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1.
J Korean Med Sci ; 36(42): e295, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1497009

ABSTRACT

BACKGROUND: To minimize nosocomial infection against coronavirus disease 2019 (COVID-19), most hospitals conduct a prescreening process to evaluate the patient or guardian of any symptoms suggestive of COVID-19 or exposure to a COVID-19 patient at entrances of hospital buildings. In our hospital, we have implemented a two-level prescreening process in the outpatient clinic: an initial prescreening process at the entrance of the outpatient clinic (PPEO) and a second prescreening process is repeated in each department. If any symptoms or epidemiological history are identified at the second level, an emergency code is announced through the hospital's address system. The patient is then guided outside through a designated aisle. In this study, we analyze the cases missed in the PPEO that caused the emergency code to be applied. METHODS: All cases reported from March 2020 to April 2021 were analyzed retrospectively. We calculated the incidence of cases missed by the PPEO per 1,000 outpatients and compared the incidence between first-time hospital visitors and those visiting for the second time or more; morning and afternoon office hours; and days of the week. RESULTS: During the study period, the emergency code was applied to 449 cases missed by the PPEO. Among those cases, 20.7% were reported in otorhinolaryngology, followed by 11.6% in gastroenterology, 5.8% in urology, and 5.8% in dermatology. Fever was the most common symptom (59.9%), followed by cough (19.8%). The incidence of cases per 1,000 outpatients was significantly higher among first-time visitors than among those visiting for the second time or more (1.77 [confidence interval (CI), 1.44-2.10] vs. 0.59 [CI, 0.52-0.65], respectively) (P < 0.001). CONCLUSION: Fever was the most common symptom missed by the PPEO, and otorhinolaryngology and gastroenterology most frequently reported missed cases. Cases missed by the PPEO were more likely to occur among first-time visitors than returning visitors. The results obtained from this study can provide insights or recommendations to other healthcare facilities in operating prescreening processes during the COVID-19 pandemic.


Subject(s)
Ambulatory Care Facilities/statistics & numerical data , COVID-19/diagnosis , COVID-19/prevention & control , Cough/etiology , Fever/etiology , Mass Screening/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Ambulatory Care , COVID-19/epidemiology , Child , Female , Humans , Incidence , Infection Control , Male , Mass Screening/organization & administration , Middle Aged , Pandemics , Young Adult
2.
J Infect Public Health ; 14(4): 454-460, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1056924

ABSTRACT

BACKGROUND: During the ongoing coronavirus disease (COVID-19) pandemic, hospitals have strengthened their guidelines on infection prevention and control (IPC), and a rigorous adherence to these guidelines is crucial. An infection control surveillance-working group (ICS-WG) and infection control coordinators (ICCs) team were created to monitor the IPC practices of the healthcare workers (HCWs) in a regional hospital in Korea. This study analyzed the surveillance results and aimed to identify what IPC practices needed improvement. METHODS: During phase 1 (March to April 2020), the ICS-WG performed random audits, recorded incidences of improper IPC practices, and provided advice to the violators. During phase 2 (April to July), the ICCs inspected the hospital units and proposed practical ideas about IPC. The surveillance and proposals targeted the following practices: patient screening, usage of personal protective equipment (PPE), hand and respiratory hygiene, equipment reprocessing, environmental cleaning, management of medical waste, and social distancing. RESULTS: In phase 1, of the 127 violations observed, most (32.3%) corresponded to hand and respiratory hygiene. In phase 2, the highest proportion of violation per category was observed in the management of medical waste (37.8%); among these, a higher proportion of violation (71.4%) was observed in the collection of medical waste. Of the 106 proposals made by the ICCs, the most addressed practice was patient screening (28.3%). No case of nosocomial infection was reported during the study period. CONCLUSION: Adherence to proper hand and respiratory hygiene was inadequate at the early stage of the COVID-19 pandemic. The results indicate that more attention and further training are needed for the management of medical waste, particularly medical waste collection, and that continuous upgrading of the strategies for patient screening is essential. These results will be useful in helping other healthcare facilities to establish their IPC strategies.


Subject(s)
COVID-19/prevention & control , Guideline Adherence/statistics & numerical data , Health Personnel , Infection Control , Clinical Audit , Hand Hygiene , Humans , Pandemics , Republic of Korea
3.
J Cardiovasc Imaging ; 29(1): 20-30, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1055187

ABSTRACT

Novel coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and it has become a pandemic problem. Cardiovascular diseases are common in COVID-19 patients, especially in severe forms of infection, and these are associated with higher mortality. SARS-CoV-2 infection can cause cardiovascular disease and worsen preexisting disease by direct invasion, hypoxia associated with pneumonia, and immunologic mechanisms. Because prompt detection and proper treatment can be critical to COVID-19 patients, echocardiographic examinations are essential diagnostic tools in the diagnosis and determination of treatment options. However, because there is an increased risk of infection during echocardiographic examinations, healthcare providers should pay attention to mitigate the risk of infection during the diagnosis and management of COVID-19 patients.

4.
Non-conventional | Homeland Security Digital Library, Grey literature | ID: grc-740472

ABSTRACT

From the Document: "The COVID-19 [coronavirus disease 2019] pandemic has had devastating health and economic effects nationwide. The economic shocks have been worse for renter households and households of color. For the past couple of months, unemployment insurance benefits and eviction moratoriums in the Coronavirus Aid, Relief, and Economic Security (CARES) Act have kept vulnerable renters in their homes. But these laws have either expired or will soon expire, and many renters face an increasing risk of displacement unless quick action is taken. In this brief, we propose an approach for identifying the hardest-hit places and people who need relief, and we create a method of targeting housing assistance to renters and homeowners in the hardest-hit states. We developed an index using available state data and suggest a race-conscious method of directing resources. Our index weights hard-hit renter households and renters of color who are experiencing disproportionate housing insecurity and greater financial damage but less government support amid the pandemic. The index also offers a state ranking for those most in need."

5.
PLoS One ; 15(8): e0237692, 2020.
Article in English | MEDLINE | ID: covidwho-717607

ABSTRACT

BACKGROUND: Our hospital experienced the first healthcare-associated COVID-19 outbreak in Seoul at the time the first COVID-19 cases were confirmed in Korea. The first confirmed COVID-19 patient was a hospital personnel who was in charge of transferring patients inside our hospital. To contain the virus spread, we shutdown our hospital, and tested all inpatients, medical staff members, and employees. METHODS: We retrospectively analyzed the results of SARS-CoV-2 RT-PCR testing according to the contact history, occupation, and presence of respiratory symptoms. Closed-circuit television (CCTV) was reviewed in the presence of an epidemiologist to identify individuals who came into contact with confirmed COVID-19 patients. RESULTS: A total of 3,091 respiratory samples from 2,924 individuals were obtained. Among 2,924 individuals, two inpatients, and one caregiver tested positive (positivity rate, 0.1%). Although all confirmed cases were linked to a general ward designated for pulmonology patients, no medical staff members, medical support personnel, or employees working at the same ward were infected. Contact with confirmed COVID-19 cases was frequent among inpatients and medical support personnel. The most common contact area was the general ward for pulmonology patients and medical support areas, including clinical and imaging examination rooms. Finally, the total number of hospital-associated infections was 14, consisting of four diagnosed at our hospital and ten diagnosed outside the hospital. CONCLUSIONS: The robust control of the COVID-19 outbreak further minimized the transmission of SARS-CoV-2 in the hospital and local communities. However, there was also a debate over the appropriate period of hospital shutdown and testing of all hospital staff and patients. Future studies are required to refine and establish the in-hospital quarantine and de-isolation guidelines based on the epidemiological and clinical settings.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Cross Infection/epidemiology , Cross Infection/prevention & control , Disease Transmission, Infectious/prevention & control , Hospitals, University , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Adult , Aged , Aged, 80 and over , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Cross Infection/virology , Female , Health Personnel , Humans , Male , Middle Aged , Patients' Rooms , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Quarantine/methods , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Seoul/epidemiology , Young Adult
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