Clinical characteristics of healthcare workers with prolonged COVID-19 symptoms: A case series

@#This study was a case series of nine healthcare workers who were documented to have had prolonged symptoms of COVID-19 between April 1, 2020, and November 30, 2020. The majority were females and middle-aged (40–59 years old) with the following comorbid conditions: hypertension, bronchial asthma, and allergic rhinitis. Four healthcare workers directly handled COVID-19 patients. Seven healthcare workers were admitted during the acute phase of the illness, three of whom were diagnosed with COVID-19 Pneumonia, and one was readmitted due to persistent palpitations. Their presenting symptoms varied among the 9 cases, such as chills, fever, headache, cough, colds, sore throat, throat itchiness, loss of taste and smell, and myalgia. Prolonged symptoms were the following: cough, myalgia, easy fatigability, exertional dyspnea, shortness of breath, hair loss, and diarrhea. The duration of symptoms from onset to resolution ranges from 4.5 weeks to 30 weeks. All individuals with COVID-19, including healthcare workers, are susceptible to long-term COVID, which involves heterogenous symptoms that may last for varying durations.

Telemedicine services in the University of the Philippines Health Service during the COVID-19 Pandemic: A two-week process documentation and analysis

@#Background. Telemedicine provides access to health care services during pandemics. It can be utilized to screen asymptomatic persons, follow up close contacts of confirmed cases, monitor individuals with symptoms, conduct specialty consultations, and offer health services to patients during pandemics. Objective. To describe the telemedicine processes, good practices, and areas for improvement in the University of the Philippines Health Service (UPHS) during the COVID-19 pandemic. Methods. This was a cross-sectional study to document telemedicine processes in UPHS. All teleconsultations of employees and students of Philippine General Hospital (PGH) and UP Manila (UPM) during the two-week study period in October 2020 were included. Quantitative data was collected from different modes of patient entry into the UPHS telemedicine services: email, Online Consultation Request and Appointment (OCRA) System, and phone hotlines. Qualitative information was gathered as narrative descriptions of observations in the clinic’s service delivery areas. A focus group discussion was also conducted to illustrate the different steps of the pathway used for telemedicine. Results. The telemedicine services of UPHS consisted of virtual triage, COVID-19/non-COVID-19 consultation, and telemonitoring. The UPHS virtual triage received patient concerns through OCRA or the hotline numbers. On the other hand, the COVID-19 teleconsultation service provided care to employees and students who contacted the clinic regarding symptoms or exposure via email. The non-COVID-19 service had teleconsultation for patients with other medical concerns. Coordination among staff and presence of a consultant were identified as good practices, while the areas for improvement include the lack of written protocols in issuing fit-to-work clearance for difficult cases and the optional use of OCRA for UPHS consult. Conclusion. Telemedicine services at the UPHS included tele-triaging, teleconsultations, and telemonitoring with use of phone calls, short messaging service (SMS), emails, and OCRA. Timely coordination, on-site duty consultants, and use of technology were identified as good practices. Lack of protocols and inconsistent OCRA use are areas for improvement.

Summary recommendations on the various disinfection strategies in the community

Background@#Local government units conduct community – based responses to control spread of COVID-19 infection. Initiatives include city-wide disinfecting operations on streets and establishments, and mist spraying outside houses, vehicles, and even directly on persons.@*Objective@#To provide a list of recommendations on the different disinfection strategies applicable for use in the community@*Methodology@#Articles and guidelines about community disinfection were searched in various research databases. All evidencebased recommendations were reviewed, appraised, evaluated and summarized@*Recommendations@#General disinfection in households and community recommends use of diluted bleach solution of 75ml Sodium hypochlorite in 3.8L or 1 gallon of water (1000ppm). It is recommended to clean and disinfect frequently touched surfaces such as tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks and electronics. In disinfecting local quarantine facilities, all surfaces must be regularly cleaned using damp cleaning cloth and mops. Ethyl alcohol (70%) is used for small surfaces and well-ventilated spaces while diluted household bleach is used for surface disinfection. Spraying or fogging with ethyl alcohol or bleach disinfectant may be hazardous and has no proven benefit on disease prevention and control@*Conclusion@#The use of properly diluted household disinfectant solution for direct surface cleaning is an effective infection control measure in the community setting. Available evidence, however, recommends against the use of spraying, misting or fogging

Summary recommendations on the use of protective equipment for health care personnel involved in triage and ambulatory consult of patients in COVID-19 pandemic

Background@#In a low resource setting, strategies to optimize Personal Protective Equipment (PPE) supplies are being observed. Alternative protective measures were identified to protect health care personnel during delivery of care@*Objective@#To provide list of recommendations on alternative protective equipment during this Coronavirus Disease 2019 (COVID-19) pandemic@*Methodology@#Articles available on the various research databases were reviewed, appraised and evaluated for its quality and relevance. Discrepancies were rechecked and consensus was achieved by discussion.@*Recommendations@#The use of engineering control such as barriers in the reception areas minimize the risk of healthcare personnel. Personal protective equipment needed are face shields or googles, N95 respirators, impermeable gown and gloves. If supplies are limited, the use of N95 respirators are prioritized in performing aerosol-generating procedures, otherwise, surgical masks are acceptable alternative. Cloth masks do not give adequate protection, but can be considered if it is used with face shield. Fluid-resistance, impermeable gown and non-sterile disposable gloves are recommended when attending to patients suspected or confirmed COVID-19. Used, soiled or damaged PPE should be carefully removed and properly discarded. Extended use of PPE can be considered, while re-use is only an option if supplies run low. Reusable equipment should be cleaned and disinfected every after use@*Conclusion@#In supplies shortage, personal protective equipment was optimized by extended use and reuse following observance of standard respiratory infection control procedures such as avoid touching the face and handwashing. The addition of physical barriers in ambulatory and triage areas add another layer of protection

Cost of Medications, Preference and Willingness-to-Pay for Pain Relief among Adult Patients Diagnosed with Acute and Chronic Musculoskeletal Pain Conditions

Objective@#To determine the current cost, medication preferences, willingness to pay for symptom relief and reduced adverse events of adult patients with acute and chronic musculoskeletal pain. @*Methods@#This was a cross-sectional study among adult Filipinos consulted for musculoskeletal conditions at Family Medicine Clinic. Data were collected through a questionnaire and a systematic sampling of respondents. @*Results@#The study had a total of 342 participants with degenerative osteoarthritis as the most common primary diagnosis. Twenty percent (N=69/342) were acutely symptomatic while 273/342 (80%) have chronic musculoskeletal pain. Most would prefer medicines at a lower price point, effectively reduces pain, fast onset of action, longer therapeutic effects and less adverse effects. Willingness-to-pay was at an average price of Php 86.11 (SD±15.47) per pill for complete symptom relief. @*Conclusion@#Adult Filipinos with musculoskeletal pain symptoms prefer pain medicines with good symptom control, less adverse event and were willing to pay for complete symptom relief at an average of eighty-six pesos per pill.