ABSTRACT
COVID-19, the unprecedented deadly pandemic has turned the world topsy-turvy. It has affected all the people like poor and rich, young and old, educated and uneducated, male and female with detrimental consequences. People who are in quarantine and/or lockdown are likely to develop a wide range of symptoms like psychological stress, irritability, anxiety, depression etc. Hence, this study was undertaken to assess the psychological effects of COVID-19 lockdown among adult population residing in Chennai, India. This study is a cross sectional descriptive study carried out in Chennai, India. A structured questionnaire was developed containing 25 questions related to the emotional disturbance, depression, self-concept, physical problems, cognitive changes and role performance and 7 questions related to the demographics. An online survey was conducted using a structured questionnaire using a non-probability snowball sampling technique. A total of 579 responses were received. The findings of the present study revealed that, among 579 respondents, more than half of the respondents 320(56.3%) were under severe psychological stress, 192(33.2%) respondents that is one third of the people had moderate psychological stress and remaining were having mild psychological stress. The study also revealed that there was a statistically significant association of psychological problems associated with demographic variables. Our Study revealed that people living in Chennai had severe psychological problem due to theCOVID-19 lockdown. This highlights the importance and immediate need for the development special intervention programmes for the people with psychological problems due to the COVID-19 lockdown.
ABSTRACT
INTRODUCTION: The COVID-19 pandemic mandated rapid, flexible solutions to meet the anticipated surge in both patient acuity and volume. This paper describes one institution's Emergency Department innovation at the center of the COVID crisis, including the creation of a temporary ED-ICU and development of interdisciplinary COVID-specific care delivery models to care for critically ill patients. METHODS: Mount Sinai Hospital, an urban quaternary academic medical center, had an existing five-bed resuscitation area insufficiently resourced due to its size and lack of negative pressure (NP) rooms. The ED-based Observation Unit, which has four NP rooms, was deemed to be the ideal spot for a new ED-ICU. An interdisciplinary and intradepartmental task force was critical to this development. This task force worked to ensure the physical supplies, medications, staffing, and clinical protocols were appropriate to allow for the proper functioning of the ED-ICU. RESULTS: Within one week, the ED-based Observation Unit was quickly converted into a COVID-specific unit, split between a 14-bed stepdown unit and a 13-bed ED-ICU unit. The ED-ICU had all the functional and staffing capacities of an ICU, and was able to efficiently care for large numbers of critically ill patients. All critically ill patients in the ED were treated in the ED-ICU. Further, all intubations and non-invasive ventilation were able to occur in the negative pressure rooms. CONCLUSIONS: The Mount Sinai Hospital Emergency Department rapidly adapted the delivery of care and treatment models to meet the challenges of the COVID-19 pandemic. An ED-ICU was rapidly built by converting the prior observation area (a 27-bed zone). A redesign of a new space in a large U.S. academic hospital often requires months, if not years, of planning and negotiations with the varying hospital interests involved. With the pressure of high COVID demand, this conversion was executed in approximately 1 week, from the initial decision to full activation. Moreover, the unit functioned during the peak of the NYC COVID-19 epidemic largely as envisioned and required surprisingly few space or workflow modifications mid-course. Its success was due to the hard work of the leadership team and front-line providers and the collaboration across the institution.