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Nur AM, Aljunid SM, Almari M. Cost of in-patient management of COVID-19 patients in a general hospital in Kuwait. BMC Health Serv Res 2023; 23:1314. [PMID: 38017444 PMCID: PMC10685622 DOI: 10.1186/s12913-023-10287-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 11/06/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Among the GCC countries affected by COVID-19 infections, Kuwait has been significantly impacted, with 658,520 cases and 2,563 deaths reported by the WHO on September 30, 2022. However, the impact of the COVID-19 epidemic on Kuwait's economy, especially in the healthcare sector, remains unknown. OBJECTIVE This study aims to determine the total cost of managing COVID-19 in-patients in Kuwait. METHOD A cross-sectional design was employed for this study. A total of 485 COVID-19 patients admitted to a general hospital responsible for COVID-19 cases management were randomly selected for this study from May 1st to September 31st, 2021. Data on sociodemographic information, length of stay (LOS), discharge status, and comorbidities were obtained from the patients' medical records. The data on costs in this study cover administration, utility, pharmacy, radiology, laboratory, nursing, and ICU costs. The unit cost per admission was calculated using a step-down costing method with three levels of cost centers. The unit cost was then multiplied by the individual patient's length of stay to determine the cost of care per patient per admission. FINDINGS The mean cost of COVID-19 in-patient care per admission was KD 2,216 (SD = 2,018), which is equivalent to USD 7,344 (SD = 6,688), with an average length of stay of 9.4 (SD = 8.5) days per admission. The total treatment costs for COVID-19 in-patients (n = 485) were estimated to be KD 1,074,644 (USD 3,561,585), with physician and nursing care costs constituting the largest share at 42.1%, amounting to KD 452,154 (USD 1,498,529). The second and third-largest costs were intensive care (20.6%) at KD 221,439 (USD 733,893) and laboratory costs (10.2%) at KD 109,264 (USD 362,123). The average cost for severe COVID-19 patients was KD 4,626 (USD 15,332), which is almost three times higher than non-severe patients of KD 1,544 (USD 5,117). CONCLUSION Managing COVID-19 cases comes with substantial costs. This cost information can assist hospital managers and policymakers in designing more efficient interventions, especially for managing high-risk groups.
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Affiliation(s)
- Amrizal Muhammad Nur
- Department of Health Policy and Management, College of Public Health, Kuwait University, Shadadiya, Kuwait.
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, College of Public Health, Kuwait University, Shadadiya, Kuwait
- Department of Public Health and Community Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Mohammad Almari
- Department of Health Policy and Management, College of Public Health, Kuwait University, Shadadiya, Kuwait
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Martínez-Redondo J, Comas C, García-Serrano C, Crespo-Pons M, Biendicho Palau P, Vila Parrot T, Reventoz Martínez F, Aran Solé L, Arola Serra N, Tarragona Tassies E, Pujol Salud J. Population Older than 69 Had Similar Fatality Rates Independently If They Were Admitted in Nursing Homes or Lived in the Community: A Retrospective Observational Study during COVID-19 First Wave. Geriatrics (Basel) 2023; 8:geriatrics8030048. [PMID: 37218828 DOI: 10.3390/geriatrics8030048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/22/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023] Open
Abstract
The aim of this study is to assess the influence of living in nursing homes on COVID-19-related mortality, and to calculate the real specific mortality rate caused by COVID-19 among people older than 20 years of age in the Balaguer Primary Care Centre Health Area during the first wave of the pandemic. We conducted an observational study based on a database generated between March and May 2020, analysing COVID-19-related mortality as a dependent variable, and including different independent variables, such as living in a nursing home or in the community (outside nursing homes), age, sex, symptoms, pre-existing conditions, and hospital admission. To evaluate the associations between the independent variables and mortality, we calculated the absolute and relative frequencies, and performed a chi-square test. To avoid the impact of the age variable on mortality and to assess the influence of the "living in a nursing home" variable, we established comparisons between infected population groups over 69 years of age (in nursing homes and outside nursing homes). Living in a nursing home was associated with a higher incidence of COVID-19 infection, but not with higher mortality in patients over 69 years of age (p = 0.614). The real specific mortality rate caused by COVID-19 was 2.270/00. In the study of the entire sample, all the comorbidities studied were associated with higher mortality; however, the comorbidities were not associated with higher mortality in the infected nursing home patients group, nor in the infected community patients over 69 years of age group (except for neoplasm history in this last group). Finally, hospital admission was not associated with lower mortality in nursing home patients, nor in community patients over 69 years of age.
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Affiliation(s)
| | - Carles Comas
- Department of Mathematics, Campus ETSEAFIV, University of Lleida, 25001 Lleida, Spain
| | - Cristina García-Serrano
- Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain
- Research Group in Therapies in Primary Care (RETICAP Group), 25007 Lleida, Spain
| | | | - Pilar Biendicho Palau
- Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain
| | - Teresa Vila Parrot
- Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain
| | | | - Lídia Aran Solé
- Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain
| | - Neus Arola Serra
- Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain
| | - Eva Tarragona Tassies
- Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain
| | - Jesús Pujol Salud
- Balaguer Primary Care Center, Institut Català de la Salut (ICS), 25600 Lleida, Spain
- Biomedical Research Institute (IRB Lleida), University of Lleida (UdL), 25198 Lleida, Spain
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Mghamba J, Gilmour E, Robinson L, Simba A, Tuyishime A, Persaud A, Mwansambo C, Somatunga L, Werema S, Mchwampaka W, Makundi V, Remedius K, Ronjiono F, Mutayoba B, Dushime T, Rwagasore E, Byiringiro B, Mugumya S, Muvunyi C, Anthony F, Singh N, Wu JTS, Yosefe S, Dube Q, Mayakaduwa N, Wadugedara R. The use of innovative approaches to strengthen health system resilience during the COVID-19 pandemic: case studies from selected Commonwealth countries. Front Public Health 2023; 11:1115415. [PMID: 37181718 PMCID: PMC10173743 DOI: 10.3389/fpubh.2023.1115415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 03/27/2023] [Indexed: 05/16/2023] Open
Abstract
This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. The COVID-19 pandemic has exposed the vulnerabilities and limitations of many health systems and underscored the need for strengthening health system resilience to make and sustain progress toward Universal Health Coverage (UHC), global health security and healthier populations in tandem. In response to the COVID-19 pandemic, Commonwealth countries have been practicing a combination of innovative integrated approaches and actions to build health systems resilience. This includes utilizing digital tools, improvements in all-hazard emergency risk management, developing multisectoral partnerships, strengthening surveillance and community engagement. These interventions have been instrumental in strengthening national COVID-19 responses and can contribute to the evidence-base for increasing country investment into health systems resilience, particularly as we look toward COVID-19 recovery. This paper gives perspectives of five Commonwealth countries and their overall responses to the pandemic, highlighting practical firsthand experiences in the field. The countries included in this paper are Guyana, Malawi, Rwanda, Sri Lanka, and Tanzania. Given the diversity within the Commonwealth both in terms of geographical location and state of development, this publication can serve as a useful reference for countries as they prepare their health systems to better absorb the shocks that may emerge in future emergencies.
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Affiliation(s)
- Janneth Mghamba
- Commonwealth Secretariat, London, United Kingdom
- *Correspondence: Janneth Mghamba,
| | | | | | - Azma Simba
- Ministry of Health, Community Development, Gender, Elderly and Children (Tanzania), Dar es Salaam, Tanzania
| | | | | | | | | | - Solomon Werema
- Ministry of Health, Community Development, Gender, Elderly and Children (Tanzania), Dar es Salaam, Tanzania
| | - Witness Mchwampaka
- Ministry of Health, Community Development, Gender, Elderly and Children (Tanzania), Dar es Salaam, Tanzania
| | - Vida Makundi
- Ministry of Health, Community Development, Gender, Elderly and Children (Tanzania), Dar es Salaam, Tanzania
| | - Kakulu Remedius
- Ministry of Health, Community Development, Gender, Elderly and Children (Tanzania), Dar es Salaam, Tanzania
| | - Fidelis Ronjiono
- Ministry of Health, Community Development, Gender, Elderly and Children (Tanzania), Dar es Salaam, Tanzania
| | - Beatrice Mutayoba
- Ministry of Health, Community Development, Gender, Elderly and Children (Tanzania), Dar es Salaam, Tanzania
| | | | | | | | | | | | | | | | | | | | - Queen Dube
- Ministry of Health (Malawi), Lilongwe, Malawi
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Balakrishnan JM, Sirur FM, Prakash N, Bhat R, Wilson W, Angadi B, Asanar S. Portable Biosafety Barrier Innovations to Limit Transmissibility of Infectious Diseases during Patient Care in Resource-limited Settings during the COVID-19 Pandemic. Indian J Crit Care Med 2022; 26:1036-1038. [PMID: 36213704 PMCID: PMC9492750 DOI: 10.5005/jp-journals-10071-24307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 01/25/2023] Open
Abstract
Background The coronavirus disease-2019 (COVID-19) pandemic has brought about a change in healthcare practices that are likely to persist into the foreseeable future. In particular, is the exposure risk to the healthcare practitioners in the emergency department (ED) and the intensive care units. Mitigating this issue in a low-resource setting remains challenging, and in particular, in developing nations such as India, where ED patient flows can overwhelm a system and its human resources, breaking down processes and infecting healthcare workers (HCWs). Technique To tackle this and the possible lack of appropriate personal protective equipment (PPE), we designed and built biosafety barrier devices using local resources for use in patient stabilization, transport, and continued care in the ED or the intensive care units. Results Four biosafety devices bio-safe levels 1 and 2, ultra-ductile portable interface of interventions in infections, and tented transport trolley for transmissibility (4T) were tested for the feasibility of usage for patient care during the pandemic with simulation. Conclusion We anticipate that with time it may be common practice for in situ isolation of patients in the emergency departments with a suspicion of an infectious disease. With the proof of concept, simulation, hospital infection control committee (HICC) approval, and trial run, we look to close the gaps that exist in these initial innovations. How to cite this article Balakrishnan JM, Sirur FM, Prakash N, Bhat R, Wilson W, Angadi B, et al. Portable Biosafety Barrier Innovations to Limit Transmissibility of Infectious Diseases during Patient Care in Resource-limited Settings during the COVID-19 Pandemic. Indian J Crit Care Med 2022;26(9):1036–1038.
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Affiliation(s)
- Jayaraj Mymbilly Balakrishnan
- Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Freston Marc Sirur
- Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Freston Marc Sirur, Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India, Phone: +91 9604200840, e-mail:
| | - Nayan Prakash
- Department of Biomedical Engineering, Manipal Institute of Technology, Manipal, Karnataka, India
| | - Rachana Bhat
- Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - William Wilson
- Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Bharath Angadi
- Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sanjan Asanar
- Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Kurt Alkan T, Taşdemir N, Yıldırım Tank D. The Relation Between Fear of COVID-19, Burnout Levels of Intensive Care Nurses. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221123154. [PMID: 36036182 DOI: 10.1177/00302228221123154] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
We aimed to examine the relation between the fear of COVID-19 and depression, anxiety and burnout of intensive carenurses. This cross-sectional and descriptive research was conducted with 116 intensive care nurses. The data were obtained with a web-based questionnaire created with the "Descriptive Information Form", "COVID-19 Fear Scale", "Depression, Anxiety and Stress Scale Short Form" and "Burnout Short Version". A significant positive correlation was found between depression (r = 0.498, p < .001), anxiety (r = 0.633, p < .001), stress (r = 0.589, p < .001) and burnout (r = 0.299, p = .001) levels of intensive care nurses with a mean age of 30.18 ± 6.55 with the help of the "COVID-19 Fear Scale". It was determined that the mental health of intensive care nurses was at risk and they reached the level of burnout. Intensive care nurses should be supported in understanding the symptoms of psychological problems and in stress management, personal and professional self-care. Receiving professional mental health support when necessary.
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Affiliation(s)
- Tülin Kurt Alkan
- Department of Surgical Nursing, Institute of Health Sciences, Zonguldak Bülent Ecevit University, Kozlu, Turkey
| | - Nurten Taşdemir
- Department of Nursing, Faculty of Health Sciences, Zonguldak Bülent Ecevit University, Kozlu, Turkey
| | - Dilek Yıldırım Tank
- Department of Nursing, Faculty of Health Sciences, Zonguldak Bülent Ecevit University, Kozlu, Turkey
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Öz Y. Analytical investigation of compartmental models and measure for reactions of governments. THE EUROPEAN PHYSICAL JOURNAL. E, SOFT MATTER 2022; 45:68. [PMID: 35978210 PMCID: PMC9385104 DOI: 10.1140/epje/s10189-022-00225-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic poses a major threat to the worldwide health care. In this context, epidemic modelling is an integral part of containment strategies. Compartmental models are typically used for this purpose. Analytical solutions of the two distinct but connected Susceptible-Infectious-Recovered-Deceased (SIRD) and Susceptible-Infectious-Quarantine-Recovered (SIQR) models are presented in this study. Furthermore, the behaviour at the start of a disease outbreak is derived. This analysis shows that a combination of transmission, recovery and isolation rates dominates the behaviour at the start of an epidemic. In addition, the loss occurring due to quarantine and lockdown measures is investigated, where it can be observed that quarantine procedures lead to a smaller loss in comparison with lockdown regulations. Within this framework, optimized strategies that lead to a constant epidemic peak or a minimized loss are presented.
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Affiliation(s)
- Yahya Öz
- Department of Research and Technology Centers, R &D and Technology Directorate, Turkish Aerospace, 06980, Ankara, Turkey.
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Development and Validation of COVID-19 Stress Scale (CSS) in an Iranian Non-Clinical Population. ZAHEDAN JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022. [DOI: 10.5812/zjrms-118719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
: Coronavirus disease 2019 (COVID-19) generated profound concerns in public. However, few validated scales measure COVID-related stress. We developed and psychometrically assessed a unique COVID-19 Stress Scale (CSS) in an Iranian non-clinical population. The CSS was developed to evaluate the existing stress measures, specialists' reviews, and interviews with healthy individuals. Experts provided feedback on content validity. The correlation of CSS with the Depression, Anxiety, and Stress Scale 21 (DASS-21) was evaluated to assess convergent validity. Moreover, construct validity and reliability were assessed. Seven items were found acceptable after experts' review. The online method was used to collect information due to the dangerous conditions of COVID-19 and traffic restrictions in Iran. The scale link was shared as an invitation on the virtual social network pages for people to respond. The statistical population of this study included all Iranian people aged 18 - 60. All 755 people, including 511 females and 244 males who completed the questionnaire online, were selected as a sample. Confirmatory Factor Analysis (CFA) showed a one-factor structure. Correlations between items were acceptable, with item-total correlations being 0.49 - 0.58. The CFA resulted in acceptable factor loadings and fit statistics. Internal consistency reliability was found as α = 0.74. Regarding convergent validity, CSS had moderate to strong correlations with the depression (r = 0.53), anxiety (r = 0.59), and stress (r = 0.64) subscales of DASS-21 (P < 0.05). The seven-item CSS demonstrated acceptable psychometric properties and can be a useful measure of research and evaluation. There is a need to test the scale's validity in a random sample and other nationalities.
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Ergen P, Koçoğlu ME, Nural M, Kuşkucu MA, Aydin Ö, İnal FY, Öztürk H, Üçişik AC, Çaşkurlu H, Güneysu B, Yildirim B, Midilli K, Çağ Y, Arslan F, Vahaboglu H. Carbapenem-resistant Klebsiella pneumoniae outbreak in a COVID-19 intensive care unit; a case-control study. J Chemother 2022; 34:517-523. [PMID: 35470780 DOI: 10.1080/1120009x.2022.2064698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We analysed a carbapenem-resistant Klebsiella pneumoniae (CRKP) outbreak in the coronavirus disease (COVID) ICU. We retrospectively collected data from ICU records. We identified 25 cases between 12 November 2020 and 19 December 2020, and compared them to 42 controls present in the ICU during the same period. The presence of a femoral haemodialysis catheter was strongly associated with invasive CRKP infections (cases, 9 [36%]; controls, 0 [0%]; odds ratio [OR] 95% confidence intervals [CIs], 21 (5; 89)). We found a significant association between old age and CRKP infection with adverse outcomes. Sequence analysis revealed three distinct carbapenemase genes: blaNDM-1, blaOXA-48 and blaKPC-2. We launched rectal swab sampling upon admission to the ICU, cohorted colonized patients and cases and conducted an intensive training programme for newly employed staff. This study revealed that the emergence and dissemination of CRKP in COVID ICUs were associated with increased adverse outcomes. The presence of a femoral haemodialysis catheter was a significant risk factor for CRKP infections.
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Affiliation(s)
- Pınar Ergen
- Enfeksiyon Hastalıkları Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
| | - M Esra Koçoğlu
- Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
| | - Müge Nural
- Anestesi ve Rehabilitasyon Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
| | - Mert Ahmet Kuşkucu
- Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dalı, Cerrahpaşa Tıp Fakültes, İstanbul Üniversitesi, İstanbul, Turkiye
| | - Özlem Aydin
- Enfeksiyon Hastalıkları Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
| | - Ferda Y İnal
- Anestesi ve Rehabilitasyon Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
| | - Hande Öztürk
- Anestesi ve Rehabilitasyon Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
| | - Ayşe C Üçişik
- Enfeksiyon Hastalıkları Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
| | - Hülya Çaşkurlu
- Enfeksiyon Hastalıkları Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
| | - Büşra Güneysu
- Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
| | - Büşra Yildirim
- Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
| | - Kenan Midilli
- Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dalı, Cerrahpaşa Tıp Fakültes, İstanbul Üniversitesi, İstanbul, Turkiye
| | - Yasemin Çağ
- Enfeksiyon Hastalıkları Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
| | - Ferhat Arslan
- Enfeksiyon Hastalıkları Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
| | - Haluk Vahaboglu
- Enfeksiyon Hastalıkları Anabilim Dalı, Tıp Fakultesi, İstanbul Medeniyet Üniversitesi, İstanbul, Turkiye
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Aydın M, Aydın Avci İ, Kulakaç Ö. Nurses as the leading fighters during the COVID-19 pandemic: Self-transcendence. Nurs Ethics 2022; 29:802-818. [PMID: 35236178 PMCID: PMC8894910 DOI: 10.1177/09697330211065848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The Covid 19 pandemic has led to and continues to pose challenges for healthcare systems globally, especially in intensive care units. This research was conducted to examine the self-transcendence of the leading fighters, intensive care nurses, during the Covid 19 pandemic. Methods The descriptive phenomenological research method was used in the study. The research was carried out between June and December 2020 with the nurses who care for Covid 19 patients in the Covid 19 intensive care service in different provinces of Turkey. The research was completed with 25 participants. A semi-structured interview form prepared based on the Theory of Self-Transcendence (vulnerability, self-transcendence, and well-being) and based on the literature was used to collect data. Ethical considerations Ethical requirements were respected in every phase of the research process. Results: The nurses in the study were found to experience vulnerability due to “administrative loneliness,” “inability to give care,” “fear of being a source of infection,” and “loneliness of patients.” Conclusions It has been found that “improvement in nursing roles and skills,” “being proud for oneself and the team,” “understanding the value of life,” and “feeling like a superhero due to the responsibilities shouldered during the pandemic” support nurses’ self-transcendence, which contributes to physical and mental well-being.
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Affiliation(s)
- Mesiya Aydın
- Faculty of Health Science, Department of Public Health Nursing, 37139Ondokuz Mayıs University, Samsun, Turkey
| | - İlknur Aydın Avci
- Faculty of Health Science, Department of Public Health Nursing, 37139Ondokuz Mayıs University, Samsun, Turkey
| | - Özen Kulakaç
- Faculty of Health Science, Department of Obstetrics and Gynecology Nursing, 37139Ondokuz Mayıs University, Samsun, Turkey
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A Theoretical Model to Investigate the Influence of Temperature, Reactions of the Population and the Government on the COVID-19 Outbreak in Turkey. Disaster Med Public Health Prep 2022; 16:214-222. [PMID: 32900399 PMCID: PMC7674791 DOI: 10.1017/dmp.2020.322] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The ongoing coronavirus disease 2019 (COVID-19) pandemic, which was initially identified in December 2019 in the city of Wuhan in China, poses a major threat to worldwide health care. By August 04, 2020, there were globally 695,848 deaths (Johns Hopkins University, https://coronavirus.jhu.edu/map.html). A total of 5765 of them come from Turkey (Johns Hopkins University, https://coronavirus.jhu.edu/map.html). As a result, various governments and their respective populations have taken strong measures to control the spread of the pandemic. In this study, a model that is by construction able to describe both government actions and individual reactions in addition to the well-known exponential spread is presented. Moreover, the influence of the weather is included. This approach demonstrates a quantitative method to track these dynamic influences. This makes it possible to numerically estimate the influence that various private or state measures that were put into effect to contain the pandemic had at time t. This might serve governments across the world by allowing them to plan their actions based on quantitative data to minimize the social and economic consequences of their containment strategies. METHODS A compartmental model based on SEIR that includes the risk perception of the population by an additional differential equation and uses an implicit time-dependent transmission rate is constructed. Within this model, the transmission rate depends on temperature, population, and government actions, which in turn depend on time. The model was tested using different scenarios, with the different dynamic influences being mathematically switched on and off. In addition, the real data of infected coronavirus cases in Turkey were compared with the results of the model. RESULTS The mathematical study of the influence of the different parameters is presented through different scenarios. Remarkably, the last scenario is also an example of a theoretical mitigation strategy that shows its maximum in August 2020. In addition, the results of the model are compared with the real data from Turkey using conventional fitting that shows good agreement. CONCLUSIONS Although most countries activated their pandemic plans, significant disruptions in health-care systems occurred. The framework of this model seems to be valid for a numerical analysis of dynamic processes that occur during the COVID-19 outbreak due to weather and human reactions. As a result, the effects of the measures introduced could be better planned in advance by use of this model.
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Ji R, Zhang L, Ji Y, Li G, Wang R, Xu C. Association of Self-Leadership With Acute Stress Responses and Acute Stress Disorders in Chinese Medics During the COVID-19 Pandemic: A Cross-Sectional Study. Front Psychiatry 2022; 13:836950. [PMID: 35770059 PMCID: PMC9235357 DOI: 10.3389/fpsyt.2022.836950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/04/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The outbreak of the highly infectious coronavirus disease 2019 (COVID-19) renders a huge physical and psychological risk to the public, especially to the medics. Additionally, self-leadership has proven to improve self-efficacy and mediate tension, such as nervousness and depression. Therefore, a cross-sectional survey was conducted to explore the association of self-leadership with acute stress responses (ASRs) and acute stress disorders (ASDs) in medics during the COVID-19 epidemic. METHODS Self-reported online questionnaires were administered, and 627 participants were finally included. The data were analyzed using the univariate analysis and the logistical regression model to identify whether self-leadership and sociodemographic and epidemic characteristics were associated with mental health, including ASRs and ASDs. RESULTS Initially, 790 medics responded. Of these, 627 remained after excluding for invalid questionnaires and those with a substantial amount of missing data. Therefore, the participation validity rate was 79.37%. Frontline medical staff (β = 0.338; p < 0.001), possibility of infection among people around the medic being mild (β = 0.141; p < 0.001), subjective estimation of epidemic duration being 3-6 months (β = 0.074; p < 0.05), self-sets (β = -0.022; p < 0.001), self-punishment (β = 0.229; p < 0.001), belief hypothesis and evaluation (β = -0.147; p < 0.05), and successful foresight (β = 0.105; p < 0.05) were statistically significant with ASRs. Marital status [adjusted odds ratio (AOR) =1.813; 95% CI (1.141, 2.881); p = 0.012], being a frontline worker [AOR = 25.760; 95% CI (14.220, 46.667); p < 0.001], visiting Hubei in the previous 14 days [AOR = 3.656; 95% CI (1.500, 8.911); p = 0.004], self-punishment [AOR = 1.352; 95% CI (1.180, 1.548); p < 0.001], and self-dialogue [AOR = 1.256; 95% CI (11.063, 1.483); p = 0.007] were the risk factors for ASD. Conversely, having frontline medical staff in one's family [AOR = 0.523; 95% CI (0.297, 0.923); p = 0.025], self-sets [AOR = 0.814; 95% CI (0.715, 0.826); p = 0.002], and belief hypothesis and evaluation [AOR = 0.796; 95% CI (0.672, 0.943); p = 0.038] were the protective factors. CONCLUSION The special working environment of the COVID-19 epidemic resulted in ASR and ASD. Notably, findings revealed a positive association between ASR symptoms and frontline medical staff, the subjective estimation of epidemic duration, self-punishment, and successful foresight. Nevertheless, marital status, having visited Hubei in the previous 14 days, and self-dialogue were the risk factors accounting for ASD symptoms. Surprisingly, having frontline medical staff in one's family, self-sets, and belief hypothesis and evaluation had potential benefits for ASD symptoms.
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Affiliation(s)
- Rongjian Ji
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China.,Department of Nursing, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Lan Zhang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Yanbo Ji
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Guangzhao Li
- Department of Nursing, Shandong Provincial Hospital Affiliated of Shandong First Medical University, Jinan, China
| | - Renxiu Wang
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Cuiping Xu
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China.,Department of Nursing, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
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12
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Jackson WM, Price JC, Eisler L, Sun LS, Lee JJ. COVID-19 in Pediatric Patients: A Systematic Review. J Neurosurg Anesthesiol 2022; 34:141-147. [PMID: 34870638 DOI: 10.1097/ana.0000000000000803] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 08/21/2021] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The coronavirus disease (COVID)-19 pandemic has been an enormous global health burden, resulting in hundreds of millions of documented infections and more than 3 million deaths. Increasing reports characterizing the effects of COVID-19 in pediatric populations have been published during the course of the pandemic. We performed a systematic review to assess the scope of diagnosis, treatment, and management of COVID-19 in pediatric patients. MATERIALS AND METHODS We searched the Cochrane Database of Systematic Reviews, PubMed, CINAHL, and Embase for studies published between January 1, 2020, and May 1, 2021. Each result was screened by 2 authors independently, and discordant findings were adjudicated by a third party. Data extracted included demographic data, symptom data, and clinical data including mortality, severe illness, laboratory data, radiologic data, and treatment. Bias assessment was performed using the Newcastle-Ottawa Quality Assessment Scale for Cohort Studies. RESULTS We found a total of 16,266 search results, and we accepted 63 manuscripts into the review. The quality of evidence was low. It was difficult to estimate the risk of mortality in pediatric patients with COVID-19 given the quality of the evidence, but overall it is likely below 1%. The most common symptoms in symptomatic pediatric COVID-19 patients were fever (58%) and cough (50%). There was a high proportion of asymptomatic infection (65%). DISCUSSION Pediatric COVID-19 infection is mild and frequently asymptomatic. There is a low risk of severe illness or death in children who contract COVID-19. High-quality studies should be conducted to develop best practices for prevention, diagnosis, and management of symptomatic illness.
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Affiliation(s)
| | | | | | - Lena S Sun
- Departments of Anesthesiology
- Pediatrics, Columbia University, New York, NY
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13
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Wang H, Yuan P, Tang C, Guan Z, Xiang P, Chen X, Zhang D, Li Q, Hu S, Bo T, Gu J. COVID-19 Control in Community Hospitals: Experience From Four Community Hospitals in Beijing, China. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580211055621. [PMID: 35393869 PMCID: PMC9002294 DOI: 10.1177/00469580211055621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
By September 20, 2021, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been pandemic in 237 countries and regions, resulting in 228,506,698 confirmed cases and 4,692,361 deaths. At the same time, a total of 1123 cases of COVID-19 had been confirmed in Beijing, China. Peking University Shougang Hospital has 4 community hospitals with 174 staff members, covering 230,000 residents in Shijingshan district, Beijing. The community hospitals were the basic units of China’s healthcare system for public health services, as the main battlefield for screening and controlling of COVID-19. We reported our experience about the prevention of SARS-CoV-2. We suggest that community hospitals should change their process for admitting patients. While the screening of suspected cases of COVID-19 is vital, patients with suspected infections should be isolated immediately.
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Affiliation(s)
- Hongyu Wang
- Department of Vascular Medicine, 74580Peking University Shougang Hospital, Vascular Health Research Center of PKUHSC, Beijing, China
| | - Ping Yuan
- Department of Research and Development, Central laboratory, 74573Peking University Shougang Hospital, Vascular Health Research Center of PKUHSC, Beijing, China
| | - Chong Tang
- Department of Orthopedics, 74580Peking University Shougang Hospital, Beijing, China
| | - Zhenpeng Guan
- Department of Orthopedics, 74580Peking University Shougang Hospital, Beijing, China
| | - Pingchao Xiang
- Department of Respiratory and Critical Medicine, 74580Peking University Shougang Hospital, Beijing, China
| | - Xin Chen
- Jinding Street Community Health Service Center, 74580Peking University Shougang Hospital, Beijing, China
| | - Dan Zhang
- Department of Infectious Disease, 74580Peking University Shougang Hospital, Beijing, China
| | - Qi Li
- Department of Hospital-Acquired Infection Control, 74580Peking University Shougang Hospital, Beijing, China
| | - Shoukui Hu
- Department of Clinical Laboratory, 74580Peking University Shougang Hospital, Beijing, China
| | - Tianhui Bo
- Medical Department, 74580Peking University Shougang Hospital, Beijing, China
| | - Jin Gu
- Gastrointestinal Cancer Center, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 74580Peking University Cancer Hospital, Beijing, China.,Department of Gastrointestinal Surgery, Peking-Tsinghua Center for Life Science, Peking University International Cancer Center, 12519Peking University Shougang Hospital, Beijing, China
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14
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Sezgin D, Dost A, Esin MN. Experiences and perceptions of Turkish intensive care nurses providing care to Covid-19 patients: A qualitative study. Int Nurs Rev 2021; 69:305-317. [PMID: 34962292 DOI: 10.1111/inr.12740] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/27/2021] [Indexed: 12/26/2022]
Abstract
AIM To describe the experiences of intensive care nurses who provided care to Covid-19 patients and their perceptions towards the disease and their work conditions during the pandemic. INTRODUCTION Identification of experiences and perceptions of intensive care nurses towards disease, care and their workplace conditions when providing care to Covid-19 patients will inform decision-makers about improvements that can be implemented. BACKGROUND The Covid-19 pandemic has led to increased strain and workplace-related health risks to intensive care nurses, but it has also provided a unique experience and opportunities for learning and development. METHODS A descriptive qualitative study was conducted with 10 intensive care unit nurses working in seven hospitals in Istanbul, Turkey. Snowball sampling method was used, and the data were collected by semistructured online interviews. A thematic analysis was performed. The Consolidated Criteria for Reporting Qualitative Research were followed. FINDINGS Five major themes were identified: 'death and fear of death', 'impact on family and social lives', 'nursing care of Covid-19 patients', 'changing perceptions of their own profession: empowerment and dissatisfaction', and 'experiences and perceptions of personal protective equipment and other control measures'. DISCUSSION Intensive care nurses experience an increased risk of infection and psychological burden, and they lack a sense of professional satisfaction. Improvements to working conditions are needed to support nurses caring for patients during the pandemic. CONCLUSION The pandemic increased the workload and responsibilities of intensive care nurses and led to increases in their work-related health risks and challenges with care. However, it also increased nurses' awareness about the importance of their professional roles. IMPLICATIONS FOR NURSING PRACTICE AND POLICIES There is a need to improve working conditions and develop nursing standards for the care of Covid-19 patients in intensive care units.
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Affiliation(s)
- Duygu Sezgin
- School of Nursing and Midwifery, National University of Ireland Galway, Galway City, Ireland
| | - Ayşe Dost
- School of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Melek N Esin
- Florence Nightingale Faculty of Nursing, Department of Public Health Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
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15
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Helmi M, Sari D, Meliala A, Trisnantoro L. What Is Preparedness and Capacity of Intensive Care Service in Indonesia to Response to COVID-19? A Mixed-method Study. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND: Pandemics can increase disease spread, as well as unpredictable and highly in patient demand, which can have a negative impact on hospital capacity and the overall functioning of the health-care system. The preparedness and capacity of intensive care services to respond to COVID-19 in Indonesia are remain unknown.
AIM: This study aimed to investigate the preparedness and capacity of intensive care services in Indonesia to respond to the initial stage of the COVID-19 pandemic.
METHODS: A mixed-method research design was used in this study using in-depth interviews and an online survey. An in-depth interview was conducted with the medical team (intensive care consultant and an anesthesiologist) who is actively involved in the provision of COVID-19 services in 15 national referral hospitals. The online survey was conducted to all medical teams that provide direct care to the COVID-19 patients. A total of 459 (response rate was 95.2%) agreed to join the survey. The content analysis technique was used to analyze qualitative data and a descriptive analysis was used to describe issues encountered in providing health services to COVID-19 patients.
RESULTS: The analysis preparedness and capacity of intensive care service in Indonesia to respond to the initial stage of the COVID-19 pandemic resulting in 4 themes with 12 sub-themes. The four themes were limited quality and quantity of standardized intensive care unit (ICU) isolation room (inadequate zoning systems, adequacy of the standardized ICU isolation room, the readiness of the hospital infrastructure, and telemedicine facilities are not yet widely used, including in the COVID-19 isolation room), limited medical service support (lack of personal protective equipment (personal protective equipment [PPE], re-used PPE, lack of availability of medical devices), limitations in the medical team’s quality and quantity management (lack of number and distribution of expert doctors and medical team screening for ICU), and command systems (task shifting, effective communication, and leadership).
CONCLUSION: Medical team encounters several difficulties, particularly related to the quality of facilities, staff preparedness, and systems for the provision of services to COVID-19 patients with critical conditions. There is a critical need for well-defined pathways, legal protection, and occupational health for medical teams providing services in the aftermath of a pandemic.
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16
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Helmi M, Sari D, Meliala A, Trisnantoro L. Readiness of Medical Teams Caring for COVID-19 in the Intensive Care Units: A National Web-Based Survey in Indonesia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The coronavirus disease 2019 (COVID)-19 pandemic is a challenge for the intensive care unit (ICU) medical team. It requires management of space, stuff (medical equipment including drugs), staff, and system readiness (4S) to deal with the surge in the number of patients.
AIM: This survey aims to describe the current readiness efforts among ICU medical team at the COVID-19 referral hospitals in Indonesia; space, stuff readiness, staff, and systems readiness.
METHODS: We conducted a cross-sectional national web-based survey of ICUs across referral hospitals during pandemic COVID-19 in Indonesia from June to October 2020. The medical teams survey included 53 questions in multiple parts addressing five dimensions. A linear regression model was applied to determine the factors related with readiness.
RESULTS: A total of 459 participants (83.6%) agreed to join in this study. The participants’ average age was 40.43 years (SD = 5.78). About 62.53% were male, 51.20% had bachelor degree, and 55.77% lived outside of Java Island. The mean of total score of medical team readiness was 2.76 (SD = 0.320) and the highest (maximum score) mean score of medical team readiness domain was stuff (2.81, SD = 7.72). Education, working experience, training, perception of risk of contracting COVID-19, and residence had a substantial effect on the readiness, with R2 values of 0.378, p < 0.05.
CONCLUSIONS: This study provides an initial view of current preparedness efforts among a group of ICUs in Indonesia’s leading hospital during the first wave of pandemic. Interventions must be developed and implemented quickly to increase the medical team’s readiness to care for a future pandemic.
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17
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Kapoor S, Gupta A, Saidha PK. Ear, Nose, and Throat Practice Guidelines: An Update for COVID-19. Int Arch Otorhinolaryngol 2021; 25:e621-e627. [PMID: 34777595 PMCID: PMC8580158 DOI: 10.1055/s-0041-1736424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/04/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction
Amidst another wave of COVID-19, the alarming number of cases per day in India has affected the healthcare system and professionals tremendously. As the disease burden continues to increase, ear, nose, and throat (ENT) specialists remain at high risk of exposure to this aerosol borne virus. This requires the creation and regulation of protocols for conducting routine clinical practice, especially by ENT specialists.
Objectives
To review the available literature and to propose strategies and recommendations for ENT practitioners to conduct their regular practice amidst this pandemic.
Data synthesis
A systematic review of the available literature on ENT practice during the COVID-19 pandemic was done. Out of the many protocols proposed in various studies, the most practical and feasible ones that could be adopted by practicing ENT doctors/ surgeons in the long run were selected. Adequate precautions and use of high level of personal protective equipment (PPE) is required to be adopted by all practicing ENT doctors. Use of teleconsultation has been promoted as it limits face-to-face exposure. Proper guidelines should be followed for both emergency and elective surgeries. Endoscopy can be used as a safe and useful tool for ENT examination.
Conclusion
As practicing otorhinolaryngologists, it is of utmost importance that we take all necessary precautions and adopt safety measures in our clinical practice while conducting out patient department (OPD) consultations, operative procedures, and emergency care to protect our patients, ourselves, and other healthcare staff during this time.
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Affiliation(s)
- Sahil Kapoor
- Department of Ear, Nose, and Throat, Faculty of Medicine and Health Sciences, SGT University, Gurgaon, Haryana, India
| | - Ayushi Gupta
- Department of Ear, Nose, and Throat, Faculty of Medicine and Health Sciences, SGT University, Gurgaon, Haryana, India
| | - Poonam Kumar Saidha
- Department of Ear, Nose, and Throat, Faculty of Medicine and Health Sciences, SGT University, Gurgaon, Haryana, India
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18
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Elsaid AM, Mohamed HA, Abdelaziz GB, Ahmed MS. A critical review of heating, ventilation, and air conditioning (HVAC) systems within the context of a global SARS-CoV-2 epidemic. PROCESS SAFETY AND ENVIRONMENTAL PROTECTION : TRANSACTIONS OF THE INSTITUTION OF CHEMICAL ENGINEERS, PART B 2021; 155:230-261. [PMID: 34566275 PMCID: PMC8450051 DOI: 10.1016/j.psep.2021.09.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 05/06/2023]
Abstract
The Coronavirus disease (COVID-19) has spread over the world, resulting in more than 225 million patients, and 4.7 million deaths in September 2021. It also caused panic and terror, halted numerous activities, and resulted in the world economy deteriorates. It altered human behavior and compelled people to alter their lifestyles to avoid infection. Air conditioning systems are one of the most important sectors that must be considered because of the pandemic SARS-CoV-2 all over the world. Air is used as a heat transfer medium in heating, ventilation, and air conditioning (HVAC) systems. The air contains a variety of pollutants, viruses, and bacteria, all of which have an impact on and destroy human life. Significantly in summer, people spend more time in air conditioners which results in lower levels of vitamin D and melatonin which may affect the functioning of their immune system and are susceptible to receiving SARS-CoV-2 from other individuals. As an important component of air conditioning and ventilation systems, the air filter plays a significant role. As a result, researchers must work harder to improve its design to prevent the ultra-small particles loaded with COVID-19. This paper contributes to the design of existing HVAC systems in terms of their suitability and impact on the spread of the hybrid SARS-CoV-2 epidemic, as well as efforts to obtain a highly efficient air filter to remove super-sized particles for protection against epidemic infection. In addition, important guideline recommendations have been extracted to limit the spread of the SARS-CoV-2 throughout the world and to get the highest quality indoor air in air-conditioned places.
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Affiliation(s)
- Ashraf Mimi Elsaid
- Department of Refrigeration and Air Conditioning Technology, Faculty of Technology and Education, Helwan University, Cairo 11282, Egypt
| | - Hany A Mohamed
- Department of Mechanical Engineering, Faculty of Engineering, Assiut University, Asyut 71516, Egypt
- Mechanical Engineering Department, Higher Technological Institute, 10th Ramadan, Ramadan City 44634, Egypt
| | - Gamal B Abdelaziz
- Mechanical Department, Faculty of Technology and Education, Suez University, Suez, Egypt
| | - M Salem Ahmed
- Mechanical Department, Faculty of Technology and Education, Sohag University, Sohag, Egypt
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19
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Phua J, Lim CM, Faruq MO, Nafees KMK, Du B, Gomersall CD, Ling L, Divatia JV, Hashemian SMR, Egi M, Konkayev A, Mat-Nor MB, Shrestha GS, Hashmi M, Palo JEM, Arabi YM, Tan HL, Dissanayake R, Chan MC, Permpikul C, Patjanasoontorn B, Son DN, Nishimura M, Koh Y. The story of critical care in Asia: a narrative review. J Intensive Care 2021; 9:60. [PMID: 34620252 PMCID: PMC8496144 DOI: 10.1186/s40560-021-00574-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/08/2021] [Indexed: 12/29/2022] Open
Abstract
Background Asia has more critically ill people than any other part of our planet. The aim of this article is to review the development of critical care as a specialty, critical care societies and education and research, the epidemiology of critical illness as well as epidemics and pandemics, accessibility and cost and quality of critical care, culture and end-of-life care, and future directions for critical care in Asia.
Main body Although the first Asian intensive care units (ICUs) surfaced in the 1960s and the 1970s and specialisation started in the 1990s, multiple challenges still exist, including the lack of intensivists, critical care nurses, and respiratory therapists in many countries. This is aggravated by the brain drain of skilled ICU staff to high-income countries. Critical care societies have been integral to the development of the discipline and have increasingly contributed to critical care education, although critical care research is only just starting to take off through collaboration across groups. Sepsis, increasingly aggravated by multidrug resistance, contributes to a significant burden of critical illness, while epidemics and pandemics continue to haunt the continent intermittently. In particular, the coronavirus disease 2019 (COVID-19) has highlighted the central role of critical care in pandemic response. Accessibility to critical care is affected by lack of ICU beds and high costs, and quality of critical care is affected by limited capability for investigations and treatment in low- and middle-income countries. Meanwhile, there are clear cultural differences across countries, with considerable variations in end-of-life care. Demand for critical care will rise across the continent due to ageing populations and rising comorbidity burdens. Even as countries respond by increasing critical care capacity, the critical care community must continue to focus on training for ICU healthcare workers, processes anchored on evidence-based medicine, technology guided by feasibility and impact, research applicable to Asian and local settings, and rallying of governments for support for the specialty.
Conclusions Critical care in Asia has progressed through the years, but multiple challenges remain. These challenges should be addressed through a collaborative approach across disciplines, ICUs, hospitals, societies, governments, and countries.
Supplementary Information The online version contains supplementary material available at 10.1186/s40560-021-00574-4.
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Affiliation(s)
- Jason Phua
- FAST and Chronic Programmes, Alexandra Hospital, National University Health System, Singapore, Singapore.,Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore
| | - Chae-Man Lim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Mohammad Omar Faruq
- General Intensive Care Unit, Emergency and COVID ICU, United Hospital Ltd, Dhaka, Bangladesh
| | - Khalid Mahmood Khan Nafees
- Ministry of Health, Department of Critical Care Medicine, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam
| | - Bin Du
- State Key Laboratory of Complex Severe and Rare Diseases, Medical ICU, Peking Union Medical College Hospital, Beijing, China
| | - Charles D Gomersall
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Lowell Ling
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Jigeeshu Vasishtha Divatia
- Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Seyed Mohammad Reza Hashemian
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Moritoki Egi
- Department of Anesthesiology and Intensive Care Medicine, Kobe University Hospital, Kobe, Japan
| | - Aidos Konkayev
- Anaesthesiology and Reanimatology Department, Astana Medical University, Astana, Kazakhstan.,Anaesthesia and ICU Department, Institution of Traumatology and Orthopedics, Astana, Kazakhstan
| | - Mohd Basri Mat-Nor
- Department of Anaesthesiology and Intensive Care, International Islamic University Malaysia, Kuantan, Malaysia
| | - Gentle Sunder Shrestha
- Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - Madiha Hashmi
- Department of Critical Care Medicine, Ziauddin University, Karachi, Pakistan
| | | | - Yaseen M Arabi
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Hon Liang Tan
- Mount Elizabeth Novena Hospital, Singapore, Singapore
| | - Rohan Dissanayake
- Department of Intensive Care Medicine, Gosford Hospital, Gosford, NSW, Australia
| | - Ming-Cheng Chan
- Section of Critical Care and Respiratory Therapy, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,College of Science, Tunghai University, Taichung, Taiwan
| | - Chairat Permpikul
- Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Boonsong Patjanasoontorn
- Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Do Ngoc Son
- Critical Care Unit, Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Vietnam
| | | | - Younsuck Koh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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Holthof N, Luedi MM. Considerations for acute care staffing during a pandemic. Best Pract Res Clin Anaesthesiol 2021; 35:389-404. [PMID: 34511227 PMCID: PMC7726522 DOI: 10.1016/j.bpa.2020.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 12/15/2022]
Abstract
The increase in interconnectedness of the global population has enabled a highly transmissible virus to spread rapidly around the globe in 2020. The COVID-19 (Coronavirus Disease 2019) pandemic has led to physical, social, and economic repercussions of previously unseen proportions. Although recommendations for pandemic preparedness have been published in response to previous viral disease outbreaks, these guidelines are primarily based on expert opinion and few of them focus on acute care staffing issues. In this review, we discuss how working in acute care medicine during a pandemic can affect the physical and mental health of medical and nursing staff. We provide ideas for limiting staff shortages and creating surge capacity in acute care settings, and strategies for sustainability that can help hospitals maintain adequate staffing throughout their pandemic response.
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Affiliation(s)
- Niels Holthof
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Markus M Luedi
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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21
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Widiasih R, Ermiati E, Emaliyawati E, Hendrawati S, Susanti RD, Sutini T, Sari CWM, Murtiningsih M. Nurses’ Feelings and Perspectives of the COVID-19 Pandemic: A Qualitative Study in a Developing Country. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND: Nurses’ duties and responsibilities related to the risk of transmitting COVID-19. Studies that explore nurses’ feelings and perspectives in providing health services at COVID-19 referral hospitals, especially in developing countries like Indonesia, are limited.
AIM: This study aims to explore nurses’ feelings, perceptions, and expectations of the COVID-19 pandemic.
METHODS: This qualitative study applied the qualitative descriptive design that involved 17 nurses from different hospitals in Indonesia. The semi-structured interview gathered their views of COVID-19, and the comparative analysis for interviews technique was chosen to analyze the data.
RESULTS: Three themes emerged from the data analysis. The themes were nurses’ express psychological responses in facing the COVID-19 pandemic such as fear, surrender, panic, and calmness. Other two themes included the COVID 19 pandemic enhances nurses’ health awareness and behavior, and the government protect nurses from the COVID-19 transmission and social stigma.
CONCLUSION: The feelings reported dominantly by the nurse, in addition to information about health awareness, behavior, the government’s actions, and their expectations. Mental health assistance would be useful to prevent depression in nurses, and the government’s comprehensive approaches in dealing with the COVID-19 pandemic would increase the protection and productivity of health workers, including nurses.
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22
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Anand SV, Shuy YK, Lee PSS, Lee ES. One Year on: An Overview of Singapore's Response to COVID-19-What We Did, How We Fared, How We Can Move Forward. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179125. [PMID: 34501718 PMCID: PMC8431401 DOI: 10.3390/ijerph18179125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/30/2021] [Accepted: 08/20/2021] [Indexed: 01/28/2023]
Abstract
Background—One year has passed since the first COVID-19 case in Singapore. This scoping review commemorates Singaporean researchers that have expanded the knowledge on this novel virus. We aim to provide an overview of healthcare-related articles published in peer-reviewed journals, authored by the Singapore research community about COVID-19 during the first year of the pandemic. Methods—This was reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. It included healthcare-related articles about COVID-19 published between 23 January 2020 and 22 January 2021 with a Singapore-affiliated author. MEDLINE, Embase, Scopus, Web of Science, CINAHL, PsycINFO, Google Scholar, and local journals were searched. The articles were screened independently by two reviewers. Results—The review included 504 articles. Most of the articles narrated the changes to hospital practice (210), while articles on COVID-19 pathology (94) formed most of the non-narrative papers. Publications on public health (61) and the indirect impacts to clinical outcomes (45) were other major themes explored by the research community. The remaining articles detailed the psychological impact of the pandemic (35), adaptations of medical education (30), and narratives of events (14). Conclusion—Amidst a resurgence of community cases involving variant COVID-19 strains, the resources from the research community will provide valuable guidance to navigate these uncertain times.
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Affiliation(s)
- S Vivek Anand
- Ministry of Health Holdings, Singapore 099253, Singapore;
| | - Yao Kang Shuy
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308207, Singapore;
| | - Poay Sian Sabrina Lee
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore 138543, Singapore;
| | - Eng Sing Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308207, Singapore;
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore 138543, Singapore;
- Correspondence:
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23
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Elsaid AM, Ahmed MS. Indoor Air Quality Strategies for Air-Conditioning and Ventilation Systems with the Spread of the Global Coronavirus (COVID-19) Epidemic: Improvements and Recommendations. ENVIRONMENTAL RESEARCH 2021; 199:111314. [PMID: 34048748 PMCID: PMC8146370 DOI: 10.1016/j.envres.2021.111314] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/06/2021] [Indexed: 05/08/2023]
Abstract
The coronavirus has come to the world and spread with great wide among the countries of the world and has resulted in numerous infections that exceeded 167,181,023 million patients and are close to 3.5 deaths by September 2021. It also brought with it panic and fear, halted many activities, and led to the decline of the global economy. It changed human behavior and forced people to change their lifestyles to avoid infection. One of the most sectors that must be taken into consideration through pandemic coronavirus (COVID-19) around the globe is the air conditioning systems. The HVAC systems depend on the air as a heat transfer medium. The air contains a group of pollutants, viruses, and bacteria, and it affects and destroys human life. The air filter plays a major role as an important component in the air conditioning systems. Thus, it requires more effort by researchers to improve its design to prevent the ultra-size of particles loaded with coronavirus (COVID-19). This paper provides insight into the design of existing combined air-conditioners on their suitability and their impact on the spread of the hybrid coronavirus epidemic and review efforts to obtain a highly efficient air filter to get rid of super-sized particles for protection against epidemic infection. In addition, important guideline recommendations have been made to limit the spread of the COVID-19 virus and to obtain indoor air quality in air-conditioned places.
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Affiliation(s)
- Ashraf Mimi Elsaid
- RHVAC Department of Technology, Faculty of Technology and Education, Helwan University, Cairo, 11282, Egypt.
| | - M Salem Ahmed
- Mechanical Power Engineering Department, Faculty of Technology and Education, Sohag University, Egypt
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24
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Blum E, Margalit R, Levy L, Getter T, Lahav R, Zilber S, Bradfield P, Imhof BA, Alpert E, Gruzman A. A Potent Leukocyte Transmigration Blocker: GT-73 Showed a Protective Effect against LPS-Induced ARDS in Mice. Molecules 2021; 26:4583. [PMID: 34361736 PMCID: PMC8348436 DOI: 10.3390/molecules26154583] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/13/2021] [Accepted: 07/22/2021] [Indexed: 01/08/2023] Open
Abstract
We recently developed a molecule (GT-73) that blocked leukocyte transendothelial migration from blood to the peripheral tissues, supposedly by affecting the platelet endothelial cell adhesion molecule (PECAM-1) function. GT-73 was tested in an LPS-induced acute respiratory distress syndrome (ARDS) mouse model. The rationale for this is based on the finding that the mortality of COVID-19 patients is partly caused by ARDS induced by a massive migration of leukocytes to the lungs. In addition, the role of tert-butyl and methyl ester moieties in the biological effect of GT-73 was investigated. A human leukocyte, transendothelial migration assay was applied to validate the blocking effect of GT-73 derivatives. Finally, a mouse model of LPS-induced ARDS was used to evaluate the histological and biochemical effects of GT-73. The obtained results showed that GT-73 has a unique structure that is responsible for its biological activity; two of its chemical moieties (tert-butyl and a methyl ester) are critical for this effect. GT-73 is a prodrug, and its lipophilic tail covalently binds to PECAM-1 via Lys536. GT-73 significantly decreased the number of infiltrating leukocytes in the lungs and reduced the inflammation level. Finally, GT-73 reduced the levels of IL-1β, IL-6, and MCP-1 in bronchoalveolar lavage fluid (BALF). In summary, we concluded that GT-73, a blocker of white blood cell transendothelial migration, has a favorable profile as a drug candidate for the treatment of ARDS in COVID-19 patients.
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Affiliation(s)
- Eliav Blum
- Department of Chemistry, Faculty of Exact Sciences, Campus Ramat-Gan, Bar-Ilan University, Ramat-Gan 5290002, Israel; (E.B.); (L.L.); (T.G.)
| | - Raanan Margalit
- Science in Action, 3 Pinchas Sapir Street, Weizmann Science Park, Ness-Ziona 7403650, Israel;
| | - Laura Levy
- Department of Chemistry, Faculty of Exact Sciences, Campus Ramat-Gan, Bar-Ilan University, Ramat-Gan 5290002, Israel; (E.B.); (L.L.); (T.G.)
| | - Tamar Getter
- Department of Chemistry, Faculty of Exact Sciences, Campus Ramat-Gan, Bar-Ilan University, Ramat-Gan 5290002, Israel; (E.B.); (L.L.); (T.G.)
| | - Ron Lahav
- AltA-ZuZ Therapeutics, 3 Pinchas Sapir Street, Weizmann Science Park, Ness-Ziona 7403650, Israel;
| | - Sofia Zilber
- Department of Pathology, Shaare Zedek Medical Center, 12 Shmuel Bait Street, Jerusalem 9103102, Israel;
| | - Paul Bradfield
- MesenFlow Technologies, Chemin des Aulx, 14, CH-1228 Geneva, Switzerland;
| | - Beat A. Imhof
- Department of Pathology and Immunology, University of Geneva, Rue Michel-Servet, CH-1211 Geneva, Switzerland;
| | - Evgenia Alpert
- AltA-ZuZ Therapeutics, 3 Pinchas Sapir Street, Weizmann Science Park, Ness-Ziona 7403650, Israel;
| | - Arie Gruzman
- Department of Chemistry, Faculty of Exact Sciences, Campus Ramat-Gan, Bar-Ilan University, Ramat-Gan 5290002, Israel; (E.B.); (L.L.); (T.G.)
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25
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Rao H, Mancini D, Tong A, Khan H, Santacruz Gutierrez B, Mundo W, Collings A, Cervantes L. Frontline interdisciplinary clinician perspectives on caring for patients with COVID-19: a qualitative study. BMJ Open 2021; 11:e048712. [PMID: 33947739 PMCID: PMC8098296 DOI: 10.1136/bmjopen-2021-048712] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To describe the drivers of distress and motivations faced by interdisciplinary clinicians who were on the frontline caring for patients with COVID-19. DESIGN 50 semistructured interviews. Transcripts were analysed using qualitative thematic analysis. SETTING A safety-net hospital in Denver, Colorado. PARTICIPANTS Interdisciplinary frontline clinicians including physicians, advance practice providers, nurses, respiratory therapists and paramedics providing inpatient hospital care to patients hospitalised for COVID-19. RESULTS Fifty clinicians (32 women and 18 men) participated. Five themes with respective subthemes (in parentheses) were identified: depersonalisation and barriers to care (impeding rapport and compassion, focusing on infection risk at the expense of high-quality care, grief from witnessing patients suffer in isolation), powerless in uncertainty (inescapable awareness of personal risk, therapeutic doubt in a void of evidence, confronting ethical dilemmas, struggling with dynamic and unfamiliar challenges), overwhelmed and exhausted (burden of personal protective equipment (PPE), information overload and confusion, overstretched by additional responsibilities at work, compounded by personal life stressors, feeling vulnerable and dispensable, compassion fatigue, distress from the disproportionate impact on socially oppressed communities), bolstering morale and confidence (motivated by community and family support, equipped with data), and driven by moral duty (responsibility to patient care and community, collegial solidarity and collaboration, contributing to the greater good). CONCLUSION Frontline clinicians reported distress due to the challenges of PPE, uncertainty and powerlessness, new responsibilities at work and home, losing control of their schedules, grief from witnessing patients suffer in isolation and witnessing healthcare disparities exacerbated by this pandemic. Clinicians feel supported by their colleagues, families, and community and were driven by a sense of moral duty. Healthcare system should adopt strategies to minimise distress faced by interdisciplinary clinicians on the frontline of COVID-19.
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Affiliation(s)
- Hassan Rao
- Division of Hospital Medicine, Denver Health, Denver, Colorado, USA
| | - Diana Mancini
- Division of Hospital Medicine, Denver Health, Denver, Colorado, USA
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Humaira Khan
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - William Mundo
- University of Colorado, Anschutz Medical Campus, Denver, Colorado, USA
| | | | - Lilia Cervantes
- Division of Hospital Medicine, Denver Health, Denver, Colorado, USA
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26
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Tsai JM, Tolan NV, Petrides AK, Kanjilal S, Brigl M, Lindeman NI, Li YD, Tanasijevic MJ, Basu SS, Melanson SEF. How SARS-CoV-2 Transformed the Clinical Laboratory: Challenges and Lessons Learned. J Appl Lab Med 2021; 6:1338-1354. [PMID: 33822967 PMCID: PMC8083381 DOI: 10.1093/jalm/jfab034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/22/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic has made a devastating impact on global health and continues to challenge healthcare infrastructure and delivery. The clinical laboratories were no exception as they are responsible for diagnostic testing that dictates many clinical, infection control and public health decisions. Information technology and laboratory management tools are critical assets for maintaining and adapting operations in response to crises and when utilized effectively, promote the integration between the clinical laboratory specialties (e.g., chemistry, hematology, microbiology, and molecular pathology). During the COVID-19 pandemic, our systems and processes were strained due to high testing volumes, demand for rapid turnaround times, supply chain constraints, and constantly evolving testing algorithms and result interpretations as our knowledge of the virus and of diagnostics increased over time. In this report, we describe those challenges and subsequent adaptations made by each clinical laboratory section. We hope these details help provide potential solutions and approaches for other hospitals facing COVID-19 surges or other future pandemics.
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Affiliation(s)
- Jonathan M Tsai
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Nicole V Tolan
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Athena K Petrides
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Sanjat Kanjilal
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare Institute
| | - Manfred Brigl
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Neal I Lindeman
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Yen-Der Li
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.,Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA
| | - Milenko J Tanasijevic
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Sankha S Basu
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Stacy E F Melanson
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
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27
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Dave S, Shah A, Galvagno S, George K, Menne AR, Haase DJ, McCormick B, Rector R, Dahi S, Madathil RJ, Deatrick KB, Ghoreishi M, Gammie JS, Kaczorowski DJ, Scalea TM, Menaker J, Herr D, Krause E, Tabatabai A. A Dedicated Veno-Venous Extracorporeal Membrane Oxygenation Unit during a Respiratory Pandemic: Lessons Learned from COVID-19 Part I: System Planning and Care Teams. MEMBRANES 2021; 11:membranes11040258. [PMID: 33918355 PMCID: PMC8065909 DOI: 10.3390/membranes11040258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/16/2022]
Abstract
Background: The most critically ill patients with coronavirus disease 2019 (COVID-19) may require advanced support modalities, such as veno-venous extracorporeal membrane oxygenation (VV-ECMO). A systematic, methodical approach to a respiratory pandemic on a state and institutional level is critical. Methods: We conducted retrospective review of our institutional response to the COVID-19 pandemic, focusing on the creation of a dedicated airlock biocontainment unit (BCU) to treat patients with refractory COVID-19 acute respiratory distress syndrome (CARDS). Data were collected through conversations with staff on varying levels in the BCU, those leading the effort to make the BCU and hospital incident command system, email communications regarding logistic changes being implemented, and a review of COVID-19 patient census at our institution from March through June 2020. Results: Over 2100 patients were successfully admitted to system hospitals; 29% of these patients required critical care. The response to this respiratory pandemic augmented intensive care physician staffing, created a 70-member nursing team, and increased the extracorporeal membrane oxygenation (ECMO) capability by nearly 200%. During this time period, 40 COVID-19 patients on VV-ECMO were managed in the BCU. Challenges in an airlock unit included communication, scarcity of resources, double-bunking, and maintaining routine care. Conclusions: Preparing for a surge of critically ill patients during a pandemic can be a daunting task. The implementation of a coordinated, system-level approach can help with the allocation of resources as needed. Focusing on established strengths of hospitals within the system can guide triage based on individual patient needs. The management of ECMO patients is still a specialty care, and a systematic and hospital based approach requiring an ECMO team composed of multiple experienced individuals is paramount during a respiratory viral pandemic.
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Affiliation(s)
- Sagar Dave
- Department of Surgery, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.D.); (K.G.); (T.M.S.); (D.H.)
| | - Aakash Shah
- Department of Surgery, Division of Cardiac Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.D.); (R.J.M.); (K.B.D.); (M.G.); (J.S.G.)
- Correspondence: ; Tel.: +1-(410)-328-5842
| | - Samuel Galvagno
- Department of Anesthesiology, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA;
| | - Kristen George
- Department of Surgery, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.D.); (K.G.); (T.M.S.); (D.H.)
| | - Ashley R. Menne
- Department of Emergency Medicine, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.R.M.); (D.J.H.)
| | - Daniel J. Haase
- Department of Emergency Medicine, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (A.R.M.); (D.J.H.)
| | - Brian McCormick
- Perfusion Services, University of Maryland Medical Center, Baltimore, MD 21201, USA; (B.M.); (R.R.)
| | - Raymond Rector
- Perfusion Services, University of Maryland Medical Center, Baltimore, MD 21201, USA; (B.M.); (R.R.)
| | - Siamak Dahi
- Department of Surgery, Division of Cardiac Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.D.); (R.J.M.); (K.B.D.); (M.G.); (J.S.G.)
| | - Ronson J. Madathil
- Department of Surgery, Division of Cardiac Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.D.); (R.J.M.); (K.B.D.); (M.G.); (J.S.G.)
| | - Kristopher B. Deatrick
- Department of Surgery, Division of Cardiac Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.D.); (R.J.M.); (K.B.D.); (M.G.); (J.S.G.)
| | - Mehrdad Ghoreishi
- Department of Surgery, Division of Cardiac Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.D.); (R.J.M.); (K.B.D.); (M.G.); (J.S.G.)
| | - James S. Gammie
- Department of Surgery, Division of Cardiac Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.D.); (R.J.M.); (K.B.D.); (M.G.); (J.S.G.)
| | - David J. Kaczorowski
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA;
| | - Thomas M. Scalea
- Department of Surgery, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.D.); (K.G.); (T.M.S.); (D.H.)
| | - Jay Menaker
- Department of Surgery, University of California San Francisco Medical Center, San Francisco, CA 94143, USA;
| | - Daniel Herr
- Department of Surgery, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA; (S.D.); (K.G.); (T.M.S.); (D.H.)
| | - Eric Krause
- Department of Surgery, Division of Thoracic Surgery, School of Medicine, University of Maryland, Baltimore, MD 21201, USA;
| | - Ali Tabatabai
- Department of Medicine, Division of Pulmonary and Critical Care, Program in Trauma, School of Medicine, University of Maryland, Baltimore, MD 21201, USA;
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Sarman A, Tuncay S. Principles of approach to suspected or infected patients related Covid-19 in newborn intensive care unit and pediatric intensive care unit. Perspect Psychiatr Care 2021; 57:957-964. [PMID: 33184910 DOI: 10.1111/ppc.12643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/08/2020] [Accepted: 09/30/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE In this study, it was aimed to evaluate physical and mental health (MH) effects of children and their parents in newborn intensive care unit and pediatric intensive care unit due to Covid-19. CONCLUSIONS Children are less likely to develop severe illness than adults. It may benefit from medical and psychological/behavioral interventions. Prevent negative MH outcomes for babies/children/caregivers affected by Covid-19. PRACTICE IMPLICATIONS It is useful to clarify the clinical course of children (treatment, care procedures, psychosocial effects, etc.). The establishment of mental health expert nursing teams, psychological counseling (synchronous telemedicine services for support purposes, telepsychiatry for parents, etc.) may have helped prevent negative mental health of Covid-19 outcomes. Continuous updating of medical staff's knowledge and skills for the prevention of Covid-19 is expected to slow the spread of the disease.
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Affiliation(s)
- Abdullah Sarman
- Department of Medical Services and Techniques, Vocational School of Health Services, Bingol University, Bingol, Turkey
| | - Suat Tuncay
- Department of Pediatric Nursing, Bingol University, Bingol, Turkey
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29
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Kirk AHP, Chong SL, Kam KQ, Huang W, Ang LSL, Lee JH, Sultana R, Hon KL, Wong JJM. Psychosocial impact of the COVID-19 pandemic on paediatric healthcare
workers. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021. [DOI: 10.47102/annals-acadmedsg.2020527] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: Frontline healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19)
are at risk of psychological distress. This study evaluates the psychological impact of COVID-19 pandemic
on HCWs in a national paediatric referral centre.
Methods: This was a survey-based study that collected demographic, work environment and mental
health data from paediatric HCWs in the emergency, intensive care and infectious disease units. Psychological
impact was measured using the Depression, Anxiety, Stress Scale-21. Multivariate regression analysis
was performed to identify risk factors associated with psychological distress.
Results: The survey achieved a response rate of 93.9% (430 of 458). Of the 430 respondents, symptoms
of depression, anxiety and stress were reported in 168 (39.1%), 205 (47.7%) and 106 (24.7%),
respectively. Depression was reported in the mild (47, 10.9%), moderate (76, 17.7%), severe (23, 5.3%)
and extremely severe (22, 5.1%) categories. Anxiety (205, 47.7%) and stress (106, 24.7%) were reported
in the mild category only. Collectively, regression analysis identified female sex, a perceived lack of choice
in work scope/environment, lack of protection from COVID-19, lack of access to physical activities and
rest, the need to perform additional tasks, and the experience of stigma from the community as risk factors
for poor psychological outcome.
Conclusion: A high prevalence of depression, anxiety and stress was reported among frontline paediatric
HCWs during the COVID-19 pandemic. Personal psychoneuroimmunity and organisational prevention
measures can be implemented to lessen psychiatric symptoms. At the national level, involving mental health
professionals to plan and coordinate psychological intervention for the country should be considered.
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Affiliation(s)
| | | | | | - Weili Huang
- KK Women’s and Children’s Hospital, Singapore
| | | | | | - Rehena Sultana
- Centre for Quantitative Medicine, SingHealth Duke-NUS, Singapore
| | - Kam Lun Hon
- The Chinese University of Hong Kong, Hong Kong
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30
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Guzzi PH, Tradigo G, Veltri P. Regional Resource Assessment During the COVID-19 Pandemic in Italy: Modeling Study. JMIR Med Inform 2021; 9:e18933. [PMID: 33629957 PMCID: PMC7945976 DOI: 10.2196/18933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/05/2020] [Accepted: 01/17/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND COVID-19 has been declared a worldwide emergency and a pandemic by the World Health Organization. It started in China in December 2019, and it rapidly spread throughout Italy, which was the most affected country after China. The pandemic affected all countries with similarly negative effects on the population and health care structures. OBJECTIVE The evolution of the COVID-19 infections and the way such a phenomenon can be characterized in terms of resources and planning has to be considered. One of the most critical resources has been intensive care units (ICUs) with respect to the infection trend and critical hospitalization. METHODS We propose a model to estimate the needed number of places in ICUs during the most acute phase of the infection. We also define a scalable geographic model to plan emergency and future management of patients with COVID-19 by planning their reallocation in health structures of other regions. RESULTS We applied and assessed the prediction method both at the national and regional levels. ICU bed prediction was tested with respect to real data provided by the Italian government. We showed that our model is able to predict, with a reliable error in terms of resource complexity, estimation parameters used in health care structures. In addition, the proposed method is scalable at different geographic levels. This is relevant for pandemics such as COVID-19, which has shown different case incidences even among northern and southern Italian regions. CONCLUSIONS Our contribution can be useful for decision makers to plan resources to guarantee patient management, but it can also be considered as a reference model for potential upcoming waves of COVID-19 and similar emergency situations.
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Affiliation(s)
- Pietro H Guzzi
- Department of Surgical and Medical Sciences, University of Catanzaro, CZ, Italy
| | | | - Pierangelo Veltri
- Department of Surgical and Medical Sciences, University of Catanzaro, CZ, Italy
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31
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Nejadghaderi SA, Saghazadeh A, Rezaei N. Health Care Policies and COVID-19 Prevalence: Is There Any Association? INTERNATIONAL JOURNAL OF HEALTH SERVICES 2021; 52:9-22. [PMID: 33686893 DOI: 10.1177/0020731421993940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected almost all countries and territories. As of December 6, 2020, the United States of America and India have the highest prevalence. Each country has implemented different strategies to control and reduce the spread of disease. Here, the association between prevalence number and health policies is evaluated by comparing 2 groups of countries: (1) Italy, the United States of America, Germany, Spain, and India with a higher prevalence than a linear trend line; and (2) Singapore and China with a lower or equal prevalence than linear forecasts. A rapid overview revealed that many countries have similar strategies for controlling COVID-19, including the suspension of air travel, the lockdown on the cities with the most cases detected, active case findings, monitoring of close contacts, and raising public awareness. Also, they used a gradual and phased plan to reopen activities. So, the difference between countries in the burden of COVID-19 can be attributable to the strict mode and nonstrict mode of implementation of strategies. Limitations at the national levels call for systemic rather than regional strategies.
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Affiliation(s)
- Seyed A Nejadghaderi
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,School of Medicine, 556492Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amene Saghazadeh
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Research Center for Immunodeficiencies, Children's Medical Center, 48439Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, 48439Tehran University of Medical Sciences, Tehran, Iran.,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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SARMAN A, TUNCAY S, SARMAN E. Çocuklarda Covid-19’un Tanılanmasında Hemşirelik Yaklaşımı: Sistematik Bir İnceleme. ACTA MEDICA ALANYA 2021. [DOI: 10.30565/medalanya.843403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Lim DYY, Ng VV, Tan Z, Koh DLK. Staying SHARP in times of crisis – The impact of COVID-19 on anaesthesiology residency. PROCEEDINGS OF SINGAPORE HEALTHCARE 2021. [DOI: 10.1177/2010105821990679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic is an unprecedented crisis that has taken the world by storm, and it has taken an especially immense toll on the healthcare sector. Although much effort has been made to make changes in key areas such as clinical practice, national policy and research, we believe that it is just as important to evaluate the impact of the crisis on postgraduate medical training. To this end, we would like to share our experience within an anaesthesiology residency programme in Singapore, the SingHealth Anaesthesiology Residency Programme, which we hope will benefit other training programmes and anyone involved in postgraduate medical education as a whole. Key challenges identified include restrictions on teaching events, difficulties in completing core posting requirements, changes in clinical workload, postponement of examinations, exposure risk (particularly in relation to aerosol-generating procedures) and psychological burden. Strategies that have been implemented to tackle these challenges are also described, including the use of online platforms, modifications to posting and promotion requirements, manpower adjustments, provision of protective equipment and training in infectious disease protocols. Ultimately, we believe that a supportive work environment is essential to ensure the wellbeing of residents in times of crisis.
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Affiliation(s)
- Denise Yan Yin Lim
- SingHealth Anaesthesiology Residency Programme, Singapore
- Division of Anaesthesiology, Singapore General Hospital, Singapore
| | - Von Vee Ng
- Division of Anaesthesiology, Singapore General Hospital, Singapore
| | - Zihui Tan
- Division of Anaesthesiology, Singapore General Hospital, Singapore
| | - Darren LK Koh
- SingHealth Anaesthesiology Residency Programme, Singapore
- Division of Anaesthesiology, Singapore General Hospital, Singapore
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Dibbs RP, Ferry AM, Enochs J, Ward A, Glover CD, Archer N, Taylor KD, Almaguer-Bravo J, Hollier LH. The use of personal protective equipment during the COVID-19 pandemic in a tertiary pediatric hospital. J Healthc Risk Manag 2021; 40:38-44. [PMID: 33496074 PMCID: PMC8014889 DOI: 10.1002/jhrm.21460] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/09/2020] [Accepted: 12/28/2020] [Indexed: 12/15/2022]
Abstract
The provision of health care in the perioperative setting has undergone significant changes due to severe respiratory distress syndrome coronavirus‐2 (SARS‐CoV‐2). Hospital facilities have been tasked with developing and implementing personal protective equipment (PPE) protocols to protect both medical providers and patients. Texas Children's Hospital has created a set of protocols for donning and doffing PPE while managing surgical pediatric patients. These requirements have undergone numerous modifications as a result of our internal infrastructural recommendations and the Centers for Disease Control and Prevention guidance, which has led to more lenient regulations. While these perioperative PPE protocols were less stringent compared to the original guidelines, we were able to create a safe surgical environment without further exposing patients and health care providers to SARS‐CoV‐2. In this article, we detail the design, distribution, implementation, and modification of our institutional surgical PPE protocols.
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Affiliation(s)
- Rami P Dibbs
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.,Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas, USA
| | - Andrew M Ferry
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.,Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas, USA
| | - Joyce Enochs
- Department of Surgery, Texas Children's Hospital, Houston, Texas, USA
| | - Amanda Ward
- Department of Surgery, Texas Children's Hospital, Houston, Texas, USA
| | - Chris D Glover
- Department of Anesthesiology, Texas Children's Hospital, Houston, Texas, USA
| | - Nakeisha Archer
- Department of Surgery, Texas Children's Pavilion for Women, Houston, Texas, USA
| | - Kimberly D Taylor
- Department of Anesthesiology, Texas Children's Hospital, Houston, Texas, USA
| | - Judy Almaguer-Bravo
- Department of Anesthesiology, Texas Children's Hospital, Houston, Texas, USA
| | - Larry H Hollier
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.,Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, Texas, USA
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González-Bustamante B. Evolution and early government responses to COVID-19 in South America. WORLD DEVELOPMENT 2021; 137:105180. [PMID: 32921879 PMCID: PMC7473024 DOI: 10.1016/j.worlddev.2020.105180] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/28/2020] [Indexed: 05/22/2023]
Abstract
This article analyses the evolution of COVID-19 and early government responses to the pandemic in eight South American countries. To this aim, this study explores indicators which trace the progression of the pandemic and analyses factors related of state capacity which impacted on the early response of governments of implementing restrictive policies of social distancing associated with a suppression strategy. The pressure on the health systems is evaluated with early projections of the growth-phase of the epidemic, which is incorporated as an indicator in the analysis of early interventions based on Cox proportional hazards models. The results indicate that fiscal expenditure on health, regional and local government capacity, and pressure on the health system accelerate government response with stringent interventions. A counter-intuitive finding is that the economic strength of a country delays these types of reactions. The effect of these interventions is something that should be studied in greater depth, considering, for example, sociocultural factors. Lastly, only cases such as Uruguay and Paraguay show some signs of having the pandemic relatively under control by mid-May, while Brazil and Peru face very adverse scenarios. In this context, considering the characteristics of the states in the region and the level of informal employment, it will be a public policy challenge to keep the equilibrium between restrictive measures and the economic and social problems which these responses imply in the medium term.
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Affiliation(s)
- Bastián González-Bustamante
- Department of Politics and International Relations, University of Oxford, St Hilda's College, Cowley Place, Oxford OX4 1DY, United Kingdom
- Department of Public Administration and Policy, Universidad de Santiago de Chile, 3363 Lib. Bernardo O'Higgins Av., Faculty of Economics and Management Building, Santiago, Chile
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Hospital El Salvador: a novel paradigm of intensive care in response to COVID-19 in central America. LANCET GLOBAL HEALTH 2020; 9:e241-e242. [PMID: 33357501 PMCID: PMC7834343 DOI: 10.1016/s2214-109x(20)30513-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 12/04/2022]
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Chong SL, Soo JSL, Allen JC, Ganapathy S, Lee KP, Tyebally A, Yung CF, Thoon KC, Ng YH, Oh JY, Teoh OH, Mok YH, Chan YH. Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore. BMC Pediatr 2020; 20:562. [PMID: 33353540 PMCID: PMC7755581 DOI: 10.1186/s12887-020-02469-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/11/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has impacted the provision of health services in all specialties. We aim to study the impact of COVID-19 on the utilization of pediatric hospital services including emergency department (ED) attendances, hospitalizations, diagnostic categories and resource utilization in Singapore. METHODS We performed a retrospective review of ED attendances and hospital admissions among children < 18 years old from January 1st to August 8th 2020 in a major pediatric hospital in Singapore. Data were analyzed in the following time periods: Pre-lockdown (divided by the change in Disease Outbreak Response System Condition (DORSCON) level), during-lockdown and post-lockdown. We presented the data using proportions and percentage change in mean counts per day with the corresponding 95% confidence intervals (CIs). RESULTS We attended to 58,367 children with a mean age of 5.1 years (standard deviation, SD 4.6). The mean ED attendance decreased by 331 children/day during lockdown compared to baseline (p < 0.001), attributed largely to a drop in respiratory (% change - 87.9, 95% CI - 89.3 to - 86.3, p < 0.001) and gastrointestinal infections (% change - 72.4, 95%CI - 75.9 to - 68.4, p < 0.001). Trauma-related diagnoses decreased at a slower rate across the same periods (% change - 40.0, 95%CI - 44.3 to - 35.3, p < 0.001). We saw 226 children with child abuse, with a greater proportion of total attendance seen post-lockdown (79, 0.6%) compared to baseline (36, 0.2%) (p < 0.001). In terms of ED resource utilization, there was a decrease in the overall mean number of procedures performed per day during the lockdown compared to baseline, driven largely by a reduction in blood investigations (% change - 73.9, 95%CI - 75.9 to - 71.7, p < 0.001). CONCLUSIONS We highlighted a significant decrease in infection-related presentations likely attributed to the lockdown and showed that the relative proportion of trauma-related attendances increased. By describing the impact of COVID-19 on health services, we report important trends that may provide guidance when planning resources for future pandemics.
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Affiliation(s)
- Shu-Ling Chong
- Department of Emergency Medicine, KK Women's and Children's Hospital, 100, Bukit Timah Road, Singapore, 229899, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
| | | | - John Carson Allen
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Sashikumar Ganapathy
- Department of Emergency Medicine, KK Women's and Children's Hospital, 100, Bukit Timah Road, Singapore, 229899, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Khai Pin Lee
- Department of Emergency Medicine, KK Women's and Children's Hospital, 100, Bukit Timah Road, Singapore, 229899, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Arif Tyebally
- Department of Emergency Medicine, KK Women's and Children's Hospital, 100, Bukit Timah Road, Singapore, 229899, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Chee Fu Yung
- Duke-NUS Medical School, Singapore, Singapore
- Department of KK Women's and Children's Hospital, Infectious Disease Service, Singapore, Singapore
| | - Koh Cheng Thoon
- Duke-NUS Medical School, Singapore, Singapore
- Division of Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yong Hong Ng
- Duke-NUS Medical School, Singapore, Singapore
- Division of Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jean Yin Oh
- Duke-NUS Medical School, Singapore, Singapore
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Oon Hoe Teoh
- Duke-NUS Medical School, Singapore, Singapore
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yee Hui Mok
- Duke-NUS Medical School, Singapore, Singapore
- Children's Intensive Care Unit, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yoke Hwee Chan
- Duke-NUS Medical School, Singapore, Singapore
- Division of Medicine, KK Women's and Children's Hospital, Singapore, Singapore
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Kumar A, Kapila M, Pankaj R. Medicine and Law in the Times of COVID-19 Pandemic: Understanding the Interphase. Indian J Crit Care Med 2020; 24:971-974. [PMID: 33281324 PMCID: PMC7689127 DOI: 10.5005/jp-journals-10071-23553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Coronavirus disease-2019 (COVID-19) has heralded a wide set of challenges involving not only the medical management of the patients but also the legal dilemma with regards to provision of healthcare services. The medical professionals have experienced difficulty in balancing their obligations and duties toward the patients, and their own right to safeguard self, family, and their clinical establishments. The professional regulatory bodies and government have formulated new policies and amended laws to control the current situation. It is the need of the hour to be mindful of the existing laws and our rights and duties in the era of current pandemic. Collaborative efforts are needed to provide best possible care in the current unpredictable environment. The commonly encountered problems and their possible solutions are discussed in the context of medicolegal framework applicable to Indian medical practitioner. How to cite this article: Kumar A, Kapila M, Pankaj R. Medicine and Law in the Times of COVID-19 Pandemic: Understanding the Interphase. Indian J Crit Care Med 2020;24(10):971–974.
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Affiliation(s)
- Arun Kumar
- Department of Intensive Care, Medical Intensive Care Unit, Fortis Healthcare Ltd, Mohali, Punjab, India
| | - Munish Kapila
- Advocate, Punjab & Haryana High Court, Chandigarh, India
| | - Ritu Pankaj
- Department of Laboratory Medicine, Fortis Healthcare Ltd, Mohali, Punjab, India
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Prone Positioning for Severe Acute Respiratory Distress Syndrome in COVID-19 Patients by a Dedicated Team: A Safe and Pragmatic Reallocation of Medical and Surgical Work Force in Response to the Outbreak. Ann Surg 2020; 272:e311-e315. [PMID: 32740251 PMCID: PMC7668324 DOI: 10.1097/sla.0000000000004265] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: The aim of this study was to define whether rapidly reallocating health care workers not experienced with PP for performing PP in ICU is feasible and safe. Summary Background Data: In the setting of severe acute respiratory distress syndrome (ARDS), the use of prone and supine positioning procedures (PP) has been associated with improved oxygenation resulting in decreased mortality. Nevertheless, applying PP is time consuming for ICU staffs that are at risk of mental of physical exhaustion, especially with the constant surge of admitted COVID-19 patients with severe ARDS. Methods: This prospective cohort study conducted at a single regional university hospital between March 27 and April 15, 2020. Among 117 patients admitted to ICU, 67 patients (57.3%) presented with proven SARS-CoV-2 infection with severe ARDS requiring PP. After accelerated simulation training, 109 volunteers including surgeons, physicians, nurses and physiotherapists, multiple dedicated teams performed daily multiple PP following a systematic checklist. Patient demographics and PP data were collected. Patient safety and health care workers safety were assessed. Results: Among 117 patients admitted to ICU, 67 patients (57.3%) required PP. Overall, 53 (79%) were male, with a median age of 68.5 years and median body mass index of 29.3 kg/m2. A total of 384 PP were performed. Overall, complication occurred in 34 PP (8.8%) and led to PP cancelation in 4 patients (1%). Regarding health care workers safety, four health care workers presented with potential COVID-19 related symptoms and none was positive. Conclusions: To overcome the surge of critically ill COVID-19 patients, reallocating health care workers to targeted medical tasks beyond their respective expertise such as PP was safe.
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40
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Kuek JTY, Ngiam LXL, Kamal NHA, Chia JL, Chan NPX, Abdurrahman ABHM, Ho CY, Tan LHE, Goh JL, Khoo MSQ, Ong YT, Chiam M, Chin AMC, Mason S, Krishna LKR. The impact of caring for dying patients in intensive care units on a physician's personhood: a systematic scoping review. Philos Ethics Humanit Med 2020; 15:12. [PMID: 33234133 PMCID: PMC7685911 DOI: 10.1186/s13010-020-00096-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/11/2020] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Supporting physicians in Intensive Care Units (ICU)s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review (SSR) is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for ICU physicians. METHODS An SSR adopts the Systematic Evidenced Based Approach (SEBA) to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis (Split Approach) is adopted. RESULTS Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed. CONCLUSION This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support.
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Affiliation(s)
- Joshua Tze Yin Kuek
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Lisa Xin Ling Ngiam
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Nur Haidah Ahmad Kamal
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Jeng Long Chia
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Natalie Pei Xin Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Ahmad Bin Hanifah Marican Abdurrahman
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Chong Yao Ho
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Lorraine Hui En Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Jun Leng Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Michelle Shi Qing Khoo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Annelissa Mien Chew Chin
- Medical Library, National University of Singapore Libraries, National University of Singapore, Singapore, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK.
- Duke-NUS Graduate Medical School, Singapore, Singapore.
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore.
- PalC, The Palliative Care Centre for Excellence in Research and Education, Singapore, Singapore.
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Tan THY, Toh MPHS, Vasoo S, Lye DCB, Ang BSP, Leo YS, Lee VJM, Puah SH, Kurup A. Coronavirus Disease 2019 (COVID-19): The Singapore Experience. A Review of the First Eight Months. ANNALS ACADEMY OF MEDICINE SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020306] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
As of 27 October 2020, there have been 57,980 confirmed cases of COVID-19 in Singapore, with 28 fatalities. To summarise the Singapore experience in managing and containing COVID-19 based on available published data and from relevant sources, a review of literature using research databases such as PubMed and OVID Medline, along with non-peer-reviewed articles and other sources, was conducted with the search terms ‘COVID-19’ and ‘Singapore’. Research conducted in Singapore has provided insight into the clinical manifestations and period of infectivity of COVID-19, demonstrated evidence of pre-symptomatic transmission, linked infection clusters using serological tools, and highlighted aspects of hospital-based environmental contamination. It has also provided guidance for diagnostic testing and has described immune and virologic correlates with disease severity. Evidence of effectiveness of containment measures such as early border control, rigorous contact training, and calibrated social distancing measures have also been demonstrated. Singapore’s multipronged strategy has been largely successful at containing COVID-19 and minimising fatalities, but the risk of re-emergence is high. Keywords: Epidemiology, management, prevention, transmission
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Moran A, Mphahlele M, Mvusi L, Dlamini C, Ahmedov S, AlMossawi HJ, Kak N. Learning from tuberculosis: COVID-19 highlights the need for more robust infection control policy. J Glob Health 2020; 10:020328. [PMID: 33110528 PMCID: PMC7561217 DOI: 10.7189/jogh.10.020328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Alexander Moran
- University Research Co., LLC (URC), Center for Innovation and Technology, Chevy Chase, Maryland, USA
| | - Matsie Mphahlele
- University Research Co., LLC (URC), USAID Tuberculosis South Africa Project, Pretoria, Gauteng, South Africa
| | - Lindiwe Mvusi
- National Department of Health, Pretoria, Gauteng, South Africa
| | - Cindy Dlamini
- United States Agency for International Development (USAID), Pretoria, Gauteng, South Africa
| | - Sevim Ahmedov
- United States Agency for International Development (USAID), Washington, D. C., USA
| | - Hala Jassim AlMossawi
- University Research Co., LLC (URC), Center for Innovation and Technology, Chevy Chase, Maryland, USA
| | - Neeraj Kak
- University Research Co., LLC (URC), Center for Innovation and Technology, Chevy Chase, Maryland, USA
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43
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Shoukat A, Wells CR, Langley JM, Singer BH, Galvani AP, Moghadas SM. Projection de la demande de lits de soins intensifs durant l’épidémie de COVID-19 au Canada. CMAJ 2020; 192:E1315-E1322. [PMID: 33106307 DOI: 10.1503/cmaj.200457-f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2020] [Indexed: 01/09/2023] Open
Affiliation(s)
- Affan Shoukat
- Center for Infectious Disease Modeling and Analysis (A. Shoukat, C. Wells, A. Galvani), École de santé publique de Yale, New Haven (Connecticut); Centre canadien de vaccinologie (J. Langley), Université Dalhousie, Centre de soins de santé IWK et Régie de la santé de la Nouvelle-Écosse (J. Langley), Halifax (Nouvelle-Écosse); Emerging Pathogens Institute (B. Singer), Université de Floride, Gainesville (Floride); Agent-Based Modelling Laboratory (S. Moghadas), Université York, Toronto (Ontario)
| | - Chad R Wells
- Center for Infectious Disease Modeling and Analysis (A. Shoukat, C. Wells, A. Galvani), École de santé publique de Yale, New Haven (Connecticut); Centre canadien de vaccinologie (J. Langley), Université Dalhousie, Centre de soins de santé IWK et Régie de la santé de la Nouvelle-Écosse (J. Langley), Halifax (Nouvelle-Écosse); Emerging Pathogens Institute (B. Singer), Université de Floride, Gainesville (Floride); Agent-Based Modelling Laboratory (S. Moghadas), Université York, Toronto (Ontario)
| | - Joanne M Langley
- Center for Infectious Disease Modeling and Analysis (A. Shoukat, C. Wells, A. Galvani), École de santé publique de Yale, New Haven (Connecticut); Centre canadien de vaccinologie (J. Langley), Université Dalhousie, Centre de soins de santé IWK et Régie de la santé de la Nouvelle-Écosse (J. Langley), Halifax (Nouvelle-Écosse); Emerging Pathogens Institute (B. Singer), Université de Floride, Gainesville (Floride); Agent-Based Modelling Laboratory (S. Moghadas), Université York, Toronto (Ontario)
| | - Burton H Singer
- Center for Infectious Disease Modeling and Analysis (A. Shoukat, C. Wells, A. Galvani), École de santé publique de Yale, New Haven (Connecticut); Centre canadien de vaccinologie (J. Langley), Université Dalhousie, Centre de soins de santé IWK et Régie de la santé de la Nouvelle-Écosse (J. Langley), Halifax (Nouvelle-Écosse); Emerging Pathogens Institute (B. Singer), Université de Floride, Gainesville (Floride); Agent-Based Modelling Laboratory (S. Moghadas), Université York, Toronto (Ontario)
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis (A. Shoukat, C. Wells, A. Galvani), École de santé publique de Yale, New Haven (Connecticut); Centre canadien de vaccinologie (J. Langley), Université Dalhousie, Centre de soins de santé IWK et Régie de la santé de la Nouvelle-Écosse (J. Langley), Halifax (Nouvelle-Écosse); Emerging Pathogens Institute (B. Singer), Université de Floride, Gainesville (Floride); Agent-Based Modelling Laboratory (S. Moghadas), Université York, Toronto (Ontario)
| | - Seyed M Moghadas
- Center for Infectious Disease Modeling and Analysis (A. Shoukat, C. Wells, A. Galvani), École de santé publique de Yale, New Haven (Connecticut); Centre canadien de vaccinologie (J. Langley), Université Dalhousie, Centre de soins de santé IWK et Régie de la santé de la Nouvelle-Écosse (J. Langley), Halifax (Nouvelle-Écosse); Emerging Pathogens Institute (B. Singer), Université de Floride, Gainesville (Floride); Agent-Based Modelling Laboratory (S. Moghadas), Université York, Toronto (Ontario)
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44
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Patangi SO, Kanchi M. The Intensive Care Unit in the “COVID-19 Era”. JOURNAL OF CARDIAC CRITICAL CARE TSS 2020. [DOI: 10.1055/s-0040-1718649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Sanjay Orathi Patangi
- Department of Adult Cardiac Intensive Care, Narayana Institute of Cardiac Sciences, Narayana Health City, Bangalore, Karnataka, India
| | - Muralidhar Kanchi
- Department of Anaesthesia and Intensive Care, Narayana Institute of Cardiac Sciences, Narayana Health City, Bangalore, Karnataka, India
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Rahim F, Amin S, Noor M, Bahadur S, Gul H, Mahmood A, Usman M, Khan MA, Ullah R, Shahab K. Mortality of Patients With Severe COVID-19 in the Intensive Care Unit: An Observational Study From a Major COVID-19 Receiving Hospital. Cureus 2020; 12:e10906. [PMID: 33194473 PMCID: PMC7657313 DOI: 10.7759/cureus.10906] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Objective To determine the mortality of patients with severe COVID-19 in the intensive care unit (ICU) in relation to age, gender, co-morbidities, ventilatory status, and length of stay (LOS). Methods This was a cross-sectional study based on data retrieved for 204 patients admitted to the ICU of Hayatabad Medical Complex, Peshawar, Pakistan, from April to August 2020. Study variables were age, gender, co-morbid conditions, ventilatory status, and length of stay (LOS). The data were analyzed using SPSS version 21 (IBM Corp., Armonk, NY). The independent t-test and the chi-square test were used to compare the means and frequencies of variables. Multivariate regression analysis was used to predict the likelihood of mortality. Results The overall mortality was 77%. Non-invasive ventilation (NIV) was administered to 61.8% of patients. Mortality was higher for invasive mechanical ventilation (IMV) (93.6% vs 66.7%, p<0.001) and for over 60 years (87.3% vs 72.3%, p=0.019). Mortality without co-morbidities was 75.2%. Comparative mortality rates for at least one co-morbidity (79.7%), diabetes mellitus (80.0%), hypertension (100%), diabetes mellitus and hypertension both (87.1%), and chronic obstructive pulmonary disease (75%) were insignificant. The LOS for survivors was longer (8.9±8.9 versus 5.4±5.2 days, p=0.017). The LOS < 24h was associated with higher mortality (85.9% vs 72.9%, p=0.040). On multivariable regression, the likelihood of mortality was high for IMV (7.330, 95% CI 2.667 - 20.143, p<0.001) and elderly (>60 years) patients (2.607, 95%CI 1.063 - 6.394, p=0.036). Mortality decreased with LOS longer than 24h (0.412, 95%CI 0.173 - 0.982, p=0.045). Co-morbidities did not have any effect on mortality. Conclusions Age more than 60 years and IMV were independent risk factors for higher mortality. Longer ICU stay, specifically more than 24 hours, was associated with lower mortality but LOS less than 24 hours might not have a causal relationship with mortality. The odds of survival were not affected by co-morbidities.
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Affiliation(s)
- Fawad Rahim
- Internal Medicine, Khyber Girls Medical College, Peshawar, PAK
| | - Said Amin
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Mohammad Noor
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Sher Bahadur
- Epidemiology and Public Health, Khyber Institute of Child Health, Peshawar, PAK
| | - Huma Gul
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Afsheen Mahmood
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Muhammad Usman
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Muhammad Asif Khan
- Critical Care Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Raza Ullah
- Critical Care Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Khalid Shahab
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
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Semenova Y, Pivina L, Khismetova Z, Auyezova A, Nurbakyt A, Kauysheva A, Ospanova D, Kuziyeva G, Kushkarova A, Ivankov A, Glushkova N. Anticipating the Need for Healthcare Resources Following the Escalation of the COVID-19 Outbreak in the Republic of Kazakhstan. J Prev Med Public Health 2020; 53:387-396. [PMID: 33296578 PMCID: PMC7733753 DOI: 10.3961/jpmph.20.395] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives The lack of advance planning in a public health emergency can lead to wasted resources and inadvertent loss of lives. This study is aimed at forecasting the needs for healthcare resources following the expansion of the coronavirus disease 2019 (COVID-19) outbreak in the Republic of Kazakhstan, focusing on hospital beds, equipment, and the professional workforce in light of the developing epidemiological situation and the data on resources currently available. Methods We constructed a forecast model of the epidemiological scenario via the classic susceptible-exposed-infected-removed (SEIR) approach. The World Health Organization’s COVID-19 Essential Supplies Forecasting Tool was used to evaluate the healthcare resources needed for the next 12 weeks. Results Over the forecast period, there will be 104 713.7 hospital admissions due to severe disease and 34 904.5 hospital admissions due to critical disease. This will require 47 247.7 beds for severe disease and 1929.9 beds for critical disease at the peak of the COVID-19 outbreak. There will also be high needs for all categories of healthcare workers and for both diagnostic and treatment equipment. Thus, Republic of Kazakhstan faces the need for a rapid increase in available healthcare resources and/or for finding ways to redistribute resources effectively. Conclusions Republic of Kazakhstan will be able to reduce the rates of infections and deaths among its population by developing and following a consistent strategy targeting COVID-19 in a number of inter-related directions.
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Affiliation(s)
- Yuliya Semenova
- Department of Neurology, Ophthalmology and Otolaryngology, Semey Medical University, Semey, Kazakhstan
| | - Lyudmila Pivina
- Department of Internal Medicine, Semey Medical University, Semey, Kazakhstan
| | - Zaituna Khismetova
- Department of Public Health, Semey Medical University, Semey, Kazakhstan
| | - Ardak Auyezova
- Head Office, Kazakhstan Medical University Higher School of Public Health, Almaty, Kazakhstan
| | - Ardak Nurbakyt
- Department of Epidemiology, Evidence Medicine and Biostatistics, Kazakhstan Medical University Higher School of Public Health, Almaty, Kazakhstan
| | - Almagul Kauysheva
- Department of Research and International Affairs Kazakhstan Medical University Higher School of Public Health, Almaty, Kazakhstan
| | - Dinara Ospanova
- Department of Public Health, Kazakh Medical University of Continuing Education, Almaty, Kazakhstan
| | - Gulmira Kuziyeva
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | | | - Alexandr Ivankov
- Department of Postgraduate Education, Kazakh Medical University of Continuing Education, Almaty, Kazakhstan
| | - Natalya Glushkova
- Department of Epidemiology, Evidence Medicine and Biostatistics, Kazakhstan Medical University Higher School of Public Health, Almaty, Kazakhstan
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Lord H, Loveday C, Moxham L, Fernandez R. Effective communication is key to intensive care nurses' willingness to provide nursing care amidst the COVID-19 pandemic. Intensive Crit Care Nurs 2020; 62:102946. [PMID: 33139165 PMCID: PMC7528824 DOI: 10.1016/j.iccn.2020.102946] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/03/2020] [Accepted: 09/06/2020] [Indexed: 01/08/2023]
Abstract
Background The COVID-19 pandemic posed and continues to pose challenges for health care systems globally, particularly to Intensive Care Units (ICU). At the forefront of the ICU are highly trained nurses with a professional obligation to care for patients with COVID-19 despite the potential to become infected. The aim of this study was to explore ICU nurses’ willingness to care during the COVID-19 pandemic. Methods A prospective cross-sectional study to explore ICU nurses’ willingness to provide care during the COVID-19 pandemic was undertaken between 25 March and 3 April 2020 at a large principal and referral teaching hospital in Sydney, NSW Australia. Results A total of 83 ICU nurses completed the survey. Approximately 60% reported receiving sufficient information from managers regarding COVID-19 and about caring for a patient with COVID-19. Ninety percent of nurses were concerned about spreading COVID-19 to their family. Sixty one percent of the nurses indicated that they were willing to care for patients with COVID-19. Receiving timely communication from managers was the only predictor of willingness to care among ICU nurses. Conclusions Effective communication is a vital component during a public health emergency in order to promote nurses’ willingness to care for patients in the ICU.
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Affiliation(s)
- Heidi Lord
- Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, Kogarah, NSW, Australia; Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, NSW, Australia.
| | - Clare Loveday
- Intensive Care Services, St George Hospital, Kogarah, NSW, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, Building 41, University of Wollongong, NSW, Australia
| | - Ritin Fernandez
- Centre for Research in Nursing and Health, Level 1 Research and Education Building, St George Hospital, Kogarah, NSW, Australia; Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, NSW, Australia; School of Nursing, Faculty of Science, Medicine and Health, Building 41, University of Wollongong, NSW, Australia
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Contreras S, Biron-Lattes JP, Villavicencio HA, Medina-Ortiz D, Llanovarced-Kawles N, Olivera-Nappa Á. Statistically-based methodology for revealing real contagion trends and correcting delay-induced errors in the assessment of COVID-19 pandemic. CHAOS, SOLITONS, AND FRACTALS 2020; 139:110087. [PMID: 32834623 PMCID: PMC7341964 DOI: 10.1016/j.chaos.2020.110087] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/19/2020] [Accepted: 07/02/2020] [Indexed: 05/14/2023]
Abstract
COVID-19 pandemic has reshaped our world in a timescale much shorter than what we can understand. Particularities of SARS-CoV-2, such as its persistence in surfaces and the lack of a curative treatment or vaccine against COVID-19, have pushed authorities to apply restrictive policies to control its spreading. As data drove most of the decisions made in this global contingency, their quality is a critical variable for decision-making actors, and therefore should be carefully curated. In this work, we analyze the sources of error in typically reported epidemiological variables and usual tests used for diagnosis, and their impact on our understanding of COVID-19 spreading dynamics. We address the existence of different delays in the report of new cases, induced by the incubation time of the virus and testing-diagnosis time gaps, and other error sources related to the sensitivity/specificity of the tests used to diagnose COVID-19. Using a statistically-based algorithm, we perform a temporal reclassification of cases to avoid delay-induced errors, building up new epidemiologic curves centered in the day where the contagion effectively occurred. We also statistically enhance the robustness behind the discharge/recovery clinical criteria in the absence of a direct test, which is typically the case of non-first world countries, where the limited testing capabilities are fully dedicated to the evaluation of new cases. Finally, we applied our methodology to assess the evolution of the pandemic in Chile through the Effective Reproduction Number Rt , identifying different moments in which data was misleading governmental actions. In doing so, we aim to raise public awareness of the need for proper data reporting and processing protocols for epidemiological modelling and predictions.
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Affiliation(s)
- Sebastián Contreras
- Laboratory for Rheology and Fluid Dynamics, Universidad de Chile, Beauchef 850, Santiago 8370448, Chile
- Centre for Biotechnology and Bioengineering, Universidad de Chile, Beauchef 851, Santiago 8370448, Chile
| | - Juan Pablo Biron-Lattes
- Centre for Biotechnology and Bioengineering, Universidad de Chile, Beauchef 851, Santiago 8370448, Chile
- Department of Chemical Engineering, Biotechnology, and Materials, Universidad de Chile, Beauchef 851, Santiago,8370448 Chile
| | - H Andrés Villavicencio
- Centre for Biotechnology and Bioengineering, Universidad de Chile, Beauchef 851, Santiago 8370448, Chile
| | - David Medina-Ortiz
- Centre for Biotechnology and Bioengineering, Universidad de Chile, Beauchef 851, Santiago 8370448, Chile
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA 91125, USA
| | - Nyna Llanovarced-Kawles
- Centre for Biotechnology and Bioengineering, Universidad de Chile, Beauchef 851, Santiago 8370448, Chile
- Department of Chemical Engineering, Biotechnology, and Materials, Universidad de Chile, Beauchef 851, Santiago,8370448 Chile
| | - Álvaro Olivera-Nappa
- Centre for Biotechnology and Bioengineering, Universidad de Chile, Beauchef 851, Santiago 8370448, Chile
- Department of Chemical Engineering, Biotechnology, and Materials, Universidad de Chile, Beauchef 851, Santiago,8370448 Chile
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Dubey N, Dubey P, Dubey PK. Aftermath of COVID-19: Need for developing novel bedside communication skills? Saudi J Anaesth 2020; 14:564-565. [PMID: 33447219 PMCID: PMC7796749 DOI: 10.4103/sja.sja_457_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 05/09/2020] [Accepted: 05/19/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Niyati Dubey
- Undergraduate, MGM Medical College, Navi Mumbai, Maharashtra, India
| | - Preksha Dubey
- Department of Maxillofacial Surgery, ITS Dental College, Greater Noida, Uttar Pradesh, India
| | - Prakash K Dubey
- Department of Anesthesiology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
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