ABSTRACT
AIMS AND OBJECTIVES: To examine the impact of the workforce crisis on healthcare service delivery for a year during the coronavirus disease 2019 (COVID-19) pandemic on healthcare service delivery and hospital economy in a healthcare facility. MATERIALS AND METHODS: An examination was conducted of employees who were issued with a report for incapacity to work due to the pandemic between March 2020 and March 2021. A record was made of the employees' ages, genders, fields of work and lost workdays. The employees were classified as physicians, nursing services, guest services, hotel services, and support services. Diagnoses were made of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), based on computed tomography (CT) and polymerase chain reaction (PCR) test results. Employees diagnosed with SARS-CoV-2 infection were put into isolation in the hospital during the first months of the pandemic, and treatment was initiated in accordance with the protocols. By contrast, during the last eight months, our personnel who were not indicated for hospitalization completed their treatment in a home isolation setting. According to the Turkish Ministry of Health COVID-19 (SARS-CoV-2 Infection) Scientific Advisory Board Study Guide, the isolation period was initially 14 days, before being reduced to 7-10 days, in line with the revised guide. Employees with at least one negative PCR test result following isolation were allowed to return to work. RESULTS: The study included 575 individuals who were employed at our hospital between March 2020, when the first case was identified in Turkey, and March 2021. Among these employees, 257 were issued with a report for incapacity to work due to COVID-19. Of these, 239 had a positive PCR test result. There were 11 individuals who just had symptoms and/or positive CT findings but a negative PCR test result. There were only seven individuals who were put into isolation due to high-risk contact. The combined lost workdays of the employees totaled 3792. The highest lost workday rate (52%) was in nursing services (1973 days, n = 126). There was no mortality. Conclusion: Lost workdays due to the pandemic in the midsize healthcare facility severely affected the morale and motivation of both the diagnosed and the remaining employees. Hospital administrations also had difficulties in maintaining the quality and continuity of the services provided.
ABSTRACT
We present demographic, clinical, laboratory characteristics and outcomes of the patients with solid malignancies and novel coronavirus disease (COVID-19) collected from the National COVID-19 Registry of Turkey. A total of 1523 patients with a current or past diagnosis of solid tumors and diagnosed with COVID-19 (confirmed with PCR) between 11 March and 20 May 2020 were included. The primary outcome was 30-day mortality. Median age was 61 (range: 18-94), and 752 (49%) were male. The most common types of cancers were breast (19.8%), prostate (10.9%) and colorectal cancer (10.8%). 65% of the patients had at least one comorbidity. At least one COVID-19-directed therapy was given in 73% of the patients.. Hospitalization rate of the patients was 56.6% and intensive care unit admission rate was 11.4%. Seventy-seven (5.1%) patients died within 30 days of diagnosis. The first multivariate model which included only the demographic and clinical characteristics showed older age, male gender and presence of diabetes and receipt of cytotoxic therapy to be associated with increased 30-day mortality, while breast and prostate cancer diagnoses were associated with lower 30-day mortality. In the second set, we further included laboratory parameters. The presence of leukocytosis (OR 6.7, 95% CI 3.3-13.7, P < .001), lymphocytopenia (OR 3,1, 95% CI 1,6-6,1, P = .001) and thrombocytopenia (OR 3,4 95% CI 1,5-8,1, P = .005) were found to be associated with increased 30-day mortality. Relatively lower mortality compared to Western countries and China mainly results from differences in baseline risk factors but may also implicate the importance of intensive supportive care.