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Sahni C, Reddy KRC, Nayak AK, Seth S. Plastic Pandemic after COVID-19: A Global Health Concern. Clin Ter 2024; 175:181-183. [PMID: 38767076 DOI: 10.7417/ct.2024.5060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Abstract COVID-19 pandemic has increased the amount of plastic burden to environment and complexities of plastic waste management. Change in behavioral pattern with advent of this pandemic led to increased practice of hygiene and increased use of different types of personal protective equipment. Unfortunately, rapid rise in production of the PPEs (like Hazmat suit, gloves, etc.) and single-use plastics used in RT-PCR and other testing are the biggest source for increased non-biodegradable plastic waste leading to amplified burden on plastic waste management. A number of measures like prioritizing the policies directed towards changes at behavioral, social and institutional level need to be started. Also, reduction in plastic waste along with proper plastic waste management policies should be implemented. To prevent the transition from one pandemic to other; improvement in government policies with public private partnership are the need of the hour.
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Affiliation(s)
- C Sahni
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - K R C Reddy
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - A K Nayak
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - S Seth
- All India Institute of Medical Sciences, Gorakhpur, India
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Zerden LDS, Ross AM, Cederbaum J, Guan T, Zelnick J, Ruth BJ. Race and COVID-19 among Social Workers in Health Settings: Physical, Mental Health, Personal Protective Equipment, and Financial Stressors. Health Soc Work 2023; 48:91-104. [PMID: 36869753 DOI: 10.1093/hsw/hlad002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/13/2021] [Accepted: 12/22/2021] [Indexed: 06/18/2023]
Abstract
Social work is an essential workforce integral to the United States' public health infrastructure and response to COVID-19. To understand stressors among frontline social workers during COVID-19, a cross-sectional study of U.S-based social workers (N = 1,407) in health settings was collected (in June through August 2020). Differences in outcome domains (health, mental health, personal protective equipment [PPE] access, financial stress) were examined by workers' demographics and setting. Ordinal logistic, multinomial, and linear regressions were conducted. Participants reported moderate or severe physical (57.3 percent) and mental (58.3 percent) health concerns; 39.3 percent expressed PPE access concerns. Social workers of color were more likely to report significantly higher levels of concern across all domains. Those identifying as Black, American Indian/Alaska Native (AIAN), Asian American/Pacific Islander (AAPI), multiracial, or Hispanic/Latinx were over 50 percent more likely to experience either moderate or severe physical health concerns, 60 percent more likely to report severe mental health concerns, and over 30 percent more likely to report moderate PPE access concerns. The linear regression model was significantly associated with higher levels of financial stress for social workers of color. COVID-19 has exposed racial and social injustices that that hold true for social workers in health settings. Improved social systems are critical not just for those impacted by COVID-19, but also for the protection and sustainability of the current and future workforce responding to COVID-19.
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Affiliation(s)
- Lisa de Saxe Zerden
- PhD, MSW, is associate professor, School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB 3550, Chapel Hill, NC 27599-3550, USA
| | - Abigail M Ross
- PhD, is assistant professor, Graduate School of Social Service, Fordham University, New York, NY USA
| | - Julie Cederbaum
- PhD, is associate professor, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Ting Guan
- MS, is an assistant professor, Syracuse University, Syracuse, NY, USA
| | - Jennifer Zelnick
- ScD, is social welfare policy chair and professor, Graduate School of Social Work, Touro College, New York, NY, USA
| | - Betty J Ruth
- MSW, is a retired clinical professor, School of Social Work, Boston University, Boston, MA, USA
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Messing EG, Abraham RS, Quinn NJ, Duthie EA. CE: Using Smart IV Infusion Pumps Outside of Patient Rooms. Am J Nurs 2022; 122:36-43. [PMID: 35027523 DOI: 10.1097/01.naj.0000819772.45006.5d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The COVID-19 pandemic has created unique challenges for health care workers, who have demonstrated dedication, collaboration, and innovation in response. In this article, the authors describe an important nursing innovation they employed at Montefiore Medical Center in the Bronx, New York, during the spring 2020 COVID-19 surge: the relocation of smart IV infusion pumps outside of patient rooms. The goals of this innovation were to improve delivery of care, conserve personal protective equipment, limit the spread of the virus, and protect staff from exposure. The authors discuss the initial concerns that arose regarding the safety and efficacy of this practice; the research they conducted with other colleagues in nursing, pharmacy, infection control, and patient safety in the face of scant clinical literature relevant to the difficult circumstances the pandemic created; and the strategies they ultimately employed to ensure that this practice maintained safety and efficacy.
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Affiliation(s)
- Emily G Messing
- Emily G. Messing is a clinical pharmacy manager, informatics, Renu S. Abraham is a patient safety manager, Nicholas J. Quinn is a clinical pharmacy manager, critical care, and Elizabeth A. Duthie is director of patient safety, all at Montefiore Medical Center, Bronx, NY. The authors acknowledge Christina Rohan for her photography assistance and Theresa Madaline, Mary Ellen Lindros, Mark Sinnett, Inessa Gendlina, and Maureen Scanlan for their feedback on the manuscript prior to submission. Contact author: Emily G. Messing, . The authors and planners have disclosed no potential conflicts of interest, financial or otherwise
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Hirsh-Yechezkel G, Chetrit A, Ben Avraham S, Agbarya A, Yakobson A, Asna N, Bar-Sela G, Ben-Aharon I, Ben-Baruch NE, Berger R, Brenner R, Gottfried M, Paluch-Shimon S, Pfeffer R, Popovtzer A, Ryvo L, Semenisty V, Shai A, Shulman K, Zidan J, Wolf I. Oncology Treatments during the COVID-19 Pandemic in Israel: the ONCOR Study. Isr Med Assoc J 2021; 23:759-765. [PMID: 34954913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The increased susceptibility of cancer patients to coronavirus disease-2019 (COVID-19) infections and complications calls for special precautions while treating cancer patients during COVID-19 pandemics. Thus, oncology departments have had to implement a wide array of prevention measures. OBJECTIVES To address issues associated with cancer care during the COVID-19 pandemic and to assess the implementation of measures aimed at containment of COVID-19 diffusion while allowing continuation of quality cancer care. METHODS A national survey among oncology departments in Israel was conducted between 12 April 2020 and 14 April 2020. Eighteen heads of hospital-based oncology departments completed a self-report questionnaire regarding their institute's preparedness for treatment of cancer patients during the COVID-19 pandemic. RESULTS In this national survey, prevention measures against COVID-19 spread were taken prior to patients' arrival and at arrival or while staying in the departments. Most participants (78-89%) reported using a quick triage of patients and caregivers prior to their entrance to the oncology units, limiting the entrance of caregivers, and reducing unnecessary visits to the clinic. Switching to oral therapies rather than intravenous ones when possible was considered by 82% and shortage in personal protective equipment was reported by five (28%) heads of oncology departments. Some differences between large and small/medium sized medical centers were observed regarding issues related to COVID-19 containment measures and changes in treatment. CONCLUSIONS Oncology departments in Israel were able to prepare and adapt their services to guidelines and requirements related to the COVID-19 pandemic with little harm to their treatment capacity.
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Affiliation(s)
- Galit Hirsh-Yechezkel
- Cancer and Radiation Epidemiology Unit, affiliated with Tel Aviv University, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Angela Chetrit
- Cancer and Radiation Epidemiology Unit, affiliated with Tel Aviv University, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Sivan Ben Avraham
- Cancer and Radiation Epidemiology Unit, affiliated with Tel Aviv University, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Abed Agbarya
- Department of Oncology, Bnai Zion Medical Center, Haifa, Israel
| | - Alexander Yakobson
- Legacy Heritage Oncology Center and Norton Institute, Soroka Medical Center, Beer Sheva, Israel
- Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Noam Asna
- Department of Oncology Ziv Medical Center, Safed, Israel
| | - Gil Bar-Sela
- Cancer Center, Emek Medical Center, Afula, Israel
| | - Irit Ben-Aharon
- Division of Oncology, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel
| | - Noa Efrat Ben-Baruch
- Department of Oncology, Kaplan Medical Center, Rehovot, Israel
- Department of Oncology, Nazareth Hospital, Nazareth, Israel
| | - Raanan Berger
- Cancer Center, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronen Brenner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Oncology Institute, Wolfson Medical Center, Holon, Israel
| | - Maya Gottfried
- Department of Oncology, Meir Medical Center, Kfar Saba, Israel
| | - Shani Paluch-Shimon
- Division of Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
- Division of Oncology, Hadassah University Hospital, Jerusalem, Israel
| | - Raphael Pfeffer
- Ben Gurion University of the Negev, Beer Sheva, Israel
- Oncology Institute, Assuta Medical Center, Tel Aviv, Israel
| | - Aron Popovtzer
- Oncology Institute, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Larisa Ryvo
- Department of Oncology, Assuta Ashdod Academic Medical Center, Ashdod, Israel
| | | | - Ayelet Shai
- Department of Oncology, Galilee Medical Center, Nahariya, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Katerina Shulman
- Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel
- Oncology Unit, Carmel Medical Center, Haifa, Israel
| | - Jamal Zidan
- Department of Oncology Ziv Medical Center, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Ido Wolf
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Oncology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Sayyed A, Baker ML, Peesay T, Rooney A, Syed Z. An Auxiliary Medical Education: The Evolution of a Medical Student-Founded Organization in Response to the COVID-19 Era Personal Protective Equipment Shortage. Acad Med 2021; 96:1663-1670. [PMID: 34074901 PMCID: PMC8603433 DOI: 10.1097/acm.0000000000004185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
At the outset of the COVID-19 pandemic, many medical students were removed from clinical duties and had their education put on hold. Some found novel ways to join efforts to respond to the pandemic. Georgetown University School of Medicine medical students created Medical Supply Drive (MSD or MedSupplyDrive), a 501(c)(3), on March 17, 2020, in response to the national shortage of personal protective equipment (PPE). This article reviews the formation of a national response to the pandemic, the methods employed to distribute PPE, and the results of MSD's work from March 17, 2020, through June 20, 2020. A focus was placed on equitable distribution, both within local regions and on the national scale, by distinguishing COVID-19 hotspots, including Native American reservations. As of June 20, 2020, over half a million items were donated, with 1,001 deliveries made to 423 hospitals, 182 clinics, 175 long-term care facilities, 25 homeless shelters, 32 public health departments, and 164 other facilities. From 46 states and the District of Columbia, 1,514 individuals volunteered, and 202 signed up as regional coordinators. MSD formed 2 international organizations, MedSupplyDrive UK and MedSupplyDrive Scotland, and established U.S.-based partnerships with 19 different PPE and aid organizations. MSD gained local, national, and international media attention with over 45 interviews conducted about the organization. While the pandemic temporarily disrupted formal medical education, MSD empowered medical students to actively learn about the needs of their communities and organize ways to address them while incorporating these values into their professional identities. The framework that this organization employed also provides a potential model for future disaster relief efforts in times of crisis. MSD hopes to motivate budding physicians to collaborate and play an active role in tackling public health inequities beyond hospitals and within the communities students will one day serve.
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Affiliation(s)
- Adaah Sayyed
- A. Sayyed is a third-year medical student, Georgetown University School of Medicine, Washington, DC, and cofounder, Medical Supply Drive; ORCID: https://orcid.org/0000-0001-7998-5970
| | - Melissa L. Baker
- M.L. Baker is a third-year medical student, Georgetown University School of Medicine, Washington, DC, and cofounder, Medical Supply Drive; ORCID: https://orcid.org/0000-0003-4042-0707
| | - Tejasvi Peesay
- T. Peesay is a third-year medical student, Georgetown University School of Medicine, Washington, DC, and cofounder, Medical Supply Drive; ORCID: https://orcid.org/0000-0001-7441-1572
| | - Allison Rooney
- A. Rooney is a third-year medical student, Georgetown University School of Medicine, Washington, DC, and cofounder, Medical Supply Drive; ORCID: https://orcid.org/0000-0002-0046-4935
| | - Zuby Syed
- Z. Syed is a third-year medical student, Georgetown University School of Medicine, Washington, DC, and cofounder, Medical Supply Drive; ORCID: https://orcid.org/0000-0003-4104-0992
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Vranas KC, Golden SE, Mathews KS, Schutz A, Valley TS, Duggal A, Seitz KP, Chang SY, Nugent S, Slatore CG, Sullivan DR, Hough CL. The Influence of the COVID-19 Pandemic on ICU Organization, Care Processes, and Frontline Clinician Experiences: A Qualitative Study. Chest 2021; 160:1714-1728. [PMID: 34062115 PMCID: PMC8164514 DOI: 10.1016/j.chest.2021.05.041] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/20/2021] [Accepted: 05/25/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic resulted in unprecedented adjustments to ICU organization and care processes globally. RESEARCH QUESTIONS Did hospital emergency responses to the COVID-19 pandemic differ depending on hospital setting? Which strategies worked well to mitigate strain as perceived by intensivists? STUDY DESIGN AND METHODS Between August and November 2020, we carried out semistructured interviews of intensivists from tertiary and community hospitals across six regions in the United States that experienced early or large surges of COVID-19 patients, or both. We identified themes of hospital emergency responses using the four S framework of acute surge planning: space, staff, stuff, system. RESULTS Thirty-three intensivists from seven tertiary and six community hospitals participated. Clinicians across both settings believed that canceling elective surgeries was helpful to increase ICU capabilities and that hospitals should establish clearly defined thresholds at which surgeries are limited during future surge events. ICU staff was the most limited resource; staff shortages were improved by the use of tiered staffing models, just-in-time training for non-ICU clinicians, designated treatment teams, and deployment of trainees. Personal protective equipment (PPE) shortages and reuse were widespread, causing substantial distress among clinicians; hands-on PPE training was helpful to reduce clinicians' anxiety. Transparency and involvement of frontline clinicians as stakeholders were important components of effective emergency responses and helped to maintain trust among staff. INTERPRETATION We identified several strategies potentially to mitigate strain as perceived by intensivists working in both tertiary and community hospital settings. Our study also demonstrated the importance of trust and transparency between frontline staff and hospital leadership as key components of effective emergency responses during public health crises.
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Affiliation(s)
- Kelly C Vranas
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR; Division of Pulmonary and Critical Care, Oregon Health & Science University, Portland, OR; Palliative and Advanced Illness Research (PAIR) Center, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
| | - Sara E Golden
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR
| | - Kusum S Mathews
- Division of Pulmonary, Critical Care, & Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Amanda Schutz
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Thomas S Valley
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI; Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI
| | - Abhijit Duggal
- Department of Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
| | - Kevin P Seitz
- Division of Pulmonary, Allergy, and Critical Care Medicine, Vanderbilt University, Nashville, TN
| | - Steven Y Chang
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, Ronald Reagan-UCLA Medical Center, Los Angeles, CA
| | - Shannon Nugent
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR; Department of Psychiatry, Oregon Health & Science University, Portland, OR
| | - Christopher G Slatore
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR; Division of Pulmonary and Critical Care, Oregon Health & Science University, Portland, OR
| | - Donald R Sullivan
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR; Division of Pulmonary and Critical Care, Oregon Health & Science University, Portland, OR; Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Catherine L Hough
- Division of Pulmonary and Critical Care, Oregon Health & Science University, Portland, OR
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Billings J, Abou Seif N, Hegarty S, Ondruskova T, Soulios E, Bloomfield M, Greene T. What support do frontline workers want? A qualitative study of health and social care workers' experiences and views of psychosocial support during the COVID-19 pandemic. PLoS One 2021; 16:e0256454. [PMID: 34473755 PMCID: PMC8412294 DOI: 10.1371/journal.pone.0256454] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/08/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has placed a significant burden on the mental health and wellbeing of frontline health and social care workers. The need to support frontline staff has been recognised. However, there is to date little research specifically on how best to support the mental health needs of frontline workers, and none on their own experiences and views about what might be most helpful. AIMS We set out to redress this research gap by qualitatively exploring UK frontline health and social care workers' own experiences and views of psychosocial support during the pandemic. METHOD Frontline health and social care workers were recruited purposively through social media and by snowball sampling via healthcare colleagues. Workers who volunteered to take part in the study were interviewed remotely following a semi-structured interview guide. Transcripts of the interviews were analysed by the research team following the principles of Reflexive Thematic Analysis. RESULTS We conducted 25 interviews with frontline workers from a variety of professional groups working in health and social care settings across the UK. Themes derived from our analysis showed that workers' experiences and views about psychosocial support were complex. Peer support was many workers' first line of support but could also be experienced as a burden. Workers were ambivalent about support shown by organisations, media and the public. Whilst workers valued psychological support services, there were many disparities in provision and barriers to access. CONCLUSIONS The results of this study show that frontline health and social care workers are likely to need a flexible system of support including peer, organisational and professional support. More research is needed to fully unpack the structural, systemic and individual barriers to accessing psychosocial support. Greater collaboration, consultation and co-production of support services and their evaluation is warranted.
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Affiliation(s)
- Jo Billings
- Division of Psychiatry, University College London, London, United Kingdom
| | - Nada Abou Seif
- Division of Psychiatry, University College London, London, United Kingdom
| | - Siobhan Hegarty
- Division of Psychiatry, University College London, London, United Kingdom
| | - Tamara Ondruskova
- Division of Psychiatry, University College London, London, United Kingdom
| | - Emilia Soulios
- Division of Psychiatry, University College London, London, United Kingdom
| | - Michael Bloomfield
- Division of Psychiatry, University College London, London, United Kingdom
- Traumatic Stress Clinic, Camden & Islington NHS Foundation Trust, London, United Kingdom
- National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, United Kingdom
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Talya Greene
- Division of Psychiatry, University College London, London, United Kingdom
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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Krause M, Henderson A, Griner D, Rissland OS, Beard J, Bartels K. A Statewide Voluntary Movement Addressing the Shortage of Medical Supplies During the COVID-19 Pandemic. Am J Public Health 2021; 111:1595-1599. [PMID: 34436929 PMCID: PMC8589063 DOI: 10.2105/ajph.2021.306364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 11/04/2022]
Abstract
During the COVID-19 pandemic, a shortage of personal protective equipment compromised efficient patient care and provider safety. Volunteers from many different backgrounds worked to meet these demands. Additive manufacturing, laser cutting, and alternative supply chains were used to produce, test, and deliver essential equipment for health care workers and first responders. Distributed equipment included ear guards, face shields, and masks. Contingent designs were created for powered air-purifying respirator hoods, filtered air pumps, intubation shields, and N95 masks.
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Affiliation(s)
- Martin Krause
- Martin Krause is with the Department of Anesthesiology, University of Colorado School of Medicine, Aurora. Andrew Henderson and Daniel Griner are with Inworks Innovation Initiative, College of Engineering, Design, and Computing, University of Colorado, Denver. Olivia S. Rissland is with the Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora. Jeremy Beard is with the Center for Engagement and Innovation, IDEA Lab, Red Rocks Community College, Lakewood, CO. Karsten Bartels is with the Department of Anesthesiology, University of Nebraska Medical Center, Omaha
| | - Andrew Henderson
- Martin Krause is with the Department of Anesthesiology, University of Colorado School of Medicine, Aurora. Andrew Henderson and Daniel Griner are with Inworks Innovation Initiative, College of Engineering, Design, and Computing, University of Colorado, Denver. Olivia S. Rissland is with the Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora. Jeremy Beard is with the Center for Engagement and Innovation, IDEA Lab, Red Rocks Community College, Lakewood, CO. Karsten Bartels is with the Department of Anesthesiology, University of Nebraska Medical Center, Omaha
| | - Daniel Griner
- Martin Krause is with the Department of Anesthesiology, University of Colorado School of Medicine, Aurora. Andrew Henderson and Daniel Griner are with Inworks Innovation Initiative, College of Engineering, Design, and Computing, University of Colorado, Denver. Olivia S. Rissland is with the Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora. Jeremy Beard is with the Center for Engagement and Innovation, IDEA Lab, Red Rocks Community College, Lakewood, CO. Karsten Bartels is with the Department of Anesthesiology, University of Nebraska Medical Center, Omaha
| | - Olivia S Rissland
- Martin Krause is with the Department of Anesthesiology, University of Colorado School of Medicine, Aurora. Andrew Henderson and Daniel Griner are with Inworks Innovation Initiative, College of Engineering, Design, and Computing, University of Colorado, Denver. Olivia S. Rissland is with the Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora. Jeremy Beard is with the Center for Engagement and Innovation, IDEA Lab, Red Rocks Community College, Lakewood, CO. Karsten Bartels is with the Department of Anesthesiology, University of Nebraska Medical Center, Omaha
| | - Jeremy Beard
- Martin Krause is with the Department of Anesthesiology, University of Colorado School of Medicine, Aurora. Andrew Henderson and Daniel Griner are with Inworks Innovation Initiative, College of Engineering, Design, and Computing, University of Colorado, Denver. Olivia S. Rissland is with the Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora. Jeremy Beard is with the Center for Engagement and Innovation, IDEA Lab, Red Rocks Community College, Lakewood, CO. Karsten Bartels is with the Department of Anesthesiology, University of Nebraska Medical Center, Omaha
| | - Karsten Bartels
- Martin Krause is with the Department of Anesthesiology, University of Colorado School of Medicine, Aurora. Andrew Henderson and Daniel Griner are with Inworks Innovation Initiative, College of Engineering, Design, and Computing, University of Colorado, Denver. Olivia S. Rissland is with the Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora. Jeremy Beard is with the Center for Engagement and Innovation, IDEA Lab, Red Rocks Community College, Lakewood, CO. Karsten Bartels is with the Department of Anesthesiology, University of Nebraska Medical Center, Omaha
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Stöcker A, Demirer I, Gunkel S, Hoffmann J, Mause L, Ohnhäuser T, Scholten N. Stockpiled personal protective equipment and knowledge of pandemic plans as predictors of perceived pandemic preparedness among German general practitioners. PLoS One 2021; 16:e0255986. [PMID: 34383827 PMCID: PMC8360569 DOI: 10.1371/journal.pone.0255986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/28/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic significantly changed the work of general practitioners (GPs). At the onset of the pandemic in March 2020, German outpatient practices had to adapt quickly. Pandemic preparedness (PP) of GPs may play a vital role in their management of a pandemic. OBJECTIVES The study aimed to examine the association in the stock of seven personal protective equipment (PPE) items and knowledge of pandemic plans on perceived PP among GPs. METHODS Three multivariable linear regression models were developed based on an online cross-sectional survey for the period March-April 2020 (the onset of the pandemic in Germany). Data were collected using self-developed items on self-assessed PP and knowledge of a pandemic plan and its utility. The stock of seven PPE items was queried. For PPE items, three different PPE scores were compared. Control variables for all models were gender and age. RESULTS In total, 508 GPs were included in the study; 65.16% believed that they were very poorly or poorly prepared. Furthermore, 13.83% of GPs were aware of a pandemic plan; 40% rated those plans as beneficial. The stock of FFP-2/3 masks, protective suits, face shields, safety glasses, and medical face masks were mostly considered completely insufficient or insufficient, whereas disposable gloves and disinfectants were considered sufficient or completely sufficient. The stock of PPE was significantly positively associated with PP and had the largest effect on PP; the association of the knowledge of a pandemic plan was significant but small. PPE scores did not vary considerably in their explanatory power. The assessment of a pandemic plan as beneficial did not significantly affect PP. CONCLUSION The stock of PPE seems to be the determining factor for PP among German GPs; for COVID-19, sufficient masks are the determining factor. Knowledge of a pandemic plans play a secondary role in PP.
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Affiliation(s)
- Arno Stöcker
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Ibrahim Demirer
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Sophie Gunkel
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Jan Hoffmann
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Laura Mause
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Tim Ohnhäuser
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Nadine Scholten
- Faculty of Human Sciences, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
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da Fonseca EP, Pereira-Junior EA, Palmier AC, Abreu MHNG. A Description of Infection Control Structure in Primary Dental Health Care, Brazil. Biomed Res Int 2021; 2021:5369133. [PMID: 34373834 PMCID: PMC8349252 DOI: 10.1155/2021/5369133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/13/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study is aimed at describing a score to assess infection control structures in Oral Health Teams (OHT) in Primary Health Care (PHC) in Brazil. METHODS Secondary data from a national external evaluation of PHC conducted in 2017 and 2018 were analyzed. The construction of the score used 14 variables, divided into the following: structural characteristics of the PHC, infection control equipment under conditions of use, and biosafety supplies in sufficient quantity. The questions were mostly dichotomous (yes/no). Descriptive analyses were carried out to characterize the OHT and factor analyses to reduce the number of observed variables to a specific number of factors. RESULTS Among 20,301 health units with OHT, 4,510 (22.2%) units did not have washable floors, ceilings, and walls; 8,406 (41.4%) did not have a sealer; 16,780 (82.7%) did not have taps with noncontact activation, and 4,663 (23.0%) units did not have rubber gloves. Regarding personal protective equipment (PPE), 1,618 (8.0%) units did not have a sufficient quantity of basic PPE. Three factors were defined to explain the 14 evaluated variables. The South region had the best score of infection control, while the North had the worst. CONCLUSIONS Regional inequalities in the failures in infection control structures identified in PHC with OHT were related to the physical structure, equipment, and supplies used for infection control and the absence of PPE for OHT.
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Affiliation(s)
- Emílio Prado da Fonseca
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Andréa Clemente Palmier
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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11
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Reutman SR, Reponen T, Yermakov M, A Grinshpun S. Homemade facemasks: particle filtration, breathability, fit, and other performance characteristics. J Occup Environ Hyg 2021; 18:334-344. [PMID: 34080950 DOI: 10.1080/15459624.2021.1925124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Homemade cloth masks and other improvised face coverings have become widespread during the COVID-19 pandemic driven by severe shortages of personal protective equipment. In this study, various alternative (mostly common household) materials, which have not traditionally been used in respiratory protective devices, were tested for particle filtration performance and breathability. Most of these materials were found of some-but rather limited-utility in facemasks. At a breathing flow rate of 30 L min-1, 17 out of 19 tested materials demonstrated collection efficiency below 50%; at 85 L min-1, only one material featured particle collection efficiency above 50%. Pressure drop values were mostly below 4 mm w.g. (observed in 89% of cases for the two flow rates), which provides comfortable breathing. Only for one fabric material (silk) tested at 85 L min-1 did the pressure drop reach 11 mm w.g. Based on these results, a three-layer facemask prototype was designed and fabricated comprised of the best performing materials. Additional tests were conducted to examine possible particle detachment/shedding from the materials used in the newly developed facemask, but no such phenomenon was observed. The prototype was evaluated on 10 human subjects using the standard OSHA-approved quantitative fit testing protocol. The mask protection level, determined as an adopted fit factor, was found to lie between that of the two commercial surgical/medical masks tested for comparison. A 10-cycle washing of the mask prototype lowered its collection efficiency across the particle size range; however, washing did not substantially affect mask breathability. The study revealed that although homemade masks offer a certain level of protection to a wearer, one should not expect them to provide the same respiratory protection as high-end commercial surgical/medical masks or-by any means-NIOSH-certified N95 filtering facepieces.
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Affiliation(s)
- Susan R Reutman
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tiina Reponen
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Michel Yermakov
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Sergey A Grinshpun
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Canoutas DA, Gregor A, Gertner AK. An Interdisciplinary, Service-Learning Effort to Address Personal Protective Equipment Shortages. Acad Med 2021; 96:942. [PMID: 33656005 DOI: 10.1097/acm.0000000000004037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Demitra A Canoutas
- Fourth-year medical student, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina;
| | - Alex Gregor
- Fourth-year medical student, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0002-3556-2260
| | - Alex K Gertner
- Fourth-year medical student, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
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13
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Foroushani S, Woodbridge A, Hopper T. How Medical Students in New Orleans Bridged the Personal Protective Equipment Supply Gap. Acad Med 2021; 96:941-942. [PMID: 33656007 DOI: 10.1097/acm.0000000000004041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Sophia Foroushani
- Fourth-year medical student, Tulane University School of Medicine, New Orleans, Louisiana; ; ORCID: https://orcid.org/0000-0002-5036-3868
| | - Alexandra Woodbridge
- Fourth-year medical student, Tulane University School of Medicine, New Orleans, Louisiana
| | - Taylor Hopper
- Third-year medical student, Tulane University School of Medicine, New Orleans, Louisiana
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14
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Pendergrast TR. Holding Back a Flood: Students Organized to Bring Personal Protective Equipment to the Front Lines. Acad Med 2021; 96:944. [PMID: 33635836 DOI: 10.1097/acm.0000000000004027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Tricia Rae Pendergrast
- Second-year medical student, Northwestern University Feinberg School of Medicine, Chicago, Illinois; ; Twitter: @traependergrast
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15
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Abstract
New York City quickly became the epicenter of coronavirus disease-2019 (COVID-19) in early March of 2020. While hospitals were aware of the potential of COVID-19, the volume of critically ill patients that flooded the hospitals in the New York City area was clearly not anticipated. Hospital staff worked quickly to create COVID-19-free areas, but were overcome with the volume of COVID-positive critically ill patients. Many newly admitted patients required respiratory support with mechanical ventilation. As Governor Cuomo issued executive orders to stay at home in mid-March, some patients were afraid to go into hospitals despite symptoms of respiratory distress. Once these patients came to the hospital, they were often critically ill. Emergency departments and intensive care units filled rapidly, overwhelming staff and equipment needs with such things as pumps, dialysis machines, medications, and personal protective equipment. Plans for the day were disrupted with frequent rapid response calls and the need for additional beds. Key issues that confronted the COVID-19 response in critical care units at NYU Langone Health included communication, patient and staff safety.
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Affiliation(s)
- Mary Saputo
- New York University Langone Health, New York
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16
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Nimer R, Swedan S, Kofahi H, Khabour O. Increased Adherence to Infection Control Practices Among Medical Laboratory Technicians During the COVID-19 Pandemic: A Self-Reported Survey Study. Ann Glob Health 2021; 87:56. [PMID: 34221909 PMCID: PMC8231461 DOI: 10.5334/aogh.3378] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background The adherence of medical laboratory technicians (MLT) to infection control guidelines is essential for reducing the risk of exposure to infectious agents. This study explored the adherence of MLT towards infection control practices during the COVID-19 pandemic. Method The study population consisted of MLT (n = 444) who worked in private and government health sectors in Jordan. A self-reported survey was used to collect data from participants. Findings More than 87% of the participants reported adherence to hand-washing guidelines and using personal protective equipment (PPE) when interacting with patients (74.5%), and handling clinical samples (70.0%). Besides, 88.1%, 48.2%, and 7.7% reported wearing of lab coats, face masks, and goggles, at all times, respectively. The majority reported increased adherence to infection control practices during the COVID-19 pandemic. This includes increased PPE use at the workplace (94.2%), increased frequency of disinfection of laboratory surfaces (92.4%) and laboratory equipment (86.7%), and increased frequency of handwashing/use of antiseptics (94.6%). Having a graduate degree was significantly associated with increased adherence of participants to the daily use of goggles/eye protection (p = 0.002), and the use of PPE while handling clinical samples (p = 0.011). Having work experience of >10 years was associated with increased adherence to the use of PPE while handling clinical samples (p = 0.001). Conclusion MLT reported very good adherence with most assessed infection control practices. In addition, they reported increased conformity with infection control guidelines during the COVID-19 pandemic.
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Affiliation(s)
- Refat Nimer
- Faculty of Applied Medical Sciences, Dept. of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Samer Swedan
- Faculty of Applied Medical Sciences, Dept. of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Hassan Kofahi
- Faculty of Applied Medical Sciences, Dept. of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Omar Khabour
- Faculty of Applied Medical Sciences, Dept. of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
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Abstract
COVID-19 is a worldwide pandemic, with frontlines that look drastically different than in past conflicts: that is, women now make up a sizeable majority of the health care workforce. American women have a long history of helping in times of hardship, filling positions on the home front vacated by men who enlisted as soldiers during World War I and similarly serving in crucial roles on U.S. military bases, on farms, and in factories during World War II. The COVID-19 pandemic has represented a novel battleground, as the first in which women have taken center stage, not only in their roles as physicians, respiratory therapists, nurses, and the like, but also by serving in leadership positions and facilitating innovations in science, technology, and policy. Yet, the pandemic has exacerbated multiple pain points that have disproportionally impacted women in health care, including shortages in correctly sized personal protective equipment and uniforms, inadequate support for pregnant and breastfeeding providers, and challenges associated with work-life balance and obtaining childcare. While the pandemic has facilitated several positive advancements in addressing these challenges, there is still much work to be done for women to achieve equity and optimal support in their roles on the frontlines.
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Affiliation(s)
- Loren Galler Rabinowitz
- L.G. Rabinowitz is a fellow, Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York; ORCID: http://orcid.org/0000-0002-6673-4096
| | - Danielle Galler Rabinowitz
- D.G. Rabinowitz is resident physician, Boston Combined Residency Program, Boston Children’s Hospital and Boston Medical Center, Harvard Medical School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-5437-5719
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Shanahan MC, Akudjedu TN. Australian radiographers' and radiation therapists' experiences during the COVID-19 pandemic. J Med Radiat Sci 2021; 68:111-120. [PMID: 33590670 PMCID: PMC8013350 DOI: 10.1002/jmrs.462] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/27/2021] [Accepted: 01/27/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Radiographers and radiation therapists are key patient-facing health practitioners supporting the delivery of optimal patient care during the COVID-19 pandemic. The aim of this research was to investigate the impact of COVID-19 on clinical service delivery and well-being of these healthcare professionals in Australia. METHODS A cross-sectional online survey of Australian radiographers and radiation therapists was conducted in June-July 2020. The survey collected data on demographic characteristics, and the impact of COVID-19 on professional practice, infection control and workplace-related stress. RESULTS A total of 218 responses were received. Changes in work hours (P < 0.001) and workload (P = 0.022) were experienced due to COVID-19. Diagnostic radiographers reported increased procedural pressure on mobile radiography, computed tomography and general radiography. For radiation therapists, most pressure included areas of simulation and linear accelerator. PPE was in short supply at the start of the pandemic, and at the time of the study, shortages were identified for all PPE items. There was no difference in PPE supply reported by diagnostic radiographers and radiation therapists except for hand sanitiser (P = 0.003). Respondents experienced increased personal stress (61.4%) and anxiety (58.2%) at work due to COVID-19. In addition, their work caused increased stress to their family, partners or friends (57.4%). CONCLUSIONS COVID-19 has resulted in changes to clinical working patterns and service delivery. PPE shortages, as well as increased workplace-related stress, were identified. Workplaces should seek to mitigate the pandemic impact through the provision of adequate PPE for safe practice as well as implement strategies to support and enhance staff well-being.
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Affiliation(s)
- Madeleine C Shanahan
- Discipline of Medical Radiation ScienceFaculty of HealthUniversity of CanberraBruceACTAustralia
| | - Theophilus N Akudjedu
- Institute of Medical Imaging & VisualisationFaculty of Health & Social SciencesBournemouth UniversityBournemouthUK
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Yánez Benítez C, Ribeiro MAF, Alexandrino H, Koleda P, Baptista SF, Azfar M, Di Saverio S, Ponchietti L, Güemes A, Blas JL, Mesquita C. International cooperation group of emergency surgery during the COVID-19 pandemic. Eur J Trauma Emerg Surg 2021; 47:621-629. [PMID: 33047158 PMCID: PMC7550249 DOI: 10.1007/s00068-020-01521-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 09/26/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE The COVID-19 pandemic has changed working conditions for emergency surgical teams around the world. International surgical societies have issued clinical recommendations to optimize surgical management. This international study aimed to assess the degree of emergency surgical teams' adoption of recommendations during the pandemic. METHODS Emergency surgical team members from over 30 countries were invited to answer an anonymous, prospective, online survey to assess team organization, PPE-related aspects, OR preparations, anesthesiologic considerations, and surgical management for emergency surgery during the pandemic. RESULTS One-hundred-and-thirty-four questionnaires were returned (N = 134) from 26 countries, of which 88% were surgeons, 7% surgical trainees, 4% anesthetists. 81% of the respondents got involved with COVID-19 crisis management. Social media were used by 91% of the respondents to access the recommendations, and 66% used videoconference tools for team communication. 51% had not received PPE training before the pandemic, 73% reported equipment shortage, and 55% informed about re-use of N95/FPP2/3 respirators. Dedicated COVID operating areas were cited by 77% of the respondents, 44% had performed emergency surgical procedures on COVID-19 patients, and over half (52%), favored performing laparoscopic over open surgical procedures. CONCLUSION Surgical team members have responded with leadership to the COVID-19 pandemic, with crisis management principles. Social media and videoconference have been used by the vast majority to access guidelines or to communicate during social distancing. The level of adoption of current recommendations is high for organizational aspects and surgical management, but not so for PPE training and availability, and anesthesiologic considerations.
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Affiliation(s)
- Carlos Yánez Benítez
- General and GI Surgery Department, Royo Villanova Hospital, SALUD, Av. de San Gregorio s/n. 50015, Zaragoza, Spain
| | - Marcelo A. F. Ribeiro
- Department of General Surgery and Trauma Surgery, Catholic University of São Paulo PUC-Sorocaba and Hospital Moriah, Avenida Victor Civita, Sao Paulo, 235 Brazil
| | - Henrique Alexandrino
- Department of General Surgery, Faculty of Medicine, Coimbra University Hospital Center, University of Coimbra, Praceta Mota Pinto, 3000-045 Coimbra, Portugal
| | - Piotr Koleda
- Department of Medical Simulation, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | | | - Mohammad Azfar
- Department of General Surgery, Al Rahba Hospital, Abu Dhabi, UAE
| | - Salomone Di Saverio
- Department of General Surgery, Varese University Hospital, ASST Sette Laghi, University of Insubria, Regione Lombardia, Varese, Italy
| | - Luca Ponchietti
- Department of General Surgery, San Jorge University Hospital, Av. Martínez de Velasco, 36, 22004 Huesca, Spain
| | - Antonio Güemes
- Department of General Surgery, Lozano Blesa University Hospital, Av. San Juan Bosco, 15, 50009 Zaragoza, Spain
| | - Juan L. Blas
- General and GI Surgery Department, Royo Villanova Hospital, SALUD, Av. de San Gregorio s/n. 50015, Zaragoza, Spain
| | - Carlos Mesquita
- Department of General Surgery, Faculty of Medicine, Coimbra University Hospital Center, University of Coimbra, Praceta Mota Pinto, 3000-045 Coimbra, Portugal
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20
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Ludwig-Begall LF, Wielick C, Jolois O, Dams L, Razafimahefa RM, Nauwynck H, Demeuldre PF, Napp A, Laperre J, Thiry E, Haubruge E. "Don, doff, discard" to "don, doff, decontaminate"-FFR and mask integrity and inactivation of a SARS-CoV-2 surrogate and a norovirus following multiple vaporised hydrogen peroxide-, ultraviolet germicidal irradiation-, and dry heat decontaminations. PLoS One 2021; 16:e0251872. [PMID: 34010337 PMCID: PMC8133425 DOI: 10.1371/journal.pone.0251872] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/04/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND As the SARS-CoV-2 pandemic accelerates, the supply of personal protective equipment remains under strain. To combat shortages, re-use of surgical masks and filtering facepiece respirators has been recommended. Prior decontamination is paramount to the re-use of these typically single-use only items and, without compromising their integrity, must guarantee inactivation of SARS-CoV-2 and other contaminating pathogens. AIM We provide information on the effect of time-dependent passive decontamination (infectivity loss over time during room temperature storage in a breathable bag) and evaluate inactivation of a SARS-CoV-2 surrogate and a non-enveloped model virus as well as mask and respirator integrity following active multiple-cycle vaporised hydrogen peroxide (VHP), ultraviolet germicidal irradiation (UVGI), and dry heat (DH) decontamination. METHODS Masks and respirators, inoculated with infectious porcine respiratory coronavirus or murine norovirus, were submitted to passive decontamination or single or multiple active decontamination cycles; viruses were recovered from sample materials and viral titres were measured via TCID50 assay. In parallel, filtration efficiency tests and breathability tests were performed according to EN standard 14683 and NIOSH regulations. RESULTS AND DISCUSSION Infectious porcine respiratory coronavirus and murine norovirus remained detectable on masks and respirators up to five and seven days of passive decontamination. Single and multiple cycles of VHP-, UVGI-, and DH were shown to not adversely affect bacterial filtration efficiency of masks. Single- and multiple UVGI did not adversely affect respirator filtration efficiency, while VHP and DH induced a decrease in filtration efficiency after one or three decontamination cycles. Multiple cycles of VHP-, UVGI-, and DH slightly decreased airflow resistance of masks but did not adversely affect respirator breathability. VHP and UVGI efficiently inactivated both viruses after five, DH after three, decontamination cycles, permitting demonstration of a loss of infectivity by more than three orders of magnitude. This multi-disciplinal approach provides important information on how often a given PPE item may be safely reused.
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Affiliation(s)
- Louisa F. Ludwig-Begall
- Department of Infectious and Parasitic Diseases, Veterinary Virology and Animal Viral Diseases, FARAH Research Centre, Faculty of Veterinary Medicine, Liège University, Liège, Belgium
| | - Constance Wielick
- Department of Infectious and Parasitic Diseases, Veterinary Virology and Animal Viral Diseases, FARAH Research Centre, Faculty of Veterinary Medicine, Liège University, Liège, Belgium
| | - Olivier Jolois
- Centexbel Textile Research Centre, Grace-Hollogne, Belgium
| | - Lorène Dams
- Department of Infectious and Parasitic Diseases, Veterinary Virology and Animal Viral Diseases, FARAH Research Centre, Faculty of Veterinary Medicine, Liège University, Liège, Belgium
| | - Ravo M. Razafimahefa
- Department of Infectious and Parasitic Diseases, Veterinary Virology and Animal Viral Diseases, FARAH Research Centre, Faculty of Veterinary Medicine, Liège University, Liège, Belgium
| | - Hans Nauwynck
- Laboratory of Virology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Aurore Napp
- Department of Hospital Pharmacy, The University Hospital Center, Liège University, Liège, Belgium
| | - Jan Laperre
- Centexbel Textile Research Centre, Grace-Hollogne, Belgium
| | - Etienne Thiry
- Department of Infectious and Parasitic Diseases, Veterinary Virology and Animal Viral Diseases, FARAH Research Centre, Faculty of Veterinary Medicine, Liège University, Liège, Belgium
| | - Eric Haubruge
- TERRA Research Centre, Gembloux Agro-Bio Tech, Liège University, Gembloux, Belgium
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Adola SG, Degavi G, Edwin SEK, Utura T, Gemede U, Kasimayan P. Assessment of factors affecting practice towards COVID-19 among health care workers in health care facility of West Guji Zone, South Ethiopia, 2020. Pan Afr Med J 2021; 39:53. [PMID: 34422176 PMCID: PMC8363975 DOI: 10.11604/pamj.2021.39.53.27798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/29/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION health care workers are at greatest risk to being infected with COVID-19 in health care facilities. This study is focused on assessing the level of practice and factors affecting practice towards COVID-19 among health care workers in health care facility of West Guji Zone, Oromia region, Ethiopia. METHODS health facility based cross-sectional study design was carried out from December 1st to 30th 2020 among health care providers in West Guji Zone. The simple random sampling technique was used in study and total sample size for this study was 281. The data enter into Epi Data version 4.4.3.1 and SPSS Version 25 used for analysis. The descriptive statistics and logistic regression are needed. The cut point for statically significance settled at p < 0.05. RESULTS the response rate in this study was 97.8%. Of all study participants, 50.2%, 8.4%, and 6.5% had traveling history, chronic illnesses, and contact with COVID-19 confirmed cases. Too much working, lack of training, and shortage of protective equipment were reported by 54.5%, 50.9%, and 29.1% respectively. About 36.4% and 38.2% of health care providers had poor level of knowledge and prevention practice towards COVID-19. Working at hospital (AOR= 0.156, 95% CI=0.033-0.741), awareness of the action during suggestive symptoms and signs of COVID-19 developed (AOR= 0.038, 95% CI=0.002-0.817), hand washing (AOR= 0.043, 95% CI=0.008-0.238), not going to crowded place (AOR= 0.001, 95% CI=0.001-0.030), applying physical distance (AOR=0.091,95% CI=0.041-0.579) adherence to triage and isolation protocol (AOR=0.317,95%=0.039-0.577)and knowledge level of COVID-19 (AOR=2.378,95%CI=1.523-6.322) were factors significantly associated with prevention practice of COVID-19. CONCLUSION in this study, the knowledge level and prevention practice gap was identified. Type of facility, awareness of the action during suggestive symptoms and signs of COVID-19 developed, hands washing to the standard, not going to crowded place, keeping physical distance, adherence to triage and isolation protocol and having good level of knowledge about COVID-19 were factors associated with good prevention practices. Adequate supply of personal protective materials; provision of continuous on-job training and guideline for prevention of COVID-19 must be given to all health care facilities.
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Affiliation(s)
- Shiferaw Gelchu Adola
- Bule Hora University´s Department of Nursing, College of Health and Medical Science, Hagere Mariam, Ethiopia
| | - Girish Degavi
- Bule Hora University´s Department of Nursing, College of Health and Medical Science, Hagere Mariam, Ethiopia
| | - Sarah Ezhil Kelna Edwin
- Bule Hora University´s Department of Midwifery, College of Health and Medical Science, Hagere Mariam, Ethiopia
| | - Takala Utura
- Bule Hora University´s Department of Public Health, College of Health and Medical Science, Hagere Mariam, Ethiopia
| | - Udessa Gemede
- Bule Hora University´s Department of Nursing, College of Health and Medical Science, Hagere Mariam, Ethiopia
| | - Pandiarajan Kasimayan
- Bule Hora University´s Department of Nursing, College of Health and Medical Science, Hagere Mariam, Ethiopia
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Affiliation(s)
- Hyoung Wook Park
- Department of Social Medicine, College of Medicine, Dankook University, Cheonan, Korea.
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23
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Affiliation(s)
- Shuhan He
- Department of Emergency Medicine, Lab of Computer Science, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
| | - Ram Bala
- Department of Information Systems and Analytics, Santa Clara University, Santa Clara, CA, USA
| | - Ravi Anupindi
- Stephen M Ross School of Business, University of Michigan, Ann Arbor, MI, USA
| | - Megan L Ranney
- Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, RI, USA
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Bar-On E, Segal G, Regev-Yochay G, Barkai G, Biber A, Irony A, Luttinger A, Englard H, Grinberg A, Katorza E, Rahav G, Afek A, Kreiss Y. Establishing a COVID-19 treatment centre in Israel at the initial stage of the outbreak: challenges, responses and lessons learned. Emerg Med J 2021; 38:373-378. [PMID: 33771818 PMCID: PMC8006478 DOI: 10.1136/emermed-2020-209639] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 01/24/2021] [Accepted: 02/07/2021] [Indexed: 01/01/2023]
Abstract
Anticipating the need for a COVID-19 treatment centre in Israel, a designated facility was established at Sheba Medical Center-a quaternary referral centre. The goals were diagnosis and treatment of patients with COVID-19 while protecting patients and staff from infection and ensuring operational continuity and treatment of patients with non-COVID. Options considered included adaptation of existing wards, building a tented facility and converting a non-medical structure. The option chosen was a non-medical structure converted to a hospitalisation facility suited for COVID-19 with appropriate logistic and organisational adaptations. Operational principles included patient isolation, unidirectional workflow from clean to contaminated zones and minimising direct contact between patients and caregivers using personal protection equipment (PPE) and a multimodal telemedicine system. The ED was modified to enable triage and treatment of patients with COVID-19 while maintaining a COVID-19-free environment in the main campus. This system enabled treatment of patients with COVID-19 while maintaining staff safety and conserving the operational continuity and the ability to continue delivery of treatment to patients with non-COVID-19.
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Affiliation(s)
- Elhanan Bar-On
- The Israel Center for Disaster Medicine and Humanitarian Response, Sheba Medical Center, Tel Hashomer, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gad Segal
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Internal Medicine K, Internal Medicine T, Sheba Medical Center, Tel Hashomer, Israel
| | - Gili Regev-Yochay
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Infection Prevention and Control Unit, Sheba Medical Center, Tel Hashomer, Israel
| | - Galia Barkai
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Paediatric Infectious Disease Unit, Sheba Medical Center, Tel Hashomer, Israel
| | - Asaf Biber
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Infectious Disease Unit, The Center for Geographic Medicine and Tropical Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | - Avinoah Irony
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Emergency Medicine, Sheba Medical Center, Tel Hashomer, Israel
| | - Assaf Luttinger
- The Israel Center for Disaster Medicine and Humanitarian Response, Sheba Medical Center, Tel Hashomer, Israel
| | - Hindy Englard
- Emergency Medicine, Sheba Medical Center, Tel Hashomer, Israel
| | - Amir Grinberg
- Medical Management, Sheba Medical Center, Tel Hashomer, Israel
| | - Eldad Katorza
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Medical Management, Department of Obstetrics and Gynaecology, Sheba Medical Center, Tel Hashomer, Israel
| | - Galia Rahav
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Infection Prevention and Control Unit, Sheba Medical Center, Tel Hashomer, Israel
| | - Arnon Afek
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Medical Management, Sheba Medical Center, Tel Hashomer, Israel
| | - Yitshak Kreiss
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Medical Management, Sheba Medical Center, Tel Hashomer, Israel
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Elshami W, Akudjedu TN, Abuzaid M, David LR, Tekin HO, Cavli B, Issa B. The radiology workforce's response to the COVID-19 pandemic in the Middle East, North Africa and India. Radiography (Lond) 2021; 27:360-368. [PMID: 33032889 PMCID: PMC7510634 DOI: 10.1016/j.radi.2020.09.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION This study aimed to investigate the response of the radiology workforce to the impact of the coronavirus disease 2019 (COVID-19) pandemic on professional practice in India and eight other Middle Eastern and North African countries. It further investigated the levels of fear and anxiety among this workforce during the pandemic. METHODS A quantitative cross-sectional study was conducted using an online survey from 22 May-2 June 2020 among radiology workers employed during the COVID-19 pandemic. The survey collected information related to the following themes: (1) demographic characteristics, (2) the impact of COVID-19 on radiology practice, and (3) fear and (4) anxiety emanating from the global pandemic. RESULTS We received 903 responses. Fifty-eight percent had completed training on infection control required for handling COVID-19 patients. A large proportion (79.5%) of the respondents strongly agreed or agreed that personal protective equipment (PPE) was adequately available at work during the pandemic. The respondents reported experiences of work-related stress (42.9%), high COVID-19 fear score (83.3%) and anxiety (10%) during the study period. CONCLUSION There was a perceived workload increase in general x-ray and Computed Tomography imaging procedures because they were the key modalities for the initial and follow-up investigations of COVID-19. However, there was adequate availability of PPE during the study period. Most radiology workers were afraid of being infected with the virus. Fear was predominant among workers younger than 30 years of age and also in temporary staff. Anxiety occurred completely independent of gender, age, experience, country, place of work, and work status. IMPLICATIONS FOR PRACTICE It is important to provide training and regular mental health support and evaluations for healthcare professionals, including radiology workers, during similar future pandemics.
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Affiliation(s)
- W Elshami
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, United Arab Emirates.
| | - T N Akudjedu
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, UK
| | - M Abuzaid
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, United Arab Emirates
| | - L R David
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, United Arab Emirates
| | - H O Tekin
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, United Arab Emirates
| | | | - B Issa
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, United Arab Emirates
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Mariani A, Capurso G, Marasco G, Bertani H, Crinò SF, Magarotto A, Tringali A, Pasquale L, Arcidiacono PG, Zagari RM. Factors associated with risk of COVID-19 contagion for endoscopy healthcare workers: A survey from the Italian society of digestive endoscopy. Dig Liver Dis 2021; 53:534-539. [PMID: 33785281 PMCID: PMC7980179 DOI: 10.1016/j.dld.2021.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS The present study was aimed to assess the risk of SARS-CoV-2 infection and associated factors among HCWs in endoscopy centers in Italy. METHODS All members of the Italian Society of Digestive Endoscopy (SIED) were invited to participate to a questionnaire-based survey during the first months of the COVID-19 outbreak in Italy. RESULTS 314/1306 (24%) SIED members accounting for 201/502 (40%) endoscopic centers completed the survey. Personal Protection Equipment (PPE) were available in most centers, but filtering face-piece masks (FFP2 or FFP3) and negative pressure room were not in 10.9 and 75.1%. Training courses on PPE use were provided in 57.2% of centers only; there was at least one positive HCW in 17.4% of centers globally, 107/3308 (3.2%) HCWs were diagnosed with COVID-19 with similar rates of physicians (2.9%), nurses (3.5%) and other health operators (3.5%). Involvement in a COVID-19 care team (OR: 4.96) and the lack of training courses for PPE, (OR: 2.65) were associated with increased risk. CONCLUSIONS The risk of COVID-19 among endoscopy HCWs was not negligible and was associated with work in a COVID-19 care team and lack of education on proper PPE use. These data deserve attention during the subsequent waves.
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Affiliation(s)
- Alberto Mariani
- Pancreatobiliary and EUS Unit, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita e Salute University of Milan, Via Olgettina 60, Milan 20132, Italy
| | - Gabriele Capurso
- Pancreatobiliary and EUS Unit, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita e Salute University of Milan, Via Olgettina 60, Milan 20132, Italy.
| | - Giovanni Marasco
- Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Helga Bertani
- Gastroenterology and Endoscopy Unit, Azienda Ospedaliera-Universitaria Policlinico di Modena, Italy
| | - Stefano Francesco Crinò
- Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona, Italy
| | - Andrea Magarotto
- Diagnostic and Therapeutic Endoscopy Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Andrea Tringali
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy; Center for Endoscopic Research Therapeutics and Training (CERTT), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luigi Pasquale
- Gastroenterology Unit, S. O. Frangipane Hospital of A. Irpino, Italy
| | - Paolo Giorgio Arcidiacono
- Pancreatobiliary and EUS Unit, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Vita e Salute University of Milan, Via Olgettina 60, Milan 20132, Italy
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Lavoie ME, Tay KY, Good G, Buchhalter L, Abbadessa MK, Gaines S, Myers S. Simulation as a Dynamic Tool to Reorganize Pediatric Emergency Department Resuscitation During the Coronavirus Disease 2019 Pandemic and Beyond. Pediatr Emerg Care 2021; 37:286-289. [PMID: 33903290 DOI: 10.1097/pec.0000000000002384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic has challenged hospitals and pediatric emergency department (PED) providers to rapidly adjust numerous facets of the care of critically ill or injured children to minimize health care worker (HCW) exposure to severe acute respiratory syndrome coronavirus 2. OBJECTIVE We aimed to iteratively devise protocols and processes that minimized HCW exposure while safely and effectively caring for children who may require unanticipated aerosol-generating procedures. METHODS As part of our PED's initiative to optimize clinical care and HCW safety during the coronavirus disease 2019 pandemic, regular multidisciplinary systems and process simulation sessions were conducted. These sessions allowed us to evaluate and reorganize patient flow, test and improve communication modalities, alter the process for consultation in resuscitations, and teach and reinforce the appropriate donning and use of personal protective equipment. RESULTS Simulation was a highly effective method to disseminate new practices to PED staff. Numerous workflow modifications were implemented as a result of our in situ systems and process simulations. Total number of persons in the resuscitation room was minimized, use of a "command post" with remote providers was initiated, communication devices and strategies were trialed and adopted, and personal protective equipment standards that optimized HCW safety and communication were enacted. CONCLUSIONS Simulation can be an effective and agile tool in restructuring patient workflow and care of the most critically ill or injured patients in a PED during a novel pandemic.
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Affiliation(s)
- Megan E Lavoie
- From the Division of Emergency Medicine Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania
| | - Khoon-Yen Tay
- From the Division of Emergency Medicine Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania
| | - Grace Good
- Center for Simulation, Advanced Education, and Innovation
| | - Lillian Buchhalter
- Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Mary Kate Abbadessa
- Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Shannon Gaines
- Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Sage Myers
- From the Division of Emergency Medicine Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania
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Ong J, O'Connell F, Mazer-Amirshahi M, Pourmand A. An international perspective of out-of-hospital cardiac arrest and cardiopulmonary resuscitation during the COVID-19 pandemic. Am J Emerg Med 2021; 47:192-197. [PMID: 33894661 PMCID: PMC8057692 DOI: 10.1016/j.ajem.2021.04.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/03/2021] [Accepted: 04/11/2021] [Indexed: 12/14/2022] Open
Abstract
Background Out-of-hospital cardiac arrest (OHCA) accounts for a substantial proportion of sudden cardiac events globally, with hundreds of thousands of cases reported annually in the United States. The mortality rate of patients who suffer OHCA remains high despite extensive utilization of resources. Objectives We aim to describe the current landscape of OHCA during the COVID-19 pandemic and provide an overview of the logistical challenges and resuscitation protocols amongst emergency medical service (EMS) personnel. Discussion Recent studies in Italy, New York City, and France characterized a significant increase in OHCA incidence in conjunction with the arrival of the 2019 coronavirus disease (COVID-19) pandemic. The presence of the pandemic challenged existing protocols for field resuscitation of cardiac arrest patients as the pandemic necessitated prioritization of EMS personnel and other healthcare providers' safety through stringent personal protective equipment (PPE) requirements. Studies also characterized difficulties encountered by the first responder system during COVID-19, such as dispatcher overload, increased response times, and adherence to PPE requirements, superimposed on PPE shortages. The lack of guidance by governmental agencies and specialty organizations to provide unified safety protocols for resuscitation led to the development of different resuscitative protocols globally. Conclusions The ongoing COVID-19 pandemic modified the approach of first responders to OHCA. With the rise in OCHA during the pandemic in several geographic regions and the risks of disease transmission with superimposed equipment shortages, novel noninvasive, adjunct tools, such as point of care ultrasound, warrant consideration. Further prehospital studies should be considered to optimize OHCA and resource management while minimizing risk to personnel.
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Affiliation(s)
- Justin Ong
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Francis O'Connell
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Maryann Mazer-Amirshahi
- Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC, United States
| | - Ali Pourmand
- Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC, United States.
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ALGhasab NS, ALJadani AH, ALMesned SS, Hersi AS. Depression among physicians and other medical employees involved in the COVID-19 outbreak: A cross-sectional study. Medicine (Baltimore) 2021; 100:e25290. [PMID: 33847627 PMCID: PMC8052024 DOI: 10.1097/md.0000000000025290] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 03/06/2021] [Indexed: 01/04/2023] Open
Abstract
Health care employees are the front liners whom are directly involved in the management of COVID-19 at high risk of developing psychological distress and other mental health illness. We aim to assess the burden of depression during this pandemic on health care employees treating COVID-19 in Saudi Arabia. We also will shed the light on the best solutions of how to encounter depression.A cross-sectional, hospital-based survey conducted via a region-stratified, 2-stage cluster sample was conducted for 554 participants in >15 hospitals from April 29, 2020, to June 30, 2020. Depression is measured using the established PHQ9 score system. We grade PHQ9 depression scores as: normal, 0 to 4, mild, 5 to 9, significant (moderate or severe), 10 to 27. χ2/Fisher exact test was used; significant association between level of depression and survey characteristics were made. P value <0.05 was considered statistically significant.A total of 554 participants completed the survey. A total of 18.9% (n = 105) were aged <29 years, 51.2% (n = 284) were between 30 to 39 years and female represent 70% of all participants. Of all participants, 53.7% (n = 298) were nurses, and 38.6% (n = 214) were physicians; 68.5% (n = 380) worked in central area hospitals in Saudi Arabia. No significant (P = .432, 95% confidence interval [CI]) association was observed between sex and depression classifications. However, female had high proportion of significant depression 75.0% (n = 76) was observed as compared to male 24.8% (n = 25). Depression was significant in Saudis 61.4% (n = 62) (P < .001, 95% CI) and medical staff who encountered corona patients 51.5% (n = 52) (P < .002, 95% CI). Hospital preparedness associated with more freedom of depression symptoms 69.1% (n = 199/288) (P < .001, 95% CI).Frontline young health care workers especially physician in Saudi Arabia reported a high rate of depression symptoms. Countermeasures for health care workers represent a key component for the mental and physical well-being as part of public health measures during this pandemic. Attention to hospital preparedness and adequacy of personal protective equipment contributed to milder depression symptoms. Further studies need to be conducted on crisis management and depression.
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Affiliation(s)
- Naif Saad ALGhasab
- Department of Internal Medicine, Medical College, Ha’il University, Ha’il
| | | | | | - Ahmad Salah Hersi
- Department Cardiology, College of medicine, King Saud University, Riyadh, Saudi Arabia
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Zheng Y, Zhang X, Fang S, Qian Y, Zhang F. Prevention and control measures of the coronavirus disease 2019 (COVID-19) in low-risk departments: The spine surgery department example. Sci Prog 2021; 104:368504211009670. [PMID: 33878962 PMCID: PMC10305818 DOI: 10.1177/00368504211009670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
As the coronavirus disease 2019 (COVID-19) spreads globally, hospital departments will need take steps to manage their treatment procedures and wards. The preparations of high-risk departments (infection, respiratory, emergency, and intensive care unit) were relatively well within this pandemic, while low-risk departments may be unprepared. The spine surgery department in The First Affiliated Hospital of Anhui Medical University in Hefei, China, was used as an example in this study. The spine surgery department took measures to manage the patients, medical staff and wards to avoid the cross-infection within hospital. During the outbreak, no patients or healthcare workers were infected, and no treatment was delayed due to these measures. The prevention and control measures effectively reduced the risk of nosocomial transmission between health workers and patients while providing optimum care. It was a feasible management approach that was applicable to most low-risk and even high-risk departments.
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Affiliation(s)
- Yongshun Zheng
- Department of Orthopedics, The First
Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of General Surgery, The First
Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xingfang Zhang
- Department of Orthopedics, The First
Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Shiyuan Fang
- Department of Orthopedics, Affiliated Anhui
Provincial Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yeben Qian
- Department of General Surgery, The First
Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Fan Zhang
- Department of Orthopedics, The First
Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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Abstract
The Coronavirus (COVID-19) pandemic had a huge impact on all sectors around the world. In particular, the healthcare system has been subject to an enormous pressure that has surpassed its ability in many instances. Additionally, the pandemic has called for a review of our daily medical practices, including our approach to colorectal cancer management where treatment puts patients at high risk of virus exposure. Given their higher median age, patients are at an increased risk for severe symptoms and complications in cases of infection, especially in the setting of immunosuppression. Therefore, a review of the routine colorectal cancer practices is needed to minimize risk of exposure. Oncologists should weigh risk of exposure versus the patient's oncologic benefits when approaching management. In addition, treatment protocols should be modified to minimize hospital visits and admissions while maintaining the same treatment efficacy. In this review, we will focus on challenges that colorectal cancer patients face during the pandemic, while highlighting the priority in each case. We will also discuss the evidence for potential modifications to existing treatment plans that could reduce infectious exposure without compromising care. Finally, we will discuss the impact of the socio-economic difficulties faced by Lebanese patients due to a poor economy toppled by an unexpected pandemic.
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Affiliation(s)
- Walid Alam
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Youssef Bouferraa
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Yolla Haibe
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Deborah Mukherji
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Shamseddine
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut, Lebanon
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Abstract
When the Covid 19 pandemic affected New York State, Federal and mostly State, mandates were given to hospitals to prepare for the expected influx of patients. This is a community hospital's planning journey that includes preparing for placing patients, educating caregivers, matching the abilities of the available caregivers with the needs of the patients, securing needed equipment and supplies, and caring for the caregivers. Planning for patient placement resulted in a phased-in guide, accommodating seriously and critically ill affected patients. Education and training were initial and ongoing, rapidly changing as new information became available. Effective care delivery models that focused on team were modified depending on the needs of patients and staff competence. Securing and maintaining equipment and supplies were challenging and caring for the caregivers was a priority. Working as a team, this community hospital developed a road map that was effective in planning for the surge and allowed the hospital to maintain a safe environment for staff and patients who received quality care in difficult time.
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Abstract
In the spring of 2020, a novel virus known as COVID-19 (coronavirus disease 2019) was introduced to the human population, and the world faced a global pandemic with far-reaching consequences. One of the most difficult challenges that nurses faced in the midst of the crisis was the lack of proper personal protective equipment (PPE). The lack of PPE left health care professionals with a complicated ethical dilemma: Is there an ethical duty to care for patients in the absence of proper PPE? This article seeks to help the individual nurse (a) understand the ethical dilemma and the tensions that it brings, (b) look to the literature for guidance, and (c) understand how individuals can apply these ethical principles. After careful analysis, the recommendation is for the individual nurse to make a thorough assessment of their personal situation. This will include consideration for their family, community, financial responsibilities, legal protections, organizational policies, and personal health risk. Finally, this article serves as a call to organizations and professional leaders to increase their support of frontline health care workers and provide the individual nurse with the information they need in order to make sound decisions.
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Jafree SR, Momina AU, Malik N, Naqi SA, Fischer F. Challenges in providing surgical procedures during the COVID-19 pandemic: Qualitative study among Operating Department Practitioners in Pakistan. Sci Prog 2021; 104:368504211023282. [PMID: 34152874 PMCID: PMC10454979 DOI: 10.1177/00368504211023282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The surgical theatre is associated with the highest mortality rates since the onslaught of the COVID-19 pandemic. However, Operating Department Practitioners (ODPs) are neglected human resources for health in regards to both professional development and research for patient safety; even though they are key practitioners with respect to infection control during surgeries. Therefore, this study aims to describe challenges faced by ODPs during the pandemic. The secondary aim is to use empirical evidence to inform the public health sector management about both ODP professional development and improvement in surgical procedures, with a specific focus on pandemics. A qualitative study has been conducted. Data collection was based on an interview guide with open-ended questions. Interviews with 39 ODPs in public sector teaching hospitals of Pakistan who have been working during the COVID-19 pandemic were part of the analysis. Content analysis was used to generate themes. Ten themes related to challenges faced by ODPs in delivering services during the pandemic for securing patient safety were identified: (i) Disparity in training for prevention of COVID-19; (ii) Shortcomings in COVID-19 testing; (iii) Supply shortages of personal protective equipment; (iv) Challenges in maintaining physical distance and prevention protocols; (v) Human resource shortages and role burden; (vi) Problems with hospital administration; (vii) Exclusion and hierarchy; (viii) Teamwork limitations and other communication issues; (ix) Error Management; and (x) Anxiety and fear. The public health sector, in Pakistan and other developing regions, needs to invest in the professional development of ODPs and improve resources and structures for surgical procedures, during pandemics and otherwise.
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Affiliation(s)
- Sara Rizvi Jafree
- Department of Sociology, Forman Christian College University, Lahore, Punjab, Pakistan
| | - Ain ul Momina
- Institute of Public Health, King Edward Medical University, Lahore, Pakistan
| | - Nudra Malik
- Department of Applied Psychology, Lahore College for Women University, Lahore, Pakistan
| | - Syed Asghar Naqi
- Department of Surgery, King Edward Medical University, Lahore, Pakistan
| | - Florian Fischer
- Institute of Public Health, Charité– Universitätsmedizin Berlin, Berlin, Germany
- Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
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Affiliation(s)
- Allana Marie Brown
- Allana Marie Brown is a psychiatric NP at St. Vincent's Hospital Westchester in Harrison, N.Y., and an adjunct assistant professor at Bronx Community College in Bronx, N.Y
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Abstract
OBJECTIVE The aim of the study was to understand the experiences of advanced practice nurses (APNs) in the UK during the 2020 COVID-19 pandemic, particularly in relation to safety, shortages and retention. DESIGN A cross-sectional, mixed-methods survey. SETTING APNs in any UK setting. PARTICIPANTS The survey was sent to an existing UK-wide cohort of APNs. 124 APNs responded (51%). RESULTS UK-based APNs in this study reported shortages of staff (51%) and personal protective equipment (PPE) (68%) during the first 3 months of the coronavirus outbreak. Almost half (47%) had considered leaving their job over the same 3 months. Despite difficulties, there were reports of positive changes to working practice that have enhanced care. CONCLUSION UK APNs report COVID-19-related shortages in staff and equipment across primary and secondary care and all regions of the UK. Shortages of PPE during a pandemic are known to be a factor in the development of mental health sequelae as well as a risk factor for increased turnover and retention issues. Half of APNs surveyed were considering a change in job. The UK risks a further crisis in staff morale and retention if this is not acknowledged and addressed. APNs also expressed concern about patients not receiving routine care as many specialties closed or reduced working during the crisis. However, there were also many examples of good practice, positive changes and innovation.
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Affiliation(s)
- Emily Wood
- Health Sciences School, The University of Sheffield, Sheffield, South Yorkshire, UK
| | - Rachel King
- Health Sciences School, The University of Sheffield, Sheffield, South Yorkshire, UK
| | - Michaela Senek
- Health Sciences School, The University of Sheffield, Sheffield, South Yorkshire, UK
| | - Steve Robertson
- Health Sciences School, The University of Sheffield, Sheffield, South Yorkshire, UK
| | - Bethany Taylor
- Health Sciences School, The University of Sheffield, Sheffield, South Yorkshire, UK
| | - Angela Tod
- Health Sciences School, The University of Sheffield, Sheffield, South Yorkshire, UK
| | - Anthony Ryan
- Health Sciences School, The University of Sheffield, Sheffield, South Yorkshire, UK
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Eijkholt M, Hulsbergen A, Muskens I, Mathiesen TI, Bolger C, Feldman Z, Kitchen N, Samprón N, Sandvik U, Tisell M, Broekman M. Should neurosurgeons continue to work in the absence of personal protective equipment during the COVID-19 era? Acta Neurochir (Wien) 2021; 163:593-598. [PMID: 33469692 PMCID: PMC7815500 DOI: 10.1007/s00701-021-04703-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/01/2020] [Indexed: 02/01/2023]
Abstract
The COVID-19 pandemic has resulted in a widespread shortage of personal protective equipment (PPE). Many healthcare workers, including neurosurgeons, have expressed concern about how to safely and adequately perform their medical responsibilities in these challenging circumstances. One of these concerns revolves around the pressing question: should providers continue to work in the absence of adequate PPE? Although the first peak of the COVID-19 crisis seems to have subsided and supply of PPE has increased, concerns about insufficient PPE availability remain. Inconsistent supply, limited efficacy, and continued high demand for PPE, combined with the continued threat of a second COVID-19 wave, mean that the issues surrounding PPE availability remain unresolved, including a duty to work. This paper offers an ethical investigation of whether neurosurgeons should perform their professional responsibilities with limited availability of PPE. We evaluate ethical considerations and conflicting duties and thereby hope to facilitate providers in making a well-considered personal and moral decision about this challenging issue.
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Affiliation(s)
- Marleen Eijkholt
- Department of Medical Ethics and Health Law (Department of Neurology), Leiden University Medical Centre, Leiden, the Netherlands
| | - Alexander Hulsbergen
- Department of Neurosurgery, Haaglanden Medical Center/Leiden University Medical Center, Leiden, the Netherlands
| | - Ivo Muskens
- Department of Neurosurgery, Haaglanden Medical Center/Leiden University Medical Center, Leiden, the Netherlands
| | - Tiit Illimar Mathiesen
- Department of Clinical Medicine, Rigshospitalet - Neurocentret, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Neuroscience, Section for Neurosurgery, Karolinska Institutet, Stockholm, Sweden
| | | | - Zeev Feldman
- Pediatric Neurosurgery, Sheba Medical Center, Ramat Gan, Israel
| | - Neil Kitchen
- National Hospital Queen Square, London, England UK
| | - Nicolás Samprón
- Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastian, Spain
| | - Ulrika Sandvik
- Department of Clinical Neurosciences, Karolinska Institutet, Solna, Sweden
| | - Magnus Tisell
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenborg, Sweden
| | - Marike Broekman
- Department of Neurosurgery, Haaglanden Medical Center/Leiden University Medical Center, Leiden, the Netherlands
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Rearigh LM, Hewlett AL, Fey PD, Broadhurst MJ, Brett-Major DM, Rupp ME, Van Schooneveld TC. Utility of repeat testing for COVID-19: Laboratory stewardship when the stakes are high. Infect Control Hosp Epidemiol 2021; 42:338-340. [PMID: 32741393 PMCID: PMC7511838 DOI: 10.1017/ice.2020.397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 01/19/2023]
Abstract
As the coronavirus disease 2019 (COVID-19) continues to circulate, testing strategies are of the utmost importance. Given national shortages of testing supplies, personal protective equipment, and other hospital resources, diagnostic stewardship is necessary to aid in resource management. We report the low utility of serial testing in a low-prevalence setting.
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Affiliation(s)
- Lindsey M. Rearigh
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska
| | - Angela L. Hewlett
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska
| | - Paul D. Fey
- Division of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - M. Jana Broadhurst
- Division of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - David M. Brett-Major
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Mark E. Rupp
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska
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Armijo PR, Markin NW, Nguyen S, Ho DH, Horseman TS, Lisco SJ, Schiller AM. 3D printing of face shields to meet the immediate need for PPE in an anesthesiology department during the COVID-19 pandemic. Am J Infect Control 2021; 49:302-308. [PMID: 32763350 PMCID: PMC7402098 DOI: 10.1016/j.ajic.2020.07.037] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 11/19/2022]
Abstract
Background Anesthesia providers are at risk for contracting COVID-19 due to close patient contact, especially during shortages of personal protective equipment. We present an easy to follow and detailed protocol for producing 3D printed face shields and an effective decontamination protocol, allowing their reuse. Methods The University of Nebraska Medical Center (UNMC) produced face shields using a combination of 3D printing and assembly with commonly available products, and produced a simple decontamination protocol to allow their reuse. To evaluate the effectiveness of the decontamination protocol, we inoculated bacterial suspensions of E. coli and S. aureus on to the face shield components, performed the decontamination procedure, and finally swabbed and enumerated organisms onto plates that were incubated for 12-24 hours. Decontamination effectiveness was evaluated using the average log10 reduction in colony counts. Results Approximately 112 face shields were constructed and made available for use in 72 hours. These methods were successfully implemented for in-house production at UNMC and at Tripler Army Medical Center (Honolulu, Hawaii). Overall, the decontamination protocol was highly effective against both E. coli and S. aureus, achieving a ≥4 log10 (99.99%) reduction in colony counts for every replicate from each component of the face shield unit. Discussion Face shields not only act as a barrier against the soiling of N95 face masks, they also serve as more effective eye protection from respiratory droplets over standard eye shields. Implementation of decontamination protocols successfully allowed face shield and N95 mask reuse, offering a higher level of protection for anesthesiology providers at the onset of the COVID-19 pandemic. Conclusions In a time of urgent need, our protocol enabled the rapid production of face shields by individuals with little to no 3D printing experience, and provided a simple and effective decontamination protocol allowing reuse of the face shields.
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Affiliation(s)
- Priscila R Armijo
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE
| | - Nicholas W Markin
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE
| | | | - Dao H Ho
- Department of Clinical Investigation, Tripler Army Medical Center, Tripler AMC, HI
| | - Timothy S Horseman
- Department of Clinical Investigation, Tripler Army Medical Center, Tripler AMC, HI
| | - Steven J Lisco
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE
| | - Alicia M Schiller
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE.
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Dutour M, Kirchhoff A, Janssen C, Meleze S, Chevalier H, Levy-Amon S, Detrez MA, Piet E, Delory T. Family medicine practitioners' stress during the COVID-19 pandemic: a cross-sectional survey. BMC Fam Pract 2021; 22:36. [PMID: 33583410 PMCID: PMC7882249 DOI: 10.1186/s12875-021-01382-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 02/04/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The COVID-19 pandemic has shaken the world in early 2020. In France, General Practitioners (GPs) were not involved in the care organization's decision-making process before and during the first wave of the COVID-19 pandemic. This omission could have generated stress for GPs. We aimed first to estimate the self-perception of stress as defined by the 10-item Perceived Stress Score (PSS-10), at the beginning of the pandemic in France, among GPs from the Auvergne-Rhône-Alpes, a french administrative area severely impacted by COVID-19. Second, we aimed to identify factors associated with a self-perceived stress (PSS-10 ≥ 27) among socio-demographic characteristics of GPs, their access to reliable information and to personal protective equipment during the pandemic, and their exposure to well established psychosocial risk at work. METHODS We conducted an online cross-sectional survey between 8th April and 10th May 2020. The self-perception of stress was evaluated using the PSS-10, so to see the proportion of "not stressed" (≤20), "borderline" (21 ≤ PSS-10 ≤ 26), and "stressed" (≥27) GPs. The agreement to 31 positive assertions related to possible sources of stress identified by the scientific study committee was measured using a 10-point numeric scale. In complete cases, factors associated with stress (PSS-10 ≥ 27) were investigated using logistic regression, adjusted on gender, age and practice location. A supplementary analysis of the verbatims was made. RESULTS Overall, 898 individual answers were collected, of which 879 were complete. A total of 437 GPs (49%) were stressed (PSS-10 ≥ 27), and 283 GPs (32%) had a very high level of stress (PSS-10 ≥ 30). Self-perceived stress was associated with multiple components, and involved classic psychosocial risk factors such as emotional requirements. However, in this context of health crisis, the primary source of stress was the diversity and quantity of information from diverse sources (614 GPs (69%, OR = 2.21, 95%CI [1.40-3.50], p < 0.001). Analysis of verbatims revealed that GPs felt isolated in a hospital-based model. CONCLUSION The first wave of the pandemic was a source of stress for GPs. The diversity and quantity of information received from the health authorities were among the main sources of stress.
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Affiliation(s)
- Marion Dutour
- Infectious disease department, Annecy-Genevois hospital, Annecy, France.
| | - Anna Kirchhoff
- Infectious disease department, Annecy-Genevois hospital, Annecy, France
| | - Cécile Janssen
- Infectious disease department, Annecy-Genevois hospital, Annecy, France
| | - Sabine Meleze
- Institut national d'études démographiques (Ined), UR 14, Aubervillers, France
| | | | | | | | - Emilie Piet
- Infectious disease department, Annecy-Genevois hospital, Annecy, France
| | - Tristan Delory
- Institut national d'études démographiques (Ined), UR 14, Aubervillers, France
- Clinical research unit, Annecy-Genevois hospital, Annecy, France
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Kamar A, Maalouf N, Hitti E, El Eid G, Isma'eel H, Elhajj IH. Challenge of forecasting demand of medical resources and supplies during a pandemic: A comparative evaluation of three surge calculators for COVID-19. Epidemiol Infect 2021; 149:e51. [PMID: 33531094 PMCID: PMC7925989 DOI: 10.1017/s095026882100025x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/28/2020] [Accepted: 01/29/2021] [Indexed: 12/15/2022] Open
Abstract
Ever since the World Health Organization (WHO) declared the new coronavirus disease 2019 (COVID-19) as a pandemic, there has been a public health debate concerning medical resources and supplies including hospital beds, intensive care units (ICU), ventilators and protective personal equipment (PPE). Forecasting COVID-19 dissemination has played a key role in informing healthcare professionals and governments on how to manage overburdened healthcare systems. However, forecasting during the pandemic remained challenging and sometimes highly controversial. Here, we highlight this challenge by performing a comparative evaluation for the estimations obtained from three COVID-19 surge calculators under different social distancing approaches, taking Lebanon as a case study. Despite discrepancies in estimations, the three surge calculators used herein agree that there will be a relative shortage in the capacity of medical resources and a significant surge in PPE demand if the social distancing policy is removed. Our results underscore the importance of implementing containment interventions including social distancing in alleviating the demand for medical care during the COVID-19 pandemic in the absence of any medication or vaccine. The paper also highlights the value of employing several models in surge planning.
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Affiliation(s)
- A. Kamar
- Vascular Medicine Program, American University of Beirut, Beirut, Lebanon
| | - N. Maalouf
- Maroun Semaan Faculty of Engineering and Architecture, Department of Electrical and Computer Engineering, American University of Beirut, Beirut, Lebanon
| | - E. Hitti
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - G. El Eid
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - H. Isma'eel
- Vascular Medicine Program, American University of Beirut, Beirut, Lebanon
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - I. H. Elhajj
- Vascular Medicine Program, American University of Beirut, Beirut, Lebanon
- Maroun Semaan Faculty of Engineering and Architecture, Department of Electrical and Computer Engineering, American University of Beirut, Beirut, Lebanon
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Abedrabboh K, Pilz M, Al-Fagih Z, Al-Fagih OS, Nebel JC, Al-Fagih L. Game theory to enhance stock management of Personal Protective Equipment (PPE) during the COVID-19 outbreak. PLoS One 2021; 16:e0246110. [PMID: 33524057 PMCID: PMC7850473 DOI: 10.1371/journal.pone.0246110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/14/2021] [Indexed: 01/22/2023] Open
Abstract
Since the outbreak of the COVID-19 pandemic, many healthcare facilities have suffered from shortages in medical resources, particularly in Personal Protective Equipment (PPE). In this paper, we propose a game-theoretic approach to schedule PPE orders among healthcare facilities. In this PPE game, each independent healthcare facility optimises its own storage utilisation in order to keep its PPE cost at a minimum. Such a model can reduce peak demand considerably when applied to a variable PPE consumption profile. Experiments conducted for NHS England regions using actual data confirm that the challenge of securing PPE supply during disasters such as COVID-19 can be eased if proper stock management procedures are adopted. These procedures can include early stockpiling, increasing storage capacities and implementing measures that can prolong the time period between successive infection waves, such as social distancing measures. Simulation results suggest that the provision of PPE dedicated storage space can be a viable solution to avoid straining PPE supply chains in case a second wave of COVID-19 infections occurs.
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Affiliation(s)
- Khaled Abedrabboh
- Division of Sustainable Development, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | | | | | | | - Jean-Christophe Nebel
- School of Computer Science and Mathematics, Kingston University, London, United Kingdom
| | - Luluwah Al-Fagih
- School of Computer Science and Mathematics, Kingston University, London, United Kingdom
- Division of Engineering Management and Decision Sciences, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
- * E-mail:
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Wong P, Lim WY, Chee HL, Iqbal R. COVID-19 pandemic: ethical and legal aspects of inadequate quantity and quality of personal protective equipment for resuscitation. Korean J Anesthesiol 2021; 74:73-75. [PMID: 32842721 PMCID: PMC7862938 DOI: 10.4097/kja.20379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/10/2020] [Accepted: 08/24/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Patrick Wong
- Department of Anesthesia and Pain Medicine, Waikato District Health Board, Hamilton, New Zealand
| | - Wan Yen Lim
- Department of Anesthesiology, Singapore General Hospital, Singapore
| | - Huei Leng Chee
- Department of Anesthesiology, Singapore General Hospital, Singapore
| | - Rehana Iqbal
- Department of Anesthesiology, City Mediclinic Hospital, Dubai, United Arab Emirates
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Dizdarevic S, Abdulla M, Sewedy T, Weston C, Oxley C, Croasdale J, Redman S, Vinjamuri S, Mayes C, Flux G, Ward M, Graham R, Buscombe J. Impact of COVID-19 on nuclear medicine in the UK. Nucl Med Commun 2021; 42:138-149. [PMID: 33346606 DOI: 10.1097/mnm.0000000000001357] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE COVID-19 brought about unprecedented challenges to healthcare, with nuclear medicine (NM) being no exception. The British Nuclear Medicine Society (BNMS) COVID-19 survey assessed the impact of the first wave of pandemic on NM services in the UK. With COVID-19 resurge compounded by seasonal winter pressures, we reflect and share lessons learnt from the first wave of pandemic to guide future strategy. METHODS A questionnaire consisting of 34 questions was sent out to all BNMS members over 2 weeks in May 2020, to evaluate the impact of 'lockdown'. RESULTS One hundred thirty-eight members (92 sites) from a multidisciplinary background responded. There was a 65% reduction across all services; 97.6% of respondents reported some reduction in diagnostic procedures and 71.3% reduction in therapies; 85% worked with a reduced workforce. The North East of England, Greater London and South East and Wessex were most affected by staff absences. The North East reported the highest number of COVID-19 positive staff; London reported the greatest lack of testing. The reported time required to clear the backlog was 1-12 months. Seventy-one percent of participants used BNMS COVID-19 guidance. CONCLUSION The first wave caused a major disruption of NM service delivery and impacted on the workforce. The departmental strategies should tailor services to evolving local and regional differences in prevalence of COVID-19. A blanket shutdown of services with a 'one size fits all' strategy would likely have a severe impact on future delivery of NM and health services in general. Timely testing of staff and patients remains of paramount importance.
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Affiliation(s)
- Sabina Dizdarevic
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
- Brighton and Sussex Medical School, Brighton, UK
| | - Mahdi Abdulla
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Taha Sewedy
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Charlotte Weston
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Caroline Oxley
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Jilly Croasdale
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Stewart Redman
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Sobhan Vinjamuri
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Christopher Mayes
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Glen Flux
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Mike Ward
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - Richard Graham
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE
| | - John Buscombe
- British Nuclear Medicine Society
- Barts Health NHS Trust, London, UK
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Antman G, Tiosano A, Bahar I. The Effect of COVID-19 on Israeli Ophthalmology Departments: Directors' Perspectives. Isr Med Assoc J 2021; 23:76-81. [PMID: 33595210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The coronavirus disease-2019 (COVID-19) pandemic presented a major medical management challenge to ophthalmology departments throughout Israel. OBJECTIVES To examine the managerial challenges, actions taken, and insights of directors of ophthalmology departments in Israel during the COVID-19 pandemic. METHODS We conducted a cross sectional survey of directors of ophthalmology departments during the COVID-19 pandemic while the Israeli population was quarantined. RESULTS All 21 directors answered the survey. The majority of the COVID-19 admissions were located in the center of Israel (53%) and Jerusalem (30%). E-communication took a central role in coping with the pandemic with 80% of the directors satisfied with this form of communication; 75% reported a reduction in clinical and surgery volume of at least 25%, and 40% reported reallocations of manpower. Most of the medical staff used gloves, a face shield, disposable robe, and a mask with no uniformity across departments. Cross satisfaction was noted regarding a hospital's ability to equip the departments. Lack of preparation for post-pandemic era was reported by all directors, but one (95%). Directors sought guidelines and uniformity regarding outpatient referral to the hospital (p = 0.035). CONCLUSIONS Guidelines via safe digital platforms aid in management decisions and uniformity across departments. Advanced preparation is needed to prevent adverse clinical outcomes and to maintain treatment continuum. Our results can be used to guide and help improve the preparedness of ophthalmology departments during COVID-19 and for future pandemics.
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Affiliation(s)
- Gal Antman
- Department of Ophthalmology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alon Tiosano
- Department of Ophthalmology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Irit Bahar
- Department of Ophthalmology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Mackworth-Young CRS, Chingono R, Mavodza C, McHugh G, Tembo M, Chikwari CD, Weiss HA, Rusakaniko S, Ruzario S, Bernays S, Ferrand RA. Community perspectives on the COVID-19 response, Zimbabwe. Bull World Health Organ 2021; 99:85-91. [PMID: 33551502 PMCID: PMC7856363 DOI: 10.2471/blt.20.260224] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/15/2020] [Accepted: 09/15/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To investigate community and health-care workers' perspectives on the coronavirus disease 2019 (COVID-19) pandemic and on early pandemic responses during the first 2 weeks of national lockdown in Zimbabwe. METHODS Rapid qualitative research was carried out between March and April 2020 via phone interviews with one representative from each of four community-based organizations and 16 health-care workers involved in a trial of community-based services for young people. In addition, information on COVID-19 was collected from social media platforms, news outlets and government announcements. Data were analysed thematically. FINDINGS Four themes emerged: (i) individuals were overloaded with information but lacked trusted sources, which resulted in widespread fear and unanswered questions; (ii) communities had limited ability to comply with prevention measures, such as social distancing, because access to long-term food supplies and water at home was limited and because income had to be earned daily; (iii) health-care workers perceived themselves to be vulnerable and undervalued because of a shortage of personal protective equipment and inadequate pay; and (iv) other health conditions were sidelined because resources were redirected, with potentially wide-reaching implications. CONCLUSION It is important that prevention measures against COVID-19 are appropriate for the local context. In Zimbabwe, communities require support with basic needs and access to reliable information to enable them to follow prevention measures. In addition, health-care workers urgently need personal protective equipment and adequate salaries. Essential health-care services and medications for conditions other than COVID-19 must also continue to be provided to help reduce excess mortality and morbidity.
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Affiliation(s)
- Constance RS Mackworth-Young
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15–17 Tavistock Place, London, WC1H 9SH, England
| | - Rudo Chingono
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Constancia Mavodza
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, England
| | - Grace McHugh
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Mandikudza Tembo
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, England
| | - Chido Dziva Chikwari
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, England
| | - Helen A Weiss
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, England
| | | | | | - Sarah Bernays
- School of Public Health, University of Sydney, Sydney, Australia
| | - Rashida A Ferrand
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, England
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Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis. J Hosp Infect 2021; 108:120-134. [PMID: 33212126 PMCID: PMC7668234 DOI: 10.1016/j.jhin.2020.11.008] [Citation(s) in RCA: 215] [Impact Index Per Article: 71.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/10/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Healthcare workers (HCWs) represent a high-risk population for infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). AIM To determine the seroprevalence of SARS-CoV-2 antibodies among HCWs, and identify the factors associated with this seroprevalence. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were applied for this systematic review and meta-analysis. Databases including PubMed/MEDLINE and preprint services (medRχiv and bioRχiv) were searched from inception to 24th August 2020. FINDINGS Forty-nine studies including 127,480 HCWs met the inclusion criteria. The estimated overall seroprevalence of SARS-CoV-2 antibodies among HCWs was 8.7% (95% confidence interval 6.7-10.9%). Seroprevalence was higher in studies conducted in North America (12.7%) compared with those conducted in Europe (8.5%), Africa (8.2) and Asia (4%). Meta-regression showed that increased sensitivity of antibody tests was associated with increased seroprevalence. The following factors were associated with seropositivity: male gender; Black, Asian and Hispanic HCWs; work in a coronavirus disease 2019 (COVID-19) unit; patient-related work; front-line HCWs; healthcare assistants; shortage of personal protective equipment; self-reported belief of previous SARS-CoV-2 infection; previous positive polymerase chain reaction test; and household contact with suspected or confirmed cases of COVID-19. CONCLUSION The seroprevalence of SARS-CoV-2 antibodies among HCWs is high. Excellent adherence to infection prevention and control measures; sufficient and adequate personal protective equipment; and early recognition, identification and isolation of HCWs infected with SARS-CoV-2 are imperative to decrease the risk of SARS-CoV-2 infection.
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Affiliation(s)
- P Galanis
- Faculty of Nursing, Centre for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.
| | - I Vraka
- Department of Radiology, P & A Kyriakou Children's Hospital, Athens, Greece
| | - D Fragkou
- Faculty of Nursing, Centre for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - A Bilali
- Hospital Waste Management Unit, P & A Kyriakou Children's Hospital, Athens, Greece
| | - D Kaitelidou
- Faculty of Nursing, Centre for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
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Abuali M, Bonner R, Irigoyen M. Operationalizing an academic pediatric practice during the COVID-19 crisis. Am J Infect Control 2021; 49:226-228. [PMID: 32652255 PMCID: PMC7343646 DOI: 10.1016/j.ajic.2020.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 11/25/2022]
Abstract
We report on innovating protocols at an Academic Pediatric practice during the COVID-19 (2019 novel coronavirus) crisis. Facing the challenges of limited personal protective equipment and testing capacity, we rapidly and efficiently changed processes to optimize infection control, providing safe and effective care for our vulnerable population.
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Affiliation(s)
- Mayssa Abuali
- Einstein Medical Center Philadelphia, Philadelphia, PA, USA.
| | - Robert Bonner
- Einstein Medical Center Philadelphia, Philadelphia, PA, USA
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Abstract
PURPOSE OF REVIEW The COVID-19 pandemic has driven transformation in every aspect of the healthcare delivery system. The unpredictable onset and magnitude of COVID-19 infections resulted in wide gaps in preparedness for healthcare systems. The development of protocols to address both scarcity of resources and staff protection continues to be essential for risk mitigation. RECENT FINDINGS The northeast region of the United States had a rapid early surge of COVID-19 infections leading to the exhaustion of critical care capacity. In addition, northeastern hospitals experienced decrease in elective surgical interventions, including organ transplantation. Limited availability of COVID-19 testing and personal protective equipment further fueled the pandemic. This commentary highlights a comprehensive innovative approach to addressing the operating room and hospital demands, as well as the shortages in resources and staffing during the pandemic. SUMMARY The VCU Department of Anesthesiology operated at 40% of its regular operating room volume throughout the COVID-19 pandemic because of the increased demand from emergency cases. The delay in the peak surge allowed Virginia Commonwealth University, Department of Anesthesiology to develop a comprehensive infrastructure resulting in resulting is maximal workforce risk mitigation.
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Affiliation(s)
| | - Tamara Lawson
- Department of Anesthesiology, Virginia Commonwealth University
| | - Ronsard Daniel
- Department of Anesthesiology, Virginia Commonwealth University
| | - Christin Kim
- Division of Critical Care Medicine, Department of Anesthesiology, Virginia Commonwealth University, Richmond 23298, Virginia, USA
| | - Megan M Rashid
- Division of Critical Care Medicine, Department of Anesthesiology, Virginia Commonwealth University, Richmond 23298, Virginia, USA
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