ABSTRACT
Introduction: COVID-19 pandemic has again highlighted the crucial role of the frontline healthcare workers, including practitioners in critical care settings, in case management, disease surveillance, policy development, and clinical education and training. This study aims to explore Australian critical care nurses' knowledge, preparedness and experiences of managing SARS-CoV-2 and COVID-19. Method(s): A cross-sectional study of Australian critical care nurses was conducted between June and September 2020. An anonymous online survey was sent out to the members of the Australian College of Critical Care Nurses (ACCCN) to collect data about their knowledge, preparedness and experiences during COVID-19 outbreak. Data were summarised and reported using descriptive statistics. Textual data were analysed using conventional content analysis technique. Result(s): A total of 138 critical care nurses participated in this study. Most respondents reported 'good' to 'very good' level of knowledge about COVID-19, and used a variety of sources to obtain up-to-date information about COVID-19. A majority (82.3%) believed they were 'moderately' or 'extremely' prepared for managing COVID-19 by the time they answered the survey, and 93.4% had received specific education, training or instruction about COVID-19. Most participants were involved in assessing (89.3%) and treating (92.4%) COVID-19 cases. Varying levels of concerns about contracting SARS-CoV-2 were expressed by respondents. The most significant challenges during the COVID-19 outbreak were lack of appropriate personal protective equipment (PPE) and fear of their shortage. Conclusion(s): These findings can be used in planning for successful outbreak management during the current COVID-19 pandemic and in future outbreaks of emerging infectious diseases.Copyright © 2021
ABSTRACT
SARS-CoV-2 has caused a global pandemic unseen for nearly a century. To date hundreds of millions of people have been diagnosed and millions more have died from COVID-19 disease;many of which are in groups with comorbidities. Obesity is associated with a 3.07 times higher risk of hospitalization and a 1.42 times higher risk of severe illness. However, our understanding of obesityaccelerated severity of COVID-19 is limited. To model the increased disease severity of obese individuals with COVID-19, we used a humanized ACE2 (hACE2) transgenic mouse model, in which hACE2 is under the cytokeratin-18 promoter (K18). Modeling the effects of obesity on COVID-19 in K18-hACE2 mice will help us better understand the mechanisms underlying obesity-accelerated severity of COVID-19 disease and inflammation. We have developed a study in which K18 hACE2 mice infected with SARS-CoV-2 were fed both a normal standard diet as well as a western high fat and carbohydrate diet that causes them to gain excess weight and become obese over a period of 3 months. K18-hACE2 obese mice lose a signifyingly more percentage body weight over both a 7 (acute) 14 day (long-term) period than normal diet fed mice do after infection with SARS-CoV-2. H&E staining analysis of lung histological changes indicated a dramatic increase in inflammation in our K18 hACE2 obese mice infected with SARS-CoV-2 . Subgenomic qPCR and IHC staining was used to quantify virus (viral titer) which indicated that in both of our diet groups after infection did not have a significantly different SARS-CoV-2 viral load. No significant difference in the SARS-CoV-2 viral load was detected at either 7 or 14 dpi with SARS-CoV-2 . We further measured adipokines with an ELISA on two of the most notable adipokines: leptin and adiponectin. Levels of leptin were significantly higher in our obese K18-hACE2 mice but not in our normal mice after infection. There was no difference however in the levels of adiponectin. Obese K18-hACE2 mice show a more severe COVID 19 phenotype than normal diet mice after infection and can be used to further study the underlying mechanism of how SARS-CoV-2 infection in obese individuals causes a more severe disease phenotype.
ABSTRACT
The foundational role of health information exchanges (HIEs) is to facilitate communication between clinical partners in real time. Once this infrastructure for the secure and immediate flow of patient information is built, however, HIEs can benefit community public health and clinical care in myriad other ways that are in line with their mission, goals, patient privacy, and funding structures. We encourage the development of community-integrated HIEs and list specific steps that can be taken toward community integration. We give three examples of those steps in action from a community HIE in El Paso, TX. Each local partnership, in combination with technology innovation, resulted in the development of informatics tools to address community health needs and generated long-term benefits, especially for the most vulnerable patients. Two examples relate to different aspects of the COVID-19 pandemic and a third to the Afghan refugee evacuation.
Subject(s)
COVID-19 , Health Information Exchange , Humans , Texas , Pandemics , ConfidentialityABSTRACT
The Omicron variant (B.1.1.529) of SARS-CoV-2, the virus that causes COVID-19, was first identified in the United States in November 2021, with the BA.1 sublineage (including BA.1.1) causing the largest surge in COVID-19 cases to date. Omicron sublineages BA.2 and BA.2.12.1 emerged later and by late April 2022, accounted for most cases.* Estimates of COVID-19 vaccine effectiveness (VE) can be reduced by newly emerging variants or sublineages that evade vaccine-induced immunity (1), protection from previous SARS-CoV-2 infection in unvaccinated persons (2), or increasing time since vaccination (3). Real-world data comparing VE during the periods when the BA.1 and BA.2/BA.2.12.1 predominated (BA.1 period and BA.2/BA.2.12.1 period, respectively) are limited. The VISION network examined 214,487 emergency department/urgent care (ED/UC) visits and 58,782 hospitalizations with a COVID-19-like illness§ diagnosis among 10 states during December 18, 2021-June 10, 2022, to evaluate VE of 2, 3, and 4 doses of mRNA COVID-19 vaccines (BNT162b2 [Pfizer-BioNTech] or mRNA-1273 [Moderna]) compared with no vaccination among adults without immunocompromising conditions. VE against COVID-19-associated hospitalization 7-119 days and ≥120 days after receipt of dose 3 was 92% (95% CI = 91%-93%) and 85% (95% CI = 81%-89%), respectively, during the BA.1 period, compared with 69% (95% CI = 58%-76%) and 52% (95% CI = 44%-59%), respectively, during the BA.2/BA.2.12.1 period. Patterns were similar for ED/UC encounters. Among adults aged ≥50 years, VE against COVID-19-associated hospitalization ≥120 days after receipt of dose 3 was 55% (95% CI = 46%-62%) and ≥7 days (median = 27 days) after a fourth dose was 80% (95% CI = 71%-85%) during BA.2/BA.2.12.1 predominance. Immunocompetent persons should receive recommended COVID-19 booster doses to prevent moderate to severe COVID-19, including a first booster dose for all eligible persons and second booster dose for adults aged ≥50 years at least 4 months after an initial booster dose. Booster doses should be obtained immediately when persons become eligible.¶.