COVID-19: Lessons to be learnt from a once-in-a-century global pandemic

Staying silent during a crisis: How workplace factors influence safety decisions in U.S. nurses

RATIONALE

It is critical for healthcare organizations to promote upward communication of safety information to ensure safety issues experienced on the work floor are promptly identified and addressed, especially during crisis events.

OBJECTIVE

This study investigates mechanisms through which workplace factors affect nurses' motivation to speak up about safety issues, and ultimately their safety behaviors, in a pandemic work environment.

METHOD

The work experiences of 152 frontline U.S. nurses were captured across three time-points during the height of a global pandemic.

RESULTS

Findings indicate that nurses who experienced a greater frequency of pandemic-related demands and/or perceived a greater social risk associated with voicing concerns were more likely to remain silent about safety issues due to job-related constraints or a fear of negatively impacting their reputation, respectively. As a consequence, nurses were more likely to bypass safety protocols while completing work tasks, especially those who had a lower risk propensity.

CONCLUSION

These findings advance the literature on workplace safety by investigating factors that affect employee communication and ultimately safety workarounds in nurses within the context of a global pandemic.

Interrogating the lack of diversity of thought in the pandemic response that led to mistakes - holistic evidence-based approach to deal with future pandemics

The COVID-19 pandemic, triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), rapidly became a worldwide emergency. How it was managed garnered both commendation and vehement censure. This crisis profoundly affected healthcare, the economy, education, and public confidence in scientific endeavors. Our primary aim was to scrutinize the shortcomings in the pandemic management and to articulate a more effective strategy for handling prospective pandemics. We delved into the errors encountered in the COVID-19 response and posited a holistic, evidence-grounded approach for future pandemic mitigation.

Recent Developments of Actuation Mechanisms for Continuum Robots: A Review

Traditional rigid robots face significant challenges in congested and tight environments, including bulky size, maneuverability, and safety limitations. Thus, soft continuum robots, inspired by the incredible capabilities of biological appendages such as octopus arms, starfish, and worms, have shown promising performance in complex environments due to their compliance, adaptability, and safety. Different actuation techniques are implemented in soft continuum robots to achieve a smoothly bending backbone, including cable-driven actuators, pneumatic actuators, and hydraulic actuation systems. However, designing and developing efficient actuation mechanisms, motion planning approaches, and control algorithms are challenging due to the high degree of redundancy and non-linearity of soft continuum robots. This article profoundly reviews the merits and drawbacks of soft robots' actuation systems concerning their applications to provide the readers with a brief review reference to explore the recent development of soft robots' actuation mechanisms technology. Moreover, the authors have surveyed the recent review studies in controller design of continuum robots as a guidance for future applications.

The impact of loneliness on compliance with COVID-19 prevention guidelines

Many individuals have been reluctant to follow the COVID-19 prevention guidelines (e.g., wearing a mask, physical distancing, and vigilant handwashing) set forth by the U.S. Center for Disease Control to reduce the spread of COVID-19. In this research, we use reciprocal altruism theory to investigate the role of loneliness and its impact on compliance with these guidelines. Our findings indicate that lonely individuals are less willing to comply with COVID-19 prevention guidelines than non-lonely individuals. Process evidence suggests that this occurs as loneliness can inhibit an individual's sense of obligation to reciprocate to others. However, we demonstrate that framing information about COVID-19 through agentic (vs. communal) advertising messaging strategies can offset the negative impact of loneliness on compliance with COVID-19 prevention guidelines. Thus, marketers and policymakers may want to consider the important role of loneliness when tailoring messaging appeals that encourage compliance with COVID-19 prevention guidelines.

Do solar cycles explain the emergence of COVID-19? Neutron count comparison between the solar minima of 2008-2009 and 2019-2020

Cosmic rays are believed to be mutagenic and can stimulate virus mutation through point mutations. Neutron count on Earth ground stations is a reliable proxy to quantify cosmic ray flux. A previous study reported that the maximum flux of cosmic rays in November 2019 could be related to the emergence of COVID-19 (late November to early December). Using the latest neutron count data, this study investigated if the data from 2019 to 2020 could specifically explain the emergence of pandemic (COVID-19). The results indicate that there is no significant difference between the previous two last solar minima datasets (2008-2009 and 2019-2020; n = 24, p = 0.60). This suggests that the solar minima of 2019-2020 did not experience an increase in cosmic rays and the emergence of COVID-19 could not be solely explained by cosmic ray flux caused by solar cycles (space weather change).

Collaborative conversations during the time of COVID-19: Building a "meta"-learning community

PROBLEM

COVID-19 created new research, clinical, educational, and personal challenges, while simultaneously separating work teams who were under work-from-home restrictions. Addressing these challenges required new forms of collaborative groups.

APPROACH

To support the department community and the rapid sharing of new research, educational, clinical, and personal efforts, a Core Team from the Department of Learning Health Sciences at the University of Michigan developed a meeting series called the COVID Conversations. This Experience Report shares the organizational structure of the COVID Conversations, proposes a comparison to traditional Learning Communities, and reports the results of a questionnaire that gathered details about department members' COVID-related activities.

OUTCOMES

We identify and describe salient similarities and differences between the COVID Conversations and the characteristics of Learning Communities. We also developed and piloted a taxonomy for characterizing LHS research projects that may be further developed for use in Learning Community planning, in conjunction with other maturity grids and ontologies. We propose the term "Meta-Learning Community" to describe the structure and function of the COVID Conversations.

NEXT STEPS

In academic medicine, remote work, telemedicine, and virtual learning may be here to stay. The COVID Conversations constitute a distinct and innovative form of collaborative work in which separate teams addressing distinct goals, yet sharing a common passion to tackle the issues brought by the pandemic, are able to share experiences and learn from one other. The challenges of COVID-19 have made evident the need for multiple forms of organizing teamwork, and our study contributes the notion of a "Meta"-Learning Community as a new form of collaborative work.

Recent review of COVID-19 management: diagnosis, treatment and vaccination

The idiopathic Coronavirus disease 2019 (COVID-19) pandemic outbreak caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reached global proportions; the World Health Organization (WHO) declared it as a public health emergency during the month of January 30, 2020. The major causes of the rise of new variants of SARS-CoV-2 are genetic mutations and recombination. Some of the variants with high infection and transmission rates are termed as variants of concern (VOCs) like currently Omicron variants. Pregnant women, aged people, and immunosuppressed and compromised patients constitute the most susceptible human population to the SARS-CoV-2 infection, especially to the new evolving VOCs. To effectively manage the pathological condition of infection, the focus should be directed towards prevention and prophylactic approach. In this narrative review, we aimed to analyze the current scenario of COVID-19 management and discuss the treatment and prevention strategies. We also focused on the complications prevalent during the COVID-19 and post-COVID period and to discuss the novel approaches developed for mitigation of the global pandemic. We have also emphasized on the COVID-19 management approaches for the special population including children, pregnant women, aged groups, and immunocompromised patients. We conclude that the advancements in therapeutic and pharmacological domains have provided opportunities to develop and design novel diagnosis, treatment, and prevention strategies. New advanced techniques such as RT-LAMP, RT-qPCR, High-Resolution Computed Tomography, etc., efficiently diagnose patients with SARS-CoV-2 infection. In the case of treatment options, new drugs like paxlovid, combinations of β-lactum drugs and molnupiravir are found to be effective against even the new emerging variants. In addition, vaccination is an essential approach to prevent the infection or to reduce its severity. Vaccines for against COVID-19 from Comirnaty by Pfizer-BioNTech, SpikeVax by Moderna, and Vaxzevria by Oxford-AstraZeneca are approved and used widely. Similarly, numerous vaccines have been developed with different percentages of effectiveness against VOCs. New developments like nanotechnology and AI can be beneficial in providing an efficient and reliable solution for the suppression of SARS-CoV-2. Public health concerns can be efficiently treated by a unified scientific approach, public engagement, and better diagnosis.

Serum ferritin at admission in hospitalized COVID-19 patients as a predictor of mortality

Introduction

Some COVID-19 patients have higher mortality and the responsible factors for this unfavorable outcome is still not well understood.

Objective

To study the association between ferritin levels at admission, representing an inflammatory state, and hospital mortality in COVID-19 patients.

Methods

From May through July 2020, SARS-CoV-2 positive patients with moderate to severe clinical symptoms were evaluated at admission, regarding clinical and laboratory data on renal and hepatic function, hematologic parameters, cytomegalovirus co-infection, and acute phase proteins.

Results

A total of 97 patients were included; mean age = 59.9 ± 16.3 years, 58.8% male, 57.7% non-white, in-hospital mortality = 45.4%. Age, ferritin, C-reactive protein, serum albumin and creatinine were significantly associated with mortality. Ferritin showed area under the curve (AUC) of 0.79 (p < 0.001) for the cut-off of 1873.0 ng/mL, sensitivity of 68.4% and specificity of 79.3% in predicting in-hospital mortality. Age ≥60 years had an odds ratio (OR) of 10.5 (95% CI = 1.8–59.5; p = 0.008) and ferritin ≥1873.0 ng/mL had an OR of 6.0 (95% CI = 1.4–26.2; p = 0.016), both independently associated with mortality based on logistic regression analysis.

Conclusion

The magnitude of inflammation present at admission of COVID-19 patients, represented by high ferritin levels, is independently predictive of in-hospital mortality.

COVID-19 in Australia: our national response to the first cases of SARS-CoV-2 infection during the early biocontainment phase

BACKGROUND

On 31 December 2019, the World Health Organization recognised clusters of pneumonia-like cases due to a novel coronavirus disease (COVID-19). COVID-19 became a pandemic 71 days later.

AIM

To report the clinical and epidemiological features, laboratory data and outcomes of the first group of 11 returned travellers with COVID-19 in Australia.

METHODS

This is a retrospective, multi-centre case series. All patients with confirmed COVID-19 infection were admitted to tertiary referral hospitals in New South Wales, Queensland, Victoria and South Australia.

RESULTS

The median age of the patient cohort was 42 years (interquartile range (IQR), 24-53 years) with six men and five women. Eight (72.7%) patients had returned from Wuhan, one from Shenzhen, one from Japan and one from Europe. Possible human-to-human transmission from close family contacts in gatherings overseas occurred in two cases. Symptoms on admission were fever, cough and sore throat (n = 9, 81.8%). Co-morbidities included hypertension (n = 3, 27.3%) and hypercholesterolaemia (n = 2, 18.2%). No patients developed severe acute respiratory distress nor required intensive care unit admission or mechanical ventilation. After a median hospital stay of 14.5 days (IQR, 6.75-21), all patients were discharged.

CONCLUSIONS

This is a historical record of the first COVID-19 cases in Australia during the early biocontainment phase of the national response. These findings were invaluable for establishing early inpatient and outpatient COVID-19 models of care and informing the management of COVID-19 over time as the outbreak evolved. Future research should extend this Australian case series to examine global epidemiological variation of this novel infection.

At the Epicenter of COVID-19-the Tragic Failure of the Global Supply Chain for Medical Supplies

The tragic failure of the global supply chain in the face of the current coronavirus outbreak has caused acute shortages of essential frontline medical devices and personal protective equipment, crushing fear among frontline health workers and causing fundamental concerns about the sustainability of the health system. Much more coordination, integration, and management of global supply chains will be needed to mitigate the impact of the pandemics. This article describes the pressing need to revisit the governance and resilience of the supply chains that amplified the crisis at pandemic scale. We propose a model that profiles critical stockpiles and improves production efficiency through new technologies such as advanced analytics and blockchain. A new governance system that supports intervention by public-health authorities during critical emergencies is central to our recommendation, both in the face of the current crisis and to be better prepared for potential future crises. These reinforcements offer the potential to minimize the compromise of our healthcare workers and health systems due to infection exposure and build capacity toward preparedness and action for a future outbreak.