ABSTRACT
COVID-19 pandemic has provided a new challenge to healthcare systems and medical care providers. In the current study, we describe the challenges faced and actions taken to provide optimum healthcare in Japan during the COVID-19 pandemic based on the results of a questionnaire survey that was conducted by oral and maxillofacial surgeons. A total of 24 Japanese institutions participated in the study. The first survey was conducted between June 22, 2020 and June 26, 2020, and the second survey was conducted between October 23, 2020 and November 8, 2020. The questionnaire focused on the practical situation in the respondent's hospital, personal protective equipment (PPE) availability, and what alterations had occurred compared to the situation before the COVID-19 pandemic. The commonest reported duration of restrictions to the outpatient clinic was 1-2 months. All of the institutions had lifted their restrictions on outpatient services by September 2020. Surgical procedures in the operating room were restricted in 74% of hospitals in the first wave of the pandemic;however, 88% lifted their restrictions and restarted their regular surgical services by November 2020. Although, non-urgent or elective procedures were delayed, surgeries for malignant tumors, maxillofacial infections, and trauma were performed at almost all hospitals during the pandemic. Health care institutions will require a new approach to maintain patient volume and recover from the pandemic. Going forward, it is also necessary to minimize the risk of exposure and transmission to health care personnel as well as patients.Copyright © 2021 The Authors
ABSTRACT
A 63-year-old man was diagnosed with coronavirus infection on day 5 after onset of symptoms and treated at home. On day 6, the patient developed moderate oxygenation failure and was admitted to hospital for initiation of treatment with dexamethasone and remdesivir. On day 9, the condition deteriorated critically and a single dose of tocilizumab was administered. On day 19 post-symptom onset, the patient presented with abdominal pain, and abdominal CT indicated a perforated diverticulum in the sigmoid colon and diffuse peritonitis. In emergency surgery, laparoscopic observation revealed a large amount of pus and severe inflammation of the sigmoid colon. Sigmoid colon resection, colostomy, and intraperitoneal lavage and drainage were performed. On day 28 post-symptom onset, there was acute exacerbation of pneumonia in response to the coronavirus infection during steroid dose reduction. The condition subsequently improved with steroid pulse therapy, and transfer to another hospital was possible at 48 days post-symptom onset. We report this case as an example of perforation of the diverticulum in the sigmoid colon following administration of tocilizumab for treatment of coronavirus infection-associated pneumonia © 2022 The Japanese Society of Gastroenterological Surgery
ABSTRACT
The world was astounded by the emergence of the deadly virus COVID-19 at the end of 2019. In March 2020, Malaysia's first Movement Control Order (MCO) was initiated to stop the spread of the virus that ended in June 2021. Hence, this paper was initiated to study the impact of the pandemic and MCO on the generation of waste in Pasar Awam Maharani Muar (PAMM). The waste generation rate and the trend of waste accumulation according to different categories were recognised. The PAMM operates 8 hours daily, and the area strictly observes Standard Operating Procedures (SOP) established by the government. The compositional study was performed two times for 14 days in a month. The solid waste was segregated, and the weight were measured accordingly. The average total solid waste generated from 30 stalls was around 1.5 tonnes daily. It was further established that 38.5% of the waste comprised of chicken and fish waste, 36.3% formed inorganic waste, and 25.2% constituted vegetable and fruit waste. Several limitations were acknowledged in this research which was the short operational time, unpredictable weather, public holidays, and the closure of PAMM on Sundays. Observations also showed that some stall owners were highly mindful of the solid waste segregation and some of the organic wastes were reused as ruminant feed and some for composting. © Published under licence by IOP Publishing Ltd.
ABSTRACT
Background. High-quality data are necessary for decision-making during the SARS-CoV-2 pandemic. Lack of transparency and accuracy in data reporting can erode public confidence, mislead policymakers, and endanger safety. Two major data errors in Iowa impacted critical state- and county-level decision-making. Methods. The Iowa Department of Public Health (IDPH) publishes daily COVID-19 data. Authors independently tracked daily data from IDPH and other publicly available sources (i.e., county health departments, news media, and social networks). Data include: number and type of tests, results, hospitalizations, intensive care unit admissions, and deaths at state/county levels. Results. Discrepancies were identified between IDPH and non-IDPH data, with at least two confirmed by IDPH: (1) The backdating of test results identified on May 28, 2020. IDPH labeled results as occurring up to four months before the actual test date. IDPH confirmed that if a person previously tested for SARS-CoV-2, a new test result was attributed to the initial test's date. Corrections on August 19, 2020 increased positivity rates in 31 counties, but decreased the state's overall rate (9.1% to 7.5%). (2) The selective exclusion of antigen test results noted on August 20, 2020. Antigen testing was included in the total number of tests reported in metric denominators, but their results were being excluded from their respective numerators. Thus, positive antigen results were interpreted as de facto negative tests, artificially lowering positivity rates. Corrections increased Iowa's positivity rate (5.0% to 14.2%). In July 2020, the Iowa Department of Education mandated in-person K-12 learning for counties with < 15% positivity. These data changes occurred during critical decision-making, altering return-to-learn plans in seven counties. The Center for Medicare and Medicaid Services' requirements also caused nursing homes to urgently revise testing strategies. Timeline of changes to Iowa state COVID-19 testing through the end of August 2020. Change in positive and overall test results due to IDPH data corrections. These graphs represent the difference in cumulative total reported test results when pulled from the IDPH website on September 29, 2020 compared to data for the same dates when pulled on August 19, 2020 before the announced adjustment. The adjustment and subsequent daily changes in reported data amount to a dramatic change in the number of reported positive cases (A) with an increase of nearly 3,000 cases by April 25, as well as the loss of tens of thousands of data points when tracking total resulted tests (B). Conclusion. Data availability, quality, and transparency vary widely across the US, hindering science-based policymaking. Independent audit and curations of data can contribute to better public health policies. We urge all states to increase the availability and transparency of public health data.