ABSTRACT
Background: The pandemic has presented professional and personal challenges for the MO workforce. CAMO sought to examine the temporal effects of C19 on MOs and care practices across Canada. Methods: Three serial multiple-choice, web-based surveys were conducted in 2020 – from Mar 30th to April 4th (S1), May 6th to May 15th (S2) and Dec 10th to 18th (S3). The surveys were distributed by email to MOs identified through CAMO and the Royal College of Physicians and Surgeons directory (n=618). Participation was voluntary with no compensation. Descriptive analyses with frequency distributions are reported. Results: The timing for S1 and S3 coincided with the 1st and 2nd C19 waves in Canada. Response rates decreased slightly: 26% S1, 25% S2 and 20% S3. Per table, demographics were similar across surveys: majority of respondents were from a comprehensive cancer centre and in practice for < 15 years. Concerns regarding PPE access and C19 personal risk decreased over time. A high rate of telemedicine was observed in S1 but this notably decreased by S3, despite the 2nd wave. A similar decreasing trend was observed in the proportion of altered chemotherapy plans due to C19. Similar levels of anxiety, depression, lack of focus and concerns for personal wellness were maintained over time. In S3, respondents noted delayed cancer diagnoses and oncologist burnout as the top 2 post-pandemic challenges, and 87% believed their workload would increase. [Formula presented] Conclusions: As the pandemic continues, positive trends can be observed in concerns around PPE access and C19 risk. A high level of telemedicine adoption was observed early in the pandemic but is decreasing, and chemotherapy plans remained unchanged for most patients. Concerns regarding personal wellness remained high across all 3 surveys. Proactive strategies to support physician wellness, mitigate burnout and manage MO workload are needed. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
ABSTRACT
This article provides estimates of the opioid-related fatal overdoses in Cook County in Illinois before, during, and after a stay-at-home order was lifted. During the 99-week period from 1 January, 2018, to 6 October, 2020, a total of 3,843 people died in Cook County due to opioid overdoses. The spike in deaths during the last 16 weeks of 2019 followed an increase of almost 10% in the previous 16 weeks. It is possible that the increase in opioid overdose deaths during the stay-at-home period was a continuation of the increases that occurred in the 16 weeks before the order was lifted. Although the mean deaths declined during the period after the order, they still remained elevated above pre-2020 levels. It might indicate a persistent upward trend in the number of overdose deaths reported by the Centers for Disease Control and Prevention (CDC). Since the outbreak of COVID-19, various outreach, treatment, recovery, and education initiatives have been implemented to prevent drug-related deaths.
ABSTRACT
BACKGROUND: Understanding how severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is spread within the hospital setting is essential in order to protect staff, implement effective infection control measures, and prevent nosocomial transmission. METHODS: The presence of SARS-CoV-2 in the air and on environmental surfaces around hospitalized patients, with and without respiratory symptoms, was investigated. Environmental sampling was undertaken within eight hospitals in England during the first wave of the coronavirus disease 2019 outbreak. Samples were analysed using reverse transcription polymerase chain reaction (PCR) and virus isolation assays. FINDINGS: SARS-CoV-2 RNA was detected on 30 (8.9%) of 336 environmental surfaces. Cycle threshold values ranged from 28.8 to 39.1, equating to 2.2 x 105 to 59 genomic copies/swab. Concomitant bacterial counts were low, suggesting that the cleaning performed by nursing and domestic staff across all eight hospitals was effective. SARS-CoV-2 RNA was detected in four of 55 air samples taken <1 m from four different patients. In all cases, the concentration of viral RNA was low and ranged from <10 to 460 genomic copies/m3 air. Infectious virus was not recovered from any of the PCR-positive samples analysed. CONCLUSIONS: Effective cleaning can reduce the risk of fomite (contact) transmission, but some surface types may facilitate the survival, persistence and/or dispersal of SARS-CoV-2. The presence of low or undetectable concentrations of viral RNA in the air supports current guidance on the use of specific personal protective equipment for aerosol-generating and non-aerosol-generating procedures.