Dynamic optimal allocation of medical resources: a case study of face masks during the first COVID-19 epidemic wave in the United States

In this paper, we propose a two-group SIR epidemic model to simulate the outcome of the stay-at-home policy and the imposed face mask policy during the first COVID-19 epidemic wave in the United States. Then, we use a dynamic optimal control approach (with the objective of minimizing total deaths) to find the optimal dynamical distribution of face masks between healthcare workers and the general public. It is not surprising that all face masks should be solely reserved for healthcare workers if the supply is short. However, when the supply is indeed sufficient, our numerical study indicates that the general public should share a large portion of face masks at the beginning of the epidemic wave to dramatically reduce the death toll. This interesting result partially contradicts the guideline advised by the US Surgeon General and the Centers for Disease Control and Prevention (CDC) in March 2020. The optimality of this sounding CDC guideline highly depends on the supply level of face masks, which changes frequently; hence, it should be adjusted according to the supply of face masks.

Debriefing after critical incidents in rural and remote healthcare settings - a remote clinician perspective

Debriefing following a critical incident allows teams to reflect on the experience and to work together to improve future performance. Hot, warm and cold debriefs occur at various stages following the incident - each with its own structure and objectives. Effective debriefing requires training and practice, with a variety of tools available for this purpose. Healthcare professionals working in rural and remote areas face a variety of unique barriers, not encountered by colleagues in urban settings, that may make debriefing challenging. A hypothetical case example illustrates the complexities of a critical incident in a remote service. Evidence-based strategies are outlined to support team members in rural and remote areas to debrief effectively, including the use of technology, formal teaching in university curriculums and regular practice by simulation.

EMOTIONAL IMPACT OF THE COVID-19 PANDEMIC ON HEALTHCARE WORKERS IN UKRAINE

OBJECTIVE

The aim: To study the emotional impact of the COVID-19 pandemic on healthcare workers in Ukraine.

PATIENTS AND METHODS

Materials and methods: 1087 healthcare workers across all regions of Ukraine completed an online questionnaire. Respondents were divided into two groups: A - 863 (79.4%), В - 224 (20.6%), according to whether or not they experienced anxiety/fear related to COVID-19.

RESULTS

Results: Such factors as risk of contracting COVID-19, news of new cases, insufficient staff in healthcare facilities, risk of transmission of COVID-19 to family or friends, risk of death from COVID-19, the threat of the spread of the COVID-19 pandemic were associated with high level of anxiety/fear among healthcare workers. Factors that facilitate coping with stress included absence of Covid-19 cases among staff, recovering patients, availability of gear and protective equipment and absence of COVID-19 infected among loved ones, relieving stress (relaxation, going info sports and so on), communication with family and friends to relieve stress and get support, avoidance of COVID-19 media reports in particular on deaths connected cases, getting information about the spread of Covid-19 only from legitimate sources.

CONCLUSION

Conclusions: The data obtained in this study indicate an urgent need for the development and implementation of preventive and rehabilitation measures aimed at stabilizing the psycho-emotional state of health workers and improving the quality of care in the special conditions of the COVID-19 pandemic. Achieving these goals will be facilitated by taking into account the specifics of the response to COVID-19 and measures to reduce the effects of stress while enhancing the effects of stressors among health care workers.