Being a Social Worker in Social Services during the Covid-19 Pandemic: A Spanish Case Study

Covid-19 has led to a health, social and economic crisis, the like of which has never been seen before. The world has had to tackle a new reality that has shaken the most basic structures of our system. In Spain the Social Services have been declared essential services but, even so, the social workers interviewed in this study have not perceived that this has translated into greater support for the system or for their work. This article forms part of a national funded research project that has developed the only tool to monitor the impact of Covid-19 on the Social Services in Spain. Its sampling design has made it possible to carry out 164 telephone interviews at 52 public Social Services centres all over Spain. The aim of this article is to ascertain the effects of the pandemic on the daily practice of social work through the analysis of professional discourse, and also to discuss the impact of Covid-19 with special attention to issues such as the irruption of telematics, the emotional exhaustion of professional teams or the new forms of reorganisation of the Social Services. In other words, changes in the organisational dynamics of the centres, in the incorporation of telematics, in interpersonal relations between the work teams, etc. Changes that will all be decisive in predicting the course of social change in the Social Services in the coming years.

THE IMPACT OF COVID-19 ON THE DEAF COMMUNITY: THE CASE OF SPANISH SIGN LANGUAGE (LSE) AND CATALAN SIGN LANGUAGE (LSC)

In this article we analyze some specific issues faced by deaf communities at the local, national, and international levels during the COVID-19 pandemic, by placing special emphasis on language policies and dissemination and communication policies for Spanish Sign Language (LSE) and Catalan Sign Language (LSC), taking the perspective of their respective communities. We propose a quality control system to assess specific communications and the use and handling of languages in crisis situations by applying a combination of four dimensions, known as the 4-A standard (Availability, Accessibility, Acceptability, Adaptability). A description of the application of each dimension grounds the analyzed implications of their implementation for both languages, underlining the importance of multilingual and accessible communication in signed languages and a close collaboration between governments and deaf people's organizations to ensure their enjoyment of their linguistic rights and effective equality in accessing information and communication.

Comparative safety and effectiveness of tocilizumab, corticosteroids and combined therapy in SARS-COV2 infection

Objective: Tocilizumab (T) and corticosteroids (C) were two of the drugs used to stop the hyperinflammatory state of critically ill patients at the beginning of the COVID-19 pandemic. The objective of this study is to make a comparison of the efficacy and safety between the two drugs and the combination of both. Material and/or methods: All patients with SARSCOV2 infection from our centre during the first wave of the pandemic who had been treated with T, C or a combination of both (CT) were selected from the IDI-REM- 2020-01 COVID-19 Registry (NCT04347278). A descriptive study was carried out with an assessment of survival, mean stay (MS) in Intensive care unit (ICU) and risk of co-infection for these treatments. Results: Of 86 patients (54 men/32 women), 29 received T (33.7%), 37 C (43.1%) and 20 TC (23.2%). Median age was 66 ± 14 years, increasing in C (71 ± 15) and decreasing in T (60 ± 12) and TC (67 ± 13). The 48.9% of the patients with T and TC were admitted to the ICU compared to 8.1% of the patients with C, data related to age criteria. The median MS in the ICU decreased in the CT group at 7(±4) days compared to the T group (15 ± 3). There was no difference between the three therapies for general hospitalization MS (21 ± 5.5 to 23 ± 5.3). The 55.2% of the patients treated with T and 30% treated with CT had co-infection compared to 21.6% of the patients treated with C. Finally, a Kaplan-Meier analysis was performed, verifying a trend to have a longer survival in patients treated with T and CT, compared to C, although without statistical significance (χ2: 0.161) by sample size. Conclusions: CT appears to be more effective than T and C in patients with severe COVID-19 disease. These results support the limited literature;however, more powered studies will be required to evaluate these results.

Haematological alterations in hospitalized patients with COVID-19: Drugs involved in its aetiology

Objective: To explore the role of the drugs used to treat COVID-19 in the haematological alterations identified in patients hospitalized due to SARS-CoV-2 infection. Material and/or methods: Post-authorization observational study of 245 patients with confirmed SARS-CoV-2 (COVID-19) infection hospitalized and treated between March and April 2020 in five hospital centres in the Cantabria region. To be included in this study, complete information on the treatment used and periodic haematological examinations must be available. The data was taken from the COVID-19 Registry (NCT04347278). Results: One hundred forty-five of 245 patients (59.2%) presented haematological alterations during the acute process of infection. Leukopenia-lymphopenia appeared in 64% of the cases with alterations in the blood count and 42% presented thrombopenia. In 80% of the cases, this alteration resolved as soon as the clinical evolution of the patient improved. The following drugs were used to treat this infection: hydroxychloroquine (97.9%), lopinavir-ritonavir (82%), interferon beta-1b (7.7%), tocilizumab (20.4%) and anakinra (3,3%). The additional treatments used were enoxaparin (87.3%), methylprednisolone (23.6%), as well as antibiotics, antifungals and antivirals in patients with coinfections. A compatible temporal relationship was identified between the administration of tocilizumab and the appearance of leukopenia or worsening of pre-existing leukopenia in 40% of patients, with leukocyte recovery being observed 72 h after discontinuation of the drug. No temporal relationship was observed when other drugs were used. Regarding thrombopenia, the use of linezolid was causally involved in 8% of the patients, showing resolution in 60% of the cases when the drug was discontinued. Conclusions: Patients infected by COVID-19 can develop leukopenia-lymphopenia and thrombopenia in relation to infection by the virus itself. Tocilizumab in case of leukocyte involvement and linezolid in case of platelet decline have been shown to play a role in these haematological alterations.

Follow-up of hospitalized patients diagnosed with COVID-19 after recovery from the acute episode: COVID-19 registry (NCT04347278)

Objective: To assess the quality of life perceived by patients after recovery from COVID-19 in a period of time between 6 and 12 months after hospital discharge. Material and/or methods: Prospective observational study, IDI-REM-2020 code and EUPAS34551 registration, non-interventional, telephone survey from 6 months after discharge date. Health questionnaire consisted of 13 questions covering 8 dimensions (physical functioning, bodily pain, general health, vitality, social functioning and emotional role). Results: Out of 250 patients included and hospitalized in the first wave of the pandemic, from March to April 2020, 161 patients were surveyed. As for the data recorded: at the beginning of the questionnaire general health was fair or poor in 39.8% of respondents and in the rest there was no impact. Social activities had no impact in 39% of the respondents, and only 26.3% had appreciable impact. As for bodily pain, although it did not hinder the usual work in 83.6% of the respondents, in the rest it was a major limitation. Emotional problems affected daily activity in 29.4% of cases. After suffering COVID infection, 50.3% of the participants indicated that their health worsened while in 45.9% it remained the same or even improved in 3.1% of the participants. Conclusions: The quality of life questionnaire is essential to complete a clinical data registry and to understand whether COVID-19 infection is affecting health in the months following infection. In this cohort of patients, a negative impact on health was seen in half of the patients followed.

Spanish Oncology Nursing Society efforts during COVID-19 pandemic

Background: During the first wave of the SARS-CoV-2 Coronavirus pandemic in Spain, the care of cancer patients was altered in all aspects and in all phases of the cancer patients’ paths, especially in determined areas of population. Given the seriousness of the situation, specific actions were implemented from Spanish Society of Oncology Nursing on behalf of oncology nurses in Spain, with the aim of (a)minimizing the risk of contracting the coronavirus disease and (b) continuing to guarantee the best assistance as possible. Methods: Working and coordination meetings were established, and we planned different strategies and lines of action. This planning was carried out in an open and permanent way to be able to introduce changes and improvements with capacity to adapt in the face of uncertainty. We evolved all the team work into an uninterrupted chain of communication leading to the board, as well as the continuity of the work within the scientific society was ensured. Results: All the proposed actions were implemented successfully, through emails, with dissemination both through social networks and newsletters. a) Safe circuits were established for the care of cancer patients at the hospitals, limited number of companions, antigenic testing from early April. A telephone follow-up was implemented for both outpatient visits and information. b) Training actions: webinars on the correct use of a mask. Protective measures, hand washing. From the very beginning, early march 2020, we strongly recommended all cancer patients to wear a mask, c) Publications: Recommendations on infection and Positioning against health strategies in collaboration with other scientific and patient societies for adult and pediatric patients, and their families. Conclusions: It was possible to continue with adequate care and several actions to improve care have been promoted, although the greatest impact has been detected in new diagnoses (1 in 5 cancer patients have not been diagnosed or have been diagnosed late). The impact of the first wave has been controlled and mitigated, however, persistently, we will have a delay in the implementation of treatments. We estimate that a large part of the delays in the first diagnosis or in the implementation of treatments may be due to the pandemic situation. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Agile Computational Intelligence for Supporting Hospital Logistics During the COVID-19 Crisis

This chapter describes a case study regarding the use of ‘agile’ computational intelligence for supporting logistics in Barcelona’s hospitals during the COVID-19 crisis in 2020. Due to the lack of sanitary protection equipment, hundreds of volunteers, the so-called “Coronavirus Makers” community, used their home 3D printers to produce sanitary components, such as face covers and masks, which protect doctors, nurses, patients, and other civil servants from the virus. However, an important challenge arose: how to organize the daily collection of these items from individual homes, so they could be transported to the assembling centers and, later, distributed to the different hospitals in the area. For over one month, we have designed daily routing plans to pick up the maximum number of items in a limited time—thus reducing the drivers’ exposure to the virus. Since the problem characteristics were different each day, a series of computational intelligence algorithms was employed. Most of them included flexible heuristic-based approaches and biased-randomized algorithms, which were capable of generating, in a few minutes, feasible and high-quality solutions to quite complex and realistic optimization problems. This chapter describes the process of adapting several of our ‘heavy’ route-optimization algorithms from the scientific literature into ‘agile’ ones, which were able to cope with the dynamic daily conditions of real-life routing problems. Moreover, it also discusses some of the computational aspects of the employed algorithms along with several computational experiments and presents a series of best practices that we were able to learn during this intensive experience. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.