and feasibility barriers to applying such recommendations in LMICs, and therefore, there is a need for developing recommendations that are achievable in LMICs. We used a modified version of the GRADE method to select important questions, searched the literature for relevant evidence, and formulated pragmatic recommendations for safety while caring for patients with COVID-19 in LMICs. We selected five questions related to safety, covering minimal requirements for personal protective equipment (PPE), recommendations for extended use and reuse of PPE, restriction on the number of times healthcare workers enter patients' rooms, hand hygiene, and environmental ventilation. We formulated 21 recommendations that are feasible and affordable in LMICs.
Collapse
Affiliation(s)
- Rebecca Inglis
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
| | - Lia Barros
- Division of Cardiology, University of Washington, Seattle, Washington
| | - William Checkley
- Division of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Elif A. Cizmeci
- Interdepartmental Division of Critical Care Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Faith Lelei-Mailu
- Department of Quality Health and Safety, AIC Kijabe Hospital, Kijabe, Kenya
| | | | - Alfred Papali
- Division of Pulmonary and Critical Care Medicine, Atrium Health, Charlotte, North Carolina
| | - Marcus J. Schultz
- Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Clinical Tropical Medicine, Mahidol University, Bangkok, Thailand
- Mahidol–Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
| | - Juliana C. Ferreira
- Divisao de Pneumologia, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - for the COVID-LMIC Task Force and the Mahidol-Oxford Research Unit (MORU)
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
- Division of Cardiology, University of Washington, Seattle, Washington
- Division of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland
- Interdepartmental Division of Critical Care Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
- Department of Quality Health and Safety, AIC Kijabe Hospital, Kijabe, Kenya
- Division of Critical Care Medicine, Ispat General Hospital, Rourkela, India
- Division of Pulmonary and Critical Care Medicine, Atrium Health, Charlotte, North Carolina
- Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Clinical Tropical Medicine, Mahidol University, Bangkok, Thailand
- Mahidol–Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
- Divisao de Pneumologia, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|
207
|
Alsnes IV, Munkvik M, Flanders WD, Øyane N. How well did Norwegian general practice prepare to address the COVID-19 pandemic? Fam Med Community Health 2020; 8:fmch-2020-000512. [PMID: 33277356 PMCID: PMC7722348 DOI: 10.1136/fmch-2020-000512] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Objectives We aimed to describe the quality improvement measures made by Norwegian general practice (GP) during the COVID-19 pandemic, evaluate the differences in quality improvements based on region and assess the combinations of actions taken. Design Descriptive study. Setting Participants were included after taking part in an online quality improvement COVID-19 course for Norwegian GPs in April 2020. The participants reported whether internal and external measures were in place: COVID-19 sign on entrance, updated home page, access to video consultations and/or electronic written consultations, home office solutions, separate working teams, preparedness for home visits, isolation rooms, knowledge on decontamination, access to sufficient supplies of personal protective equipment (PPE) and COVID-19 clinics. Participants One hundred GP offices were included. The mean number of general practitioners per office was 5.63. Results More than 80% of practices had the following preparedness measures: COVID-19 sign on entrance, updated home page, COVID-19 clinic in the municipality, video and written electronic consultations, knowledge on how to use PPE, and home office solutions for general practitioners. Less than 50% had both PPE and knowledge of decontamination. Lack of PPE was reported by 37%, and 34% reported neither sufficient PPE nor a dedicated COVID-19 clinic. 15% reported that they had an isolation room, but not enough PPE. There were no geographical differences. Conclusions Norwegian GPs in this study implemented many quality improvements to adapt to the COVID-19 pandemic. Overall, the largest potentials for improvement seem to be securing sufficient supply of PPE and establishing an isolation room at their practices.
Collapse
Affiliation(s)
| | - Morten Munkvik
- Department of Public Health, University of Stavanger, Stavanger, Norway
| | - W Dana Flanders
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Nicolas Øyane
- Centre of Quality Improvement in Medical Practices, Bergen, Norway
| |
Collapse
|
208
|
Gonçalves J, Sousa RL, Jacinto MJ, Silva DA, Paula F, Sousa R, Zahedi S, Carvalho J, Cabral MG, Costa M, Branco JC, Canhão H, Alves JD, Rodrigues AM, Soares H. Evaluating SARS-CoV-2 Seroconversion Following Relieve of Confinement Measures. Front Med (Lausanne) 2020; 7:603996. [PMID: 33392225 PMCID: PMC7775303 DOI: 10.3389/fmed.2020.603996] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 11/24/2020] [Indexed: 02/04/2023] Open
Abstract
Seroprevalence studies are crucial both for estimating the prevalence of SARS-CoV-2 exposure and to provide a measure for the efficiency of the confinement measures. Portuguese universities were closed on March 16th 2020, when Portugal only registered 62 SARS-CoV-2 infection cases per million. We have validated a SARS-CoV-2 ELISA assay to a stabilized full-length spike protein using 216 pre-pandemic and 19 molecularly diagnosed SARS-CoV-2 positive individual's samples. At NOVA University of Lisbon, presential work was partially resumed on May 25th with staggered schedules. From June 15th to 30th, 3-4 weeks after the easing of confinement measures, we screened 1,636 collaborators of NOVA university of Lisbon for the presence of SARS-CoV-2 spike specific IgA and IgG antibodies. We found that spike-specific IgG in 50 of 1,636 participants (3.0%), none of which had anti-spike IgA antibodies. As participants self-reported as asymptomatic or paucisymptomatic, our study also provides a measurement of the prevalence of asymptomatic/paucisymptomatic SARS-CoV-2 infections. Our study suggests that essential workers have a 2-fold increase in viral exposure, when compared to non-essential workers that observed confinement. Additional serological surveys in different population subgroups will paint a broader picture of the effect of the confinement measures in the broader community.
Collapse
Affiliation(s)
- Juliana Gonçalves
- Human Immunobiology and Pathogenesis Laboratory, Lisbon, Portugal
- CEDOC-Chronic Diseases Research Center, NOVA Medical School | Faculdade de Ciências Médicas, NOVA University of Lisbon, Lisbon, Portugal
| | - Rita L. Sousa
- Human Immunobiology and Pathogenesis Laboratory, Lisbon, Portugal
- CEDOC-Chronic Diseases Research Center, NOVA Medical School | Faculdade de Ciências Médicas, NOVA University of Lisbon, Lisbon, Portugal
| | - Maria J. Jacinto
- Católica-Lisbon School of Business and Economics, Catholic University of Portugal, Lisbon, Portugal
| | - Daniela A. Silva
- Human Immunobiology and Pathogenesis Laboratory, Lisbon, Portugal
- CEDOC-Chronic Diseases Research Center, NOVA Medical School | Faculdade de Ciências Médicas, NOVA University of Lisbon, Lisbon, Portugal
| | - Filipe Paula
- CEDOC-Chronic Diseases Research Center, NOVA Medical School | Faculdade de Ciências Médicas, NOVA University of Lisbon, Lisbon, Portugal
- Internal Medicine Department IV/Immune Mediated Systemic Diseases (UDIMS), Fernando Fonseca Hospital, Amadora, Portugal
- Immune Response and Vascular Disease Laboratory, Lisbon, Portugal
| | - Rute Sousa
- Comprehensive Health Research Center (CHRC), NOVA Medical School, Lisbon, Portugal
- EpiDoC Unit, CEDOC, NOVA Medical School, UNL, Lisbon, Portugal
| | - Sara Zahedi
- CEDOC-Chronic Diseases Research Center, NOVA Medical School | Faculdade de Ciências Médicas, NOVA University of Lisbon, Lisbon, Portugal
- Computational and Experimental Biology Laboratory, Lisbon, Portugal
| | - Joana Carvalho
- Internal Medicine Department IV/Immune Mediated Systemic Diseases (UDIMS), Fernando Fonseca Hospital, Amadora, Portugal
- Immune Response and Vascular Disease Laboratory, Lisbon, Portugal
| | - M. Guadalupe Cabral
- CEDOC-Chronic Diseases Research Center, NOVA Medical School | Faculdade de Ciências Médicas, NOVA University of Lisbon, Lisbon, Portugal
- Tissue Repair and Inflammation Laboratory, Lisbon, Portugal
| | - Manuela Costa
- Rheumatology Department, CHLO, Egas Moniz Hospital, Lisbon, Portugal
| | - Jaime C. Branco
- Comprehensive Health Research Center (CHRC), NOVA Medical School, Lisbon, Portugal
- Rheumatology Department, CHLO, Egas Moniz Hospital, Lisbon, Portugal
| | - Helena Canhão
- Comprehensive Health Research Center (CHRC), NOVA Medical School, Lisbon, Portugal
- EpiDoC Unit, CEDOC, NOVA Medical School, UNL, Lisbon, Portugal
| | - José D. Alves
- CEDOC-Chronic Diseases Research Center, NOVA Medical School | Faculdade de Ciências Médicas, NOVA University of Lisbon, Lisbon, Portugal
- Internal Medicine Department IV/Immune Mediated Systemic Diseases (UDIMS), Fernando Fonseca Hospital, Amadora, Portugal
- Immune Response and Vascular Disease Laboratory, Lisbon, Portugal
| | - Ana M. Rodrigues
- Comprehensive Health Research Center (CHRC), NOVA Medical School, Lisbon, Portugal
- EpiDoC Unit, CEDOC, NOVA Medical School, UNL, Lisbon, Portugal
| | - Helena Soares
- Human Immunobiology and Pathogenesis Laboratory, Lisbon, Portugal
- CEDOC-Chronic Diseases Research Center, NOVA Medical School | Faculdade de Ciências Médicas, NOVA University of Lisbon, Lisbon, Portugal
| |
Collapse
|
209
|
Suppan L, Abbas M, Catho G, Stuby L, Regard S, Harbarth S, Achab S, Suppan M. Impact of a Serious Game on the Intention to Change Infection Prevention and Control Practices in Nursing Homes During the COVID-19 Pandemic: Protocol for a Web-Based Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e25595. [PMID: 33296329 PMCID: PMC7744143 DOI: 10.2196/25595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/02/2020] [Accepted: 12/08/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nursing home residents are at high risk of complications and death due to COVID-19. Lack of resources, both human and material, amplifies the likelihood of contamination in these facilities where a single employee can contaminate dozens of residents and colleagues. Improving the dissemination of and adhesion to infection prevention and control (IPC) guidelines is therefore essential. Serious games have been shown to be effective in developing knowledge and in increasing engagement, and could motivate nursing home employees to change their IPC practices. OBJECTIVE Our aim is to assess the impact of "Escape COVID-19," a serious game designed to enhance knowledge and application of IPC procedures, on the intention of nursing home employees to change their IPC practices. METHODS We will carry out a web-based randomized controlled trial following the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth) guidelines and incorporating relevant elements of CHERRIES (Checklist for Reporting Results of Internet E-Surveys). Participants will be randomized to either the control or the serious game (intervention) group. First, both groups will be asked to answer a questionnaire designed to gather demographic data and assess baseline knowledge. The control group will then receive a quick reminder of the current national guidelines and links to IPC guidelines for health care professionals, while the other group will play the game. Both groups will then have to answer a second questionnaire designed to assess their willingness to change their IPC practices after having followed their respective material. After completing this questionnaire, they will be granted access to the material presented to the group they were not assigned to and receive a course completion certificate. The primary outcome will be the proportion of participants willing to change their IPC practices according to group. Secondary outcomes will include the analysis of specific questions detailing the exact changes considered by the participants. Factors associated with participant willingness or reluctance to change behavior will also be assessed. Attrition will also be assessed at each stage of the study. RESULTS The study protocol has been presented to our regional ethics committee (Req-2020-01262), which issued a declaration of no objection as such projects do not fall within the scope of the Swiss federal law on human research. Data collection began on November 5, 2020, and should be completed by December 4, 2020. CONCLUSIONS This study should determine whether "Escape COVID-19," a serious game designed to improve compliance with COVID-19 safe practices, modifies the intention to follow IPC guidelines among nursing home employees. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/25595.
Collapse
Affiliation(s)
- Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mohamed Abbas
- Infection Control Programme, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Gaud Catho
- Infection Control Programme, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Simon Regard
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.,Division of General Surgeon, Geneva Directorate of Health, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Programme, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Sophia Achab
- Specialized Facility in Behavioral Addictions ReConnecte, Geneva University Hospitals, Geneva, Switzerland.,WHO Collaborating Center in Training and Research in Mental Health, University of Geneva, Geneva, Switzerland
| | - Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| |
Collapse
|
210
|
Suppan M, Catho G, Robalo Nunes T, Sauvan V, Perez M, Graf C, Pittet D, Harbarth S, Abbas M, Suppan L. A Serious Game Designed to Promote Safe Behaviors Among Health Care Workers During the COVID-19 Pandemic: Development of "Escape COVID-19". JMIR Serious Games 2020; 8:e24986. [PMID: 33242312 PMCID: PMC7717924 DOI: 10.2196/24986] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/12/2020] [Accepted: 11/26/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND As many countries fear and even experience the emergence of a second wave of COVID-19, reminding health care workers (HCWs) and other hospital employees of the critical role they play in preventing SARS-CoV-2 transmission is more important than ever. Building and strengthening the intrinsic motivation of HCWs to apply infection prevention and control (IPC) guidelines to avoid contaminating their colleagues, patients, friends, and relatives is a goal that must be energetically pursued. A high rate of nosocomial infections during the first COVID-19 wave was detected by IPC specialists and further cemented their belief in the need for an engaging intervention that could improve compliance with COVID-19 safe behaviors. OBJECTIVE Our aim was to develop a serious game that would promote IPC practices with a specific focus on COVID-19 among HCWs and other hospital employees. METHODS The first 3 stages of the SERES framework were used to develop this serious game. A brainswarming session between developers and IPC specialists was used to identify the target audience and acquisition objectives. Nicholson's RECIPE mnemonic (reflection, engagement, choice, information, play, exposition) for meaningful gamification was used to guide the general design. A common and simple terminology was used to suit the broad target audience. The game was tested on various platforms (smartphones, tablets, laptops, desktop computers) by different users during each development loop and before its final release. RESULTS The game was designed to target all hospital staff who could be in direct contact with patients within the Geneva University Hospitals. In total, 10 acquisition objectives were defined by IPC specialists and implemented into the game according to the principles of meaningful gamification. A simple storyboard was first created using Microsoft PowerPoint and was progressively refined through multiple iteration loops. Articulate Storyline was then used to create two successive versions of the actual game. In the final version, a unique graphic atmosphere was created with help from a professional graphic designer. Feedback mechanisms were used extensively throughout the game to strengthen key IPC messages. CONCLUSIONS The SERES framework was successfully used to create "Escape COVID-19," a serious game designed to promote safe IPC practices among HCWs and other hospital employees during the COVID-19 pandemic. This game can be obtained free of charge for research and educational purposes. A SCORM (shareable content object reference model) package is available to facilitate results and completion tracking on most current learning management systems.
Collapse
Affiliation(s)
- Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Gaud Catho
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Tomás Robalo Nunes
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
- Infectious Diseases Department, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - Valérie Sauvan
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Monique Perez
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Christophe Graf
- Department of Rehabilitation and Geriatrics, Geneva University Hospital, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mohamed Abbas
- Infection Control Program, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| |
Collapse
|
211
|
Carbapenemase-producing Enterobacterales outbreak: Another dark side of COVID-19. Am J Infect Control 2020; 48:1533-1536. [PMID: 33011336 PMCID: PMC7529666 DOI: 10.1016/j.ajic.2020.09.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 01/28/2023]
Abstract
In the hospital department dedicated to COVID-19-patient, infection prevention and control measures were upgraded. Therefore, the cross-transmission of other micro-organisms was thought unlikely to occur. However, we report an outbreak of NDM-5-producing Escherichia. coli in a 12-beds ICU dedicated to COVID-19 patients. This outbreak involved 6 patients of which 5 were asymptomatic carriers and 1 was infected. Several findings might have contributed to cross-transmission including the multiple-bedroom configuration of the department, uncomplete compliance for standard and contact precautions, overwork due to the burden of the disease, lack of training of staff for the care of ICU-patients, and misuse of gloves. Furthermore, as infection prevention and control measures were thought to be applied, contact patients were not screened for eXDR carriage. Applying rigorously standard and contact precautions and performing screening in contact patients when indicated must be the rules in COVID-19 wards.
Collapse
|
212
|
Goulding AM, Wu PE, Gold WL. A care escalation framework to address lapses in donning and doffing of personal protective equipment during the COVID-19 pandemic. Am J Infect Control 2020; 48:1566-1567. [PMID: 32771497 PMCID: PMC7409734 DOI: 10.1016/j.ajic.2020.07.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/23/2020] [Indexed: 12/01/2022]
|
213
|
Ashinyo ME, Dubik SD, Duti V, Amegah KE, Ashinyo A, Larsen-Reindorf R, Kaba Akoriyea S, Kuma-Aboagye P. Healthcare Workers Exposure Risk Assessment: A Survey among Frontline Workers in Designated COVID-19 Treatment Centers in Ghana. J Prim Care Community Health 2020; 11:2150132720969483. [PMID: 33213266 PMCID: PMC7682216 DOI: 10.1177/2150132720969483] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Healthcare workers (HCWs) are faced with an elevated risk of exposure to SARS-COV-2 due to the clinical procedures they perform on COVID-19 patients. However, data for frontline HCWs level of exposure and risk of COVID-19 virus infection are limited. Objective: We investigated the level of exposure and risk of COVID-19 virus infection among HCWs in COVID-19 treatment centers in Ghana. Methods: A cross-sectional study was utilized in this study and HCWs were invited by convenience to participate in the study, 408 HCWs in 4 COVID-19 treatment centers participated in the study. Adherence to infection prevention and control (IPC) measures were used to categorized HCWs as low or high risk of COVID-19 virus infection. The WHO COVID-19 risk assessment tool was used to collect quantitative data from the study participants. Results: There was a high (N = 328, 80.4%) level of occupational exposure to the COVID-19 virus. However, only 14.0% of the exposed HCWs were at high risk of COVID-19 virus infection. Healthcare workers who performed or were present during any aerosol-generating procedures (AGP) were 23.8 times more likely to be exposed compared to HCWs who did not perform or were absent during any AGP (AOR 23.83; 95% CI: 18.45, 39.20). High risk of COVID-19 virus infection was less likely among registered nurses (AOR = 0.09; 95% CI: 0.02, 0.60), HCWs who performed or were present during any AGP (AOR = 0.05; 95% CI: 0.01, 0.50) and HCWs with a master’s degree qualification (AOR 0.06; 95% CI: 0.01, 0.63). Conclusion: Despite the high level of exposure to the COVID-19 virus among HCWs in the treatment centers, only 14.0% were at high risk of COVID-19 virus infection. To protect this group of HCWs, treatment centers and HCWs should continue to adhere to WHO and national IPC protocols in managing of COVID-19 cases.
Collapse
Affiliation(s)
- Mary Eyram Ashinyo
- Institutional Care Division, Ghana Health Service Headquarters, Accra, Ghana
| | - Stephen Dajaan Dubik
- School of Allied Health Sciences, University for Development Studies, Tamale, Northern region, Ghana
| | - Vida Duti
- IRC-Ghana, Cantonments-Accra, Accra, Greater Accra, Ghana
| | | | - Anthony Ashinyo
- National AIDS/STI Control Programme, Ghana Health Service Headquarters Accra, Ghana
| | | | | | | |
Collapse
|
214
|
Oppong TB, Amponsem-Boateng C, Kyere EKD, Wang Y, Gheisari Z, Oppong EE, Opolot G, Duan G, Yang H. Infection Prevention and Control Preparedness Level and Associated Determinants in 56 Acute Healthcare Facilities in Ghana. Infect Drug Resist 2020; 13:4263-4271. [PMID: 33262620 PMCID: PMC7699444 DOI: 10.2147/idr.s273851] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/14/2020] [Indexed: 12/18/2022] Open
Abstract
Background Infection prevention and control (IPC) is a globally relevant aspect of all health systems impacting the health and safety of both patients and healthcare workers. However, best practices remain a challenge in healthcare delivery especially in resource limited situations. The primary objective of this study was to assess the infection prevention and control (IPC) preparedness levels of acute healthcare facilities in Ghana and to determine the factors associated with the overall IPC preparedness levels in acute healthcare facilities. Methods A cross-sectional study adapting the IPC assessment framework (IPCAF) developed by the World Health Organization (WHO) was conducted. Five of the core components of the WHO IPCAF were used to assess the IPC level of 56 acute healthcare facilities in Ghana. Results Of the 56 facilities surveyed, only 19 had an IPC program with clearly defined objectives. Overall, 8 (14.3%) facilities scored an IPC preparedness level of “Advance”, 18 (32.1%) facilities received an “Intermediate” IPC preparedness score, 23 (41.1%) facilities received an IPC preparedness level of “basic” and 7 (12.5%) facilities scored an IPC preparedness level of “inadequate”. IPC materials like detergents, running water and PPEs were not significantly supplied. Government owned facilities performed better in terms of IPC preparedness as compared to privately owned facilities. A PLUM-ordinal regression analysis revealed that an IPC program with clearly defined objectives (OR= 76; 95% CI; 7.23, 808.19), dedicated IPC budget (OR= 13; 95% CI; 3.8–44.3) and regular mandatory training (OR= 50.9; 95% CI; 6.1–425) were associated with increased IPC preparedness. Conclusion Generally, the IPC preparedness levels in a majority of the facilities were low and required significant improvements in several areas. Facilities must make periodic reviews and adjust their objectives based on facility priorities.
Collapse
Affiliation(s)
- Timothy Bonney Oppong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, People's Republic of China
| | - Cecilia Amponsem-Boateng
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, People's Republic of China
| | - Emmanuel Kumi Duodu Kyere
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, People's Republic of China
| | - Ying Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, People's Republic of China
| | - Zohreh Gheisari
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, People's Republic of China
| | | | - Godfrey Opolot
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, People's Republic of China
| | - Guangcai Duan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, People's Republic of China
| | - Haiyan Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, People's Republic of China
| |
Collapse
|
215
|
Omoronyia O, Ekpenyong N, Ukweh I, Mpama E. Knowledge and practice of COVID-19 prevention among community health workers in rural Cross River State, Nigeria: implications for disease control in Africa. Pan Afr Med J 2020; 37:50. [PMID: 33209177 PMCID: PMC7648466 DOI: 10.11604/pamj.2020.37.50.24307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/02/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction in developing countries, community health workers (CHWs) are essential, for provision of behaviour change communication towards prevention of coronavirus 2019 (COVID-19) infection at rural grassroots level. We aimed at assessing their level of knowledge and practice of preventive measures in a developing country setting. Methods total enumeration of all CHWs in a rural local government area in southern Nigeria was carried out, using cross-sectional descriptive study design. Pretested self-administered 15-item questionnaire was used to assess knowledge of COVID-19 including basic epidemiology, virology, preventive measures and use of personal protective equipment (PPE). Practice of preventive measures was also assessed. Each correct response to knowledge question contributed one unit to the total score which was converted to percentage. Total knowledge score of 50% or greater was considered satisfactory. Results complete data was obtained from eighty-six (86) respondents with mean age of 36.3±8.9 years (18-54 years). Mean total knowledge score was 28.14±12.8% (6.7 to 53.3%), and 9.3% (n=8) had score of at least 50%. Correct responses to appropriate sequence of putting on and removing personal protective equipment (PPE) were 5.8% (n=5) and 8.1% (n=7), respectively. Regular practice of use of face masks, goggles, gloves, and hand hygiene was found to be 50% (n=43), 12.8% (n=11), 30.2% (n=26), and 56.4% (n=48), respectively. Conclusion community health workers are grossly underprepared for provision of health education on COVID-19, due to their poor level of knowledge. Their capacity building through workshops and effective continuing education program are urgently needed.
Collapse
Affiliation(s)
- Ogban Omoronyia
- Department of Community Medicine, University of Calabar, Calabar, Nigeria
| | - Nnette Ekpenyong
- Department of Community Medicine, University of Calabar, Calabar, Nigeria
| | - Ikechukwu Ukweh
- Department of Community Medicine, University of Calabar, Calabar, Nigeria
| | - Enagu Mpama
- Department of Community Medicine, University of Calabar, Calabar, Nigeria
| |
Collapse
|
216
|
Birihane BM, Bayih WA, Alemu AY, Belay DM. Perceived Barriers and Preventive Measures of COVID-19 Among Healthcare Providers in Debretabor, North Central Ethiopia, 2020. Risk Manag Healthc Policy 2020; 13:2699-2706. [PMID: 33244283 PMCID: PMC7685372 DOI: 10.2147/rmhp.s287772] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Healthcare professionals are at the frontline facing the pandemic. Since the pandemic is new with sophisticated needs of resources, identifying perceived barriers of the healthcare institutions has an important input for the government in slowing the viral spread and prevents healthcare professionals from infection. OBJECTIVE The study was aimed to assessperceived barriers and preventive measures of corona virus disease among healthcare providers in Debretabor Town, north central Ethiopia. METHODS An institution-based cross-sectional survey was conducted among healthcare providers working in Debretabor town, north central Ethiopia from May 1 to 15, 2020. Data were collected using a self-administered questionnaire. Data were coded, entered, cleaned, and checked using Epi data statistical software version 4.2.0.0 and analysis using STATA Version 14 statistical software. Descriptive statistics of different variables were presented in figures, text, and tables. Chi-square (chi2) test of independence was considered to examine the nonparametric association of factors with preventive practice, and association was considered at a P-value of less than 0.05. RESULTS A total of 183 healthcare providers participated in the survey, of which 67.76% were males, and 80.87% were in the age range of 25-35 years. About 45% of participants were nurses. In the current study, overall preventive practice was 68.3%. Despite recommendations by the World Health Organization, avoidance of outdoor, physical distancing, and avoiding meeting a person with a coughwere not implemented by 32.24%, 24.18%, and 13.11% of healthcare providers, respectively. Insufficient training, lack of policy, less commitment to infection control, and limitations of resources were perceived as major barriers for practicing preventive measures during the pandemic. CONCLUSION Preventive measures taken by healthcare providers were poor. Multiple barriers, such as insufficient training related to the pandemic, limitation of resources, and less commitment of healthcare providers to infection prevention measures were reported. So, the government should work on reducing the pandemic propagation by fulfilling the barriers using different means or strategies.
Collapse
|
217
|
Alqahtani JS, Mendes RG, Aldhahir A, Rowley D, AlAhmari MD, Ntoumenopoulos G, Alghamdi SM, Sreedharan JK, Aldabayan YS, Oyelade T, Alrajeh A, Olivieri C, AlQuaimi M, Sullivan J, Almeshari MA, Esquinas A. Global Current Practices of Ventilatory Support Management in COVID-19 Patients: An International Survey. J Multidiscip Healthc 2020; 13:1635-1648. [PMID: 33239884 PMCID: PMC7680685 DOI: 10.2147/jmdh.s279031] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/19/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND As the global outbreak of COVID-19 continues to ravage the world, it is important to understand how frontline clinicians manage ventilatory support and the various limiting factors. METHODS An online survey composed of 32 questions was developed and validated by an international expert panel. RESULTS Overall, 502 respondents from 40 countries across six continents completed the survey. The mean number (±SD) of ICU beds was 64 ± 84. The most popular initial diagnostic tools used for treatment initiation were arterial blood gas (48%) and clinical presentation (37.5%), while the national COVID-19 guidelines were the most used (61.2%). High flow nasal cannula (HFNC) (53.8%), non-invasive ventilation (NIV) (47%), and invasive mechanical ventilation (IMV) (92%) were mostly used for mild, moderate, and severe COVID-19 cases, respectively. However, only 38.8%, 56.6% and 82.9% of the respondents had standard protocols for HFNC, NIV, and IMV, respectively. The most frequently used modes of IMV and NIV were volume control (VC) (36.1%) and continuous positive airway pressure/pressure support (CPAP/PS) (40.6%). About 54% of the respondents did not adhere to the recommended, regular ventilator check interval. The majority of the respondents (85.7%) used proning with IMV, with 48.4% using it for 12-16 hours, and 46.2% had tried awake proning in combination with HFNC or NIV. Increased staff workload (45.02%), lack of trained staff (44.22%) and shortage of personal protective equipment (PPE) (42.63%) were the main barriers to COVID-19 management. CONCLUSION Our results show that general clinical practices involving ventilatory support were highly heterogeneous, with limited use of standard protocols and most frontline clinicians depending on isolated and varied management guidelines. We found increased staff workload, lack of trained staff and shortage of PPE to be the main limiting factors affecting global COVID-19 ventilatory support management.
Collapse
Affiliation(s)
- Jaber S Alqahtani
- UCL Respiratory, University College London, London, UK
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Renata G Mendes
- Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil
| | - Abdulelah Aldhahir
- UCL Respiratory, University College London, London, UK
- Respiratory Care Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Daniel Rowley
- Pulmonary Diagnostics & Respiratory Therapy Services, University of Virginia Medical Center, Charlottesville, VA, USA
| | - Mohammed D AlAhmari
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
- Dammam Health Network, Dammam, Saudi Arabia
| | - George Ntoumenopoulos
- Consultant Physiotherapist, Physiotherapy Department St Vincent’s Hospital Sydney, Sydney, NSW, Australia
| | - Saeed M Alghamdi
- National Heart and Lung Institute, Imperial College London, London, UK
- Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Jithin K Sreedharan
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | | | - Tope Oyelade
- UCL Institute for Liver and Digestive Health, London, UK
| | - Ahmed Alrajeh
- Respiratory Care, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Carlo Olivieri
- Emergency Department, Ospedale Sant’Andrea, Vercelli13100, Italy
| | - Maher AlQuaimi
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Jerome Sullivan
- President, International Council for Respiratory Care, Professor Emeritus & Respiratory Care Program Director, The University of Toledo, Toledo, OH, USA
| | - Mohammed A Almeshari
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Antonio Esquinas
- Director International NIV School, Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
| |
Collapse
|
218
|
Alakhras M, Al-Mousa DS, Mahasneh A, AlSa'di AG. Factors Affecting Compliance of Infection Control Measures among Dental Radiographers. Int J Dent 2020; 2020:8834854. [PMID: 33273923 PMCID: PMC7683140 DOI: 10.1155/2020/8834854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To assess the level of dental radiographers' compliance with infection control measures and to evaluate the factors affecting their compliance. METHODS The study included 175 dental radiographers. Compliance with infection control was evaluated with a self-administered questionnaire consisting of 33 questions related to vaccination, hand hygiene (HH), personal protective equipment (PPE), disinfection and sterilization, and use of surface barriers. Pearson's chi-square test was used to compare compliance between subgroups of radiographers. RESULTS 64.6% of participants were females, and 62.9% was younger than 30 years. 13.0% of the sample population had >10 years of experience and 28.0% take radiographs for >20 patients/day. 66.9% of participants wash their hands before/after taking radiographs. 26.3% of participants had vaccination against hepatitis B, tetanus, and tuberculosis. 12.6% fully use PPE, 10.9% perform complete disinfection and sterilization, and 16.0% apply all kinds of surfaces barriers. Vaccination was significantly affected by age, gender, and practice type. HH was affected by years of experience and number of patients radiographed per day. PPE was influenced by number of hours worked per week and patients radiographed daily. Disinfection and sterilization was affected by practice type and years of experience. The use of surface barriers was affected by age, practice type, and number of patients radiographed/day. CONCLUSIONS The current study indicated poor compliance with infection control practices among dental radiographers. We recommend continuing educational programs and training courses to increase dental radiographers' awareness of local and international infection control guidelines and to enhance their implementation of these guidelines.
Collapse
Affiliation(s)
- Maram Alakhras
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Ar Ramtha, Jordan
| | - Dana S. Al-Mousa
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Ar Ramtha, Jordan
| | - Arwa Mahasneh
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Ar Ramtha, Jordan
| | | |
Collapse
|
219
|
Donaghy J. Organisational support improves adherence to infection prevention and control guidelines. Evid Based Nurs 2020; 25:10. [PMID: 33168574 DOI: 10.1136/ebnurs-2020-103305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Juliet Donaghy
- Emergency Assessment Unit, East Suffolk and North Essex Foundation Trust, Ipswich, Suffolk, UK
| |
Collapse
|
220
|
Vindrola-Padros C, Andrews L, Dowrick A, Djellouli N, Fillmore H, Bautista Gonzalez E, Javadi D, Lewis-Jackson S, Manby L, Mitchinson L, Mulcahy Symmons S, Martin S, Regenold N, Robinson H, Sumray K, Singleton G, Syversen A, Vanderslott S, Johnson G. Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK. BMJ Open 2020; 10:e040503. [PMID: 33154060 PMCID: PMC7646318 DOI: 10.1136/bmjopen-2020-040503] [Citation(s) in RCA: 153] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/07/2020] [Accepted: 10/18/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic has set unprecedented demand on the healthcare workforce around the world. The UK has been one of the most affected countries in Europe. The aim of this study was to explore the perceptions and experiences of healthcare workers (HCWs) in relation to COVID-19 and care delivery models implemented to deal with the pandemic in the UK. METHODS The study was designed as a rapid appraisal combining: (1) a review of UK healthcare policies (n=35 policies), (2) mass media and social media analysis of front-line staff experiences and perceptions (n=101 newspaper articles, n=1 46 000 posts) and (3) in-depth (telephone) interviews with front-line staff (n=30 interviews). The findings from all streams were analysed using framework analysis. RESULTS Limited personal protective equipment (PPE) and lack of routine testing created anxiety and distress and had a tangible impact on the workforce. When PPE was available, incorrect size and overheating complicated routine work. Lack of training for redeployed staff and the failure to consider the skills of redeployed staff for new areas were identified as problems. Positive aspects of daily work reported by HCWs included solidarity between colleagues, the establishment of well-being support structures and feeling valued by society. CONCLUSION Our study highlighted the importance of taking into consideration the experiences and concerns of front-line staff during a pandemic. Staff working in the UK during the COVID-19 pandemic advocated clear and consistent guidelines, streamlined testing of HCWs, administration of PPE and acknowledgement of the effects of PPE on routine practice.
Collapse
Affiliation(s)
| | - Lily Andrews
- Institute of Epidemiology and Healthcare, University College London, London, UK
| | - Anna Dowrick
- Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Nehla Djellouli
- Institute of Global Health, University College London, London, UK
| | | | | | - Dena Javadi
- Harvard TH Chan School of Public Health, Department of Social and Behavioral Sciences, Harvard University, Cambridge, Massachusetts, USA
| | | | - Louisa Manby
- Institute of Epidemiology and Healthcare, University College London, London, UK
| | - Lucy Mitchinson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, United Kingdom
| | | | - Sam Martin
- Oxford Vaccine Group, Centre for Clinical Vaccinology and Tropical Medicine (CCVTM), Oxford University, Oxford, Oxfordshire, UK
| | - Nina Regenold
- Department of Anthropology, University College London, London, UK
| | - Hannah Robinson
- School for Policy Studies, Bristol University, Bristol, United Kingdom
| | - Kirsi Sumray
- Institute of Epidemiology and Healthcare, University College London, London, UK
| | - Georgina Singleton
- Department of Targeted Intervention, University College London, London, UK
| | - Aron Syversen
- Institute of Epidemiology and Healthcare, University College London, London, UK
| | - Samantha Vanderslott
- Oxford Vaccine Group, Centre for Clinical Vaccinology and Tropical Medicine (CCVTM), Oxford University, Oxford, Oxfordshire, UK
| | - Ginger Johnson
- Department of Targeted Intervention, University College London, London, UK
| |
Collapse
|
221
|
Pollock A, Campbell P, Cheyne J, Cowie J, Davis B, McCallum J, McGill K, Elders A, Hagen S, McClurg D, Torrens C, Maxwell M. Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review. Cochrane Database Syst Rev 2020; 11:CD013779. [PMID: 33150970 PMCID: PMC8226433 DOI: 10.1002/14651858.cd013779] [Citation(s) in RCA: 207] [Impact Index Per Article: 51.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Evidence from disease epidemics shows that healthcare workers are at risk of developing short- and long-term mental health problems. The World Health Organization (WHO) has warned about the potential negative impact of the COVID-19 crisis on the mental well-being of health and social care professionals. Symptoms of mental health problems commonly include depression, anxiety, stress, and additional cognitive and social problems; these can impact on function in the workplace. The mental health and resilience (ability to cope with the negative effects of stress) of frontline health and social care professionals ('frontline workers' in this review) could be supported during disease epidemics by workplace interventions, interventions to support basic daily needs, psychological support interventions, pharmacological interventions, or a combination of any or all of these. OBJECTIVES Objective 1: to assess the effects of interventions aimed at supporting the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic. Objective 2: to identify barriers and facilitators that may impact on the implementation of interventions aimed at supporting the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic. SEARCH METHODS On 28 May 2020 we searched the Cochrane Database of Systematic Reviews, CENTRAL, MEDLINE, Embase, Web of Science, PsycINFO, CINAHL, Global Index Medicus databases and WHO Institutional Repository for Information Sharing. We also searched ongoing trials registers and Google Scholar. We ran all searches from the year 2002 onwards, with no language restrictions. SELECTION CRITERIA We included studies in which participants were health and social care professionals working at the front line during infectious disease outbreaks, categorised as epidemics or pandemics by WHO, from 2002 onwards. For objective 1 we included quantitative evidence from randomised trials, non-randomised trials, controlled before-after studies and interrupted time series studies, which investigated the effect of any intervention to support mental health or resilience, compared to no intervention, standard care, placebo or attention control intervention, or other active interventions. For objective 2 we included qualitative evidence from studies that described barriers and facilitators to the implementation of interventions. Outcomes critical to this review were general mental health and resilience. Additional outcomes included psychological symptoms of anxiety, depression or stress; burnout; other mental health disorders; workplace staffing; and adverse events arising from interventions. DATA COLLECTION AND ANALYSIS Pairs of review authors independently applied selection criteria to abstracts and full papers, with disagreements resolved through discussion. One review author systematically extracted data, cross-checked by a second review author. For objective 1, we assessed risk of bias of studies of effectiveness using the Cochrane 'Risk of bias' tool. For objective 2, we assessed methodological limitations using either the CASP (Critical Appraisal Skills Programme) qualitative study tool, for qualitative studies, or WEIRD (Ways of Evaluating Important and Relevant Data) tool, for descriptive studies. We planned meta-analyses of pairwise comparisons for outcomes if direct evidence were available. Two review authors extracted evidence relating to barriers and facilitators to implementation, organised these around the domains of the Consolidated Framework of Implementation Research, and used the GRADE-CERQual approach to assess confidence in each finding. We planned to produce an overarching synthesis, bringing quantitative and qualitative findings together. MAIN RESULTS We included 16 studies that reported implementation of an intervention aimed at supporting the resilience or mental health of frontline workers during disease outbreaks (severe acute respiratory syndrome (SARS): 2; Ebola: 9; Middle East respiratory syndrome (MERS): 1; COVID-19: 4). Interventions studied included workplace interventions, such as training, structure and communication (6 studies); psychological support interventions, such as counselling and psychology services (8 studies); and multifaceted interventions (2 studies). Objective 1: a mixed-methods study that incorporated a cluster-randomised trial, investigating the effect of a work-based intervention, provided very low-certainty evidence about the effect of training frontline healthcare workers to deliver psychological first aid on a measure of burnout. Objective 2: we included all 16 studies in our qualitative evidence synthesis; we classified seven as qualitative and nine as descriptive studies. We identified 17 key findings from multiple barriers and facilitators reported in studies. We did not have high confidence in any of the findings; we had moderate confidence in six findings and low to very low confidence in 11 findings. We are moderately confident that the following two factors were barriers to intervention implementation: frontline workers, or the organisations in which they worked, not being fully aware of what they needed to support their mental well-being; and a lack of equipment, staff time or skills needed for an intervention. We are moderately confident that the following three factors were facilitators of intervention implementation: interventions that could be adapted for local needs; having effective communication, both formally and socially; and having positive, safe and supportive learning environments for frontline workers. We are moderately confident that the knowledge or beliefs, or both, that people have about an intervention can act as either barriers or facilitators to implementation of the intervention. AUTHORS' CONCLUSIONS There is a lack of both quantitative and qualitative evidence from studies carried out during or after disease epidemics and pandemics that can inform the selection of interventions that are beneficial to the resilience and mental health of frontline workers. Alternative sources of evidence (e.g. from other healthcare crises, and general evidence about interventions that support mental well-being) could therefore be used to inform decision making. When selecting interventions aimed at supporting frontline workers' mental health, organisational, social, personal, and psychological factors may all be important. Research to determine the effectiveness of interventions is a high priority. The COVID-19 pandemic provides unique opportunities for robust evaluation of interventions. Future studies must be developed with appropriately rigorous planning, including development, peer review and transparent reporting of research protocols, following guidance and standards for best practice, and with appropriate length of follow-up. Factors that may act as barriers and facilitators to implementation of interventions should be considered during the planning of future research and when selecting interventions to deliver within local settings.
Collapse
Affiliation(s)
- Alex Pollock
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Pauline Campbell
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Joshua Cheyne
- Centre for Clinical Brain Sciences (CCBS), University of Edinburgh, Edinburgh, UK
| | - Julie Cowie
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Bridget Davis
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Jacqueline McCallum
- Department of Nursing and Community Health, Glasgow Caledonian University, Glasgow, UK
| | - Kris McGill
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Andrew Elders
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Suzanne Hagen
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Doreen McClurg
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Claire Torrens
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Glasgow, UK
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Glasgow, UK
| |
Collapse
|
222
|
Biesty L, Meskell P, Glenton C, Delaney H, Smalle M, Booth A, Chan XHS, Devane D, Houghton C. A QuESt for speed: rapid qualitative evidence syntheses as a response to the COVID-19 pandemic. Syst Rev 2020; 9:256. [PMID: 33148320 PMCID: PMC7640992 DOI: 10.1186/s13643-020-01512-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/26/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has created a sense of urgency in the research community in their bid to contribute to the evidence required for healthcare policy decisions. With such urgency, researchers experience methodological challenges to maintain the rigour and transparency of their work. With this in mind, we offer reflections on our recent experience of undertaking a rapid Cochrane qualitative evidence synthesis (QES). METHODS This process paper, using a reflexive approach, describes a rapid QES prepared during, and in response to, the COVID-19 pandemic. FINDINGS This paper reports the methodological decisions we made and the process we undertook. We place our decisions in the context of guidance offered in relation to rapid reviews and previously conducted QESs. We highlight some of the challenges we encountered in finding the balance between the time needed for thoughtfulness and comprehensiveness whilst providing a rapid response to an urgent request for evidence. CONCLUSION The need for more guidance on rapid QES remains, but such guidance needs to be based on actual worked examples and case studies. This paper and the reflections offered may provide a useful framework for others to use and further develop.
Collapse
Affiliation(s)
- Linda Biesty
- Evidence Synthesis Ireland, National University of Ireland Galway, Galway, Ireland.
- Qualitative Research in Trials Centre, National University of Ireland Galway, Galway, Ireland.
- School of Nursing and Midwifery, Aras Moyola, National University of Ireland Galway, 26 Upper Newcastle, Galway, H91 E3YV, Ireland.
| | - Pauline Meskell
- Evidence Synthesis Ireland, National University of Ireland Galway, Galway, Ireland
- Qualitative Research in Trials Centre, National University of Ireland Galway, Galway, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | | | - Hannah Delaney
- School of Nursing and Midwifery, Aras Moyola, National University of Ireland Galway, 26 Upper Newcastle, Galway, H91 E3YV, Ireland
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Mike Smalle
- James Hardiman Library, National University of Ireland Galway, Galway, Ireland
| | - Andrew Booth
- School of Health and Related Research, ScHARR, University of Sheffield, Sheffield, UK
| | - Xin Hui S Chan
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Hospital for Tropical Diseases, London, UK
| | - Declan Devane
- Evidence Synthesis Ireland, National University of Ireland Galway, Galway, Ireland
- School of Nursing and Midwifery, Aras Moyola, National University of Ireland Galway, 26 Upper Newcastle, Galway, H91 E3YV, Ireland
- Cochrane Ireland, National University of Ireland Galway, Galway, Ireland
- HRB-Trials Methodology Research Network, National University of Ireland Galway, Galway, Ireland
| | - Catherine Houghton
- Evidence Synthesis Ireland, National University of Ireland Galway, Galway, Ireland
- Qualitative Research in Trials Centre, National University of Ireland Galway, Galway, Ireland
- School of Nursing and Midwifery, Aras Moyola, National University of Ireland Galway, 26 Upper Newcastle, Galway, H91 E3YV, Ireland
| |
Collapse
|
223
|
Moreno-Casbas MT. Factors related to SARS-CoV-2 infection in healthcare professionals in Spain. The SANICOVI project. ENFERMERIA CLINICA 2020; 30:360-370. [PMID: 32571661 PMCID: PMC7247504 DOI: 10.1016/j.enfcli.2020.05.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/21/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To describe the factors related to the situation of SARS-CoV-2 transmission identified by health professionals in Spain and to propose prevention strategies. METHOD Cross-sectional descriptive study. The population were healthcare professionals working in institutions caring for COVID-19 patients and also confirmed cases of SARS-CoV-2 infection. A questionnaire with sociodemographic, occupational and epidemiological variables was used. Descriptive and bivariate analysis was performed according to the nature of the variables. RESULTS A total of 2.230 questionnaires were analysed on a potential population of 41,239 (5.47%). The diagnosis was made based on a suspicious case (63.4%) and a probable case (12.3%). A study of contacts was carried out at 50.3%. The perception about the availability of protective measures as «always/frequently» were: FPP1 mask 57.3%, gloves 89.5%, soap 95% and hydroalcoholic solution 91.5%. In PPE, FPP2, FPP3 mask, goggles and disposable gowns at around 50%. The availability of protective measures, by field of work, presented significant differences. The average number of patients attended related to the performance of hand hygiene at moment4 and the perception of performing it correctly at moments4 and5. CONCLUSIONS Preliminary data are presented, with variability in the response rate by Autonomous Region. Healthcare professionals infected by SARS-CoV-2 identified the management of the chain of infection transmission, the use and adequacy of protective equipment, as well as the effectiveness of handwashing as factors related to the transmission of the virus among professionals.
Collapse
Affiliation(s)
- María Teresa Moreno-Casbas
- Unidad de Investigación en Cuidados y Servicios de Salud del Instituto de Salud Carlos III (Investén-isciii), Madrid, España; Centro de Investigación Biomédica en Red sobre Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, España.
| |
Collapse
|
224
|
Sunkwa-Mills G, Rawal L, Enweronu-Laryea C, Aberese-Ako M, Senah K, Tersbøl BP. Perspectives and practices of healthcare providers and caregivers on healthcare-associated infections in the neonatal intensive care units of two hospitals in Ghana. Health Policy Plan 2020; 35:i38-i50. [PMID: 33165583 PMCID: PMC7649666 DOI: 10.1093/heapol/czaa102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2020] [Indexed: 12/17/2022] Open
Abstract
Healthcare-associated infections (HAIs) remain a serious threat to patient safety worldwide, particularly in low- and middle-income countries. Reducing the burden of HAIs through the observation and enforcement of infection prevention and control (IPC) practices remains a priority. Despite growing emphasis on HAI prevention in low- and middle-income countries, limited evidence is available to improve IPC practices to reduce HAIs. This study examined the perspectives of healthcare providers (HPs) and mothers in the neonatal intensive care unit on HAIs and determined the major barriers and facilitators to promoting standard IPC practices. This study draws on data from an ethnographic study using 38 in-depth interviews, four focus group discussions and participant observation conducted among HPs and mothers in neonatal intensive care units of a secondary- and tertiary-level hospital in Ghana. The qualitative data were analysed using a grounded theory approach, and NVivo 12 to facilitate coding. HPs and mothers demonstrated a modest level of understanding about HAIs. Personal, interpersonal, community, organizational and policy-level factors interacted in complex ways to influence IPC practices. HPs sometimes considered HAI concerns to be secondary in the face of a heavy clinical workload, a lack of structured systems and the quest to protect professional authority. The positive attitudes of some HPs, and peer interactions promoted standard IPC practices. Mothers expressed interest in participation in IPC activities. It however requires systematic efforts by HPs to partner with mothers in IPC. Training and capacity building of HPs, provision of adequate resources and improving communication between HPs and mothers were recommended to improve standard IPC practices. We conclude that there is a need for institutionalizing IPC policies and strengthening strategies that acknowledge and value mothers' roles as caregivers and partners in IPC. To ensure this, HPs should be better equipped to prioritize communication and collaboration with mothers to reduce the burden of HAIs.
Collapse
Affiliation(s)
- Gifty Sunkwa-Mills
- Ghana Health Service, Central Region, Ghana
- Global Health Section, Department of Public Health, University of Copenhagen, Denmark
| | - Lal Rawal
- School of Health Medical and Applied Sciences, CQUniversity, Sydney, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | | | - Matilda Aberese-Ako
- Institute of Health Research, University of Health and Allied Sciences, Ghana
| | - Kodjo Senah
- Department of Sociology, University of Ghana, Accra, Ghana
| | | |
Collapse
|
225
|
Jemal K, Gashaw K, Kinati T, Bedada W, Getahun B. Clean and Safe Healthcare Environment: Knowledge, Attitude, and Practice of Infection Prevention and Control among Health Workforce at North Showa Zone Oromiya Region. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:6021870. [PMID: 33178291 PMCID: PMC7648680 DOI: 10.1155/2020/6021870] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 10/06/2020] [Accepted: 10/21/2020] [Indexed: 11/30/2022]
Abstract
Background Infection prevention and control practice (IPCP) is essential for healthcare safety and quality service delivery. The Ethiopian government has already put in place programs and initiatives for clean and safe healthcare facilities. However, in the North Showa Zone of the Oromiya Region, the infection prevention and control practice level was not well understood. Therefore, this study aimed to assess the knowledge, attitude, and practice of infection prevention and control practice among the health workforce (HWF) in North Shoa healthcare facilities (NSHCFs) environment. Methods Healthcare facility-based cross-sectional study design was employed. Structured and pretested self-administered questionnaires were distributed for 373 health workforce. Three hospitals and six health centers were randomly selected, and the study participants were selected by systematic sampling technique. Data were entered into Epi-data version 3.5.2 and then exported to SPSS version 23 for analysis. Multivariable logistic regression was performed to determine the associated factors with infection prevention practice, and a p value of less than 0.05 was considered statistically significant. Results A total of 361 (96.8%) health workforce responded to self-administered questionnaires. About 55.70% of study participants had good knowledge, 59.3% of them had a positive attitude, and 46.8% had a good infection prevention practice. Age category of 20-29(AOR = 4.08, 95%, CI = (1.97, 8.49)), female participants (AOR = 3.87, 95%, CI = (1.91, 7.86)), single participants (AOR = 3.89, 95%, CI = (1.92, 7.87)), having greater than ten years of working experience (AOR = 3.10, 95% CI = (1.19, 8.10)), positive attitude (AOR = 10.07, 95% CI = (4.82, 21.05)), and availability of water at working area (AOR = 2.27, 95% CI = (1.18, 4.35)) were significantly associated with good infection prevention practice. Conclusion In this study, a significant number of health workers had low knowledge, negative attitudes, and poor infection prevention practices. Female participants, higher work experience, a positive attitude, and water availability in the healthcare facilities were positively associated with infection prevention and control practice. Healthcare facilities should be continued capacitating the health workforce on infection prevention and control measures and equipping health facilities with infection prevention materials.
Collapse
Affiliation(s)
- Kemal Jemal
- Salale University, College of Health Sciences, Department of Nursing, Fitche, Ethiopia
| | - Ketema Gashaw
- Salale University, College of Health Sciences, Department of Public Health, Fitche, Ethiopia
| | - Tadele Kinati
- Salale University, College of Health Sciences, Department of Nursing, Fitche, Ethiopia
| | | | - Belete Getahun
- Canadian Physicians for Aid and Relief, Addis Ababa, Ethiopia
| |
Collapse
|
226
|
Shah ASV, Wood R, Gribben C, Caldwell D, Bishop J, Weir A, Kennedy S, Reid M, Smith-Palmer A, Goldberg D, McMenamin J, Fischbacher C, Robertson C, Hutchinson S, McKeigue P, Colhoun H, McAllister DA. Risk of hospital admission with coronavirus disease 2019 in healthcare workers and their households: nationwide linkage cohort study. BMJ 2020; 371:m3582. [PMID: 33115726 PMCID: PMC7591828 DOI: 10.1136/bmj.m3582] [Citation(s) in RCA: 190] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To assess the risk of hospital admission for coronavirus disease 2019 (covid-19) among patient facing and non-patient facing healthcare workers and their household members. DESIGN Nationwide linkage cohort study. SETTING Scotland, UK, 1 March to 6 June 2020. PARTICIPANTS Healthcare workers aged 18-65 years, their households, and other members of the general population. MAIN OUTCOME MEASURE Admission to hospital with covid-19. RESULTS The cohort comprised 158 445 healthcare workers, most of them (90 733; 57.3%) being patient facing, and 229 905 household members. Of all hospital admissions for covid-19 in the working age population (18-65 year olds), 17.2% (360/2097) were in healthcare workers or their households. After adjustment for age, sex, ethnicity, socioeconomic deprivation, and comorbidity, the risk of admission due to covid-19 in non-patient facing healthcare workers and their households was similar to the risk in the general population (hazard ratio 0.81 (95% confidence interval 0.52 to 1.26) and 0.86 (0.49 to 1.51), respectively). In models adjusting for the same covariates, however, patient facing healthcare workers, compared with non-patient facing healthcare workers, were at higher risk (hazard ratio 3.30, 2.13 to 5.13), as were household members of patient facing healthcare workers (1.79, 1.10 to 2.91). After sub-division of patient facing healthcare workers into those who worked in "front door," intensive care, and non-intensive care aerosol generating settings and other, those in front door roles were at higher risk (hazard ratio 2.09, 1.49 to 2.94). For most patient facing healthcare workers and their households, the estimated absolute risk of hospital admission with covid-19 was less than 0.5%, but it was 1% and above in older men with comorbidity. CONCLUSIONS Healthcare workers and their households contributed a sixth of covid-19 cases admitted to hospital. Although the absolute risk of admission was low overall, patient facing healthcare workers and their household members had threefold and twofold increased risks of admission with covid-19.
Collapse
Affiliation(s)
- Anoop S V Shah
- Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Department of Cardiology, Imperial College NHS Trust, London, UK
| | - Rachael Wood
- Public Health Scotland, Edinburgh, UK
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | | | | | | | | | | | | | | | | | | | | | - Sharon Hutchinson
- Public Health Scotland, Edinburgh, UK
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Paul McKeigue
- MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Helen Colhoun
- Public Health Scotland, Edinburgh, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - David A McAllister
- Public Health Scotland, Edinburgh, UK
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK
| |
Collapse
|
227
|
Mercer ST, Agarwal R, Dayananda KSS, Yasin T, Trickett RW. A comparative study looking at trauma and orthopaedic operating efficiency in the COVID-19 era. ACTA ACUST UNITED AC 2020; 21:100142. [PMID: 33106778 PMCID: PMC7577267 DOI: 10.1016/j.pcorm.2020.100142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 01/12/2023]
Abstract
Backgroud COVID-19 has led to a reduction in operating efficiency. We aim to identify these inefficiencies and possible solutions as we begin to pursue a move to planned surgical care. Methods All trauma and orthopaedic emergency surgery were analysed for May 2019 and May 2020. Timing data was collated to look at the following: anaesthetic preparation time, anaesthetic time, surgical preparation time, surgical time, transfer to recovery time and turnaround time. Data for 2019 was collected retrospectively and data for 2020 was collected prospectively. Results A total of 222 patients underwent emergency orthopaedic surgery in May 2019 and 161 in May 2020. A statistically significant increase in all timings was demonstrated in 2020 apart from anaesthetic time which demonstrated a significant decrease. A subgroup analysis for hip fractures demonstrated a similar result. No increase in surgical time was observed in hand and wrist surgery or for debridement and washouts.Although the decrease in anaesthetic time is difficult to explain, this could be attributed to a reduction in combined anaesthetic techniques and possibly the effect of fear. The other increases in time demonstrated can largely be attributed to the PPE required for aerosol generating procedures and other measures taken to reduce spread of the virus. These procedures currently form a large amount of the orthopaedic case load. Conclusion COVID-19 has led to significant reductions in operating room efficiency. This will have significant impact on waiting times. Increasing frequency of regional anaesthesia concurrently with non-aerosol generating surgeries may improve efficiency.
Collapse
Affiliation(s)
- Scott Thomas Mercer
- University Hospital Llandough, Cardiff and Vale University Health Board, Penlan Road, Llandough, Penarth, CF64 2XX, United Kingdom
| | - Rishi Agarwal
- University Hospital Llandough, Cardiff and Vale University Health Board, Penlan Road, Llandough, Penarth, CF64 2XX, United Kingdom
| | - Kathryn Sian Satya Dayananda
- University Hospital Llandough, Cardiff and Vale University Health Board, Penlan Road, Llandough, Penarth, CF64 2XX, United Kingdom
| | - Tariq Yasin
- University Hospital Llandough, Cardiff and Vale University Health Board, Penlan Road, Llandough, Penarth, CF64 2XX, United Kingdom
| | - Ryan W Trickett
- University Hospital Llandough, Cardiff and Vale University Health Board, Penlan Road, Llandough, Penarth, CF64 2XX, United Kingdom
| |
Collapse
|
228
|
Nabe-Nielsen K, Nilsson CJ, Juul-Madsen M, Bredal C, Hansen LOP, Hansen ÅM. COVID-19 risk management at the workplace, fear of infection and fear of transmission of infection among frontline employees. Occup Environ Med 2020; 78:248-254. [PMID: 33077432 DOI: 10.1136/oemed-2020-106831] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES We compared COVID-19 risk management, fear of infection and fear of transmission of infection among frontline employees working within eldercare, hospital/rehabilitation, psychiatry, childcare and ambulance service and explored if group differences in fear of infection and transmission could be explained by differences in risk management. We also investigated the association of risk management with fear of infection and fear of transmission of infection among eldercare personnel. METHODS We used cross-sectional questionnaire data collected by the Danish labour union, FOA . Data were collected 5½ weeks after the first case of COVID-19 was registered in Denmark. Data for the first aim included 2623 participants. Data for the second aim included 1680 participants. All independent variables were mutually adjusted and also adjusted for sex, age, job title and region. RESULTS Fear of infection (49%) and fear of transmitting infection from work to the private sphere (68%) was most frequent in ambulance service. Fear of transmitting infection during work was most frequent in the eldercare (55%). Not all differences in fear of infection and transmission between the five areas of work were explained by differences in risk management. Among eldercare personnel, self-reported exposure to infection and lack of access to test was most consistently associated with fear of infection and fear of transmission, whereas lack of access to personal protective equipment was solely associated with fear of transmission. CONCLUSION We have illustrated differences and similarities in COVID-19 risk management within five areas of work and provide new insights into factors associated with eldercare workers' fear of infection and fear of transmission of infection.
Collapse
Affiliation(s)
| | | | | | | | | | - Åse Marie Hansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,The National Research Center for the Working Environment, Copenhagen, Denmark
| |
Collapse
|
229
|
Poor COVID-19 Preventive Practice among Healthcare Workers in Northwest Ethiopia, 2020. ADVANCES IN PUBLIC HEALTH 2020. [DOI: 10.1155/2020/7526037] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. The novel coronavirus disease (COVID-19) pandemic outbreak affects the global social, economic, and political context and becomes a significant threat to healthcare providers who are among the exposed groups to acquire and transmit the disease while caring and treating patients. It is crucial to comply with prevention recommendations so as to stay safe and protected. Therefore, this study aimed to assess COVID-19 preventive practice and associated factors among healthcare workers in Northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted among 630 healthcare workers in Northwest Ethiopia from March to April 2020. A multistage sampling technique was used to select study participants. A pretested and structured self-administered questionnaire was used to collect data. The data were entered using Epi Info 7 and analyzed using STATA 16 statistical software. Both bivariate and multivariable logistic regression analyses were employed to identify associated factors. Adjusted odds ratio (AOR) with 95% confidence interval was used to determine independent predictors of COVID-19 preventive practice. In multivariable analysis, a variable with a
value of less than 0.05 was considered as statically significant. Result. Among 630 healthcare workers participated in the study, the overall good preventive practice towards COVID-19 was found to be 38.73% (95% CI: 34.8, 42.5). Being a male healthcare provider (AOR = 1.48; 95% CI: 1.02, 2.10), having work experience of 6–10 years (AOR = 2.22; 95% CI: 1.23, 4.00), and having poor attitude towards COVID-19 (AOR = 2.22; 95% CI: 1.03, 2.22) were found to be significantly associated with poor COVID-19 preventive practice among healthcare workers. Conclusion. Overall compliance towards COVID-19 preventive practice among healthcare workers was found to be low. Multiple education and training platforms with focus on COVID-19 preventive measures and adequate personal protective equipment and supplies should be provided for healthcare providers.
Collapse
|
230
|
Derksen C, Keller FM, Lippke S. Obstetric Healthcare Workers' Adherence to Hand Hygiene Recommendations during the COVID-19 Pandemic: Observations and Social-Cognitive Determinants. Appl Psychol Health Well Being 2020; 12:1286-1305. [PMID: 33016518 PMCID: PMC7675238 DOI: 10.1111/aphw.12240] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 01/01/2023]
Abstract
Background Hand hygiene is crucial to avoid healthcare‐associated infections and the transmission of COVID‐19. Although the WHO has issued global hand hygiene recommendations for healthcare, adherence remains challenging. Considering social‐cognitive theories such as the health action process approach (HAPA) can help to improve healthcare workers’ adherence. This study aimed to observe adherence and to assess determinants in obstetric hospitals during and after the onset of the COVID‐19 pandemic. Methods In all, 267 observations of behaviour were conducted in two German obstetric university hospitals over three time periods (pre‐COVID‐19 pandemic, heightened awareness, and strict precautions). In addition, 115 healthcare workers answered questionnaires regarding social‐cognitive determinants of hand hygiene behaviour. Multiple regression and multiple mediation analyses were used to analyse associations. Results Adherence to hand hygiene recommendations increased from 47 per cent pre‐COVID‐19 pandemic to 95 per cent just before lockdown while simple measures against the pandemic were taken. Self‐efficacy was associated with the intention to sanitise hands (β = .397, p < .001). Coping self‐efficacy mediated the association of intention with hand hygiene adherence. Conclusions Obstetric healthcare workers seem to adapt their hand hygiene behaviour to prevent infections facing the global COVID‐19 pandemic. To further improve interventions, social‐cognitive determinants should be considered, especially intention and (coping) self‐efficacy.
Collapse
|
231
|
Patella V, Delfino G, Florio G, Spadaro G, Chieco Bianchi F, Senna G, Di Gioacchino M. Management of the patient with allergic and immunological disorders in the pandemic COVID-19 era. Clin Mol Allergy 2020; 18:18. [PMID: 33020697 PMCID: PMC7528155 DOI: 10.1186/s12948-020-00134-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/12/2020] [Indexed: 01/20/2023] Open
Abstract
The pandemic COVID-19 abruptly exploded, taking most health professionals around the world unprepared. Italy, the first European country to be hit violently, was forced to activate the lockdown in mid-February 2020. At the time of the spread, a high number of victims were quickly registered, especially in the regions of Northern Italy which have a high rate of highly-polluting production activities. The need to hospitalize the large number of patients with severe forms of COVID-19 led the National Health System to move a large number of specialists from their disciplines to the emergency hospital departments for the treatment of COVID-19. Furthermore, the lockdown itself has limited the possibility for general practitioners and pediatricians to be able to make outpatient visits and/or home care for patients with chronic diseases. Among them, the patient with atopic diseases, such as asthma, rhinitis and atopic dermatitis, is worthy of particular attention as she/he is immersed in a studded negative scenario with the onset of spring, a factor that should not be underestimated for those who suffer from pollen allergy. The Italian Society of Asthma Allergology and Clinical Immunology, to quickly deal with the lack of references and specialist medical procedures, has produced a series of indications for immunologic patient care that are reported in this paper, and can be used as guidelines by specialists of our discipline.
Collapse
Affiliation(s)
- Vincenzo Patella
- Division Allergy and Clinical Immunology, Department of Medicine, "Santa Maria Della Speranza" Hospital, Salerno, Italy.,Postgraduate Program in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy
| | - Gabriele Delfino
- Division Allergy and Clinical Immunology, Department of Medicine, "Santa Maria Della Speranza" Hospital, Salerno, Italy
| | - Giovanni Florio
- Division Allergy and Clinical Immunology, Department of Medicine, "Santa Maria Della Speranza" Hospital, Salerno, Italy
| | - Giuseppe Spadaro
- Postgraduate Program in Allergy and Clinical Immunology, University of Naples Federico II, Naples, Italy.,Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Gianerico Senna
- Asthma Center and Allergy Unit, Verona University and General Hospital, Verona, Italy.,Chairman of Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC), Milan, Italy
| | - Mario Di Gioacchino
- Center of Advanced Science and Technology, G. D'Annunzio University, Chieti-Pescara, Italy.,Leonardo Da Vinci, University, Chieti, Italy
| |
Collapse
|
232
|
Abd Samat AH, Isa MH, Sabardin DM, Md Jamal S, Jaafar MJ, Hamzah FA, Mahmud A, Sanip A, Syed Ali SM, Mohd Saiboon I. Knowledge and Confidence Level Among Emergency Healthcare Workers in Airway Management and Resuscitation of Suspected COVID-19 Patients: A Cross Sectional Study in Malaysia. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Introduction: This study aims to evaluate the knowledge and confidence of emergency healthcare workers (EHCW) in facing the COVID-19 pandemic. Materials and Methods: A cross-sectional online study using a validated questionnaire was distributed to doctors (MD), assistant medical officers (AMO), and staff nurses (SN) at an urban tertiary Emergency Department. It comprised of 40 knowledge and 10 confidence-level questions related to resuscitation and airway management steps. Results: A total of 135 from 167 eligible EHCW were enrolled. 68.9% (n = 93) had high knowledge while 53.3% (n = 72) possessed high confidence level. Overall knowledge mean score was 32.96/40 (SD = 3.63) between MD (33.88±3.09), AMO (32.28±4.03), and SN (32.00±3.60), P = 0.025. EHCWs with a length of service (LOS) between 4–10 years had the highest knowledge compared to those with LOS <4-year (33.71±3.39 versus 31.21±3.19 P = 0.002). Airway-related knowledge was significantly different between the designations and LOS (P = 0.002 and P = 0.003, respectively). Overall, EHCW confidence level against LOS showed significant difference [F (2, 132) = 5.46, P = 0.005] with longer LOS showing better confidence. MD showed the highest confidence compared to AMO and SN (3.67±0.69, 3.53±0.68, 3.26±0.64) P = 0.049. The majority EHCW were confident in performing highquality chest-compression, and handling of Personal Protective Equipment but less than half were confident in resuscitating, leading the resuscitation, managing the airway or being successful in first intubation attempt. Conclusions: EHCW possessed good knowledge in airway and resuscitation of COVID-19 patients, but differed between designations and LOS. A longer LOS was associated with better confidence, but there were some aspects in airway management and resuscitation that needed improvement. Keywords: Airway; Confidence; COVID-19; Knowledge; Resuscitation (CPR).
Collapse
|
233
|
Foley SJ, O'Loughlin A, Creedon J. Early experiences of radiographers in Ireland during the COVID-19 crisis. Insights Imaging 2020; 11:104. [PMID: 32986225 PMCID: PMC7520621 DOI: 10.1186/s13244-020-00910-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/03/2020] [Indexed: 12/24/2022] Open
Abstract
Background Imaging is crucial for assessing the severity and progression of COVID-19. Radiographers are amongst the first-line health professionals that may be exposed to infected persons. This work describes the early experience of radiographers in Ireland to the impact of COVID-19 using two electronic surveys distributed 6 weeks apart. Results were analysed using descriptive statistics and thematic analysis. Results A total of 370 responded to the first survey and 276 the second, with all six Irish health regions represented. Three quarters of radiographers (77%) reported having adequate personal protective equipment (PPE) available to them. However, almost half of the radiographers were inadvertently exposed to COVID-19-positive patients without appropriate PPE, largely attributed to poor communication and testing. Anxiety levels while initially high, reduced substantially 6 weeks into the crisis period. However, obvious distress was noted amongst some respondents. Forty percent of radiographers reported burnout symptoms due to the COVID-19 crisis and 30% reported considering changing jobs or retiring since the COVID-19 outbreak. Conclusion Clear communication regarding changing protocols and importantly patients’ infectious status are essential to safeguard healthcare workers and to minimise unnecessary anxiety and distress. Attention is required to staff mental health including the identification of burnout symptoms to prevent long-term negative consequences of the pandemic on radiography services.
Collapse
Affiliation(s)
- Shane J Foley
- Radiography & Diagnostic Imaging, School of Medicine, University College Dublin, Dublin 4, Ireland.
| | - Anne O'Loughlin
- Department of Radiology, Cork University Hospital, Cork, Ireland
| | - Jill Creedon
- Department of Radiology, Cork University Hospital, Cork, Ireland
| |
Collapse
|
234
|
Lo MW, Kemper C, Woodruff TM. COVID-19: Complement, Coagulation, and Collateral Damage. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2020; 205:1488-1495. [PMID: 32699160 PMCID: PMC7484432 DOI: 10.4049/jimmunol.2000644] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/06/2020] [Indexed: 12/15/2022]
Abstract
Coronavirus disease of 2019 (COVID-19) is a highly contagious respiratory infection that is caused by the severe acute respiratory syndrome coronavirus 2. Although most people are immunocompetent to the virus, a small group fail to mount an effective antiviral response and develop chronic infections that trigger hyperinflammation. This results in major complications, including acute respiratory distress syndrome, disseminated intravascular coagulation, and multiorgan failure, which all carry poor prognoses. Emerging evidence suggests that the complement system plays a key role in this inflammatory reaction. Indeed, patients with severe COVID-19 show prominent complement activation in their lung, skin, and sera, and those individuals who were treated with complement inhibitors all recovered with no adverse reactions. These and other studies hint at complement's therapeutic potential in these sequalae, and thus, to support drug development, in this review, we provide a summary of COVID-19 and review complement's role in COVID-19 acute respiratory distress syndrome and coagulopathy.
Collapse
Affiliation(s)
- Martin W Lo
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St Lucia, Queensland 4072, Australia; and
| | - Claudia Kemper
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892
| | - Trent M Woodruff
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St Lucia, Queensland 4072, Australia; and
| |
Collapse
|
235
|
Ramos-Martínez A, Fernández-Cruz A, Domínguez F, Forteza A, Cobo M, Sánchez-Romero I, Asensio A. Hospital-acquired infective endocarditis during Covid-19 pandemic. Infect Prev Pract 2020; 2:100080. [PMID: 34316565 PMCID: PMC7391975 DOI: 10.1016/j.infpip.2020.100080] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/23/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The COVID pandemic has had a major impact on healthcare in hospitals, including the diagnosis and treatment of infections. Hospital-acquired infective endocarditis (HAIE) is a severe complication of medical procedures that has shown a progressive increase in recent years. OBJECTIVES To determine whether the incidence of HAIE during the first two months of the epidemic (March-April 2020) was higher than previously observed and to describe the clinical characteristics of these cases. The probability of the studied event (HAIE) during the study period was calculated by Poisson distribution. RESULTS Four cases of HAIE were diagnosed in our institution during the study period. The incidence of HAIE during the study period was 2/patient-month and 0.3/patient-month during the same calender months in the previous 5 years (p=0.033). Two cases presented during admission for COVID-19 with pulmonary involvement treated with methylprednisolone and tocilizumab. The other two cases were admitted to the hospital during the epidemic. All cases underwent central venous and urinary catheterization during admission. The etiology of HAIE was Enterococcus faecalis (2 cases), Staphylococcus aureus and Candida albicans (one case each). A source of infection was identified in three cases (central venous catheter, peripheral venous catheter, sternal wound infection, respectively). One patient was operated on. Two patients died during hospital admission. CONCLUSIONS The incidence of HAIE during COVID-19 pandemic in our institution was higher than usual. In order to reduce the risk of this serious infection, optimal catheter care and early treatment of every local infection should be prioritized during coronavirus outbreaks.
Collapse
Affiliation(s)
- Antonio Ramos-Martínez
- Unidad de Enfermedades Infecciosas (Medicina Interna), Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, IDIPHISA, Madrid, Spain
| | - Ana Fernández-Cruz
- Unidad de Enfermedades Infecciosas (Medicina Interna), Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Fernando Domínguez
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Alberto Forteza
- Servicio de Cirugía Cardíaca, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Marta Cobo
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Isabel Sánchez-Romero
- Servicio de Microbiología, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Angel Asensio
- Servicio de Medicina Preventiva, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| |
Collapse
|
236
|
Roncero C, García-Ullán L, de la Iglesia-Larrad JI, Martín C, Andrés P, Ojeda A, González-Parra D, Pérez J, Fombellida C, Álvarez-Navares A, Benito JA, Dutil V, Lorenzo C, Montejo ÁL. The response of the mental health network of the Salamanca area to the COVID-19 pandemic: The role of the telemedicine. Psychiatry Res 2020; 291:113252. [PMID: 32623263 PMCID: PMC7329660 DOI: 10.1016/j.psychres.2020.113252] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/21/2020] [Accepted: 06/21/2020] [Indexed: 01/07/2023]
Abstract
The COVID-19 pandemic reached world-wide causing a great impact on healthcare services. The aim of this work is to describe the response of the Mental Health Network of the Salamanca´ Area (Spain) to this crisis and the reorganization of its resources within the first 8 weeks after the state of alarm was declared. The Psychiatry Service applied a contingency plan which included the reorganization of the human resources, the closure of some of the units and the implementation of telemedicine programs along with two specific programs, namely a mental health assistance program in the context of the infection by coronavirus, and another program for homeless people. 9.038 phone interviews were carried out in the outpatients and community mental health programs. The activity in subacute and acute wards, as well as that of the day hospital programs was decreased to 50%. Based on that this real-world response provided we concluded that the usage of telemedicine is promising in patients with any kind of disorder. Its implementation in daily practice will be considered in the future. Research must continue on COVID-19's impact on patients with mental disorders and Psychiatry's necessary adaptations and new approaches to them.
Collapse
Affiliation(s)
- Carlos Roncero
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain; Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain; School of Medicine, University of Salamanca, Salamanca, Spain.
| | - Llanyra García-Ullán
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain,School of Medicine, University of Salamanca, Salamanca, Spain
| | - Javier I. de la Iglesia-Larrad
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Carmen Martín
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Pilar Andrés
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Ana Ojeda
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain
| | - David González-Parra
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Javier Pérez
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Clara Fombellida
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain
| | - Ana Álvarez-Navares
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain
| | - José Antonio Benito
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain,School of Medicine, University of Salamanca, Salamanca, Spain
| | - Virginia Dutil
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain
| | - Carolina Lorenzo
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain,School of Medicine, University of Salamanca, Salamanca, Spain
| | - Ángel Luis Montejo
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain,School of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| |
Collapse
|
237
|
Jain VK, Iyengar KP, Samy DA, Vaishya R. Tuberculosis in the era of COVID-19 in India. Diabetes Metab Syndr 2020; 14:1439-1443. [PMID: 32755848 PMCID: PMC7387287 DOI: 10.1016/j.dsx.2020.07.034] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/14/2020] [Accepted: 07/18/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Tuberculosis (TB) still continues to be endemic in various regions of the world, including in India and needs surveillance, clinical assessment, testing, contact tracing, confirmation of diagnosis with supervised or in-supervised treatment regimens for an effective eradication. We assess the challenges due to COVID- 19 pandemic on management of Tuberculosis and current strategies adopted to mitigate them. METHODS We carried out a comprehensive review of the literature using suitable keywords such as 'COVID-19', 'Pandemics', 'Tuberculosis' and 'India' on the search engines of PubMed, Scopus, Google Scholar and Research Gate in the month of May 2020 during the current COVID-19 pandemic to assess the impact of COVID-19 on management of Tuberculosis. RESULTS We found considerable disruption in Tuberculosis service provisions both in the primary care and hospital settings. Lockdown, social distancing, isolation strategies and public health guidelines to prevent viral transmission impacted the delivery of all aspects of Tuberculosis care. CONCLUSIONS COVID-19 pandemic has had a significant impact in the delivery of various tuberculosis prevention, surveillance, and treatment programmes. Lockdown and public health guidelines have resulted in tough challenges in traditional management of tuberculosis and has required reconfiguration of methods to support patients including wider use of remote consultations.
Collapse
Affiliation(s)
- Vijay Kumar Jain
- Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India.
| | | | | | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, 110076, New Delhi, India.
| |
Collapse
|
238
|
Hao S, Ning K, Kuz CA, Vorhies K, Yan Z, Qiu J. Long Period Modeling SARS-CoV-2 Infection of in Vitro Cultured Polarized Human Airway Epithelium. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2020. [PMID: 32869024 DOI: 10.1101/2020.08.27.271130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replicates throughout human airways. The polarized human airway epithelium (HAE) cultured at an airway-liquid interface (HAE-ALI) is an in vitro model mimicking the in vivo human mucociliary airway epithelium and supports the replication of SARS-CoV-2. However, previous studies only characterized short-period SARS-CoV-2 infection in HAE. In this study, continuously monitoring the SARS-CoV-2 infection in HAE-ALI cultures for a long period of up to 51 days revealed that SARS-CoV-2 infection was long lasting with recurrent replication peaks appearing between an interval of approximately 7-10 days, which was consistent in all the tested HAE-ALI cultures derived from 4 lung bronchi of independent donors. We also identified that SARS-CoV-2 does not infect HAE from the basolateral side, and the dominant SARS-CoV-2 permissive epithelial cells are ciliated cells and goblet cells, whereas virus replication in basal cells and club cells was not detectable. Notably, virus infection immediately damaged the HAE, which is demonstrated by dispersed Zonula occludens-1 (ZO-1) expression without clear tight junctions and partial loss of cilia. Importantly, we identified that SARS-CoV-2 productive infection of HAE requires a high viral load of 2.5 × 10 5 virions per cm 2 of epithelium. Thus, our studies highlight the importance of a high viral load and that epithelial renewal initiates and maintains a recurrent infection of HAE with SARS-CoV-2.
Collapse
|
239
|
Díaz-Guio DA, Díaz-Guio Y, Pinzón-Rodas V, Díaz-Gomez AS, Guarín-Medina JA, Chaparro-Zúñiga Y, Ricardo-Zapata A, Rodriguez-Morales AJ. COVID-19: Biosafety in the Intensive Care Unit. CURRENT TROPICAL MEDICINE REPORTS 2020; 7:104-111. [PMID: 32868986 PMCID: PMC7449784 DOI: 10.1007/s40475-020-00208-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Purpose of Review COVID-19 is a new, highly transmissible disease to which healthcare workers (HCWs) are exposed, especially in the intensive care unit (ICU). Information related to protection mechanisms is heterogeneous, and the infected HCWs’ number is increasing. This review intends to summarize the current knowledge and practices to protect ICU personnel during the patient management process in the context of the current pandemic. Recent Findings The transmission mechanisms of SARS-CoV-2 are mainly respiratory droplets, aerosols, and contact. The virus can last for a few hours suspended in the air and be viable on surfaces for several days. Some procedures carried out in the ICU can generate aerosols. The shortage of respirators, such as the N95, has generated an increase in the demand for other protective equipment in critical care settings. Summary The probability of transmission depends on the characteristics of the pathogen, the availability of quality personal protective equipment, and the human factors associated with the performance of health workers. It is necessary to have knowledge of the virus and availability of the best possible personal protection equipment, develop skills for handling equipment, and develop non-technical skills during all intensive care process; this can be achieved through structured training.
Collapse
Affiliation(s)
- Diego Andrés Díaz-Guio
- Education and Simulation Research Group (EdSIMc), Centro de Simulación Clínica VitalCare, 16N street 14-50, Armenia, Colombia.,Critical Care Department, Hospital Universitario San Juan de Dios, Armenia, Colombia.,Doctoral Program in Education, Arts and Humanities Faculty, Universidad de Caldas, Manizales, Colombia
| | - Yimmy Díaz-Guio
- Education and Simulation Research Group (EdSIMc), Centro de Simulación Clínica VitalCare, 16N street 14-50, Armenia, Colombia.,Critical Care Department, Hospital Universitario San Juan de Dios, Armenia, Colombia
| | - Valentina Pinzón-Rodas
- Education and Simulation Research Group (EdSIMc), Centro de Simulación Clínica VitalCare, 16N street 14-50, Armenia, Colombia
| | - Ana Sofía Díaz-Gomez
- Education and Simulation Research Group (EdSIMc), Centro de Simulación Clínica VitalCare, 16N street 14-50, Armenia, Colombia
| | | | | | - Alejandra Ricardo-Zapata
- Education and Simulation Research Group (EdSIMc), Centro de Simulación Clínica VitalCare, 16N street 14-50, Armenia, Colombia
| | - Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda Colombia.,Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Sede Pereira, Pereira, Colombia
| |
Collapse
|
240
|
Bruyneel M, Gabrovska M, Rummens P, Roman A, Claus M, Stevens E, Dechamps P, Demey L, Truffaut L, Ninane V. Bronchoscopy in COVID-19 intensive care unit patients. Respirology 2020; 25:1313-1315. [PMID: 32844524 PMCID: PMC7460941 DOI: 10.1111/resp.13932] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/27/2020] [Accepted: 08/04/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Marie Bruyneel
- Department of Pneumology, CHU Saint-Pierre, Brussels, Belgium.,Université Libre de Bruxelles, Brussels, Belgium
| | - Maria Gabrovska
- Department of Pneumology, CHU Saint-Pierre, Brussels, Belgium.,Université Libre de Bruxelles, Brussels, Belgium
| | - Peter Rummens
- Department of Pneumology, CHU Saint-Pierre, Brussels, Belgium.,Université Libre de Bruxelles, Brussels, Belgium
| | - Alain Roman
- Université Libre de Bruxelles, Brussels, Belgium.,Department of Intensive Care Medicine, CHU Saint-Pierre, Brussels, Belgium
| | - Marc Claus
- Université Libre de Bruxelles, Brussels, Belgium.,Department of Intensive Care Medicine, CHU Saint-Pierre, Brussels, Belgium
| | - Etienne Stevens
- Université Libre de Bruxelles, Brussels, Belgium.,Department of Intensive Care Medicine, CHU Saint-Pierre, Brussels, Belgium
| | - Philippe Dechamps
- Université Libre de Bruxelles, Brussels, Belgium.,Department of Intensive Care Medicine, CHU Saint-Pierre, Brussels, Belgium
| | - Lucas Demey
- Department of Pneumology, CHU Saint-Pierre, Brussels, Belgium.,Université Libre de Bruxelles, Brussels, Belgium
| | - Laurent Truffaut
- Department of Pneumology, CHU Saint-Pierre, Brussels, Belgium.,Université Libre de Bruxelles, Brussels, Belgium
| | - Vincent Ninane
- Department of Pneumology, CHU Saint-Pierre, Brussels, Belgium.,Université Libre de Bruxelles, Brussels, Belgium
| |
Collapse
|
241
|
Hartley PD, Tillett RL, Aucoin DP, Sevinsky JR, Xu Y, Gorzalski A, Pandori M, Buttery E, Hansen H, Picker MA, Rossetto CC, Verma SC. Genomic surveillance revealed prevalence of unique SARS-CoV- 2 variants bearing mutation in the RdRp gene among Nevada patients.. [PMID: 32869037 PMCID: PMC7457609 DOI: 10.1101/2020.08.21.20178863] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Patients with signs of COVID-19 were tested with CDC approved diagnostic RT-PCR for SARS-CoV-2 using RNA extracted from nasopharyngeal/nasal swabs. In order to determine the variants of SARS-CoV-2 circulating in the state of Nevada, 200 patient specimens from COVID-19 patients were sequenced through our robust protocol for sequencing SARS-CoV-2 genomes. Our protocol enabled sequencing of SARS-CoV-2 genome directly from the specimens, with even very low viral loads, without the need of culture-based amplification. This allowed the identification of specific nucleotide variants including those coding for D614G and clades defining mutations. These sequences were further analyzed for determining SARS-CoV-2 variants circulating in the state of Nevada and their phylogenetic relationships with other variants present in the united states and the world during the same period of the outbreak. Our study reports the occurrence of a novel variant in the nsp12 (RNA dependent RNA Polymerase) protein at residue 323 (314aa of orf1b) to Phenylalanine (F) from Proline (P), present in the original isolate of SARS-CoV-2 (Wuhan-Hu-1). This 323F variant is found at a very high frequency (46% of the tested specimen) in Northern Nevada. Functional significance of this unique and highly prevalent variant of SARS-CoV-2 with RdRp mutation is currently under investigation but structural modeling showed this 323aa residue in the interface domain of RdRp, which is required for association with accessory proteins. In conclusion, we report the introduction of specific SARS-CoV-2 variants at a very high frequency within a distinct geographic location, which is important for clinical and public health perspectives in understanding the evolution of SARS-CoV-2 while in circulation.
Collapse
|
242
|
Suppan L, Abbas M, Stuby L, Cottet P, Larribau R, Golay E, Iten A, Harbarth S, Gartner B, Suppan M. Effect of an E-Learning Module on Personal Protective Equipment Proficiency Among Prehospital Personnel: Web-Based Randomized Controlled Trial. J Med Internet Res 2020; 22:e21265. [PMID: 32747329 PMCID: PMC7446759 DOI: 10.2196/21265] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 12/13/2022] Open
Abstract
Background To avoid misuse of personal protective equipment (PPE), ensure health care workers’ safety, and avoid shortages, effective communication of up-to-date infection control guidelines is essential. As prehospital teams are particularly at risk of contamination given their challenging work environment, a specific gamified electronic learning (e-learning) module targeting this audience might provide significant advantages as it requires neither the presence of learners nor the repetitive use of equipment for demonstration. Objective The aim of this study was to evaluate whether a gamified e-learning module could improve the rate of adequate PPE choice by prehospital personnel in the context of the coronavirus disease (COVID-19) pandemic. Methods This was an individual-level randomized, controlled, quadruple-blind (investigators, participants, outcome assessors, and data analysts) closed web-based trial. All emergency prehospital personnel working in Geneva, Switzerland, were eligible for inclusion, and were invited to participate by email in April 2020. Participants were informed that the study aim was to assess their knowledge regarding PPE, and that they would be presented with both the guidelines and the e-learning module, though they were unaware that there were two different study paths. All participants first answered a preintervention quiz designed to establish their profile and baseline knowledge. The control group then accessed the guidelines before answering a second set of questions, and were then granted access to the e-learning module. The e-learning group was shown the e-learning module right after the guidelines and before answering the second set of questions. Results Of the 291 randomized participants, 176 (60.5%) completed the trial. There was no significant difference in baseline knowledge between groups. Though the baseline proportion of adequate PPE choice was high (75%, IQR 50%-75%), participants’ description of the donning sequence was in most cases incorrect. After either intervention, adequate choice of PPE increased significantly in both groups (P<.001). Though the median of the difference in the proportion of correct answers was slightly higher in the e-learning group (17%, IQR 8%-33% versus 8%, IQR 8%-33%), the difference was not statistically significant (P=.27). Confidence in the ability to use PPE was maintained in the e-learning group (P=.27) but significantly decreased in the control group (P=.04). Conclusions Among prehospital personnel with an already relatively high knowledge of and experience with PPE use, both web-based study paths increased the rate of adequate choice of PPE. There was no major added value of the gamified e-learning module apart from preserving participants' confidence in their ability to correctly use PPE.
Collapse
Affiliation(s)
- Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mohamed Abbas
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Philippe Cottet
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Robert Larribau
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Eric Golay
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Anne Iten
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Birgit Gartner
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| |
Collapse
|
243
|
Martin G, Koizia L, Kooner A, Cafferkey J, Ross C, Purkayastha S, Sivananthan A, Tanna A, Pratt P, Kinross J. Use of the HoloLens2 Mixed Reality Headset for Protecting Health Care Workers During the COVID-19 Pandemic: Prospective, Observational Evaluation. J Med Internet Res 2020; 22:e21486. [PMID: 32730222 PMCID: PMC7431236 DOI: 10.2196/21486] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/13/2020] [Accepted: 07/27/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The coronavirus disease (COVID-19) pandemic has led to rapid acceleration in the deployment of new digital technologies to improve both accessibility to and quality of care, and to protect staff. Mixed-reality (MR) technology is the latest iteration of telemedicine innovation; it is a logical next step in the move toward the provision of digitally supported clinical care and medical education. This technology has the potential to revolutionize care both during and after the COVID-19 pandemic. OBJECTIVE This pilot project sought to deploy the HoloLens2 MR device to support the delivery of remote care in COVID-19 hospital environments. METHODS A prospective, observational, nested cohort evaluation of the HoloLens2 was undertaken across three distinct clinical clusters in a teaching hospital in the United Kingdom. Data pertaining to staff exposure to high-risk COVID-19 environments and personal protective equipment (PPE) use by clinical staff (N=28) were collected, and assessments of acceptability and feasibility were conducted. RESULTS The deployment of the HoloLens2 led to a 51.5% reduction in time exposed to harm for staff looking after COVID-19 patients (3.32 vs 1.63 hours/day/staff member; P=.002), and an 83.1% reduction in the amount of PPE used (178 vs 30 items/round/day; P=.02). This represents 222.98 hours of reduced staff exposure to COVID-19, and 3100 fewer PPE items used each week across the three clusters evaluated. The majority of staff using the device agreed it was easy to set up and comfortable to wear, improved the quality of care and decision making, and led to better teamwork and communication. In total, 89.3% (25/28) of users felt that their clinical team was safer when using the HoloLens2. CONCLUSIONS New technologies have a role in minimizing exposure to nosocomial infection, optimizing the use of PPE, and enhancing aspects of care. Deploying such technologies at pace requires context-specific information security, infection control, user experience, and workflow integration to be addressed at the outset and led by clinical end-users. The deployment of new telemedicine technology must be supported with objective evidence for its safety and effectiveness to ensure maximum impact.
Collapse
Affiliation(s)
- Guy Martin
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Division of Surgery, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Louis Koizia
- Cutrale Perioperative and Ageing Group, Imperial College London, London, United Kingdom
| | - Angad Kooner
- Division of Medicine, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - John Cafferkey
- Division of Medicine, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Clare Ross
- Division of Medicine, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Sanjay Purkayastha
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Division of Surgery, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Arun Sivananthan
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Anisha Tanna
- West London Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Philip Pratt
- The Helix Centre, Imperial College London, London, United Kingdom
| | - James Kinross
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Division of Surgery, Imperial College Healthcare NHS Trust, London, United Kingdom
| |
Collapse
|
244
|
Glenton C, Winje BA, Carlsen B, Eilers R, Wennekes MD, Lewin S. Healthcare workers’ perceptions and experiences of communicating with people over 50 about vaccination: a qualitative evidence synthesis. Hippokratia 2020. [DOI: 10.1002/14651858.cd013706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
| | | | - Benedicte Carlsen
- Department of health promotion and development; University of Bergen; Bergen Norway
| | - Renske Eilers
- Centre for Infectious Disease Control; National Institute for Public Health and the Environment (RIVM); Bilthoven Netherlands
| | | | - Simon Lewin
- Norwegian Institute of Public Health; Oslo Norway
- Health Systems Research Unit; South African Medical Research Council; Cape Town South Africa
| |
Collapse
|
245
|
Wee LE, Sim JXY, Conceicao EP, Aung MK, Tan JY, Venkatachalam I. Containment of COVID-19 among ancillary healthcare workers: an integral component of infection control. J Hosp Infect 2020; 106:392-396. [PMID: 32781199 PMCID: PMC7414694 DOI: 10.1016/j.jhin.2020.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 01/23/2023]
Affiliation(s)
- L E Wee
- Singhealth Infectious Diseases Residency, Singapore; Department of Infectious Diseases, Singapore General Hospital, Singapore.
| | - J X Y Sim
- Department of Infectious Diseases, Singapore General Hospital, Singapore; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - E P Conceicao
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - M K Aung
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - J Y Tan
- Department of Internal Medicine, Singapore General Hospital, Singapore
| | - I Venkatachalam
- Department of Infectious Diseases, Singapore General Hospital, Singapore; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| |
Collapse
|
246
|
Rincón A, Moreso F, López-Herradón A, Fernández-Robres MA, Cidraque I, Nin J, Méndez O, López M, Pájaro C, Satorra À, Stuard S, Ramos R. The keys to control a COVID-19 outbreak in a haemodialysis unit. Clin Kidney J 2020; 13:542-549. [PMID: 32885797 PMCID: PMC7454433 DOI: 10.1093/ckj/sfaa119] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/25/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The high rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreading represents a challenge to haemodialysis (HD) units. While fast isolation of suspected cases plays an essential role to avoid disease outbreaks, significant rates of asymptomatic cases have recently been described. After detecting an outbreak in one of our HD clinics, wide SARS-CoV-2 screening and segregation of confirmed cases were performed. METHODS The entire clinic population, 192 patients, underwent testing for SARS-CoV-2 detection by real-time reverse-transcriptase polymerase chain reaction . We used univariate and multivariate logistic regression to define variables involved in SARS-CoV-2 infection in our dialysis unit. Later, we analysed differences between symptomatic and asymptomatic SARS-CoV-2-positive patients. RESULTS In total, 22 symptomatic and 14 of the 170 asymptomatic patients had a SARS-CoV-2-positive result. Living in a nursing home/homeless [odds ratio (OR) 3.54; P = 0.026], having been admitted to the reference hospital within the previous 2 weeks (OR 5.19; P = 0.002) and sharing health-care transportation with future symptomatic (OR 3.33; P = 0.013) and asymptomatic (OR 4.73; P = 0.002) positive patients were independent risk factors for a positive test. Nine positive patients (25.7%) remained asymptomatic after a 3-week follow-up. We found no significant differences between symptomatic and asymptomatic SARS-CoV-2-positive patients. CONCLUSIONS Detection of asymptomatic SARS-CoV-2-positive patients is probably one of the key points to controlling an outbreak in an HD unit. Sharing health-care transportation to the dialysis unit, living in a nursing home and having been admitted to the reference hospital within the previous 2 weeks, are major risk factors for SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Abraham Rincón
- Medical Department, Fresenius Medical Care Spain, Madrid, Spain
| | - Francesc Moreso
- Medical Department, Fresenius Medical Care Spain, Madrid, Spain
| | | | | | - Ignacio Cidraque
- Tarrasa Dialysis Center, Fresenius Medical Care Spain, Tarrasa, Barcelona, Spain
| | - Jordi Nin
- Hospitalet Dialysis Center, Fresenius Medical Care Spain, Hospitalet de Llobregat, Barcelona, Spain
| | - Orleans Méndez
- Hospitalet Dialysis Center, Fresenius Medical Care Spain, Hospitalet de Llobregat, Barcelona, Spain
| | - Marisol López
- Hospitalet Dialysis Center, Fresenius Medical Care Spain, Hospitalet de Llobregat, Barcelona, Spain
| | - Carlota Pájaro
- Tarrasa Dialysis Center, Fresenius Medical Care Spain, Tarrasa, Barcelona, Spain
| | - Àngels Satorra
- Hospitalet Dialysis Center, Fresenius Medical Care Spain, Hospitalet de Llobregat, Barcelona, Spain
| | - Stefano Stuard
- Global Medical Office - Clinical & Therapeutic Governance EMEA, Fresenius Medical Care, Bad Homburg, Germany
| | - Rosa Ramos
- Medical Department, Fresenius Medical Care Spain, Madrid, Spain
| |
Collapse
|
247
|
The efficacy of PPE for COVID-19-type respiratory illnesses in primary and community care staff. Br J Gen Pract 2020; 70:413-416. [PMID: 32661012 DOI: 10.3399/bjgp20x710969] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
|
248
|
Fenn D, Coppel J, Kearney J, Everson L, Braithwaite S, Chodhari R. Walkie talkies to aid health care workers' compliance with personal protective equipment in the fight against COVID-19. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2020; 24:424. [PMID: 32660612 PMCID: PMC7356127 DOI: 10.1186/s13054-020-03150-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/03/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Dominic Fenn
- Asthma Innovation Research, London, UK. .,Department of Respiratory Medicine, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Jonny Coppel
- Asthma Innovation Research, London, UK.,Department of Intensive Care, Royal Free Hospital, Barnet site, London, UK
| | - Jessica Kearney
- Asthma Innovation Research, London, UK.,Department of Medicine, Kings College Hospital, London, UK
| | - Lucy Everson
- Asthma Innovation Research, London, UK.,Department of Obstetrics and Gynecology, Southmead Hospital, Bristol, UK
| | - Simon Braithwaite
- Asthma Innovation Research, London, UK.,Department of Radiology, John Radcliff Hospital, Oxford, UK
| | - Rahul Chodhari
- Asthma Innovation Research, London, UK.,Department of Paediatrics, Royal Free Hospital, London, UK
| |
Collapse
|
249
|
Shamekh A, Mahmoodpoor A, Sanaie S. COVID-19: Is it the black death of the 21st century? Health Promot Perspect 2020; 10:166-167. [PMID: 32802750 PMCID: PMC7420170 DOI: 10.34172/hpp.2020.27] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/30/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Ali Shamekh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ata Mahmoodpoor
- Anesthesiology and Critical Care Department, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sarvin Sanaie
- Neurosciences Research Center, Aging Research institute, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
250
|
Garcia-Basteiro AL, Moncunill G, Tortajada M, Vidal M, Guinovart C, Jiménez A, Santano R, Sanz S, Méndez S, Llupià A, Aguilar R, Alonso S, Barrios D, Carolis C, Cisteró P, Chóliz E, Cruz A, Fochs S, Jairoce C, Hecht J, Lamoglia M, Martínez MJ, Mitchell RA, Ortega N, Pey N, Puyol L, Ribes M, Rosell N, Sotomayor P, Torres S, Williams S, Barroso S, Vilella A, Muñoz J, Trilla A, Varela P, Mayor A, Dobaño C. Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital. Nat Commun 2020; 11:3500. [PMID: 32641730 PMCID: PMC7343863 DOI: 10.1038/s41467-020-17318-x] [Citation(s) in RCA: 264] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/19/2020] [Indexed: 01/19/2023] Open
Abstract
Health care workers (HCW) are a high-risk population to acquire SARS-CoV-2 infection from patients or other fellow HCW. This study aims at estimating the seroprevalence against SARS-CoV-2 in a random sample of HCW from a large hospital in Spain. Of the 578 participants recruited from 28 March to 9 April 2020, 54 (9.3%, 95% CI: 7.1-12.0) were seropositive for IgM and/or IgG and/or IgA against SARS-CoV-2. The cumulative prevalence of SARS-CoV-2 infection (presence of antibodies or past or current positive rRT-PCR) was 11.2% (65/578, 95% CI: 8.8-14.1). Among those with evidence of past or current infection, 40.0% (26/65) had not been previously diagnosed with COVID-19. Here we report a relatively low seroprevalence of antibodies among HCW at the peak of the COVID-19 epidemic in Spain. A large proportion of HCW with past or present infection had not been previously diagnosed with COVID-19, which calls for active periodic rRT-PCR testing in hospital settings.
Collapse
Affiliation(s)
- Alberto L Garcia-Basteiro
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
- International Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
| | - Gemma Moncunill
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Marta Tortajada
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Marta Vidal
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Alfons Jiménez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sergi Sanz
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Basic Clinical Practice, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Susana Méndez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Anna Llupià
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Selena Alonso
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Diana Barrios
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Carlo Carolis
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Pau Cisteró
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Eugenia Chóliz
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Angeline Cruz
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Silvia Fochs
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Chenjerai Jairoce
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Jochen Hecht
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Montserrat Lamoglia
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Faculty of Health Sciences of Blanquerna, Universitat Ramon Llull de Barcelona, Barcelona, Spain
| | - Mikel J Martínez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Department of Microbiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Robert A Mitchell
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Natalia Ortega
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Nuria Pey
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Laura Puyol
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Marta Ribes
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Neus Rosell
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | | | - Sara Torres
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sarah Williams
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Sonia Barroso
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Anna Vilella
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - José Muñoz
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- International Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Trilla
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Pilar Varela
- Occupational Health Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| |
Collapse
|