ABSTRACT
Background: For almost two years, the Covid-19 pandemic has posed an enormous challenge to healthcare systems. Recurrent waves of disease brought the health systems to the limit of their resilience. Purpose(s): The Tele-Covid telemedicine care program was installed in December 2020 to monitor high-risk patients in home isolation. Close monitoring allows early detection of disease deterioration and timely intensification of therapy, ideally avoiding intensive care. Conversely, if the course of the disease is stable, unnecessary hospitalisation can be avoided, thus reducing the burden on the healthcare system. Method(s): Patient acquisition was performed in collaboration with the local public health service and primary care physicians. Covid-19 positive highrisk patients (age >65 years and/or severe comorbidities) from the greater Innsbruck area were fitted with an ear sensor-based home monitoring system. The ear sensor measures SpO2, respiratory rate, body temperature and heart rate. The monitoring team (25 medical students supervised by 6 physicians) provided continuous monitoring of vital signs (24/7). After validation of the measurements, the collected parameters were evaluated using a specially developed risk score. If a defined risk score was exceeded, the patient was contacted by telephone. The combination of the clinical condition and the risk score determined the further course of action: (a) wait and see, (b) notify the primary care physician, or (c) refer for inpatient admission. The program was active from December 2020 to March 2022. In Summer 2021, the program was temporarily paused due to the epidemiological situation. Result(s): A total of 132 patients (59.8% women) were monitored. The median age was 74 years (IQR: [67.3-80.8]). 91 patients (68.9%) had at least one relevant comorbidity. During the monitoring period, hospitalisation was required in 20 patients (15.2%), 3 of whom were transferred to the intensive care unit. Of the hospitalised patients, 3 (15%) patients died. During the same monitoring period, the Austrian Ministry of Health reported a mortality rate of 20.5% of all hospitalised patients in Austria aged 70-79 years. Subjectively, the patients felt safe due to close monitoring. Conclusion(s): The Tele-Covid program is the successful implementation of a remote monitoring system in a pandemic situation. In the future, a broad application of the program is feasible.
ABSTRACT
Background: For almost two years, the Covid-19 pandemic has posed an enormous challenge to healthcare systems. Recurrent waves of disease brought the health systems to the limit of their resilience. Purpose: The Tele-Covid telemedicine care program was installed in December 2020 to monitor high-risk patients in home isolation. Close monitoring allows early detection of disease deterioration and timely intensification of therapy, ideally avoiding intensive care. Conversely, if the course of the disease is stable, unnecessary hospitalisation can be avoided, thus reducing the burden on the healthcare system. Methods: Patient acquisition was performed in collaboration with the local public health service and primary care physicians. Covid-19 positive high-risk patients (age >65 years and/or severe comorbidities) from the greater Innsbruck area were fitted with an ear sensor-based home monitoring system. The ear sensor measures SpO2, respiratory rate, body temperature and heart rate. The monitoring team (25 medical students supervised by 6 physicians) provided continuous monitoring of vital signs (24/7).After validation of the measurements, the collected parameters were evaluated using a specially developed risk score. If a defined risk score was exceeded, the patient was contacted by telephone. The combination of the clinical condition and the risk score determined the further course of action: (a) wait and see, (b) notify the primary care physician, or (c) refer for inpatient admission.The program was active from December 2020 to March 2022. In Summer 2021, the program was temporarily paused due to the epidemiological situation. Results: A total of 132 patients (59.8% women) were monitored. The median age was 74 years (IQR: [67.3–80.8]). 91 patients (68.9%) had at least one relevant comorbidity. During the monitoring period, hospitalisation was required in 20 patients (15.2%), 3 of whom were transferred to the intensive care unit. Of the hospitalised patients, 3 (15%) patients died. During the same monitoring period, the Austrian Ministry of Health reported a mortality rate of 20.5% of all hospitalised patients in Austria aged 70–79 years. Subjectively, the patients felt safe due to close monitoring. Conclusion: The Tele-Covid program is the successful implementation of a remote monitoring system in a pandemic situation. In the future, a broad application of the program is feasible. Funding Acknowledgement: Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Funded by the Region of the Tyrol
ABSTRACT
Towards the end of 2020, as people changed their usual behavior due to end of year festivities, increasing the frequency of meetings and the number of people who attended them, the COVID-19 local epidemic’s dynamic changed. Since the beginnings of this pandemic, we have been developing, calibrating and validating a local agent-based model (AbcSim) that can predict intensive care unit and deaths’ evolution from data contained in the state electronic medical records and sociological, climatic, health and geographic information from public sources. In addition, daily symptomatic and asymptomatic cases and other epidemiological variables of interest disaggregated by age group can be forecast. Through a set of Hidden Markov Models, AbcSim reproduces the transmission of the virus associated with the movements and activities of people in this city, considering the behavioral changes typical of local holidays. The calibration and validation were performed based on official data from La Rioja city in Argentina. With the results obtained, it was possible to demonstrate the usefulness of these models to predict possible outbreaks, so that decision-makers can implement the necessary policies to avoid the collapse of the health system. © 2022, The Author(s).