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Purpose : During the COVID-19 pandemic, ophthalmologists were presented with the challenge of providing safe care to patients while limiting the spread of COVID-19. As a result, many institutions implemented universal pre-surgical COVID-19 screening prior to surgery for all patients. The goals of this study are to characterize the rate of COVID-19 positivity during pre-surgical screening at our institution, the surgical outcomes experienced in COVID-19 positive ophthalmic patients, and to report overall cost of universal pre-surgical screening. Methods : This retrospective study included patients ≥ 18 years who underwent ophthalmic surgical procedures at a tertiary institution between May 11, 2020 and December 31, 2020. Patients without a valid pre-surgical COVID-19 test within the three days prior to their scheduled procedure, incomplete or mislabeled visits, and incomplete or missing data in their file were excluded. COVID-19 screening was completed by the Thermo Fisher TaqPath Polymerase Chain Reaction (PCR) kit. Results : Of the 3,585 patients who met inclusion criteria, 2,044 patients (57.02%) were female, and the average age was 68.2 ± 12.8 years (mean ± standard deviation). 13 asymptomatic patients (0.36%) tested positive for COVID-19 via PCR screening. Three patients had known positive COVID-19 infection within the 90 days prior to surgery, thus 10 patients (0.28%) were found to have asymptomatic naïve COVID-19 infection via PCR. Testing was associated with a total charge of $788,700. Five of the 13 COVID-19 positive patients (38.46%) experienced a delay in their surgery. The average surgical delay was 17.23 ± 22.97 days (mean ± standard deviation). Conclusions : Asymptomatic ophthalmic surgical patients experienced a low positivity rate with a limited impact on surgery scheduling at a significant cost. Further studies would be valuable in evaluating a targeted pre-surgical screening population as opposed to universal testing.
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Social media is emerging as a popular platform for health communication and has gained an even stronger impetus since the COVID-19 pandemic. With conversations about mental health slowly building momentum in recent times even in developing countries like India, this study sought to understand the current status of mental health communication on social media in the country. The factors predicting these communication behaviours were explored as well. The data comprised 421 participants (Mean age = 28.26 years) hailing from metros, urban and semi-urban areas. Almost 64% of participants reported having used social media for mental health communication. The extent of mental health knowledge and empathy emerged as the most consistent predictors of indulging in mental health communication behaviours on social media. Almost 92% of participants reported that they observed an increase in these communication behaviours among people, as a result of the pandemic. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Introduction Policies to increase global vaccine access involve HICs making ethically fraught tradeoffs between saving lives at home or abroad. Such policies should be justifiable to the affected populations. Yet there is little robust data on whether HIC residents endorse their countries' policy choices. Most existing data asks highly simplified questions, without providing background on the ethical tradeoffs involved. These data do not capture the public's informed views, giving policymakers limited guidance on how to craft international vaccine policy. This paper provides the first nuanced data on the informed views of a representative sample of the U.S. public about providing COVID vaccine to poorer countries. Methods This study involved two interventions: a description of ethical arguments for/against providing vaccine to poorer countries and visuals depiction of ethically relevant tradeoffs about providing vaccine to poorer countries at different time points in the US vaccination campaign. A representative sample of 4000 U.S. adults were surveyed, divided evenly into four arms: 1) arguments only;2) tradeoffs only;3) both interventions;4) no interventions. Results Across all four arms, people are more willing to donate vaccines than previously reported, with generosity increasing over time. 43% of respondents were willing to share at an early timepoint when supply was extremely limited, increasing to 54% and 71% at intermediate and current timepoints, respectively. Some specific variables (e.g., political affiliation, age, acceptability of masks) were predictive of willingness to donate and endorsement of specific arguments. Discussion These data can guide policy about providing or keeping U.S. vaccine doses as the world navigates the effects of new variants and the potential need for booster shots in the coming months. Given high levels of willingness to donate, U.S. policy could have initiated global vaccine donations earlier and could be more generous currently.
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Purpose : Telehealth has a variety of proposed uses in ophthalmology and has become a valuable asset to health care in the COVID-19 pandemic. This retrospective, observational study characterizes the use of virtual visits and compares the outcomes of these visits to in-person visits during the pandemic period at a large academic institution. Methods : 2,943 virtual and 56,174 in-person visits occurring at Cole Eye Institute, Cleveland Clinic, were identified. A random sample of 3,000 in-person visits was selected for comparison. Canceled, incomplete and duplicated visits, as well as visits for patients aged less than 18 years old were excluded. Pearson's chi-square test of independence and test of proportions were used to assess relationships between categorical variables. Results : 2,266 virtual visits and 2,590 in-person visits were included. The visits distribution across ophthalmology specialties is summarized in table 1. 72.3% of the virtual visits resulted in a planned follow-up compared to 70.3% following an in-person visit (p=0.121). 15.9% of virtual patients were discharged compared to 10.8% of in-person patients (p<0.001). 5.6% of virtual patients were referred to a primary care doctor or different ophthalmology subspecialty compared to 6.9% in-person patients (p=0.081). 6.0% of the patients had an outpatient surgery scheduled after a virtual visit compared to 4.8% inperson patients (p=0.08). 0.2% of the virtual patients had a clinic procedure scheduled compared to 7.2% in-person patients (p<0.001). Loss to follow-up occurred due to cancelations (4.6% and 3.5% in the virtual and in-person visits, respectively, p=0.11), no shows (2.8% and 2.1%, p=0.2) and no schedule (10.4% and 2.3%, p<0.001). 84.6% of the completed follow-up visits after virtual visits were in-person and 15.4% were virtual, in comparison to 97.4% and 2.6% after an in-person encounter (p<0.001). Conclusions : The similar number of follow-up, referral and outpatient surgery outcomes across virtual and in-person visits suggests that teleophthalmology is a viable alternative for patient care. Virtual follow-ups occurred more often after a virtual visit. Discharges and unscheduled follow-up visits were also more prevalent in the virtual setting, implying a higher risk of care discontinuation in this group. Further research into the applications of telehealth for ophthalmology may be beneficial.
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Purpose The impact of COVID 19 on lung donors and lung transplant recipients in Australia has not been studied. This study followed the impact of COVID 19 in the initial Australian COVID 19 surge. Methods This was a retrospective cohort study which examined data from the centre's local CPRS transplant database, Australia and New Zealand Organ Donation Registry and hospital medical records from 01st Jan 2017 to 31st August 2020. Organ donation patterns, cause of donor deaths, recipient characteristics and transplant surgery volumes were monitored. Results Over the 8 months, from 1st of January to 31st August, there were 26 lung transplants in 2020 compared to 35 in the same period in 2019 at the centre. Suicide and overdose became 2.65 times more likely as causes of donor death at the centre and 1.60 times more likely nationally. Heart attack and stroke became less likely causes of donor death. Lung transplant recipients were more likely to have a diagnosis of pulmonary fibrosis, but had on average improved measures of pre-surgical frailty and improved operative outcomes. The exception to this was ICU time and ventilatory time, which increased on average. MOCA scores improved on average, suggestive of better mental acuity. Indicators of mental health were worse in the 2020 cohort, based on the average dmi10 depression screening score. Conclusion There was a 69.23% decline in volume of organ transplantation as of August 2020. With the initial surge of cases the transplant volumes decreased dramatically, however with “lockdown” and control of “COVID cases” the lung transplant rates increased. The Victorian outbreak from August further diminished rates of transplant due to travel restrictions, however the NSW based unit managed to maintain lung transplant levels with local donors and minor interstate referrals. An increase in physical robustness corresponds to increased referral and uptake of “prehabilitation” by waitlisted patients.
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BACKGROUND: Fibre-optic nasoendoscopy and fibre-optic laryngoscopy are high-risk procedures in the coronavirus disease 2019 era, as they are potential aerosol-generating procedures. Barrier protection remains key to preventing transmission. METHODS: A device was developed that patients can wear to reduce potential aerosol contamination of the surroundings. CONCLUSION: This device is simple, reproducible, easy to use, economical and well-tolerated. Full personal protection equipment should additionally be worn by the operator.