Subject(s)
Coronavirus Infections , Infection Control/methods , Lung/diagnostic imaging , Pandemics , Pneumonia, Viral , Surgical Procedures, Operative/methods , Tomography, X-Ray Computed/methods , Algorithms , Ambulatory Care/methods , Asymptomatic Infections/therapy , Betacoronavirus/isolation & purification , COVID-19 , COVID-19 Testing , Canada , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/surgery , False Negative Reactions , Humans , Pneumonia, Viral/diagnosis , Pneumonia, Viral/surgery , Preoperative Care/methods , Risk Adjustment/methods , SARS-CoV-2ABSTRACT
OBJECTIVE: The University of British Columbia's General Surgery Program delineates a unique and systematic approach to wellness for surgical residents during a pandemic. SUMMARY BACKGROUND DATA: During the COVID-19 pandemic, health care workers are suffering from increased rates of mental health disturbances. Residents' duty obligations put them at increased physical and mental health risk. It is only by prioritizing their well-being that we can better serve the patients and prepare for a surge. Therefore, it is imperative that measures are put in place to protect them. METHODS: Resident wellness was optimized by targeting 3 domains: efficiency of practice, culture of wellness and personal resilience. RESULTS: Efficiency in delivering information and patient care minimizes additional stress to residents that is caused by the pandemic. By having a reserve team, prioritizing the safety of residents and taking burnout seriously, the culture of wellness and sense of community in our program are emphasized. All of the residents' personal resilience was further optimized by the regular and mandatory measures put in place by the program. CONCLUSIONS: The new challenges brought on by a pandemic puts increased pressure on residents. Measures must be put in place to protect resident from the increased physical and mental health stress in order to best serve patients during this difficult time.
Subject(s)
COVID-19/epidemiology , Education, Medical, Graduate , General Surgery/education , Internship and Residency , Mental Health , Surgeons/psychology , Adult , Attitude of Health Personnel , British Columbia/epidemiology , Burnout, Professional/prevention & control , Efficiency, Organizational , Female , Humans , Male , Organizational Culture , Pandemics , Resilience, Psychological , SARS-CoV-2ABSTRACT
Coronavirus disease 2019 (COVID-19) is a novel, viral-induced respiratory disease that in â¼10-15% of patients progresses to acute respiratory distress syndrome (ARDS) triggered by a cytokine storm. In this Perspective, autopsy results and literature are presented supporting the hypothesis that a little known yet powerful function of neutrophils-the ability to form neutrophil extracellular traps (NETs)-may contribute to organ damage and mortality in COVID-19. We show lung infiltration of neutrophils in an autopsy specimen from a patient who succumbed to COVID-19. We discuss prior reports linking aberrant NET formation to pulmonary diseases, thrombosis, mucous secretions in the airways, and cytokine production. If our hypothesis is correct, targeting NETs directly and/or indirectly with existing drugs may reduce the clinical severity of COVID-19.