ABSTRACT
Aim: To investigate the effects of rehabilitation (Rehab) added to usual care (UC) versus UC on symptoms, mental health and quality of life (QoL) outcomes post COVID-19. Method(s): A supervised Rehab program was offered to 55 post COVID-19 patients who were hospitalized with severe/critical COVID-19 pneumonia and a Copd Assesment Test (CAT) score >= 10, post hospital discharge (6-8 weeks). Twenty-eight patients accepted to enroll to Rehab, whereas 27 refused to participate (UC). All patients were evaluated at baseline and after 2 months. Result(s): Groups were not different in mean age (56 years), gender (53% ), ICU admission (65%), intubation (47%), days of hospitalization (31), number of symptoms (9), and number of comorbidities (1.4). The baseline evaluation was conducted at 82+/-30 days after symptoms onset. Only Rehab was associated with improvements in respiratory symptoms, dyspnea, fatigue, depression/anxiety, cognitive impairment, and QoL. (Table 1) Conclusion(s): Rehabilitation facilitates recovery of symptoms and QoL post COVID-19 that otherwise would remain incomplete with usual care.
ABSTRACT
Aim: To investigate the effects of rehabilitation (Rehab) added to usual care (UC) versus UC on functional capacity outcomes in patients with COVID-19 pneumonia. Method(s): A supervised Rehab program was offered to 55 post COVID patients who were hospitalized with severe/critical COVID-19 pneumonia and a COPD Assessment Test (CAT) score >= 10, post hospital discharge (6-8 weeks). Twenty-eight patients accepted to enroll to Rehab, whereas 27 refused to participate (UC). All patients were evaluated at baseline and after 2 months. Result(s): Groups were not different in mean age (56 years), gender (53% ), ICU admission (65%), intubation (47%), days of hospitalization (31), number of symptoms (9), and number of comorbidities (1.4). The baseline evaluation was conducted at 82+/-30 days after symptoms onset. Both Rehab and UC were associated with improvements in functional capacity;however, these were greater following Rehab (Table 1). Conclusion(s): Rehabilitation amplifies the functional recovery post COVID-19. (Figure Presented).
ABSTRACT
Purpose The coronavirus disease (COVID-19) pandemic has emerged as an unprecedented health crisis worldwide and heavily disrupted the healthcare supply chain. This study focuses on analysing the different types of disruptions occurring in personal protective equipment (PPE) supply chains during the COVID-19 pandemic and on proposing mitigation strategies that are fit to the global scale and many interdependencies that are characteristic for this pandemic. The authors construct a conceptual system dynamics model (SD) based on the literature and adjusted with the use of empirical data (interviews) to capture the complexity of a global supply chain and identify leverage points (mitigation strategies). Design/methodology/approach This research follows a mix-methods approach. First, the authors developed a conceptual framework based on four types of disruptions that usually occur during health emergencies (direct effect, policy, supply chain strategy, and behaviourally induced disruptions). Second, the authors collected and analysed data from interviews with experts in the PPE supply chain. Based on the interviews data, the authors developed a conceptual system dynamics (SD) model that allows to capture the complex and dynamic interplay between the elements of the global supply chain system, by highlighting key feedback loops, delays, and the way the mitigation strategies can impact on them. From this analysis, the authors developed four propositions for supply chain risk management (SCRM) in global health emergencies and four recommendations for the policy and decision makers. Findings The SD model highlights that without a combination of mitigation measures, it is impossible to overcome all disruptions. As such, a co-ordinated effort across the different countries and sectors that experience the disruptions is needed. The SD model also shows that there are important feedback loops, by which initial disruptions create delays and shortages that propagate through the supply chain network. If the co-ordinated mitigation measures are not implemented early at the onset of the pandemic, these disruptions will be persistent, creating potential shortages of PPE and other critical equipment at the onset of a pandemic - when they are most urgently needed. Originality/value This research enriches the understanding of the disruptions of PPE supply chains on the systems level and proposes mitigation strategies based on empirical data and the existing literature.
ABSTRACT
The coronavirus disease 2019 (COVID-19) outbreak affects not just populations but also global and local economies and supply chains. The outbreak itself has impacted on production lines and manufacturing capacities. In response to the outbreak, policies have been put in place that blocks the movement of people and materials, causing supply chain disruptions. Mainstream supply chain management has been at a loss in responding to these disruptions, mostly due to a dominant focus on minimizing costs for stable operations, while following lean, just-in-time, and zero-inventory approaches. On the other hand, pandemic response supply chains, and their related supply chain disruptions, share many characteristics with disaster response and thereby with humanitarian supply chains. Much can thus be learned from humanitarian supply chains for managing pandemic-related supply chain disruptions. What is more, facing, and managing, supply chain disruptions can be considered the new norm also in light of other disruptive forces such as climate change, or financial or political crises. This article therefore presents lessons learned from humanitarian supply chains that help mitigate and overcome supply chain disruptions. These lessons not only relate to preparedness and mobilization, but also relate to standardization, innovation, and collaboration. Together, they brace organizations, supply chains, and societies, to manage current and future disruptions. © 2020 The Authors. Journal of Supply Chain Management published by Wiley Periodicals LLC