Enhancement of maternal-neonatal bonding during the COVID-19 pandemic: A quality improvement initiative.

AIM: The COVID-19 pandemic adversely affected the essential care of newborns. In a tertiary care hospital in India, all COVID-19 suspect post-natal mothers awaiting COVID results were transferred to a ward shared with symptomatic COVID suspect female patients from other clinical specialities, due to shortage of space and functional health workforce. Babies born to COVID-19 suspect mothers were moved to a separate ward with a caretaker until their mothers tested negative. Due to shortage of beds and delay in receiving COVID results, mothers and babies were often discharged separately 2-3 days apart to their home. This deprived babies of their mother's milk and bonding. We, therefore, undertook a quality improvement (QI) initiative aiming to improve rooming-in of eligible COVID-19 suspect mother-newborn dyads from 0% to more than 90% over a period of 6 weeks. METHODS: A QI team was formed which ran multiple Plan-Do-Study-Act cycles. The results were reviewed at regular intervals and interventions were adopted, adapted or abandoned. These included advocacy, rearrangement of wards, counselling of mothers and caretakers regarding infection prevention practices and coordination between labour room, post-natal ward and nursery staff. RESULTS: An improvement in rooming-in from 0% to more than 90% was achieved. CONCLUSION: QI methodology is a systematic approach in addressing and solving unexpected unforeseen problems effectively.

The emergence of Covid-19: evolution from endemic to pandemic.

Human race has survived several outbreak of pandemics in the past and their impact was long lasting. Some of the recent pandemics have been caused by a viruses known as Coronaviruses (CoVs) which are diverse, complex, adaptable viruses that have a significant impact on human health and animal productivity. The novel coronavirus that emerged in Wuhan, China (SARS-CoV-2) in 2019 has quickly spread throughout the world. Human coronaviruses (HCoVs), including severe acute respiratory syndrome coronavirus (SARS-CoV) and 2019 novel coronavirus (2019-nCoV, also known as SARS-CoV-2), have led to a global epidemic with high morbidity and mortality. Human pathogenic coronaviruses, SARS-CoV and SARS-CoV-2, bind to their target cells through angiotensin-converting enzyme 2 (ACE2), which is expressed by epithelial cells of the lung, intestine, kidneys, and blood vessels. The efforts to contain the virus are undergoing throughout the world, given the many uncertainties regarding pathogen transmissibility and virulence. Thus, the ongoing studies to promote the understanding of HCoVs will help to avoid or/and minimize the impact of anticipated pandemics in future.

An overview of Covid-19 pandemic: immunology and pharmacology.

In this review, we present an elaborate account of coronavirus in context to Covid-19 focusing on its origin, genome, life cycle, and immunology with a basic understanding of the disease and its cause. Further, the transmission, prevention and advances in therapeutics have also been discussed anticipating the possible outcomes in the near future. Moreover, the recently emerged unconventional approaches to this viral disease like drug repurposing, plasma therapy, nasal spray, and other preventive measures worldwide are studied for a long-term impact and relevance. Hence, this account on coronavirus and the ongoing pandemic serves a purpose of spreading awareness and to pass on relevant knowledge for a better chance to combat such unfortunate health crisis in future.