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1.
Infect Control Hosp Epidemiol ; : 1-3, 2022 Jun 02.
Article in English | MEDLINE | ID: covidwho-20242632

ABSTRACT

After implementing a coronavirus disease 2019 (COVID-19) infection prevention bundle, the incidence rate ratio (IRR) of non-severe acute respiratory coronavirus virus 2 (non-SARS-CoV-2) hospital-acquired respiratory viral infection (HA-RVI) was significantly lower than the IRR from the pre-COVID-19 period (IRR, 0.322; 95% CI, 0.266-0.393; P < .01). However, HA-RVIs incidence rates mirrored community RVI trends, suggesting that hospital interventions alone did not significantly affect HA-RVI incidence.

2.
Am J Disaster Med ; 17(3): 261-268, 2022.
Article in English | MEDLINE | ID: covidwho-2315978

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has required healthcare systems to adapt, innovate, and collaborate to protect public health through treatment, testing, and vaccination initiatives related to the virus. As the pandemic evolved, lessons learned early on through testing and treatment were applied to vaccination efforts. Hartford HealthCare (HHC) is one of the largest healthcare systems in New England and took an integral role in vaccinating patients throughout the region, thus providing one of the largest vaccination campaigns in Connecticut. Early planning for equipment and personnel, in addition to effective communication between providers and patients, was critical in accomplishing HHC's goal of rapidly providing access to COVID-19 vaccines. The efficient and effective response to the pandemic at HHC was led by the Office of Emergency Management, which worked to ensure continuity of patient care and physician excellence in the face of disaster. Initially, resources were directed to testing and treatment of the disease; as vaccine clinical trials announced successful outcomes, these efforts shifted to preparing for the storage and distribution of a mass number of vaccines. This manuscript details the factors that enabled success in HHC's vaccination campaign and serves to provide a useful template for similar healthcare systems for future pandemic response.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Connecticut/epidemiology , Delivery of Health Care , Immunization Programs
3.
J Cancer Educ ; 2022 May 05.
Article in English | MEDLINE | ID: covidwho-2316501

ABSTRACT

Provision of online and remote specialist education and general continued professional education in medicine is a growing field. For radiology specifically, the ability to access web-based platforms that house high resolution medical images, and the high fidelity of simulated activities is increasingly growing due to positive changes in technology. This study investigates the differences in providing a self-directed specialist radiology education system in two modes: at clinics and in-person workshops. 335 Australian radiologists completed 562 readings of mammogram test sets through the web-based interactive BREAST platform with 325 at conference workshops and 237 at their workplaces. They engaged with test sets with each comprising of 60 mammogram cases (20 cancer and 40 normal). Radiologists marked the location of any cancers and had their performance measured via 5 metrics of diagnostic accuracy. Results show that the location of engagement with BREAST did not yield any significant difference in the performances of all radiologists and the same radiologists between two reading modes (P > 0.05). Radiologists who read screening mammograms for BreastScreen Australia performed better when they completed the test sets at designated workshops (P < 0.05), as was also the case for radiologists who read > 100 cases per week (P < 0.05). In contrast, radiologists who read less mammograms frequently recorded better performances in specificity and JAFROC at clinics (P < 0.05). Findings show that remotely accessed online education for specialised training and core skills building in radiology can provide a similar learning opportunity for breast radiologists when compared to on-site dedicated workshops at scientific meetings. For readers with high volumes of mammograms, a workshop setting may provide a superior experience while clinic setting is more helpful to less experienced readers.

4.
Infect Dis Health ; 28(2): 102-114, 2023 05.
Article in English | MEDLINE | ID: covidwho-2297212

ABSTRACT

BACKGROUND: Infection prevention and control (IPC) in the medical imaging (MI) setting is recognised as an important factor in providing high-quality patient care and safe working conditions. Surveys are commonly used and have advantages for IPC research. The aim of this study was to identify the core concepts in surveys published in the literature that examined IPC in MI environments. METHODS: A literature review was conducted to identify studies that employed a survey relating to IPC in the MI setting. For each included study, descriptive study information and survey information were extracted. For IPC-specific survey items, directed content analysis was undertaken, using eleven pre-determined codes based on the 'Australian Guidelines for the Prevention and Control of Infection in Healthcare'. Content that related to 'Knowledge', 'Attitudes' and 'Practice' were also identified. RESULTS: A total of 23 studies and 21 unique surveys were included in this review. IPC-specific survey items assessed diverse dimensions of IPC, most commonly relating to 'transmission-based precautions' and 'applying standard and transmission-based precautions during procedures'. 'Practice' and 'Knowledge' related survey items were most frequent, compared to 'Attitudes'. CONCLUSION: MI research using survey methods have focused on the 'entry' points of IPC, rather than systemic IPC matters around policy, education, and stewardship. The concepts of 'Knowledge', 'Attitudes' and 'Practice' are integrated in IPC surveys in the MI context, with a greater focus evident on staff knowledge and practice. Existing topics within IPC surveys in MI are tailored to individual studies and locales, with lack of consistency to national frameworks.


Subject(s)
Cross Infection , Humans , Cross Infection/prevention & control , Australia , Infection Control/methods , Health Facilities , Diagnostic Imaging
5.
Information Technology and Libraries (Online) ; 42(1):1-25, 2023.
Article in English | ProQuest Central | ID: covidwho-2269438

ABSTRACT

Libraries are adapting to the changing times by providing mobile services. One hundred fifty-one libraries were chosen based on circulation, with at least one library or library system from each state, to explore the diverse services provided to mobile users across the United States. According to the data, mobile apps, mobile reference services, mobile library catalogs, and mobile printing are among public libraries' most-frequently offered services, as determined by mobile visits, content analysis, and librarian survey responses. Every library examined had at least one mobile website, mobile catalog, mobile app, or webpage adapted for a mobile device. Following the COVID-19 outbreak, services such as mobile renewal, subscriber database access, mobile reservations, and the ability to interact with a librarian were expanded to allow better communication with customers-all from the comfort and safety of their own homes. Libraries are continually looking for innovative methods to assist their mobile customers as the world changes.

6.
Antimicrobial Stewardship and Healthcare Epidemiology ; 2(S1):s37-s38, 2022.
Article in English | ProQuest Central | ID: covidwho-2184953

ABSTRACT

Background: SARS-CoV-2 N95 mask contamination in healthcare providers (HCPs) treating patients with COVID-19 is poorly understood. Method: We performed a prospective observational study of HCP N95 respirator SARS-CoV-2 contamination during aerosol-generating procedures (AGPs) on SARS-CoV-2–positive patients housed in a COVID-19–specific unit at an academic medical center. Medical masks were used as surrogates for N95 respirators to avoid waste and were worn on top of HCP N95 respirators during study AGPs. Study masks were provided to HCPs while donning PPE and were retrieved during doffing. Additionally, during doffing, face shields were swabbed with Floq swabs premoistened with viral transport media (VTM) prior to disinfection. Medical masks were cut into 9 position-based pieces, placed in VTM, vortexed, and centrifuged (Fig. 1). RNA extraction and RT-PCR were completed on all samples. RT-PCR–positive samples underwent cell culture infection to detect cytopathic effects (CPE). Contamination was characterized by mask location and front and back of face shields. Patient COVID-19 symptoms were collected from routine clinical documentation. Study HCPs completed HCP-role–specific routine care (eg, assessing, administering medications, and maintaining oxygen supplementation) while in patient rooms and were observed by study team members. Results: We enrolled 31 HCPs between September and December 2021. HCP and patient characteristics are presented in Table 1. In total, 330 individual samples were obtained from 31 masks and 26 face shields among 12 patient rooms. Of the 330 samples, 0 samples were positive for SARS-CoV-2 via RT-PCR. Positive controls were successfully performed in the laboratory setting to confirm that the virus was recoverable using these methods. Notably, all samples were collected from HCPs caring for COVID-19 patients on high-flow, high-humidity Optiflow (AGP), with an average of 960 seconds (IQR, 525–1,680) spent in each room. In addition to Optiflow and routine care, study speech pathologists completed an additional AGP of fiberoptic endoscopic evaluation of swallowing. Notably, 29 (94%) of 31 study HCP had physical contact with their patient. Conclusions: Overall, mask contamination in HCPs treating patients with COVID-19 undergoing AGPs was not detectable while wearing face shields, despite patient contact and performing AGP.Funding: NoneDisclosures: None

7.
Pediatr Ann ; 51(12): e469-e473, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2155464

ABSTRACT

Vulnerable child syndrome (VCS) is a condition in which a caregiver perceives a child as inherently frail and consequently employs health care services disproportionate to medical need. Historically, VCS has been described after a medical event or diagnosis in developed countries. There is little to no literature on VCS outside of well-resourced countries. Cases from a medium-resource setting are presented to illustrate risks for development of VCS, including impaired feeding practices and the potential consequences of coronavirus disease 2019 (COVID-19). Exploring VCS through this different lens offers insights to providers working with immigrant populations on the United States mainland, including guidance on how to foster more resilience and less hypervigilance among their patients' parents. [Pediatr Ann. 2022;51(12):e469-e473.].


Subject(s)
COVID-19 , Child , Humans , COVID-19/epidemiology , Parents
8.
Infect Control Hosp Epidemiol ; 41(9): 1066-1067, 2020 09.
Article in English | MEDLINE | ID: covidwho-2096295

ABSTRACT

With concerns for presymptomatic transmission of COVID-19 and increasing burden of contact tracing and employee furloughs, several hospitals have supplemented pre-existing infection prevention measures with universal masking of all personnel in hospitals. Other hospitals are currently faced with the dilemma of whether or not to proceed with universal masking in a time of critical mask shortages. We summarize the rationale behind a universal masking policy in healthcare settings, important considerations before implementing such a policy and the challenges with universal masking. We also discusses proposed solutions such as universal face shields.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral , COVID-19 , Humans , Prospective Studies , SARS-CoV-2 , Stem Cell Transplantation
9.
J Med Radiat Sci ; 69(3): 279-281, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1935698

ABSTRACT

Our article comments on the enduring impact of COVID-19 in medical imaging. The emotional impact on COVID-19 is well reported in articles published at JMRS. This editorial covers the qualitative and quantitative structured templates now used for the reporting of chest x-rays on COVID-19.


Subject(s)
COVID-19 , COVID-19/diagnostic imaging , Humans , Radiography , Tomography, X-Ray Computed/methods
10.
Emerg Infect Dis ; 28(7): 1527-1530, 2022 07.
Article in English | MEDLINE | ID: covidwho-1817900

ABSTRACT

Epidemiologic and genomic investigation of SARS-CoV-2 infections associated with 2 repatriation flights from India to Australia in April 2021 indicated that 4 passengers transmitted SARS-CoV-2 to >11 other passengers. Results suggest transmission despite mandatory mask use and predeparture testing. For subsequent flights, predeparture quarantine and expanded predeparture testing were implemented.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , Genome, Viral , Genomics , Humans , Quarantine , SARS-CoV-2/genetics
11.
Infect Control Hosp Epidemiol ; : 1-4, 2021 Aug 02.
Article in English | MEDLINE | ID: covidwho-1751600

ABSTRACT

We performed surveillance for hospital-acquired COVID-19 (HA-COVID-19) and compared time-based, electronic definitions to real-time adjudication of the most likely source of acquisition. Without real-time adjudication, nearly 50% of HA-COVID-19 cases identified using electronic definitions were misclassified. Both electronic and traditional contact tracing methods likely underestimated the incidence of HA-COVID-19.

12.
Clin Infect Dis ; 75(1): e307-e309, 2022 08 24.
Article in English | MEDLINE | ID: covidwho-1746921

ABSTRACT

We assessed environmental contamination of inpatient rooms housing coronavirus disease 2019 (COVID-19) patients in a dedicated COVID-19 unit. Contamination with severe acute respiratory syndrome coronavirus 2 was found on 5.5% (19/347) of surfaces via reverse transcriptase polymerase chain reaction and 0.3% (1/347) of surfaces via cell culture. Environmental contamination is uncommon in hospitals rooms; RNA presence is not a specific indicator of infectious virus.


Subject(s)
COVID-19 , SARS-CoV-2 , Culture Techniques , Environmental Pollution/analysis , Hospitals , Humans , RNA, Viral
13.
BMJ Open ; 11(11): e050656, 2021 11 23.
Article in English | MEDLINE | ID: covidwho-1533046

ABSTRACT

OBJECTIVES: To estimate occupation risk from COVID-19 among teachers and others working in schools using publicly available data on mortality in England and Wales. DESIGN: Analysis of national death registration data from the Office for National Statistics. SETTING: England and Wales, 8 March-28 December 2020, during the COVID-19 pandemic. PARTICIPANTS: The total working age population in England and Wales plus those still working aged over 65 years. PRIMARY AND SECONDARY OUTCOMES: Death with COVID-19 as a primary outcome and death from all causes as a secondary outcome. RESULTS: Across occupational groups, there was a strong correlation between COVID-19 mortality and both non-COVID-19 and all-cause mortality. The absolute mortality rates for deaths with COVID-19 were low among those working in schools (from 10 per 100 000 in female primary school teachers to 39 per 100 000 male secondary school teachers) relative to many other occupations (range: 9-50 per 100 000 in women; 10-143 per 100 000 in men). There was weak evidence that secondary school teachers had slightly higher risks of dying with COVID-19 compared with the average for all working-aged people, but stronger evidence of a higher risk compared with the average for all professionals; primary school teachers had a lower risk. All-cause mortality was also higher among all teachers compared with all professionals. Teaching and lunchtime assistants were not at higher risk of death from COVID-19 compared with all working-aged people. CONCLUSION: There was weak evidence that COVID-19 mortality risk for secondary school teachers was above expectation, but in general school staff had COVID-19 mortality risks which were proportionate to their non-COVID-19 mortality risk.


Subject(s)
COVID-19 , Pandemics , Aged , Female , Humans , Male , Occupations , Routinely Collected Health Data , SARS-CoV-2 , Schools , Wales/epidemiology
14.
Br J Haematol ; 196(1): 79-94, 2022 01.
Article in English | MEDLINE | ID: covidwho-1402884

ABSTRACT

Coagulation dysfunction and thrombosis are major complications in patients with coronavirus disease 2019 (COVID-19). Patients on oral anticoagulants (OAC) prior to diagnosis of COVID-19 may therefore have better outcomes. In this multicentre observational study of 5 883 patients (≥18 years) admitted to 26 UK hospitals between 1 April 2020 and 31 July 2020, overall mortality was 29·2%. Incidences of thrombosis, major bleeding (MB) and multiorgan failure (MOF) were 5·4%, 1·7% and 3·3% respectively. The presence of thrombosis, MB, or MOF was associated with a 1·8, 4·5 or 5·9-fold increased risk of dying, respectively. Of the 5 883 patients studied, 83·6% (n = 4 920) were not on OAC and 16·4% (n = 963) were taking OAC at the time of admission. There was no difference in mortality between patients on OAC vs no OAC prior to admission when compared in an adjusted multivariate analysis [hazard ratio (HR) 1·05, 95% confidence interval (CI) 0·93-1·19; P = 0·15] or in an adjusted propensity score analysis (HR 0·92 95% CI 0·58-1·450; P = 0·18). In multivariate and adjusted propensity score analyses, the only significant association of no anticoagulation prior to diagnosis of COVID-19 was admission to the Intensive-Care Unit (ICU) (HR 1·98, 95% CI 1·37-2·85). Thrombosis, MB, and MOF were associated with higher mortality. Our results indicate that patients may have benefit from prior OAC use, especially reduced admission to ICU, without any increase in bleeding.


Subject(s)
Anticoagulants/therapeutic use , COVID-19/complications , Thrombosis/complications , Thrombosis/drug therapy , Administration, Oral , Adult , Aged , Aged, 80 and over , Anticoagulants/adverse effects , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , Female , Hemorrhage/chemically induced , Hospitalization , Humans , Intensive Care Units , Male , Middle Aged , SARS-CoV-2/isolation & purification , Severity of Illness Index , Thrombosis/epidemiology , United Kingdom/epidemiology
16.
Pediatr Allergy Immunol ; 32(8): 1756-1763, 2021 11.
Article in English | MEDLINE | ID: covidwho-1276762

ABSTRACT

BACKGROUND: Internationally, the COVID-19 pandemic severely curtailed access to hospital facilities for those awaiting elective/semi-elective procedures. For allergic children in Ireland, already waiting up to 4 years for an elective oral food challenge (OFC), the restrictions signified indefinite delay. At the time of the initiative, there were approx 900 children on the Children's Health Ireland (CHI) waiting list. In July 2020, a project was facilitated by short-term (6 weeks) access to an empty COVID stepdown facility built, in a hotel conference centre, commandeered by the Health Service Executive (HSE), Ireland. The aim of this study was to achieve the rapid roll-out of an offsite OFC service, delivering high throughput of long waiting patients, while aligning with existing hospital policies and quality standards, international allergy guidelines and national social distancing standards. METHODS: The working group engaged key stakeholders to rapidly develop an offsite OFC facility. Consultant paediatric allergists, consultant paediatricians, trainees and allergy clinical nurse specialists were seconded from other duties. The facility was already equipped with hospital beds, bedside monitors (BP, pulse and oxygen saturation) and bedside oxygen. All medication and supplies had to be brought from the base hospital. Daily onsite consultant anaesthetic cover was resourced and a resuscitation room equipped. Standardized food challenge protocols were created. Access to the onsite hotel chef facilitated food preparation. A risk register was established. RESULTS: After 6 weeks of planning, the remote centre became operational on 7/9/2020, with the capacity of 27 OFC/day. 474 challenges were commenced: 465 (98%) were completed and 9 (2%) were inconclusive. 135 (29%) OFCs were positive, with 25 (5%) causing anaphylaxis. No child required advanced airway intervention. 8 children were transferred to the base hospital. The CHI allergy waiting list was reduced by almost 60% in only 24 days. CONCLUSIONS: Oral food challenges remain a vital tool in the care of allergic children, with their cost saving and quality-of-life benefits negatively affected by a delay in their delivery. This project has shown it is possible to have huge impacts on a waiting list efficiently, effectively and safely with good planning and staff buy-in-even in a pandemic. Adoption of new, flexible and efficient models of service delivery will be important for healthcare delivery in the post-COVID-19 era.


Subject(s)
COVID-19 , Pandemics , Allergens , Allergists , Child , Humans , SARS-CoV-2
17.
Br J Haematol ; 195(1): 85-89, 2021 10.
Article in English | MEDLINE | ID: covidwho-1270821

ABSTRACT

The impact of COVID-19 infection on pregnant women remains relatively unknown but the physiological changes of pregnancy and hypercoagulability of COVID-19 may further increase thrombotic risk. In this retrospective multicentre observational study, we report clinical characteristics and outcomes in 36 pregnant women requiring hospitalisation for COVID-19 compared to a propensity-matched cohort of non-pregnant women. Pregnant women had a lower haemoglobin and higher lymphocyte counts but no differences in other haematological or biochemical parameters on admission compared to non-pregnant women. There was no significant difference in the duration of hospitalisation; median two days (1-77) for pregnant versus eight days (1-49) for non-pregnant women. A higher proportion of non-pregnant women required mechanical ventilation [11/36 (31%) vs 3/36 (8%), P = 0·03] and received thromboprophylaxis with low-molecular-weight heparin (LMWH) within 24 h of admission [25/36 (69%) vs 15 /36(42%), P = 0·03] compared to pregnant women. One pregnant woman required extracorporeal membrane oxygenation. The rate of thrombosis was similar in both groups (one in each group). No women developed major bleeding or died. Data suggest that although non-pregnant women had a severe clinical course, overall outcomes were not different between women with or without pregnancy. The use of thromboprophylaxis was inconsistent, demonstrating a need for establishing evidence-based guidance for COVID-19 during pregnancy.


Subject(s)
COVID-19/blood , Thrombosis/drug therapy , Adult , Female , Hospitalization , Humans , Middle Aged , Pregnancy , Pregnant Women , Retrospective Studies , United Kingdom , Young Adult
18.
BMJ Neurol Open ; 3(1): e000140, 2021.
Article in English | MEDLINE | ID: covidwho-1160595

ABSTRACT

INTRODUCTION: This short article summarises findings about reduced physical activity of adults with progressive muscle disease as a result of COVID-19 lockdown. METHODS: As part of an ongoing longitudinal cohort study, we prospectively and objectively measured physical activity using accelerometry at baseline in 2019 and follow-up in 2020. A subset of 85 participants incidentally had follow-up data collected during the first UK COVID-19 lockdown from 23 March to 4 July 2020. Thus, for this cohort we had activity data from before and during the COVID-19 pandemic and we were able to prospectively and accurately quantify the changes in their physical activity. RESULTS: Our data highlighted reduced overall activity intensity and reduced light activity time in particular. CONCLUSIONS: From our findings, we can infer specific evidence-based recommendations about how to redress inactivity secondary to COVID-19 restrictions for adults with progressive muscle diseases. These recommendations are likely to be generalisable to other groups who are vulnerable to functional decline secondary to prolonged inactivity.

19.
Infect Control Hosp Epidemiol ; 42(3): 341-343, 2021 03.
Article in English | MEDLINE | ID: covidwho-1131954

ABSTRACT

We implemented universal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing of patients undergoing surgical procedures as a means to conserve personal protective equipment (PPE). The rate of asymptomatic coronavirus disease 2019 (COVID-19) was <0.5%, which suggests that early local public health interventions were successful. Although our protocol was resource intensive, it prevented exposures to healthcare team members.


Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19/epidemiology , Preoperative Care/methods , Surgical Procedures, Operative/statistics & numerical data , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , North Carolina/epidemiology , Personal Protective Equipment/supply & distribution
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