Evaluation of criteria and COVID-19 patients for intensive care unit admission in the era of pandemic: A multi-criteria decision making approach.

BACKGROUND AND OBJECTIVE: The COVID-19 pandemic results in an intense flow of patients to hospitals especially to the intensive care units (ICUs) to be treated. The ICUs will therefore be confronted with a massive influx of patients (e.g. Spain and Italy). However, if the number of patients is higher than the resources available in ICUs, rationing decisions such as determining and evaluating the criteria for ICU admission becomes essential. In this case, the decision of which patients will be admitted to the ICUs may put significant pressure on healthcare personnel. The goal of this paper is to determine the criteria to be used in the decision of admission of COVID-19 patients to the ICUs. METHODS: A three-step methodology is applied. In the first step, the evaluation criteria are determined, and then the criteria are prioritized using a fuzzy analytical hierarchy process (AHP) in an uncertain and multiple-criteria environment choice. Finally, COVID-19 patients are ranked using the Multi-Objective Optimization Method by Ratio Analysis to find out which patient is more urgent. RESULTS: According to experts' evaluation of ICU admission criteria, "increment of >2 in SOFA score" seems the most dominant factor among others. The proposed methodology is tested on 10 anonymous COVID-19 positive patients being treated in a public hospital and the ICU admission results are discussed. CONCLUSIONS: Obtained priorities and ranking is in line with the hospitals' behavior that potentially depicts the usefulness and validity of the proposed approach.

Assessment of anxiety in elderly population during the COVID-19 pandemic and the impact of compulsory home-stay in the central districts of Ankara, Turkey: A quantitative, qualitative mixed method study.

OBJECTIVE: This study aimed to determine the level of anxiety in elderly individuals during the COVID-19 pandemic in Ankara province of Turkey and determine its associated factors. METHODS: A quantitative, qualitative mixed-method study performed in 1-10 June 2020 during the compulsory home-stay for elderly people in Turkey. The quantitative study was conducted using a structured online questionnaire with 278 participants aged 65 or older. The Geriatric Anxiety Inventory (GAI) was used to assess the anxiety. An in-depth interview with 20 participants was used to fill the gap of face-to-face interview due to pandemic situation and strengthen the results of quantitative survey. Qualitative and quantitative data were analyzed separately. RESULTS: Of all participants, 88 (31.7%) had a score above the cut-off point for GAI. The prevalence of Generalized Anxiety Disorder (GAD) was significantly higher in female (37.8%) than in male (23.8%). Female gender, economic loss, uncertainty, and the time participants expend to follow news about COVID-19 pandemic were risk factors of GAD. On the other hand, higher education level, hobbies, and regular physical activity were protective factors against GAD. CONCLUSION: During the pandemic, social isolation and lockdown for elderly people make serious risk factor for their mental well-being. Measures must be taken to support the psychological well-being of elderly by promoting physical activity and hobbies at home, and reducing their economic concerns.

Covid-19 salgininda savunmasiz gruplardan biri: Göçmenler

A new type of coronavirus caused a serious public health crisis in early 2020 and virus started to spread rapidly and required serious preventions. Understanding and implementing these preventions may be insufficient in some vulnerable groups. The migrants is one of these groups. Migrants may not be able to adequately understand the suggestions expected to reach the public due to language differences. Some negative living conditions brought by the migration process may make it difficult for them to implement these preventions adequately. Also such as socioeconomic level and legal status can restrict migrants access to healthcare. Especially with regard to infectious diseases and epidemics that require rapid intervention, immigrants' disregard may prevent the measures from achieving their intended purpose. Therefore, immigrant groups should be included in the intervention plans and health strategies of the states. immigrants should be made part of the holistic efforts against the COVID-19 epidemic in the general community. It should be ensured that all measures can be taken and implemented for immigrants, regardless of their status and inclusion.