Transitioning beyond COVID-19-what lies ahead for an emergency department nurse?

Background and objectives: Severe active respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the worldwide outbreak of a coronavirus disease better known as COVID-19. This pandemic has increased the physical and mental challenges of being a nurse;thus, our study looked at emergency department (ED) nurses who are at the forefront of this battle. Researchers have found that nurses are more likely to develop psychological disorders through the course of pandemics such as the current COVID-19 situation. As the uncertain future of a world living with COVID-19 lies ahead, there is minimal discussion on what nurses may need to support their psychosocial well-being in the post-COVID-19 era. The aim of this study was to understand the impact this pandemic has had on ED nurses and to explore the resources needed to support them as we transit beyond the COVID-19 pandemic. Methods: This study employed a descriptive qualitative research design. Data collection took place in the ED of an acute regional hospital in Singapore. Written informed consent was obtained from the participants. We adopted purposive sampling to recruit 15 nurses with minimum 1year working experience in the ED for semi-structured interviews. They were audio transcribed verbatim to facilitate thematic analysis. Results: The Neumans Systems Model will be adapted as a conceptual framework for data analysis. Preliminary results show that despite facing personal and professional challenges working during the pandemic, nurses relied on personal resilience to sustain their psychological well-being. In addition, a steady provision of Personal Protective Equipment (PPE) with well-executed operational updates from the management contributed to a stable and safe environment for them to work with confidence. Participants expressed hope to be involved in workflow planning which affects their daily operations and the establishment of community support within the department to provide platforms for commiseration and camaraderie. Conclusions: The findings gathered from this study will allow healthcare management to better understand the impact of the challenges faced and needs of their nursing staff. This will in turn allow for improvements in existing support measures to better help our nurses as we learn to live and work beyond this global pandemic.

PERSONAL SENSITIVITY, SELF-MEDICATION, MASK USAGE, AND COVID-19 SYMPTOMS IN SUB-SAHARAN AFRICANS

Objective: The study objective was to explore the episode of COVID-19 symptoms among sub-Saharan African (SSA) by examining the predicting effect of mask usage, self-medication, and personal sensitivity on the symptoms. Materials and Methods: In a cross-sectional study in the SSA population, 536 individuals were asked about the episode of COVID-19 symptoms, personal sensitivity, mask usage, and self-medication. "Hierarchical multiple linear regression statistical method" was used to evaluate the data. Results: The personal sensitivity (r=0.245<0.01), taking off face mask in enclosed public places (r=0.255<0.01) and self -medication (r=0.392<0.01) were positively associated with COVID-19 symptoms. Overall, the total predictive effect of self-medication, taking off the mask in public spaces, and personal sensitivity accounted for 21% of the variance in the episode of COVID-19 symptoms of the study population. Conclusion: Personal sensitivity, mask usage, and self -medication support understanding of the episode of COVID-19 symptoms experienced among the study population. It is important to encourage the use of masks in high-risk areas. To improve post-COVID-19 health policies, self-medication used to decrease the risk of COVID-19 infection and other related public health concerns should be reduced.

Post-COVID-19 pandemic: Standard operating procedures for gross anatomy laboratory in the new standard.

The culture of cadaver dissection remains the most commonly used method of practical teaching and learning of human anatomy. Anatomist and medical professionals considered cadaver dissection as the gold standard for teaching and learning anatomy in detail. The increase seen in the establishment of new medical training institutions globally has consequently led to a proportionate increase in the sourcing for cadavers. Moreover, the surge in mortality rates following the recent coronavirus disease 2019 (COVID-19) pandemic with no cure or approved vaccine has been a source of concern for academia, especially on the safety in the usage of cadavers for dissection. Notwithstanding, several countries continue to depend on unclaimed bodies as the primary source for cadavers, regardless of the cause of death. Besides, body donation is also usually reported to be strained during disease outbreaks thereby putting countries that depend solely on it in a dilemma. This study highlighted the recommended standard operating procedures (SOPs) to be imbibed in gross anatomy dissection halls during and post-COVID-19 pandemic.

Consecutive Hyperoxia Exposure Increased Expression of Interferon α and γ Receptor Genes IFNAR2 and IFNGR2, the SARS-CoV-2, MERS and Influenza Viral Entry Genes TMPRSS2, DPP4 and ST3GAL4, as Well as the Interferon-Stimulated and Fibrosis-Associated Genes DUOX2, MDK, PI3, S100P, ASS1, OAS1 and MX1 in COPD-Diseased Human Small Airway Epithelial Cells

Rationale: The therapeutic application of both hyperbaric oxygen (HBO) and hyperoxia exposure has been proven to be effective procedures for mitigating the hypoxia situation in the COVID-19 patients with pneumonia. However, given that hyperoxic exposure has been shown to increase reactive oxygen species (ROS) and oxidative stress and cause a variety of cardiovascular and pulmonary side effects including damages to endothelial cells, alveolar hypoplasia, pulmonary congestion and edema, and pulmonary vascular abnormalities, it is of interest to study whether HBO and hyperoxia exposure affect expression and regulation of viral entry genes and innate immune response genes including interferons and interferon receptors in human airway epithelial cells. Methods: The normal (N-SAECs) and COPD-diseased (D-SAECs) human small airway epithelial cells were respectively exposed daily to 100% O2 at 2.5 ATA for 90 min for 3 days in total, or cultured under hyperoxia (85% O2) for consecutively 3 days, followed by cultured under 21% O2 for consecutively another 3 days. Total mRNAs were then extracted from N-SAECs and D-SAECs followed by microarray and qPCR analyses. Results: While HBO exposure did not significantly influence the expression levels of both viral entry/receptor genes and innate immune response genes, we observed concordantly increased expression of the coronaviral entry genes TMPRSS2 and DPP4 and the influenza viral receptor gene ST3GAL4 in D-SAECs cultured under consecutive hyperoxia compared to those cultured under normoxia or under HBO, and concordantly increased expression of the interferon α and γ receptor genes IFNAR2 and IFNGR2 in both N-SAECs and D-SAECs cultured under hyperoxia compared to those cultured under normoxia or under HBO. Concordant with the significantly upregulated expression of interferon receptor genes, we also observed significantly increased expression of various interferon α- and γ-stimulated genes (ISGs) including ASS1, DUOX2, IDO1, MDK, MX1, OAS1, PI3, and S100P in D-SAECs cultured under hyperoxia. Notably, among these ISGs, MDK, MX1 and PI3 also showed significantly increased expression in N-SAECs cultured under hyperoxia. Conclusions: Given that the ISGs DUOX2, MDK, MX1, PI3 and S100P have also been reported to be positively correlated with pulmonary fibrosis, our study demonstrates for the first time that consecutive hyperoxia exposure may increase the probability of intrusion of SARS-CoV-2, MERS and influenza viruses as well as pulmonary fibrosis. It remains to be studied whether inhibition of interferon receptors IFNAR2 and/or IFNGR2 will provide an effective therapeutic intervention for mitigating pulmonary fibrosis in severely ill COVID-19 patients.

The place of cadaveric dissection in post-COVID-19 anatomy education.

From time immemorial, cadaveric dissection has been commonly employed as a method of practical teaching and learning for anatomical education globally. Conventionally, cadaveric dissection has been embraced and widely accepted as the best fit for comprehensive and gross teaching in anatomy education, thus placing an undue rise in cadavers' demands. The emergence of the new coronavirus disease 2019 (COVID-19) has posed significant effects on medical education with substantial impacts on anatomy education, as seen in the shift from classroom to virtual learning. An essential area of anatomy education and training requiring immediate consideration is the position of cadaveric dissection in a post-COVID-19 era, which entails the safety of cadavers from possible SARS-CoV-2 infection before their use. This article explores the place of cadaveric dissection in post-COVID-19 anatomy education.

Fighting the Coronavirus disease (Covid-19) pandemic: Employing lessons from the Ebola virus disease response.

Coronavirus disease (COVID-19) is caused by a beta-coronavirus (SARS-CoV-2) that affects the lower respiratory tract and appears as pneumonia in humans. COVID-19 became apparent in December 2019 in Wuhan City of China, and has propagated profusely globally. Despite stringent global quarantine and containment drives, the incidence of COVID-19 keeps soaring high. Measures to minimize human-to-human transmission have been implemented to control the pandemic. However, special efforts to reduce transmission via efficient public health communications and dissemination of risks should be applied in susceptible populations including children, health care providers, and the elderly. In response to this global pandemic, this article summarizes proven strategies that could be employed to combat the COVID-19 disease outbreak, taking a cue from lessons learned from the Ebola virus disease response.

La maladie à coronavirus (COVID-19) est causée par un bêta-coronavirus (SARS-CoV-2) qui affecte les voies respiratoires inférieures et se présente sous forme de pneumonie chez l'homme. La COVID-19 est apparue en décembre 2019 dans la ville chinoise de Wuhan, et s'est propagée à grande échelle dans le monde entier. Malgré des mesures de quarantaine et de confinement rigoureuses, l'incidence de COVID-19 continue de grimper en flèche. Des mesures visant à minimiser la transmission interhumaine ont été mises en œuvre pour contrôler la pandémie. Toutefois, des efforts particuliers pour réduire la transmission par le biais de communications efficaces en matière de santé publique et de diffusion des risques doivent être déployés dans les populations sensibles, notamment les enfants, les prestataires de soins de santé et les personnes âgées. En réponse à cette pandémie mondiale, cet article résume les stratégies éprouvées qui pourraient être employées pour combattre l'épidémie de maladie COVID-19, en s'inspirant des leçons tirées de la réponse à la maladie du virus Ebola.