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Duverger C, Monteil C, Souyri V, Fournier S. Factors associated with extent of COVID-19 outbreaks: A prospective study in a large hospital network. Am J Infect Control 2024; 52:696-700. [PMID: 38224818 DOI: 10.1016/j.ajic.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND The COVID-19 pandemic has generated numerous hospital outbreaks. This study aimed to identify factors related to the extent of nosocomial COVID-19 outbreaks in the largest French public health institution. METHODS An observational study was conducted from July 2020 to September 2021. Outbreaks were defined as at least 2 cases, patients and/or health care workers (HCWs), linked by time and geographic location. Logistic regression was performed to identify risk factors for large outbreaks among nine variables: variant, medical ward, COVID-19 vaccination rate and incidence among HCWs and Paris population, number of weekly COVID-19 tests among HCWs and the positivity rate, epidemic waves. RESULTS Within 14 months, 799 outbreaks were identified: 450 small ones (≤6 cases) and 349 large ones (≥7 cases), involving 3,260 patients and 3,850 HCWs. In univariate analysis, large outbreaks were positively correlated to geriatrics wards, COVID-19 incidence, and rate of weekly positive tests among HCWs; and negatively correlated to intensive care units, variant Delta, fourth wave, vaccination rates of the Paris region's population and that of the HCWs. In multivariate analysis, factors that remained significant were the type of medical ward and the vaccination rate among HCWs. CONCLUSIONS Intensive care unit and high vaccination rates among HCWs were associated with a lower risk of large COVID-19 outbreaks, as opposed to geriatric wards, which are associated with a higher risk.
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Affiliation(s)
- Clarisse Duverger
- Central Infection Prevention and Control Team, Assistance Publique-Hôpitaux de Paris, Paris, France.
| | - Catherine Monteil
- Central Infection Prevention and Control Team, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Valérie Souyri
- Central Infection Prevention and Control Team, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sandra Fournier
- Central Infection Prevention and Control Team, Assistance Publique-Hôpitaux de Paris, Paris, France
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2
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Gaube S, Walton K, Kleine AK, Däumling S, Rohrmeier C, Müller S, Bonrath E, Schneider-Brachert W. Examining outpatients' hand hygiene behaviour and its relation to COVID-19 infection prevention measures. J Hosp Infect 2023; 141:55-62. [PMID: 37634601 DOI: 10.1016/j.jhin.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/03/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND The increasing demand for outpatient care is associated with a higher risk of infection transmission in these settings. However, there is limited research on infection prevention and control practices in ambulatory clinics, and none focuses on patients. AIM To examine outpatients' hand hygiene behaviours, their determinants, and their associations with other infection prevention measures during the COVID-19 pandemic. METHODS We observed the hand hygiene behaviour of one cohort of patients in one outpatient clinic and surveyed a separate sample in five clinics about their hand hygiene practice in outpatient facilities. A questionnaire based on the Theoretical Domains Framework (TDF) was used to examine predictors of the behaviour. Moreover, patients indicated their compliance with COVID-19 infection prevention measures, vaccination status, disease risk perception, and vaccine hesitancy. FINDINGS Observed hand hygiene rates among 618 patients were low (12.8%), while 67.3% of the 300 surveyed patients indicated sanitizing their hands upon entering the clinic. The TDF domains 'memory, attention, and decision processes' and 'emotions' significantly predicted both current (today's) and general hand hygiene behaviour in outpatient clinics. Hand hygiene behaviour and compliance with COVID-19 infection prevention showed a positive association; however, no significant connection was found with patients' vaccination status, suggesting different behavioural motivators. CONCLUSION Hand hygiene among outpatients should be improved through interventions focusing on helping patients remember to clean their hands. More research on infection prevention in outpatient facilities is needed to ensure patient safety.
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Affiliation(s)
- S Gaube
- Global Business School for Health, University College London, London, UK.
| | - K Walton
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - A-K Kleine
- LMU Center for Leadership and People Management, LMU Munich, Munich, Germany
| | - S Däumling
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - C Rohrmeier
- Faculty of Medicine, University of Regensburg, Regensburg, Germany; HNO-Gemeinschaftspraxis, Straubing, Germany
| | - S Müller
- Clinic and Polyclinic for Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany; MKG-Praxis im Turm, Straubing, Germany
| | - E Bonrath
- Praxis für Chirurgie & Handchirurgie, Regensburg, Germany
| | - W Schneider-Brachert
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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Zhou Y, Huang Y, Wu C, Yang H, Shan C, Zhou Z. Epidemiological and Clinical Characteristics of COVID-19 Outbreak in a Mental Hospital in Wenzhou, China, December 2022-January 2023. Infect Drug Resist 2023; 16:5719-5728. [PMID: 37667807 PMCID: PMC10475278 DOI: 10.2147/idr.s416565] [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: 04/10/2023] [Accepted: 08/10/2023] [Indexed: 09/06/2023] Open
Abstract
Background Coronavirus disease (COVID-19) mainly caused by the Omicron virus strain currently is still prevalent worldwide, and many medical institutions have experienced COVID-19 outbreaks in the past three years. Objective This article reported COVID-19 outbreak among health care workers in a mental hospital to clarify the epidemiological and clinical characteristics of COVID-19 outbreak in a medical institution, to assess the susceptible factors related to COVID-19 among these personnel and to evaluate the effect of COVID-19 vaccine on the medical workers. Methods A uniform questionnaire was used to investigate all employees, including age, gender, department, time of onset, clinical symptoms, vaccination status. At the same, the results of laboratory testing, chest computed tomography (CT) and/or X-ray examination were collected. Results Among 1047 hospital employees, 842 cases were diagnosed as COVID-19, with a total attack rate of 80.42%. The attack rate of doctors, nurses, medical technicians, and administrators (83.50-90.67%) was higher than that of logistics departments (56.81%). Out of the 842 patients, 9 were hospitalized; 833 were non-hospitalized patients who belong to mild or moderate cases. No deaths were reported. The full vaccination rate and booster rate of COVID-19 vaccine were 78.26% and 80.87%, respectively. There was no significant correlation between the attack rate and COVID-19 vaccine (χ2 = 3.41 P > 0.05). Conclusion This is an outbreak of COVID-19 with a high attack rate among employees in a mental hospital. The attack rate of medical personnel is higher than that of logistics personnel, which may be related to opportunities and duration of contact with infected individuals. COVID-19 vaccine has no significant protective effect on patients with mild or moderate symptoms 13 months after the full vaccination. It is suggested that they should be timely boostered with COVID-19 vaccine to maintain their immunity to the disease.
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Affiliation(s)
- Yiwei Zhou
- Business School, University of Shanghai for Science and Technology, Shanghai, People’s Republic of China
| | - Yu Huang
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou, People’s Republic of China
| | - Chunhua Wu
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou, People’s Republic of China
| | - Hongsheng Yang
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou, People’s Republic of China
| | - Chunyan Shan
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou, People’s Republic of China
| | - Zumu Zhou
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou, People’s Republic of China
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Pardoel ZE, Reijneveld SA, Lensink R, Postma M, Thuy TB, Viet NC, Phuong LNT, Koot JAR, Landsman JJA. The implementation of community-based programs in Vietnam is promising in promoting health. Front Public Health 2023; 11:1182947. [PMID: 37415708 PMCID: PMC10322193 DOI: 10.3389/fpubh.2023.1182947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023] Open
Abstract
Background Low-and middle-income countries mostly have ageing populations with many unmet economic, social, or health-related needs, Vietnam being an example. Community-based support in Vietnam, organized as Intergenerational Self-Help Clubs (ISHCs) based on the Older People Associations (OPA) model, can help to meet these needs by the provision of services for various aspects of life. This study aims to assess the implementation of the ISHCs and whether successful implementation is associated with more member-reported positive health. Methods We used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the implementation using multiple data sources: ISHC board surveys (n = 97), ISHC member surveys (n = 5,080 in 2019 and n = 5,555 in 2020), focus group discussions (6; n = 44), and interviews with members and board leaders (n = 4). Results Reach ranged between 46 and 83% of ISHCs reaching target groups, with a majority of women and older people participating. Regarding Effectiveness, members indicated high satisfaction with the ISHCs. Adoption scores were high, with 74%-99% for healthcare and community support activities, and in 2019, higher adoption scores were associated with more members reporting good positive health. In 2020, reported positive health slightly decreased, probably due to the influence of the COVID-19 pandemic. A total of 61 ISHCs had consistent or improving Implementation from 2019 to 2020, and confidence in Maintenance was high. Conclusion The implementation of the OPA model in Vietnam is promising regarding its promotion of health and may help to tackle the needs of an ageing population. This study further shows that the RE-AIM framework helps to assess community health promotion approaches.
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Affiliation(s)
- Zinzi E. Pardoel
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Robert Lensink
- Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
| | - Maarten Postma
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
- Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Centre of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
| | | | | | | | - Jaap A. R. Koot
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Jeanet J. A. Landsman
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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van Doorn HR, Miliya T, Douangnouvong A, Ta Thi Dieu N, Soputhy C, Lem M, Chommanam D, Keoluangkhot V, Soumphonphakdy B, Rassavong K, Thanadabouth K, Sayarath M, Chansamouth V, Vu MD, Dong PK, Dang VD, Tran VB, Do TKY, Ninh TN, Nguyen HL, Kim NH, Prak S, Vongsouvath M, Van DT, Nguyen TKT, Nguyen HK, Hamers RL, Ling C, Roberts T, Waithira N, Wannapinij P, Vu TVD, Celhay O, Ngoun C, Vongphachanh S, Pham NT, Ashley EA, Turner P. A Clinically Oriented antimicrobial Resistance surveillance Network (ACORN): pilot implementation in three countries in Southeast Asia, 2019-2020. Wellcome Open Res 2022; 7:309. [PMID: 37854668 PMCID: PMC10579863 DOI: 10.12688/wellcomeopenres.18317.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 10/20/2023] Open
Abstract
Background: Case-based surveillance of antimicrobial resistance (AMR) provides more actionable data than isolate- or sample-based surveillance. We developed A Clinically Oriented antimicrobial Resistance surveillance Network (ACORN) as a lightweight but comprehensive platform, in which we combine clinical data collection with diagnostic stewardship, microbiological data collection and visualisation of the linked clinical-microbiology dataset. Data are compatible with WHO GLASS surveillance and can be stratified by syndrome and other metadata. Summary metrics can be visualised and fed back directly for clinical decision-making and to inform local treatment guidelines and national policy. Methods: An ACORN pilot was implemented in three hospitals in Southeast Asia (1 paediatric, 2 general) to collect clinical and microbiological data from patients with community- or hospital-acquired pneumonia, sepsis, or meningitis. The implementation package included tools to capture site and laboratory capacity information, guidelines on diagnostic stewardship, and a web-based data visualisation and analysis platform. Results: Between December 2019 and October 2020, 2294 patients were enrolled with 2464 discrete infection episodes (1786 community-acquired, 518 healthcare-associated and 160 hospital-acquired). Overall, 28-day mortality was 8.7%. Third generation cephalosporin resistance was identified in 54.2% (39/72) of E. coli and 38.7% (12/31) of K. pneumoniae isolates . Almost a quarter of S. aureus isolates were methicillin resistant (23.0%, 14/61). 290/2464 episodes could be linked to a pathogen, highlighting the level of enrolment required to achieve an acceptable volume of isolate data. However, the combination with clinical metadata allowed for more nuanced interpretation and immediate feedback of results. Conclusions: ACORN was technically feasible to implement and acceptable at site level. With minor changes from lessons learned during the pilot ACORN is now being scaled up and implemented in 15 hospitals in 9 low- and middle-income countries to generate sufficient case-based data to determine incidence, outcomes, and susceptibility of target pathogens among patients with infectious syndromes.
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Affiliation(s)
- H. Rogier van Doorn
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Univeristy of Oxford, Oxford, OX3 7LG, UK
- Oxford University Clinical Research Unit, Hanoi, Vietnam
| | - Thyl Miliya
- University of Oxford, Siem Reap, 171202, Cambodia
| | | | | | | | - Meymey Lem
- University of Oxford, Siem Reap, 171202, Cambodia
| | - Danoy Chommanam
- Laos Oxford Mahosot Wellcome Research Unit, Vientiane, Lao People's Democratic Republic
| | | | | | | | | | | | - Vilada Chansamouth
- Laos Oxford Mahosot Wellcome Research Unit, Vientiane, Lao People's Democratic Republic
- Mahosot Hospital, Vientiane, Lao People's Democratic Republic
| | - Minh Dien Vu
- National Hospital for Tropical Diseases, Hanoi, Vietnam
| | | | | | - Van Bac Tran
- National Hospital for Tropical Diseases, Hanoi, Vietnam
| | | | - Thi Ngoc Ninh
- National Hospital for Tropical Diseases, Hanoi, Vietnam
| | | | - Ngoc Hao Kim
- National Hospital for Tropical Diseases, Hanoi, Vietnam
| | - Sothea Prak
- University of Oxford, Siem Reap, 171202, Cambodia
| | - Manivanh Vongsouvath
- Laos Oxford Mahosot Wellcome Research Unit, Vientiane, Lao People's Democratic Republic
- Mahosot Hospital, Vientiane, Lao People's Democratic Republic
| | | | | | | | - Raph L. Hamers
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Univeristy of Oxford, Oxford, OX3 7LG, UK
- Oxford University Clinical Research Unit - Indonesia, Jakarta, Indonesia
| | - Clare Ling
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Univeristy of Oxford, Oxford, OX3 7LG, UK
- Shoklo Malaria Research Unit, Mae Sot, 63110, Thailand
| | - Tamalee Roberts
- Laos Oxford Mahosot Wellcome Research Unit, Vientiane, Lao People's Democratic Republic
| | - Naomi Waithira
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Univeristy of Oxford, Oxford, OX3 7LG, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, 10400, Thailand
| | - Prapass Wannapinij
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, 10400, Thailand
| | | | - Olivier Celhay
- Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, 10400, Thailand
| | | | | | | | - Elizabeth A. Ashley
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Univeristy of Oxford, Oxford, OX3 7LG, UK
- Laos Oxford Mahosot Wellcome Research Unit, Vientiane, Lao People's Democratic Republic
| | - Paul Turner
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Univeristy of Oxford, Oxford, OX3 7LG, UK
- University of Oxford, Siem Reap, 171202, Cambodia
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Cheng CC, Fann LY, Chou YC, Liu CC, Hu HY, Chu D. Nosocomial infection and spread of SARS-CoV-2 infection among hospital staff, patients and caregivers. World J Clin Cases 2022; 10:12559-12565. [PMID: 36579113 PMCID: PMC9791523 DOI: 10.12998/wjcc.v10.i34.12559] [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: 09/30/2022] [Revised: 10/18/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND There are difficulties in diagnosing nosocomial transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in hospital settings. Furthermore, mortality of cases of nosocomial infection (NI) with SARS-CoV-2 is higher than that of the general infected population. In the early stage of the pandemic in Taiwan, as patients were not tested for SARS-CoV-2 at admission, NIs often go undetected. Strictly applying the systematic polymerase chain reaction (PCR) screening, as a standard infection control measure was subsequently implemented to reduce NI incidence. However, evidence on risk factors for SARS-CoV-2 NIs among healthcare workers (HCWs) and caregivers is limited.
AIM To assess NI incidence of SARS-CoV-2 among hospital staff, hospitalized patients, and caregivers, and the transmission routes of clusters of infection.
METHODS This descriptive retrospective analysis at our hospital from May 15 to August 15, 2021 included data on 132 SARS-CoV-2 NIs cases among hospital staff, inpatients, and caregivers who previously tested negative but subsequently identified with a positive SARS-CoV-2 reverse transcriptase-PCR (RT-PCR) test results, or a hospital staff who tested positive following routine SARS-CoV-2 RT-PCR test. Chi-square tests were performed to compare the differences between hospital staff and private caregivers, and between clusters and sporadic infections.
RESULTS Overall, 9149 patients and 2005 hospital staff members underwent routine SARS-CoV-2 RT-PCR testing, resulting in 12 confirmed cluster and 23 sporadic infections. Among the index cases of the clusters, three (25%) cases were among hospital staff and nine (75%) cases were among other contacts. Among sporadic infections, 21 (91%) cases were among hospital staff and two (9%) cases were among other contacts (P < 0.001). There was an average of 8.08 infections per cluster. The secondary cases of cluster infection were inpatients (45%), hospital staff (30%), and caregivers (25%). Private caregivers constituted 27% and 4% of the clusters and sporadic infections, respectively (P = 0.024); 92.3% of them were infected in the clusters. The mortality rate was 0.0%.
CONCLUSION The incidence of SARS-CoV-2 infection was relatively high among private caregivers, indicating a need for infection control education in this group, such as social distancing, frequent hand-washing, and wearing PPE.
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Affiliation(s)
- Chih-Chien Cheng
- Department of Education and Research, Taipei City Hospital, Taipei 116009, Taiwan
| | - Li-Yun Fann
- Department of Nursing, Taipei City Hospital, Taipei 106243, Taiwan
| | - Yi-Chang Chou
- Department of Education and Research, Taipei City Hospital, Taipei 106109, Taiwan
| | - Chia-Chen Liu
- School of Medicine, College of Medicine, Fu Jen Catholic University, Taipei 106109, Taiwan
| | - Hsiao-Yun Hu
- Department of Education and Research, Taipei City Hospital, Taipei 106109, Taiwan
| | - Dachen Chu
- Department of Education and Research, Taipei City Hospital, Taipei 106109, Taiwan
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Ha NX, Le-Van T, Nam NH, Raut A, Varney J, Huy NT. A problem of self-isolation in Japan: The relationship between self-isolation and COVID-19 community case. Health Promot Perspect 2022; 12:192-199. [PMID: 36276422 PMCID: PMC9508386 DOI: 10.34172/hpp.2022.24] [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: 02/04/2022] [Accepted: 04/15/2022] [Indexed: 01/08/2023] Open
Abstract
Background: The Japanese government advised mild or asymptomatic coronavirus disease-2019 (COVID-19) cases to self-isolate at home, while more severe individuals were treated at health posts. Poor compliance with self-isolation could be a potential reason for the new outbreak. Our study aimed to find out the correlation between the rising new cases of COVID-19 and home-based patients in Japan. Methods: A secondary data analysis study was conducted with the data from COVID-19- involved databases collected from Johns Hopkins University, Japanese Ministry of Health, Labour and Welfare, and Community Mobility Reports of Google. New community cases, stringency index, number of tests, and active cases were analyzed. Using a linear regression model, an independent variable was utilized for a given date to predict the future number of community cases. Results: Research results show that outpatient cases, the stringency, and Google Mobility Trend were all significantly associated with the number of COVID-19 community cases from the sixth day to the ninth day. The model predicting community cases on the eighth day (R2=0.8906) was the most appropriate showing outpatients, residential index, grocery and pharmacy index, retail and recreation index, and workplaces index were positively related (β1=24.2, 95% CI: 20.3– 26.3, P<0.0001; β2=277.7, 95% CI: 171.8–408.2, P<0.0001; β3=112.4, 95% CI: 79.8–158.3, P<0.0001; β4=73.1, 95% CI: 53- 04.4, P<0.0001; β5=57.2, 95% CI: 25.2–96.8, P=0.001, respectively). In contrast, inpatients, park index, and adjusted stringency index were negatively related to the number of community cases (β6=-2.8, 95% CI: -3.9 – -1.6, P<0.0001; β7=-33, 95% CI: -43.6 – -27, P<0.0001; β8=-14.4, 95% CI: -20.1– -12, P<0.0001, respectively). Conclusion: Outpatient cases and indexes of Community Mobility Reports were associated with COVID-19 community cases.
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Affiliation(s)
- Nam Xuan Ha
- Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan 3
| | - Truong Le-Van
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan 3
- Traditional Medicine Hospital of Ministry of Public Security, Hanoi, Vietnam
| | - Nguyen Hai Nam
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan 3
- Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Global Clinical Scholars Research Training Program, Harvard Medical School, Boston, Massachusetts, USA
| | - Akshay Raut
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan 3
- St. George’s Hospital, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai 400001, India
| | - Joseph Varney
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan 3
- American University of the Caribbean, School of Medicine, Sint Maarten, Sint Maarten
| | - Nguyen Tien Huy
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan 3
- School of Tropical Diseases and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
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The Analysis of Patterns of Two COVID-19 Outbreak Clusters in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084876. [PMID: 35457742 PMCID: PMC9032159 DOI: 10.3390/ijerph19084876] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 02/04/2023]
Abstract
Since the emergence of COVID-19, there have been many local outbreaks with foci at shopping malls in China. We compared and analyzed the epidemiological and spatiotemporal characteristics of local COVID-19 outbreaks in two commercial locations, a department store building (DSB) in Baodi District, Tianjin, and the Xinfadi wholesale market (XFD) in Fengtai District, Beijing. The spread of the infection at different times was analyzed by the standard deviation elliptical method. The spatial transfer mode demonstrated that outbreaks started at the center of each commercial location and spread to the periphery. The number of cases and the distance from the central outbreak showed an inverse proportional logarithmic function shape. Most cases were distributed within a 10 km radius; infected individuals who lived far from the outbreak center were mainly infected by close-contact transmission at home or in the workplace. There was no efficient and rapid detection method at the time of the DSB outbreak; the main preventative measure was the timing of COVID-19 precautions. Emergency interventions (closing shopping malls and home isolation) were initiated five days before confirmation of the first case from the shopping center. In contrast, XFD closed after the first confirmed cases appeared, but those infected during this outbreak benefitted from efficient nucleic acid testing. Quick results and isolation of infected individuals were the main methods of epidemic control in this area. The difference in the COVID-19 epidemic patterns between the two shopping malls reflects the progress of Chinese technology in the prevention and control of COVID-19.
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9
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Ng CYH, Lim NA, Bao LXY, Quek AML, Seet RCS. Mitigating SARS-CoV-2 Transmission in Hospitals: A Systematic Literature Review. Public Health Rev 2022; 43:1604572. [PMID: 35296115 PMCID: PMC8906284 DOI: 10.3389/phrs.2022.1604572] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/19/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives: Hospital outbreaks of SARS-CoV-2 infection are dreaded but preventable catastrophes. We review the literature to examine the pattern of SARS-CoV-2 transmission in hospitals and identify potential vulnerabilities to mitigate the risk of infection. Methods: Three electronic databases (PubMed, Embase and Scopus) were searched from inception to July 27, 2021 for publications reporting SARS-CoV-2 outbreaks in hospital. Relevant articles and grey literature reports were hand-searched. Results: Twenty-seven articles that described 35 SARS-CoV-2 outbreaks were included. Despite epidemiological investigations, the primary case could not be identified in 37% of outbreaks. Healthcare workers accounted for 40% of primary cases (doctors 17%, followed by ancillary staff 11%). Mortality among infected patients was approximately 15%. By contrast, none of the infected HCWs died. Several concerning patterns were identified, including infections involving ancillary staff and healthcare worker infections from the community and household contacts. Conclusion: Continuous efforts to train-retrain and enforce correct personal protective equipment use and regular routine screening tests (especially among ancillary staff) are necessary to stem future hospital outbreaks of SARS-CoV-2.
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Affiliation(s)
- Chester Yan Hao Ng
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nicole-Ann Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lena X. Y. Bao
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Amy M. L. Quek
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Raymond C. S. Seet
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- *Correspondence: Raymond C. S. Seet,
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Outbreak of COVID-19 among children and young adults in a cancer center daycare unit. Epidemiol Infect 2022; 150:e40. [PMID: 35184772 PMCID: PMC8886074 DOI: 10.1017/s0950268822000012] [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] [Indexed: 11/17/2022] Open
Abstract
Nosocomial transmission of COVID-19 among immunocompromised hosts can have a serious impact on COVID-19 severity, underlying disease progression and SARS-CoV-2 transmission to other patients and healthcare workers within hospitals. We experienced a nosocomial outbreak of COVID-19 in the setting of a daycare unit for paediatric and young adult cancer patients. Between 9 and 18 November 2020, 473 individuals (181 patients, 247 caregivers/siblings and 45 staff members) were exposed to the index case, who was a nursing staff. Among them, three patients and four caregivers were infected. Two 5-year-old cancer patients with COVID-19 were not severely ill, but a 25-year-old cancer patient showed prolonged shedding of SARS-CoV-2 RNA for at least 12 weeks, which probably infected his mother at home approximately 7–8 weeks after the initial diagnosis. Except for this case, no secondary transmission was observed from the confirmed cases in either the hospital or the community. To conclude, in the day care setting of immunocompromised children and young adults, the rate of in-hospital transmission of SARS-CoV-2 was 1.6% when applying the stringent policy of infection prevention and control, including universal mask application and rapid and extensive contact investigation. Severely immunocompromised children/young adults with COVID-19 would have to be carefully managed after the mandatory isolation period while keeping the possibility of prolonged shedding of live virus in mind.
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Aghdassi SJS, Schwab F, Peña Diaz LA, Brodzinski A, Fucini GB, Hansen S, Kohlmorgen B, Piening B, Schlosser B, Schneider S, Weikert B, Wiese-Posselt M, Wolff S, Behnke M, Gastmeier P, Geffers C. Risk factors for nosocomial SARS-CoV-2 infections in patients: results from a retrospective matched case-control study in a tertiary care university center. Antimicrob Resist Infect Control 2022; 11:9. [PMID: 35039089 PMCID: PMC8762437 DOI: 10.1186/s13756-022-01056-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/09/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Factors contributing to the spread of SARS-CoV-2 outside the acute care hospital setting have been described in detail. However, data concerning risk factors for nosocomial SARS-CoV-2 infections in hospitalized patients remain scarce. To close this research gap and inform targeted measures for the prevention of nosocomial SARS-CoV-2 infections, we analyzed nosocomial SARS-CoV-2 cases in our hospital during a defined time period. METHODS Data on nosocomial SARS-CoV-2 infections in hospitalized patients that occurred between May 2020 and January 2021 at Charité university hospital in Berlin, Germany, were retrospectively gathered. A SARS-CoV-2 infection was considered nosocomial if the patient was admitted with a negative SARS-CoV-2 reverse transcription polymerase chain reaction test and subsequently tested positive on day five or later. As the incubation period of SARS-CoV-2 can be longer than five days, we defined a subgroup of "definite" nosocomial SARS-CoV-2 cases, with a negative test on admission and a positive test after day 10, for which we conducted a matched case-control study with a one to one ratio of cases and controls. We employed a multivariable logistic regression model to identify factors significantly increasing the likelihood of nosocomial SARS-CoV-2 infections. RESULTS A total of 170 patients with a nosocomial SARS-CoV-2 infection were identified. The majority of nosocomial SARS-CoV-2 patients (n = 157, 92%) had been treated at wards that reported an outbreak of nosocomial SARS-CoV-2 cases during their stay or up to 14 days later. For 76 patients with definite nosocomial SARS-CoV-2 infections, controls for the case-control study were matched. For this subgroup, the multivariable logistic regression analysis revealed documented contact to SARS-CoV-2 cases (odds ratio: 23.4 (95% confidence interval: 4.6-117.7)) and presence at a ward that experienced a SARS-CoV-2 outbreak (odds ratio: 15.9 (95% confidence interval: 2.5-100.8)) to be the principal risk factors for nosocomial SARS-CoV-2 infection. CONCLUSIONS With known contact to SARS-CoV-2 cases and outbreak association revealed as the primary risk factors, our findings confirm known causes of SARS-CoV-2 infections and demonstrate that these also apply to the acute care hospital setting. This underscores the importance of rapidly identifying exposed patients and taking adequate preventive measures.
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Affiliation(s)
- Seven Johannes Sam Aghdassi
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany. .,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Digital Clinician Scientist Program, Anna-Louisa-Karsch-Straße 2, 10178, Berlin, Germany.
| | - Frank Schwab
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Luis Alberto Peña Diaz
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Annika Brodzinski
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Giovanni-Battista Fucini
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Sonja Hansen
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Britta Kohlmorgen
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Brar Piening
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Beate Schlosser
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Sandra Schneider
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Beate Weikert
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Miriam Wiese-Posselt
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Sebastian Wolff
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Michael Behnke
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Petra Gastmeier
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Christine Geffers
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
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12
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Manabe T, Phan D, Nohara Y, Kambayashi D, Nguyen TH, Van Do T, Kudo K. Spatiotemporal distribution of COVID-19 during the first 7 months of the epidemic in Vietnam. BMC Infect Dis 2021; 21:1124. [PMID: 34717588 PMCID: PMC8556820 DOI: 10.1186/s12879-021-06822-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/26/2021] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Understanding the spatiotemporal distribution of emerging infectious diseases is crucial for implementation of control measures. In the first 7 months from the occurrence of COVID-19 pandemic, Vietnam has documented comparatively few cases of COVID-19. Understanding the spatiotemporal distribution of these cases may contribute to development of global countermeasures. METHODS We assessed the spatiotemporal distribution of COVID-19 from 23 January to 31 July 2020 in Vietnam. Data were collected from reports of the World Health Organization, the Vietnam Ministry of Health, and related websites. Temporal distribution was assessed via the transmission classification (local or quarantined cases). Geographical distribution was assessed via the number of cases in each province along with their timelines. The most likely disease clusters with elevated incidence were assessed via calculation of the relative risk (RR). RESULTS Among 544 observed cases of COVID-19, the median age was 35 years, 54.8% were men, and 50.9% were diagnosed during quarantine. During the observation period, there were four phases: Phase 1, COVID-19 cases occurred sporadically in January and February 2020; Phase 2, an epidemic wave occurred from the 1st week of March to the middle of April (Wave 1); Phase 3, only quarantining cases were involved; and Phase 4, a second epidemic wave began on July 25th, 2020 (Wave 2). A spatial cluster in Phase 1 was detected in Vinh Phuc Province (RR, 38.052). In Phase 2, primary spatial clusters were identified in the areas of Hanoi and Ha Nam Province (RR, 6.357). In Phase 4, a spatial cluster was detected in Da Nang, a popular coastal tourist destination (RR, 70.401). CONCLUSIONS Spatial disease clustering of COVID-19 in Vietnam was associated with large cities, tourist destinations, people's mobility, and the occurrence of nosocomial infections. Past experiences with outbreaks of emerging infectious diseases led to quick implementation of governmental countermeasures against COVID-19 and a general acceptance of these measures by the population. The behaviors of the population and the government, as well as the country's age distribution, may have contributed to the low incidence and small number of severe COVID-19 cases.
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Affiliation(s)
- Toshie Manabe
- Nagoya City University Graduate School of Medicine, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601 Japan
- Nagoya City University West Medical Center, Aichi, Japan
| | - Dung Phan
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC Australia
| | - Yasuhiro Nohara
- Utsunomiya University Center for Regional Design, Tochigi, Japan
| | - Dan Kambayashi
- Nagoya City University Graduate School of Medicine, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601 Japan
- Showa Pharmaceutical University Center for Education and Research on Clinical Pharmacy, Tokyo, Japan
| | - Thang Huu Nguyen
- School for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Thanh Van Do
- Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | - Koichiro Kudo
- Yurin Hospital, Tokyo, Japan
- Waseda University, Tokyo, Japan
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13
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Komasawa M, Aung MN, Saito K, Isono M, Tanaka G, Makimoto S. Overcoming Current and Preventing Future Nosocomial Outbreaks during the COVID-19 Pandemic: Lessons Learned at Three Hospitals in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910226. [PMID: 34639526 PMCID: PMC8508432 DOI: 10.3390/ijerph181910226] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/12/2022]
Abstract
Hospitals are increasingly challenged by nosocomial infection (NI) outbreaks during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Although standardized guidelines and manuals regarding infection prevention and control (IPC) measures are available worldwide, case-studies conducted at specified hospitals that are required to cope with real settings are limited. In this study, we analyzed three hospitals in Japan where large-scale NI outbreaks occurred for hints on how to prevent NI outbreaks. We reviewed openly available information from each hospital and analyzed it applying a three domain framework: operation management; identification of infection status; and infection control measures. We learned that despite having authorized infection control teams and using existing standardized IPC measures, SARS-CoV-2 may still enter hospitals. Early detection of suspected cases and confirmation by PCR test, carefully dealing with staff-to-staff transmission were the most essential factors to prevent NI outbreaks. It was also suggested that ordinary training on IPC for staff does not always provide enough practical knowledge and skills; in such cases external technical and operational supports are crucial. It is expected that our results will provide insights into preventing NI outbreaks of COVID-19, and contribute to mitigate the damage to health care delivery systems in various countries.
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Affiliation(s)
- Makiko Komasawa
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Tokyo 1628433, Japan; (K.S.); (M.I.); (S.M.)
- Correspondence: ; Tel.: +81-3-3269-2916
| | - Myo Nyein Aung
- Advanced Research Institute for Health Sciences and Faculty of International Liberal Arts, Juntendo University, Bunkyo-ku, Tokyo 1138421, Japan;
| | - Kiyoko Saito
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Tokyo 1628433, Japan; (K.S.); (M.I.); (S.M.)
| | - Mitsuo Isono
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Tokyo 1628433, Japan; (K.S.); (M.I.); (S.M.)
| | - Go Tanaka
- Human Development Department, Japan International Cooperation Agency, Chiyuda-ku, Tokyo 1028012, Japan;
| | - Saeda Makimoto
- Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Shinjuku-ku, Tokyo 1628433, Japan; (K.S.); (M.I.); (S.M.)
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14
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Infection prevention measures in acute care settings based on severe acute respiratory syndrome coronavirus 2 transmission patterns and risk: a review. Curr Opin Infect Dis 2021; 34:346-356. [PMID: 34127582 DOI: 10.1097/qco.0000000000000738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW During the coronavirus disease 2019 pandemic, when facing extraordinary infection prevention challenges, acute care settings have balanced routine patient safety needs while minimizing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission risk to patients and healthcare personnel (HCP). Mitigation strategies in acute care settings are based on a combination of basic science, environmental, and epidemiologic evidence. Here, we review the literature on SARS-CoV-2 transmission, how it has shaped infection prevention interventions in acute care settings, and the results of such measures to reduce transmission. RECENT FINDINGS HCP adherence to transmission-based precautions in acute care settings, such as the use of personal protective equipment (PPE), is essential to mitigating SARS-CoV-2 spread. Although the SARS-CoV-2 virus has been isolated in nonrespiratory body sites, such exposure has not been shown to definitively cause transmission in humans. Epidemiologic evidence has demonstrated that implementation and adherence to infection prevention strategies reduces acute setting transmission. SUMMARY Given SARS-CoV-2 infection occurs primarily through respiratory transmission, preventing HCP acquisition requires fidelity to consistent PPE usage. Infection prevention strategies and implementation of transmission-based precautions have reduced spread and outbreaks. Epidemiologic studies of acute care outbreaks often include reports of PPE nonadherence and community exposure contributing to SARS-CoV-2 transmission within this setting.
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15
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Patel B, Vilendrer S, Kling SMR, Brown I, Ribeira R, Eisenberg M, Sharp C. Using a Real-Time Locating System to Evaluate the Impact of Telemedicine in an Emergency Department During COVID-19: Observational Study. J Med Internet Res 2021; 23:e29240. [PMID: 34236993 PMCID: PMC8315159 DOI: 10.2196/29240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/27/2021] [Accepted: 06/13/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Telemedicine has been deployed by health care systems in response to the COVID-19 pandemic to enable health care workers to provide remote care for both outpatients and inpatients. Although it is reasonable to suspect telemedicine visits limit unnecessary personal contact and thus decrease the risk of infection transmission, the impact of the use of such technology on clinician workflows in the emergency department is unknown. OBJECTIVE This study aimed to use a real-time locating system (RTLS) to evaluate the impact of a new telemedicine platform, which permitted clinicians located outside patient rooms to interact with patients who were under isolation precautions in the emergency department, on in-person interaction between health care workers and patients. METHODS A pre-post analysis was conducted using a badge-based RTLS platform to collect movement data including entrances and duration of stay within patient rooms of the emergency department for nursing and physician staff. Movement data was captured between March 2, 2020, the date of the first patient screened for COVID-19 in the emergency department, and April 20, 2020. A new telemedicine platform was deployed on March 29, 2020. The number of entrances and duration of in-person interactions per patient encounter, adjusted for patient length of stay, were obtained for pre- and postimplementation phases and compared with t tests to determine statistical significance. RESULTS There were 15,741 RTLS events linked to 2662 encounters for patients screened for COVID-19. There was no significant change in the number of in-person interactions between the pre- and postimplementation phases for both nurses (5.7 vs 7.0 entrances per patient, P=.07) and physicians (1.3 vs 1.5 entrances per patient, P=.12). Total duration of in-person interactions did not change (56.4 vs 55.2 minutes per patient, P=.74) despite significant increases in telemedicine videoconference frequency (0.6 vs 1.3 videoconferences per patient, P<.001 for change in daily average) and duration (4.3 vs 12.3 minutes per patient, P<.001 for change in daily average). CONCLUSIONS Telemedicine was rapidly adopted with the intent of minimizing pathogen exposure to health care workers during the COVID-19 pandemic, yet RTLS movement data did not reveal significant changes for in-person interactions between staff and patients under investigation for COVID-19 infection. Additional research is needed to better understand how telemedicine technology may be better incorporated into emergency departments to improve workflows for frontline health care clinicians.
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Affiliation(s)
- Birju Patel
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Stacie Vilendrer
- Evaluation Sciences Unit, Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Samantha M R Kling
- Evaluation Sciences Unit, Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Ian Brown
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Ryan Ribeira
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Matthew Eisenberg
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Christopher Sharp
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
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16
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Nam NH, Do Le BT, Huy NT. Community-Based Measures to Against the COVID-19: An Experience From Vietnam With Consecutive 3 Months of no New Infection in the Community During the First Wave of Pandemic. Front Public Health 2021; 9:583655. [PMID: 34368034 PMCID: PMC8334003 DOI: 10.3389/fpubh.2021.583655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 03/10/2021] [Indexed: 12/23/2022] Open
Abstract
Vietnam has faced a high risk of transmission of COVID-19 during the pandemic. Despite the specific challenges that come with a low-resource country, the Vietnamese government has provided a sustainable response, demonstrating both great capacity and rapid decision-making to manage the entirety of the COVID-19 outbreak with lessons learned from the SARS and H1N1 epidemics in 2003 and 2009, respectively. A rapid response, specific epidemiological F0–F5 tracing system, and public education are some of the key measures that have helped Vietnam to control the outbreak. As of July 15, 2020, Vietnam has reported 373 accumulated confirmed cases and no deaths within the last 90 consecutive days of no new infections in the community. Vietnam can now consider declaring an end to the COVID-19 crisis on their part.
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Affiliation(s)
- Nguyen Hai Nam
- Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Bao-Tran Do Le
- Department of Biochemistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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17
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Wendling JM, Saulnier A, Sabatier JM. Shared Food, Meals and Drinks: 10 Arguments Suggesting an Oral Transmission Route of SARS-CoV-2. Infect Disord Drug Targets 2021; 22:e160721194830. [PMID: 34279208 DOI: 10.2174/1871526521666210716110603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Numerous observational, epidemiologic data have suggested that the risk of COVID19 is related to shared meals or drinks. The presence of ACE2 receptors in the gastrointestinal tract supports this hypothesis. Furthermore, several patients experience gastrointestinal symptoms without any respiratory disease. The SARS-CoV-2 found on food and packaging in China and the epidemic resurgence attributed to foods are also strong indications of an oral transmission route. Unprecedented biopersistence on skin, food, and beverages supports this theory. Finally, animal models reproducing the disease by oral inoculation are additional arguments in favor of an oro-digestive route of infection.
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Affiliation(s)
- Jean-Michel Wendling
- ACST - Strasbourg - Occupational health - 37 avenue de Colmar - 67100 Strasbourg. France
| | | | - Jean-Marc Sabatier
- Université Aix-Marseille - Institut de Neuro-Physiopathologie (INP) - UMR 7051, Faculté de Pharmacie, 27 Bd Jean Moulin, 13385 Marseille Cedex. France
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18
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Nguyen QT, Hoang TA, Nguyen HYT, Thanh Do V, Dong VT, Vu VG, Hoang VM. Prevent and control cross-transmission of COVID-19 in hospital settings: Lessons learned from a national hospital in Hanoi, Vietnam. J Glob Health 2021; 11:03079. [PMID: 34131485 PMCID: PMC8183157 DOI: 10.7189/jogh.11.03079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Van Minh Hoang
- Bach Mai Hospital, Hanoi, Vietnam.,Hanoi University of Public Health, Hanoi, Vietnam
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19
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Nguyen HB, Nguyen THM, Tran TTT, Vo THN, Tran VH, Do TNP, Truong QB, Nguyen TH, Ly LK. Knowledge, Attitudes, Practices, and Related Factors Towards COVID-19 Prevention Among Patients at University Medical Center Ho Chi Minh City, Vietnam. Risk Manag Healthc Policy 2021; 14:2119-2132. [PMID: 34079399 PMCID: PMC8163721 DOI: 10.2147/rmhp.s305959] [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: 02/11/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
AIM This study measured the level of knowledge, attitudes and practices towards COVID-19 prevention and examined associated factors among patients at a national tertiary general hospital in Vietnam. METHODS Adult patients admitted to University Medical Center during research period were recruited in a cross-sectional study, which employed a convenience sampling method with a 4-component questionnaire in order to examine the patients' consciousness towards COVID-19 spreading prevention based on four aspects: demographic characteristics (10 items), knowledge (14 items), attitudes (6 items), and practices (7 items). RESULTS The study involved 2769 respondents (18-90 years) with the mean age of 38.05±13.91 years. About two thirds of the respondents obtained diploma degree or higher (63.4%) and shared their living space with others (64.4%). The majority of patients settled in urban area (74.9%). All participants stayed informed about COVID-19, with the most commonly used channels like television (75.2%), the Internet (72.2%) and phone (69.8%). The vast majority showed sufficient knowledge (93.7%) and positive attitudes (76.3%). Just over half of participants remained good practiced of COVID-19 prevention (57.7%). On average, the factors of younger age, higher educational level, frequency and department of admission, and the number of COVID-19 informative channels were significantly associated with sufficient knowledge, positive attitudes, and good practices regarding preventive action against COVID-19 spreading. The optimistic attitude and having more undergoing chronic diseases were associated with the likelihood of well-practiced COVID-19 preventive measures (OR 3.63, 95% CI 1.54-8.55, p=0.003 and OR 0.86, 95% CI 0.78-0.98, p=0.02, respectively). CONCLUSION The results of this study demonstrated that the likelihood of good preventive practices in the fight against COVID-19 pandemic was influenced by attitudes and several sociodemographic factors. More drastic interventions for the prevention of COVID-19 should be widely furnished and equipped in hospitals, through various routes to maximize the efficiency and adherence to prevention practices.
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Affiliation(s)
- Hoang Bac Nguyen
- University Medical Center Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam
| | | | - Thi Thanh Tam Tran
- University Medical Center Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam
| | - Thi Hong Nhan Vo
- University Medical Center Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam
| | - Van Hung Tran
- University Medical Center Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam
| | - Thi Nam Phuong Do
- University Medical Center Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam
| | - Quang Binh Truong
- University Medical Center Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam
| | - Thi Hiep Nguyen
- Tissue Engineering and Regenerative Medicine Department, School of Biomedical Engineering, International University, Ho Chi Minh City, 700000, Vietnam
- Vietnam National University, Ho Chi Minh City, 700000, Vietnam
| | - Loan Khanh Ly
- Tissue Engineering and Regenerative Medicine Department, School of Biomedical Engineering, International University, Ho Chi Minh City, 700000, Vietnam
- Vietnam National University, Ho Chi Minh City, 700000, Vietnam
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20
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Kwok KO, Huang Y, Tsoi MTF, Tang A, Wong SYS, Wei WI, Hui DSC. Epidemiology, clinical spectrum, viral kinetics and impact of COVID-19 in the Asia-Pacific region. Respirology 2021; 26:322-333. [PMID: 33690946 PMCID: PMC8207122 DOI: 10.1111/resp.14026] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/08/2021] [Indexed: 01/08/2023]
Abstract
COVID-19 has hit the world by surprise, causing substantial mortality and morbidity since 2020. This narrative review aims to provide an overview of the epidemiology, induced impact, viral kinetics and clinical spectrum of COVID-19 in the Asia-Pacific Region, focusing on regions previously exposed to outbreaks of coronavirus. COVID-19 progressed differently by regions, with some (such as China and Taiwan) featured by one to two epidemic waves and some (such as Hong Kong and South Korea) featured by multiple waves. There has been no consensus on the estimates of important epidemiological time intervals or proportions, such that using them for making inferences should be done with caution. Viral loads of patients with COVID-19 peak in the first week of illness around days 2 to 4 and hence there is very high transmission potential causing community outbreaks. Various strategies such as government-guided and suppress-and-lift strategies, trigger-based/suppression approaches and alert systems have been employed to guide the adoption and easing of control measures. Asymptomatic and pre-symptomatic transmission is a hallmark of COVID-19. Identification and isolation of symptomatic patients alone is not effective in controlling the ongoing outbreaks. However, early, prompt and coordinated enactment predisposed regions to successful disease containment. Mass COVID-19 vaccinations are likely to be the light at the end of the tunnel. There is a need to review what we have learnt in this pandemic and examine how to transfer and improve existing knowledge for ongoing and future epidemics.
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Affiliation(s)
- Kin On Kwok
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
- Stanley Ho Centre for Emerging Infectious DiseasesThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
- Shenzhen Research Institute of the Chinese University of Hong KongShenzhenChina
| | - Ying Huang
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - Margaret Ting Fong Tsoi
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - Arthur Tang
- Department of SoftwareSungkyunkwan UniversitySeoulRepublic of Korea
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - Wan In Wei
- JC School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
| | - David Shu Cheong Hui
- Stanley Ho Centre for Emerging Infectious DiseasesThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong Kong Special Administrative RegionChina
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21
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Nguyen TV, Tran QD, Phan LT, Vu LN, Truong DTT, Truong HC, Le TN, Vien LDK, Nguyen TV, Luong QC, Pham QD. In the interest of public safety: rapid response to the COVID-19 epidemic in Vietnam. BMJ Glob Health 2021; 6:bmjgh-2020-004100. [PMID: 33495284 PMCID: PMC7839307 DOI: 10.1136/bmjgh-2020-004100] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/24/2022] Open
Abstract
We describe the status of the COVID-19 epidemic in Vietnam, major response successes, factors that prompted implementation of certain public health actions, and the impact of these actions. In addition, information for three case studies is reported, with crucial learnings to inform future response. Findings from this study suggest that as early as 20 January 2020, Vietnam held a national risk assessment, established a national COVID-19 Response Plan and Technical Treatment and Care Guidelines, and prepared public health laboratories to accurately diagnose cases and hospitals to effectively treat patients. The first COVID-19 case was detected on 23 January. As of 30 September, there had been three waves of the COVID-19 epidemic totalling 1095 cases, and resulting in 35 deaths all among people with underlying health conditions. Evidence of potential transmission of SARS-CoV-2 from a commercial passenger flight inbound to Vietnam was reported. This study also highlights the importance of early technical preparedness, strong political commitment, multisectoral and multilevel efforts, increased resourcing and coordination towards an effective COVID-19 response. Controlling outbreaks in settings, such as crowded public places (bars and hospitals), within certain villages and over cities, required early detection, aggressive trace-test-quarantine efforts, a geographically extensive lockdown area and an adoption of several non-pharmaceutical interventions. Many low-income and middle-income countries have experienced their second or third wave of the COVID-19 epidemic, and they can learn from Vietnam's response across the three epidemic waves. Swift governmental action, strict border control measures, effective communication of health promotion measures, widespread community engagement, expanded testing capacity and effective social measures to slow the spread of SARS-CoV-2, are highly important in these locations.
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Affiliation(s)
- Thuong Vu Nguyen
- Directorial Board, Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Quang Dai Tran
- Communicable Diseases Control Division, General Department of Preventive Medicine, Hanoi, Vietnam
| | - Lan Trong Phan
- Directorial Board, Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Long Ngoc Vu
- Communicable Diseases Control Division, General Department of Preventive Medicine, Hanoi, Vietnam
| | - Dung Thi Thuy Truong
- Department for Disease Control and Prevention, Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hieu Cong Truong
- Department for Disease Control and Prevention, Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tu Ngoc Le
- Department for Disease Control and Prevention, Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Linh Dang Khanh Vien
- Department for Disease Control and Prevention, Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thinh Viet Nguyen
- Department for Disease Control and Prevention, Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Quang Chan Luong
- Department for Disease Control and Prevention, Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Quang Duy Pham
- Training Centre, Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam .,Planning Division, Pasteur Institute of Ho Chi Minh City, Ho Chi Minh City, Vietnam
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22
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Cobb N, Papali A, Pisani L, Schultz MJ, Ferreira JC. Pragmatic Recommendations for Infection Prevention and Control Practices for Healthcare Facilities in Low- and Middle-Income Countries during the COVID-19 Pandemic. Am J Trop Med Hyg 2021; 104:25-33. [PMID: 33410392 PMCID: PMC7957238 DOI: 10.4269/ajtmh.20-1009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/20/2020] [Indexed: 01/19/2023] Open
Abstract
Infection prevention and control (IPC) strategies are key in preventing nosocomial transmission of COVID-19. Several commonly used IPC practices are resource-intensive and may be challenging to implement in resource-constrained settings. An international group of healthcare professionals from or with experience in low- and middle-income countries (LMICs) searched the literature for relevant evidence. We report on a set of pragmatic recommendations for hospital-based IPC practices in resource-constrained settings of LMICs. For cases of confirmed or suspected COVID-19, we suggest that patients be placed in a single isolation room, whenever possible. When single isolation rooms are unavailable or limited, we recommend cohorting patients with COVID-19 on dedicated wards or in dedicated hospitals. We also recommend that cases of suspected COVID-19 be cohorted separately from those with confirmed disease, whenever possible, to minimize the risk of patient-to-patient transmission in settings where confirmatory testing may be limited. We suggest that healthcare workers be designated to care exclusively for patients with COVID-19, whenever possible, as another approach to minimize nosocomial spread. This approach may also be beneficial in conserving limited supplies of reusable personal protective equipment (PPE). We recommend that visitors be restricted for patients with COVID-19. In settings where family members or visitors are necessary for caregiving, we recommend that the appropriate PPE be used by visitors. We also recommend that education regarding hand hygiene and donning/doffing procedures for PPE be provided. Last, we suggest that all visitors be screened for symptoms before visitation and that visitor logs be maintained.
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Affiliation(s)
- Natalie Cobb
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington
| | - Alfred Papali
- Division of Pulmonary and Critical Care Medicine, Atrium Health, Charlotte, North Carolina
| | - Luigi Pisani
- Section of Operative Research, Doctors with Africa, CUAMM, Padova, Italy
- Mahidol–Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
| | - Marcus J. Schultz
- Mahidol–Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
- Department of Intensive Care, Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - Juliana C. Ferreira
- Divisao de Pneumologia, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | - for the COVID-LMIC Task Force and the Mahidol-Oxford Research Unit (MORU)
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington
- Division of Pulmonary and Critical Care Medicine, Atrium Health, Charlotte, North Carolina
- Section of Operative Research, Doctors with Africa, CUAMM, Padova, Italy
- Mahidol–Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
- Department of Intensive Care, Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
- Divisao de Pneumologia, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
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23
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Manh Than H, Minh Nong V, Trung Nguyen C, Phu Dong K, Ngo HT, Thu Doan T, Thu Do N, Huyen Thi Nguyen T, Van Do T, Xuan Dao C, Quang Nguyen T, Ngoc Pham T, Duy Do C. Mental Health and Health-Related Quality-of-Life Outcomes Among Frontline Health Workers During the Peak of COVID-19 Outbreak in Vietnam: A Cross-Sectional Study. Risk Manag Healthc Policy 2020; 13:2927-2936. [PMID: 33324126 PMCID: PMC7733435 DOI: 10.2147/rmhp.s280749] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/14/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Mental health is an important component of the protection strategy for healthcare workers (HCWs). However, it has not been well described in Vietnam during the COVID-19 outbreak. This study aims to measure the psychological distress and health-related quality-of-life among frontline healthcare workers during the peak of the outbreak in Vietnam. PATIENTS AND METHODS We conducted a cross-sectional survey on 173 health workers at two national tertiary hospitals in Hanoi, Vietnam from March to April 2020. The psychological distress was measured by the Depression, Anxiety, and Stress Scale - 21 Items (DASS-21), Impact of Event Scale - Revised (IES-R), and the Insomnia Severity Index (ISI). EQ-5D-5L was used to determine the health-related quality-of-life (HRQoL) outcomes. RESULTS Among 173 HCWs, the proportion of reported depression symptoms, anxiety symptoms, and stress was 20.2%, 33.5%, and 12.7%, respectively. The median EQ-5D-5L index score was 0.93 (IQR=0.85-0.94), and the anxiety/depression aspect had the highest reported problems. The most COVID-19-specific concerns among frontline HCWs were the reduction of income (59%) and the increase of living costs (54.3%). HCWs working in the COVID-19-designated hospital had a significantly higher rate of mental health problems and had a lower HRQoL outcome than those working in non-COVID-19-designated hospitals. Other factors associated with psychological distress and sleep problems include age, job title, income, chronic diseases status, and years of working in healthcare settings. HCWs who were ≥30 years old, had higher working years, had higher incomes, and had mental health and sleep problems were more likely to have lower HRQoL scores. CONCLUSION We reported a moderate rate of psychological distress and lower HRQoL outcomes among frontline HCWs during the COVID-19 outbreak in Vietnam. Various factors were found to be associated with mental health and HRQoL that might be useful for implementing appropriate interventions for HCWs in low-resource settings.
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Affiliation(s)
- Hung Manh Than
- Emergency Department, National Hospital for Tropical Diseases, Hanoi, Vietnam
| | - Vuong Minh Nong
- Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | - Cap Trung Nguyen
- Emergency Department, National Hospital for Tropical Diseases, Hanoi, Vietnam
| | | | - Hoa Thi Ngo
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tra Thu Doan
- Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | - Nga Thu Do
- Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | | | - Thanh Van Do
- Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | | | | | | | - Cuong Duy Do
- Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam
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