ABSTRACT
Purpose: This project specifically aims to examine (1) the individual impact of coronavirus disease 2019 (COVID-19) on first responders, (2) the organizational impact of COVID-19 on first response agencies and (3) policy and organizational response and support efforts to mitigate potentially harmful effects of the pandemic. Design/methodology/approach: The authors' conducted a mixed-methods analysis, including a review of secondary sources (e.g. government documents, organizational policies and news pieces), state-level policies, encompassing surveys, in-depth semi-structured interviews and PhotoVoice focus groups. Findings: COVID-19 compounded many of the inherent risks facing first responders and added new stressors. First responders assumed added responsibilities during the pandemic which increased workloads, job-related stress, burnout, distance from the community and first responders' feelings of frustration. Even with personal protective equipment (PPE), first responders faced greater exposure to individuals with COVID-19 and were primarily concerned with transmitting the virus to family members, or other members of the first responders' support networks. State-level COVID-19 policies that were geared toward first responders aimed to improve the first responders' personal lives outside of work and mitigate burnout within the profession. First response agencies adapted to the pandemic by implementing a wide range of measures. Practical implications: First responders also identified several weaknesses in the first responders' agencies' approach to the pandemic. To prepare for the next public health emergency, first response agencies should proactively train employees, build up the first responders' supplies of equipment and PPE, implement policies to strengthen their workforce (e.g. increase hiring for understaffed positions, reduce turnover and mitigate role abandonment), allow for greater employee autonomy, improve communication between leaders and employees and prioritize employees' mental health, as well as other factors relating to departments' informal culture. Originality/value: This is one of the largest studies conducted on three types of first responders (police officers, fire firefighters, emergency medical technicians (EMTs) and paramedics) across the United States of America during a public health crisis. © 2023, Emerald Publishing Limited.
ABSTRACT
The Covid-19 pandemic has generated changes in the delivery of classes, especially in the modality online. Most of the educational institutions were not up to this challenge. Thus, both teachers and students were navigating this challenge under uncertainty. Therefore, these institutions faced difficulties regarding information technologies and how to deliver the contents effectively to the students. One of the potential ways to overcome these difficulties is to implement innovative tools that provide certainty to students through frameworks such as Agile. Agile is a proven framework in software development that allows distributing tasks in sprints with tolerance to constant changes. Additionally, The Service-Learning methodology allows students to get a hands-on learning experience by working with real-life cases and firms. Therefore, the research question is whether implementing one of the Agile frameworks such as Scrum and the Service-Learning methodology would improve students' content delivery. To test this research question, we evaluated the implementation of these methodologies through a case study based on one course of Engineering in Information and Management Control at the Universidad Catolica del Norte in Chile. Our findings show that this setup increased teamwork levels, time management, and overall work satisfaction.
ABSTRACT
Pharmaceutical and non-pharmaceutical interventions (NPIs) have been crucial for controlling COVID-19. They are complemented by voluntary health-protective behavior, building a complex interplay between risk perception, behavior, and disease spread. We studied how voluntary health-protective behavior and vaccination willingness impact the long-term dynamics. We analyzed how different levels of mandatory NPIs determine how individuals use their leeway for voluntary actions. If mandatory NPIs are too weak, COVID-19 incidence will surge, implying high morbidity and mortality before individuals react;if they are too strong, one expects a rebound wave once restrictions are lifted, challenging the transition to endemicity. Conversely, moderate mandatory NPIs give individuals time and room to adapt their level of caution, mitigating disease spread effectively. When complemented with high vaccination rates, this also offers a robust way to limit the impacts of the Omicron variant of concern. Altogether, our work highlights the importance of appropriate mandatory NPIs to maximise the impact of individual voluntary actions in pandemic control. Copyright © 2022 Dönges, Wagner, Contreras, Iftekhar, Bauer, Mohr, Dehning, Calero Valdez, Kretzschmar, Mäs, Nagel and Priesemann.
ABSTRACT
In this chapter, we aim to provide a biological, statistical, and mathematical framework to understand and formulate sensible models to study the spreading dynamics of COVID-19. First, we discuss the epidemiological and clinical features that make COVID-19 challenging-to-control in different scales and ways. We then describe the different error sources present in raw COVID-19 epidemiological data and the logistic limitations associated with non-pharmaceutical interventions (NPIs), like test-trace-and-isolate (TTI). By studying compartmental SIR and SIR-like mathematical models and their underlying hypotheses, we demonstrate the derivation of significant parameters for evaluating this pandemic’s progression, as the reproduction number Rt. Then, we provide the statistical basis for the correction of delay-induced errors in raw data through the “nowcasting” of infections and describe the Machine-Learning-based approaches to tackle significant challenges in modeling COVID-19. We end our chapter with several case studies, where we describe the modeling aspects as carefully as their results, providing the reader with fresh multi-disciplinary insights to inspire their own models. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
Objective: To analyze the complications developed in patients with COVID-19 supported with ECMO and to evaluate their impact in outcomes. Methods: Prospective observational study including all the COVID-19 patients with ECMO support in the ICU of the VHUH from 15 March to 30 July. Infectious, renal, thrombotic, hemorrhagic and other complications during support were prospectively registered. Continuous variables expressed as median (interquartile range) and categorical variables as number (percentage). The impact of complications in mortality was analyzed using Chi-squared or Fisheŕs exact test as appropriate. Results: Twenty-four patients [55 (46-57) years, 58% male, BMI 32.1 (27-35)] received ECMO support [23 (96%) VV-ECMO] during 11 (5.7-19.2) days. The longest run lasted 67 days (awake ECMO). Eighteen (75%) patients could be decannulated and 16 (67%) were discharged alive from the ICU. Fifteen (63%) patients suffered hemorrhagic complications and 12 (48%) thrombotic events, with 7 (29%) patients needing circuit change. Ventilator-associated pneumonia (VAP) was diagnosed in 8 (33%) patients and acute kidney injury (AKI) in 7 (29%). Other complications were air leak (5 patients), fungal infection (4), CMV replication (3) and cardiac tamponade (1). Hemorrhage and thrombosis were not associated with mortality (P=1.0 and P=0.6, respectively). VAP and AKI were neither associated with mortality (P=0.3 both). Conclusions: Complications are frequent in COVID-19 patients supported with ECMO, especially thrombotic and hemorrhagic. VAP and AKI might be studied in further studies to confirm their association with a higher risk of mortality.