ABSTRACT
Introduction/Aim: Telehealth has been rapidly adopted by cystic fibrosis (CF) centres in response to the COVID-19 pandemic, and ongoing use in routine CF care is endorsed by CF consumers. Data describing CF clinician perceptions and experiences with telehealth are scarce. These data are crucial to inform the future use of telehealth in CF care. We aimed to describe clinician experiences and attitudes towards telehealth in CF care among multidisciplinary health professionals across Australian paediatric and adult CF centres. Method(s): An anonymous electronic survey was sent to CF multidisciplinary health professionals from all CF clinics in Australia on a single occasion. The survey consisted of 48 questions designed by a multidisciplinary team. Result(s): Eighty-five responses were received representing 15/23 (65%) centres. Respondents worked in a mixture of paediatric (57.6%), adult (36.5%) and combined (5.9%) settings. Most clinicians reported using telehealth for routine clinic visits and a range of other clinical encounters (69.9%). Telehealth was widely perceived as acceptable (91.8%), and clinicians were comfortable/very comfortable (81.2%) integrating telehealth into future CF care. Despite this, 64.1% of respondents considered telehealth clinics to be much worse than face-to-face clinics and 57.5% reported quality of care was somewhat/much worse using telehealth. Home spirometry was available in 73.7% of centres, however, only 26.7% of clinics could provide spirometers for >75% eligible patients. Growth and microbiology assessments were often missed in telehealth clinics and 75.7% reported a technical issue had prevented a telehealth consultation from occurring. Conclusion(s): Telehealth for CF in Australia is considered feasible and acceptable by CF health professionals, although use of telehealth varies widely between centres. Concerns exist around the impact of telehealth on health outcomes;especially given core assessments are frequently omitted. National guidelines may help ensure the benefits of telehealth are realised for people with CF without compromising the standard of care.
ABSTRACT
The novel coronavirus responsible for COVID-19 has spread to several countries within a considerably short period. The virus gets deposited in the human nasal cavity and moves to the lungs that might be fatal. As per safety guidelines by the World Health Organization (WHO), social distancing has emerged as one of the major factors to avoid the spread of infection. However, different guidelines are being followed across the countries with regards to what should be the safe distance. Thus, the current work is an attempt to understand the virus deposition pattern in the realistic human nasal cavity and also to find the impact of distance that could be termed as a safety measure. This study is performed using Computational Fluid Dynamics as a solution tool to investigate the impact of COVID-19 deposition (i) On a realistic 3D human upper airway model and (ii) 2D social distancing protocol for a distance of 0.6, 1.2, 1.8, and 2.4 m. The results revealed that the regional deposition flux within the nasal cavity was predominantly observed in the external nasal cavity and nasopharyngeal section. Frequent flushing of these regions with saltwater substitutes can limit contamination in healthy individuals. The safe distancing limit estimated with 1 m/s airflow was about 1.8 m. The extensive deposition was observed for distances less than 1.8 m in this study, emphasizing the fact that social distancing advisories are not useful and do not take into account the external dynamics associated with airflow. © 2020 Tech Science Press. All rights reserved.