Impact of COVID-19-related restricted family presence policies on Canadian pediatric intensive care unit clinicians: a qualitative study

PURPOSE

Pediatric intensive care units (PICUs) worldwide restricted family presence in response to the COVID-19 pandemic. We aimed to explore the experiences and impact of restricted family presence policies on Canadian PICU clinicians.

METHODS

We conducted a qualitative study that followed an interpretive phenomenological design. Participants were PICU clinicians providing direct patient care in Canada during periods of COVID-19-related restricted family presence. We purposively sampled for maximum variation among survey participants who consented to be contacted for further research on the same topic. In-depth interviews were conducted remotely via telephone or video-call, audio-recorded, and transcribed. Interviews were inductively coded and underwent thematic analysis. Proposed themes were member-checked by interviewees.

RESULTS

Sixteen PICU clinicians completed interviews. Interviewees practiced across Canada, represented a range of disciplines (eight nurses, two physicians, two respiratory therapists, two child life specialists, two social workers) and years in profession (0-34 years). We identified four themes representing the most meaningful aspects of restricted family presence for participants: 1) balancing infection control and family presence; 2) feeling disempowered by hospital and policy-making hierarchies; 3) empathizing with family trauma; and 4) navigating threats to the therapeutic relationship.

CONCLUSION

Pediatric intensive care unit clinicians were impacted by restricted family presence policies during the COVID-19 pandemic. These policies contributed to feelings of disempowerment and challenged clinicians' perceived ability to provide the best family-centred care possible. Frontline expertise should be incorporated into the design and implementation of policies to best support family-centred care in any context and minimize risks of moral distress for PICU clinicians.

Digital Twins in Unmanned Aerial Vehicles for Rapid Medical Resource Delivery in Epidemics

The purposes are to explore the effect of Digital Twins (DTs) in Unmanned Aerial Vehicles (UAVs) on providing medical resources quickly and accurately during COVID-19 prevention and control. The feasibility of UAV DTs during COVID-19 prevention and control is analyzed. Deep Learning (DL) algorithms are introduced. A UAV DTs information forecasting model is constructed based on improved AlexNet, whose performance is analyzed through simulation experiments. As end-users and task proportion increase, the proposed model can provide smaller transmission delays, lesser energy consumption in throughput demand, shorter task completion time, and higher resource utilization rate under reduced transmission power than other state-of-art models. Regarding forecasting accuracy, the proposed model can provide smaller errors and better accuracy in Signal-to-Noise Ratio (SNR), bit quantizer, number of pilots, pilot pollution coefficient, and number of different antennas. Specifically, its forecasting accuracy reaches 95.58% and forecasting velocity stabilizes at about 35 Frames-Per-Second (FPS). Hence, the proposed model has stronger robustness, making more accurate forecasts while minimizing the data transmission errors. The research results can reference the precise input of medical resources for COVID-19 prevention and control.

Optimization of COVID-19 prevention and control with low building energy consumption

COVID-19 is a global threat. Non-pharmaceutical interventions were commonly adopted for COVID-19 prevention and control. However, during stable periods of the pandemic, energy would be inevitably wasted if all interventions were implemented. The study aims to reduce the building energy consumption when meet the demands of epidemic prevention and control under the stable period of COVID-19. Based on the improved Wells-Riley model considering dynamic quanta generation and pulmonary ventilation rate, we established the infection risk - equivalent fresh air volume - energy consumption model to analyze the infection risk and building energy consumption during different seasons and optimized the urban building energy consumption according to the spatio-temporal population distribution. Shopping centers and restaurants contributed the most in urban energy consumption, and if they are closed during the pandemic, the total infection risk would be reduced by 25%-40% and 15%-25% respectively and the urban energy consumption would be reduced by 30%-40% and 13%-20% respectively. If people wore masks in all public indoor environments (exclude restaurants and KTV), the infection risk could be reduced by 60%-70% and the energy consumption could be reduced by 20%-60%. Gyms pose the highest risk for COVID-19 transmission. If the energy consumption kept the same with the current value, after the optimization, infection risk in winter, summer and the transition season could be reduced by 65%, 53% and 60%, respectively. After the optimization, under the condition of R _t  < 1, the energy consumption in winter, summer, and the transition season could be reduced by 72%, 64%, and 68% respectively.

A rapid and highly effective approach for SARS-CoV-2 nucleic acid daily testing in more than four thousand single-tube samples

BACKGROUND

Presently, the global spread of COVID-19 is still going on, with more than 0.6 million new cases confirmed per day (as of November 20, 2021). However, since China entered a post-epidemic phase in mid-March 2020, the daily number of new domestic infections in the Chinese mainland has been maintained at almost zero or single digits, which was attributed to a series of effective measures for COVID-19 prevention and control adopted by the Chinese government. Among these measures, SARS-CoV-2 nucleic acid testing holds key role for the timely confirmation and isolation of the infections to prevent further transmission.

METHODS

Referring to the national policy requirements, since April 30, 2020, The Affiliated Hospital of Qingdao University has conducted SARS-CoV-2 nucleic acid testing in its PCR laboratory for patients and social workers, as well as for environmental monitoring and employee screening. As of mid-November 2020, the daily amount of single-tube samples for nucleic acid testing rose above 4,000.

RESULTS

In this article, a rapid and highly effective approach for SARS-CoV-2 nucleic acid daily testing is presented, allowing five technicians to complete nucleic acid testing in 6,500 single-tube samples in one day with a high level of quality. Using this approach, since the samples entered the PCR laboratory, all testing results were reported in 2.5-3 h with satisfactory quality control and precise reporting criterion as prerequisites.

CONCLUSION

This testing approach provides a referable workflow for other testing institutions and is expected to play an important role in COVID-19 prevention and control.

Online User Information Sharing and Government Pandemic Prevention and Control Strategies-Based on Evolutionary Game Model

Background: The sharing and utilization of online users' information has become an important resource for governments to manage COVID-19; however, it also involves the risk of leakage of users' personal information. Online users' sharing decisions regarding personal information and the government's COVID-19 prevention and control decisions influence each other and jointly determine the efficiency of COVID-19 control and prevention. Method: Using the evolutionary game models, this paper examines the behavioral patterns of online users and governments with regard to the sharing and disclosure of COVID-19 information for its prevention and control. Results: This paper deduce the reasons and solutions underlying the contradiction between the privacy risks faced by online users in sharing information and COVID-19 prevention and control efforts. The inconsistency between individual and collective rationality is the root cause of the inefficiency of COVID-19 prevention and control. Conclusions: The reconciliation of privacy protection with COVID-19 prevention and control efficiency can be achieved by providing guidance and incentives to modulate internet users' behavioral expectations.