Benchmarking SARS CoV-2 Infection in the Workplace to Support Continuity of Operations

OBJECTIVE

The COVID-19 pandemic jeopardizes continuity of operations of workplaces and the health and safety of workers. Exemplar workplace-related SARS-CoV-2 benchmarks are described and illustrated with empirical data.

METHODS

Benchmarks were collected over a 9-month period on a large workplace (N = 5500+). These ranged from quantitative indices associated with RT-qPCR targeted testing and random surveillance screening, surveillance for new variants of SARS-CoV-2, intensive contact tracing, case management, return to work procedures, to monitoring of antibody seropositive status.

RESULTS

Data and analyses substantiated effectiveness of interventions. This was evidenced in suppressed infection rates, rapid case identification and isolation, acceptance of the program by employees, documentation of presumptive immunity, and working relationships with senior management.

CONCLUSIONS

These SARS-CoV-2 exemplar benchmarks provided an evidence-base for practice and contributed strategically to organizational decisions.

Occupational Contamination with a Highly Enriched Uranium Solution

This medical case report describes the first reported instance of occupational skin contamination with a uranyl nitrate solution containing highly enriched uranium. The report provides an overview of the unique medical treatment and management considerations in such a case. Internal dose assessment is covered in detail. The discussion covers key points regarding uranium characteristics, chemical and radiological damage to body tissues from HEU exposure, and resources available for assistance with a case of radiological contamination. This information adds to the limited medical literature on this topic and provides a valuable reference for medical personnel when dealing with this uncommon problem.

Combat dermatology: the role of the deployed army dermatologist

Shortly after completing residency or fellowship, army dermatologists routinely deploy to combat zones as field surgeons. The US Army generally does not deploy dermatologists for their expertise in diagnosing and managing cutaneous diseases; rather, as field surgeons they provide routine, emergency, and trauma care for active-duty soldiers and coalition forces. In this article, we review the various functions of the deployed dermatologist and highlight the importance of maintaining basic emergency medical skills that could be generalized to the civilian population in case of local or national emergencies.

A review of the first 10 years of critical care aeromedical transport during operation iraqi freedom and operation enduring freedom: the importance of evacuation timing

IMPORTANCE

Advances in the care of the injured patient are perhaps the only benefit of military conflict. One of the unique aspects of the military medical care system that emerged during Operation Iraqi Freedom and Operation Enduring Freedom has been the opportunity to apply existing civilian trauma system standards to the provision of combat casualty care across an evolving theater of operations.

OBJECTIVES

To identify differences in mortality for soldiers undergoing early and rapid evacuation from the combat theater and to evaluate the capabilities of the Critical Care Air Transport Team (CCATT) and Joint Theater Trauma Registry databases to provide adequate data to support future initiatives for improvement of performance.

DESIGN, SETTING, AND PARTICIPANTS

Retrospective review of CCATT records and the Joint Theater Trauma Registry from September 11, 2001, to December 31, 2010, for the in-theater military medicine health system, including centers in Iraq, Afghanistan, and Germany. Of 2899 CCATT transport records, those for 975 individuals had all the required data elements.

EXPOSURE

Rapid evacuation by the CCATT.

MAIN OUTCOMES AND MEASURES

Survival as a function of time from injury to arrival at the role IV facility at Landstuhl Regional Medical Center.

RESULTS

The patient cohort demonstrated a mean Injury Severity Score of 23.7 and an overall 30-day mortality of 2.1%. Mortality en route was less than 0.02%. Statistically significant differences between survivors and decedents with respect to the Injury Severity Score (mean [SD], 23.4 [12.4] vs 37.7 [16.5]; P < .001), cumulative volume of blood transfused among the patients in each group who received a transfusion (P < .001), worst base deficit (mean [SD], -3.4 [5.0] vs -7.8 [6.9]; P = .02), and worst international normalized ratio (median [interquartile range], 1.2 [1.0-1.4] vs 1.4 [1.1-2.2]; P = .03) were observed. We found no statistically significant difference between survivors and decedents with respect to time from injury to arrival at definitive care.

CONCLUSIONS AND RELEVANCE

Rapid movement of critically injured casualties within hours of wounding appears to be effective, with a minimal mortality incurred during movement and overall 30-day mortality. We found no association between the duration of time from wounding to arrival at Landstuhl Regional Medical Center with respect to mortality.