ABSTRACT
BACKGROUND: No clear evidence exists regarding the effects of the different periods and magnitude of spread of the COVID-19 infection on cancer treatments. This study investigated the effects of the different periods and magnitude of COVID-19 infection spread on in-hospital cancer operations. METHODS: Medical claims data from 17 hospitals where in-hospital operations for patients with malignant neoplasms were performed between 1 April 2017 and 31 March 2021 in Yamagata were extracted and analyzed. The critical time points as exposure used to evaluate the impact of different COVID-19 infection spread periods on cancer operations were (1) April 2020 (emergency declaration introduced by the government) and (2) December 2020 (the second wave). From April to November 2020 and December 2020 to March 21, the number of confirmed COVID-19 cases was 130 and 840, respectively. The 17 hospitals were classified into intervention or control groups based on whether in-hospital treatments for patients with COVID-19 were provided. RESULTS: The interrupted time series analysis reported that the difference in the trend of pre-COVID-19 and postsecond wave (March 2020 to December 2020) periods was statistically significant between groups, with 50.67 fewer operations (95% confidence interval [CI] = 12.19-89.15) performed per month in the intervention group compared with the control group. Moreover, the immediate change in the number of operations in April 2020 (beginning of the first wave) was statistically significant between groups, with 80.14 operations (95% CI = 39.62-120.67) less immediately after the first wave in the intervention group compared with the control group. CONCLUSION: Our findings suggest that a statement of emergency by the government and the COVID-19 infection spread are both associated with the number of cancer operations performed in the Yamagata prefecture during the COVID-19 pandemic.
ABSTRACT
Aim: We investigated personal protective equipment (PPE) use and supply shortage, training, and adverse events among health-care workers (HCWs) in the intensive care unit (ICU) during the coronavirus disease (COVID-19) pandemic in Japan and compared the results with an international survey that used the same methodology. Methods: This Web-based survey was carried out from 14 April to 6 May, 2020, in Japan and included HCWs directly involved in ICU management of COVID-19 patients. A survey invitation was emailed using the Japanese Society of Intensive Care Medicine's mailing list. Results: We analyzed 460 valid responses from among 976 responses. The N95/FFP2 mask (77%) was the most frequently used, although half of our respondents reported reuse of single-use N95/FFP2 masks. The median duration (1 h) of uninterrupted PPE use per shift was less than that in the international study. The most common PPE-related adverse event was experiencing intense heat (75%). Logistic regression analysis revealed that being a nurse was independently associated with experiencing intense heat. Conclusion: Shortage of PPE and frequent mask reuse were prevalent during the COVID-19 pandemic in Japan. Intense heat is the most significant symptom, especially for nurses, even with short-duration PPE use. Strategies to protect HCWs from dehydration and intense heatstroke are needed.