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1.
Critical Care Medicine ; 51(1 Supplement):190, 2023.
Article in English | EMBASE | ID: covidwho-2190533

ABSTRACT

INTRODUCTION: The current CDC guidelines recommend COVID-19 vaccine boosters for all eligible individuals to enhance protection. Resources have been allocated to research done regarding the COVID-19 vaccine, and we speculate that there is a correlation between COVID booster rates and number of COVID patients in the ICU. We hypothesize that the states with a higher percentage of the population that received the booster shot will have decreased COVID ICU bed utilization and vice versa. METHOD(S): The percentage of people who received the COVID-19 booster vaccine and the number of ICU beds occupied by patients with COVID-19 per 10,000 population, both stratified by states, were reviewed to determine the pattern of correlation. The data for both the variables was sourced from Becker's Healthcare as it used information from the CDC's data tracker to rank states by their booster rates. The rankings were last updated based on data from July 20th, 2022. The state of Idaho was excluded because the data was not available. Limitations of the study included reporting lags between the states and CDC, the emergence of numerous variants of the virus, and a lack of a standardized timeline across the states. RESULT(S): Pearson Correlation Coefficient was used to determine the pattern of correlation between COVID booster rates and the number of COVID patients in the ICU for all US states. Booster rates was set as x and ICU patients was set as y. The data was analyzed while using the formula r = SIGMA((X - My)(Y - Mx)) / ((SSx)(SSy)). X Values were calculated with SIGMA = 2407.7, Mean = 48.154 and SIGMA(X - Mx)2 = SSx = 2308.544. Y Values were calculated with SIGMA = 5112, Mean = 102.24 and SIGMA(Y - My)2 = SSy = 835103.12. The coefficient of determination, R2, was 0.0611. Our obtained R was -0.25 which means no strong correlation was found. The data was analyzed independently by two statisticians and the same results were obtained. The results failed to confirm our hypothesis and suggested that there was no correlation between COVID booster rates and the number of COVID patients in the ICU. CONCLUSION(S): Based on our results, no correlation was found between the states' COVID booster rates and ICU bed occupancy. Further studies are needed to quantify this association if any as highly virulent COVID strains pose a threat to humanity.

2.
Critical Care Medicine ; 51(1 Supplement):181, 2023.
Article in English | EMBASE | ID: covidwho-2190525

ABSTRACT

INTRODUCTION: As of July 26th, 2022, 3,591 confirmed cases of Monkeypox have been reported in the United States (US). Globally, the number of cases exceeded 17,000. As a result, the World Health Organization (WHO) declared this outbreak a global health emergency. The Center for Disease Control (CDC) is currently working with states and local health officials to track the spread of the virus, monitor the health of infected individuals, and control the outbreak. We hypothesized that global travel may be a factor that facilitated the spread of monkeypox. METHOD(S): To test our hypothesis, we used the CDC data for the number of monkeypox cases in each state in the US. In addition, we obtained the U.S. Department of Transportation Bureau of Transportation Statistics for the busiest airports in the US (last updated - 2021). We compared the statereported Monkeypox cases to the volume of international travelers at the airports. We included 26 states in our analysis as data for both the variables, i.e. Monkeypox cases and busiest airports statistics were accessible. RESULT(S): As these data variables are not normally distributed, and outliers were expected, we used Spearman's Rho Calculator instead of the Pearson Correlation Coefficient. In addition, the scale of measurement was in the form of matched pairs, and the association was monotonic, Spearman's Rho Calculator was found to be more appropriate. Rs value was 0.63786 with two-tailed p-value= 0.00034 (statistically significant). The data was analyzed independently by two statisticians and the same results were obtained. Our study was limited by various factors including nascent and scant data on the recent global outbreak, variability of population diversity in states with busy international airports, and possible underreporting due to social stigma associated with the disease. CONCLUSION(S): Relaxed COVID masking guidelines along with arecent surge in air travel, may have played a role in the spread of monkeypox. Healthcare systems in highly populated states, particularly with busy international airports should stay vigilant and prepare themselves for the management of high volumes of cases.

3.
Chest ; 162(4):A1485-A1486, 2022.
Article in English | EMBASE | ID: covidwho-2060829

ABSTRACT

SESSION TITLE: Actionable Improvements in Safety and Quality SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/17/2022 12:15 pm - 1:15 pm PURPOSE: The overall mortality rate for patients ‘transfered’ to the medical intensive care units is thought to be significantly higher than the mortality rate amongst those admitted directly. (1) It has also been suggested that uninsured critically ill patients have a higher probability of being ‘transferred’ to other hospitals as well as a higher mortality rate. (2, 3) We aim to determine whether insurance coverage impacts the transfer of critically ill patients. METHODS: This study was conducted at a quaternary care hospital which is also a regional transfer center. We accessed the public data for the year 2020 through our institutions Transfer Center Dashboard, System Analytics. The two aspects of transferred patients we focused upon were: 1) Hospital service (subspecialty care required) and 2) Financial class. Major subspecialties included in the study were: Pulmonology, Internal Medicine, Neurosurgery, Cardiology, and Neurology. Our study was a patient safety project, hence it qualified for IRB exemption. We classified the percentage of transfers as ‘Accepted’, ‘Declined’, or ‘Canceled’;and determined the insurance status of the patient. RESULTS: We found a total of 3552 patients transfers were initiated. 31.9% (1136) transfer patients were accepted, 46.79% (1662) transfers were declined, and 21.23% (754) were canceled due to reasons including unsafe transfer, acceptance at other institutions, or death prior to transfer. Major categories for transfers were Pulmonology (16.1%), other Internal Medicine related diseases (15.3%), and Neurosurgery (11.8%) were the subspecialties with the highest rate of transfers. In terms of financial class, we determined that 44.81% (n=509) of the ICU transfers had no insurance, 27.81% (n=316) had Medicare support, and 17.81% (n=202) had managed care through a health maintenance organization (HMO);the remaining 9.59% had other insurance plans. We used a binomial test to determine the probability of a transfer under no insurance (p) with the formula p + q=1, across the total number of transfer requests (n). K was the number of actual transfers that occurred. Total transfer requests were n=3552, actual transfers were k=1136 and transfers without insurance were 509/44.8%, converted into p=0.45 with a resulting q of 0.55.For z-test, we used the formula z = ((K - np) +- 0.5) / √npq = 15.58. Our one-tailed probability of exactly, or fewer than, 1136(K) out of 3552(n) was p <.000001. Our study was limited because of the COVID-19 pandemic occurring in the same year. CONCLUSIONS: Based on our results, we conclude that the ‘uninsured’ patients are more susceptible to getting transferred to other institutions. CLINICAL IMPLICATIONS: Critically ill ‘uninsured’ patients are selctively subjected to be transfered to other hospitals for higher level of care. These transfers may have significant health implications thereby resulting in higher morbidity and mortality in unisured populations. DISCLOSURES: No relevant relationships by Joodi Akhtar No relevant relationships by Sahar Fatima Advisory Committee Member relationship with Astra Zeneca Please note: 24 months Added 03/16/2022 by FAISAL MASUD, value=Honoraria Advisory Committee Member relationship with Teleflex Please note: 12 months Added 03/16/2022 by FAISAL MASUD, value=Consulting fee Advisory Committee Member relationship with La Jolla Please note: 12 months Added 03/16/2022 by FAISAL MASUD, value=Consulting fee No relevant relationships by Iqbal Ratnani No relevant relationships by Salim Surani No relevant relationships by Anza Zahid

4.
Chest ; 162(4):A1458, 2022.
Article in English | EMBASE | ID: covidwho-2060819

ABSTRACT

SESSION TITLE: Quality Improvement SESSION TYPE: Original Investigations PRESENTED ON: 10/17/22 1:30 pm - 2:30 pm PURPOSE: Organ transplant is the ultimate necessity in managing many end-stage organ pathologies. As per the health resource and service administration, 17 people die every day while waiting for an organ transplant. In the year 2020, 169 million Americans registered as organ donors, but due to the limitations of organ donation such as cause of death and condition of the organ at the time of death, only about 3 in 1000 people die in such a way that their organs are in an optimum condition for transplantation 1. The role of nurses in organ donation is critical in both acute and critical care settings 2. Educating nurses on certain aspects of organ donation, such as approaching the families and counseling regarding moral and legal considerations, will acclererate the process of organs retrieval from the interested donors. We hypothesized that in addition to Best Practice Alert (BPA) on Electronic Medical Record (EMR), educating nurses can optimize organ donation by timely referring the organs for transplantation. METHODS: ICU-wide nursing education sessions were conducted elucidating that when a ventilated patient qualifies for Life Gift notification and a BPA does not pop up in EMR, Nurses should immediately call the Houston Methodist organ donation service, Life Gift within one hour of the following two triggers: 1) Loss of one or more brainstem reflex(es), 2) Glasgow Coma Scale (GCS) ≤ 5. Nurses were also educated to start a timely discussion with the family proposing Life Gift prior to discussing the withdrawal of life-sustaining treatments, popularly known as terminal extubation. The data for timely organ referral from the preceding six months (January 2021 to June 2021) was compared to the four months (July 2021 to October 2021) following the nursing education sessions. RESULTS: The total number of timely referrals in the pre- and post-education period were n=23/33 Vs. n=29/31. The overall timely referral of the organ for transplantation increased from 69.2% to 95%. Out of four months post-education, two months record the compliance of 100%. Our chi-square statistic was 5.969 with a p-value of 0.01456. We performed Yates continuity correction due to small sample size and to compensate for deviations from the theoretical (smooth) probability distribution. Our chi-square statistic with Yates correction was 4.506, and the p-value was 0.034 (Significant at p < 0.05). Our study was limited by the small sample size, high nursing turnover due to the COVID-19 pandemic, and logistic restrictions due to the pandemic. CONCLUSIONS: The overall referring time for organs improved after nursing education sessions, including targeted triggers. CLINICAL IMPLICATIONS: Nursing education plays a crucial role in organ donation programs. Further studies are needed to better understand the issues that nurses face and develop new strategies that can be implemented to improve the organ and tissue referrals for organ donation. DISCLOSURES: No relevant relationships by Muhammad Mohsin Abid No relevant relationships by Sana Jogezai No relevant relationships by Iqbal Ratnani No relevant relationships by Salim Surani No relevant relationships by Muhammad Hassan Virk

5.
Chest ; 162(4):A1454, 2022.
Article in English | EMBASE | ID: covidwho-2060818

ABSTRACT

SESSION TITLE: Use of Machine Learning and Artificial Intelligence SESSION TYPE: Original Investigations PRESENTED ON: 10/16/22 10:30 am - 11:30 am PURPOSE: The COVID-19 pandemic has significantly impacted the US healthcare system. Between March 1, 2020, and January 2, 2021, a 22.9% increase in all-cause mortality was reported [1]. We used Artificial Intelligence (AI) for data analysis to have a prototype national average by matching various characteristics. This is a novel approach known as Digital Twinning Method (DTM). We intend to compare non-COVID mortality between 2020 and 2019 using this DTM approach. METHODS: Data was collected by a contracted vendor that provided analysis utilizing an AI framework. Mortality rates were calculated at four points of care categorized as 1) In-patient mortality, 2) 30-day on-admission, 3) 30-day on discharge, and 4) 90-day on-admission. Baseline risk predictions were generated using DTM for matching patient demographics such as age, gender, race, Medicare status, and community-dwelling status. Hence, each person was compared to a "twin” with the same risk of hospitalization, death, acute myocardial infarction, or stroke. RESULTS: Our institution had a higher actual non-COVID mortality in 2020 compared to the actual mortality in 2019 across all four points of care studied. The highest increase was noticed in the 90-day on-admission category (9.7% in 2019 vs 12.6% in 2020) followed by 30-day on-admission (5.0% in 2019, to 6.6% in 2020), 30-day on-discharge (4.2% in 2019, to 5.7% in 2020), and in-patient mortality (1.8% in 2019, to 2.6% in 2020). However, when compared to twinned patients at other hospitals, our institution had a lower non-COVID mortality rate across all categories in 2019 and 2020. We utilized the Sign Test to evaluate our repeated-paired-measures for the above four points of care categories during two different conditions, i.e., under a normal healthcare situation (2019) and in the pandemic year (2020). Our two-tailed p-value was 0.0455 with statistical significance at p < 0.05, with M1-M2 (M=measure) difference of -0.8 (in-patient mortality), -1.6 (30 day on-admission), -1.5 (30 day on-discharge), and -2.9 (90 day on-admission) for the four categories. Our z-score was +2 under the formula z = (X - pn) / √npq, signifying positive deviation from the mean. Our study was limited by the unavailable data of patients who may have had COVID but were undiagnosed. CONCLUSIONS: AI is a novel method to obtain reliable data. Based on our results, we conclude that the non-COVID mortality rate at our institution increased during the pandemic. Further studies are needed to specify the underlying causes attributable to the increased mortality. CLINICAL IMPLICATIONS: By leveraging Artificial intelligence in healthcare to analyze big datasets and perform complex analyses, it may be of clinical importance to utilize AI-generated risk prediction models to accurately identify variables that can be controlled in future pandemics to decrease mortality while increasing overall efficiency of the healthcare system. DISCLOSURES: No relevant relationships by Muhammad Mohsin Abid No relevant relationships by Sana Jogezai No relevant relationships by Iqbal Ratnani No relevant relationships by Muhammad Hassan Virk No relevant relationships by Anza Zahid

6.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927738

ABSTRACT

Background - Among all the specialties, Critical Care Medicine physicians have reported the highest rate of burnout in the year 2021[Medscape National Physician Burnout & Suicide Report 2021]. Likewise, all Intensive Care Unit (ICU) staff such as nurses, respiratory therapists and patient care assistants as frontline workers have been experiencing stress during g the past 18 months of the COVID-19 pandemic. Here we present an initiative of Center for Performing Arts (CPAM) department at a tertiary care academic medical center to help reduce fatigue and burnout among ICU staff through splatter painting. Methods - This study was conducted in a 36-bed Cardiovascular ICU at a tertiary care hospital. Permission was obtained from the relative departments for the use of data. CPAM planned a 3-day splatter tent event in the ICU. This event was mainly for the ICU staff but was open to all the hospital staff. The event was advertised using colorful flyers. Each participant was led to a quiet room where they would drape, pick their favorite music selection, and color prop. Participants were then left alone to unwind and release all the feels in the form of creating art and could stay as long as they wanted. Pre- and post-completion surveys were recorded and, data was analyzed. Results - A total of 49 staff participated. 32 out of 49 participants returned their surveys. Overwhelmingly majority of the comments were positive. The most popular music genre was rap/hip hop. Average stress levels 1(low) to 5(high) were 4.19 - before to 2.56 - after. The average score (1-least) to 5-most) for if the intervention helped with compassion fatigue (F) and mental exhaustion (ME) was 4.22 and 4.44 respectively. The average score for if the intervention helped them feel more engaged at work (EW) and instilled positive attitude (PA) towards organization was 4.34 and 4.77 respectively. We did Pearson's correlation for the four components of the activity i.e., F, ME, EW and PA. Our R was strongly positive with value of 0.9913, using formula r = Σ((X - My)(Y - Mx)) / √((SSx)(SSy)). We also cross checked meta-numerics. Our value of R2 (the coefficient of determination) was 0.9827. Our P-Value was .001199, with significance at p < .05. Conclusions - The level of burnout amongst healthcare workers is at a critical level globally. Healthcare administrations need to find ways to mitigate feelings of burnout and fatigue amongst staff. (Figure Presented).

7.
Open Respiratory Medicine Journal ; 16(1), 2022.
Article in English | EMBASE | ID: covidwho-1779849

ABSTRACT

The emergence of SARS-CoV-2 in late December 2019 has taken the world by storm. In March 2020, the World Health Organization (WHO) named this virus COVID-19. To date, it has infected approximately 186 million people worldwide and is attributed as the cause of death of more than 5 million people (and this number is only increasing.) The global effort to develop vaccines and therapeutics occurred at the fastest pace yet, with several vaccines' approval under emergency authorization use. There are also several post-marketing side effects, including myocarditis, cerebral venous embolism, and Guillain Barre Syndrome. Global vaccine disparity complicates the control of pandemic challenges. Several highly infectious variants have emerged, and more variants are feared to emerge if global vaccination plans are not developed soon.

8.
Chest ; 160(4):A1278, 2021.
Article in English | EMBASE | ID: covidwho-1466142

ABSTRACT

TOPIC: Disaster Medicine TYPE: Original Investigations PURPOSE: Healthcare crisis presents an opportunity to harvest extensive learning around optimizing the real-time support for physical, cognitive, and organizational work of healthcare staff in a rapidly transforming work setting. We aim to inform the 'service reset' program of healthcare services at Northern Health and Social Care Trust (NHSCT) in Northern Ireland during the Covid-19 crisis. METHODS: We retrospectively applied the systems engineering initiative for patient safety (SEIPS) model in-situ at the Intensive Care Unit (ICU) of the Antrim Area Hospital-NHSCT. A quality improvement and human factors professional during June 2020 shadowed and interviewed the ICU staff one-to-one, gathering qualitative data using the SEIPS model. The findings were analyzed using the human factors and ergonomics (HFE) approach to identify successful interventions during the Covid-19 healthcare crisis. RESULTS: HFE adaptations enabled the ICU to consistently run at 200% of its funded capacity during the healthcare crisis due to the Covid-19 surge. We found that HFE analysis learnings for efficient and safe day-to-day healthcare operations during the crisis were focused on five major domain elements of the SEIPS model work system, 1) person via upskilling through a buddy system by matching redeployed staff with experienced staff, medical simulations, and just-in-time training;staff motivation when seeing Covid-19 patients recover and discharged;providing access to psychological services for staff well-being;2) organization via teamwork with a compassionate leadership approach and virtual communication platforms;management supervisory style of shared leadership in and across clinical teams promoting the non-silo working;organizational quality improvement culture facilitating staff empowerment in collective decision making;3) tools and technologies by providing access to technology through increased electronic health record workstations and virtual ICU visits to ease patient care;standardizing medical devices to enhance staff familiarity;4) tasks by reducing cognitive workload via staff role-specific action cards, and stickers for staff identification;creating new teams;enhanced job autonomy through Covid-19 specific medication preparation areas;5) environment by focusing on healthcare work environment layout and human-centered workstation design to support 'work as done' instead of 'work as imagined.' CONCLUSIONS: Application of the HFE based design to support the frontline staff performance during a large-scale healthcare crisis yields an effective and efficient crisis response. CLINICAL IMPLICATIONS: It is of great utility to consider human cognition and behavior as healthcare organizations redesign the services and operations during a crisis. Leaderships at high-stakes organizations should consider approaches to encourage and empower frontline staff for rapidly adaptive change during a healthcare crisis. DISCLOSURES: No relevant relationships by Muhammad Hasan Abid, source=Web Response No relevant relationships by Muhammad Mohsin Abid, source=Web Response No relevant relationships by Iqbal Ratnani, source=Web Response No relevant relationships by Gill Smith, source=Web Response

9.
American Journal of Respiratory and Critical Care Medicine ; 203(9):1, 2021.
Article in English | Web of Science | ID: covidwho-1407247
10.
Critical Care Medicine ; 49(1):43-43, 2021.
Article in English | Web of Science | ID: covidwho-1326443
11.
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277179

ABSTRACT

Introduction: Thoracic endometriosis syndrome (TES) is a rare phenomenon that affects 6-10% of women of reproductive age. It is characterized by presence of ectopic endometrial tissue within the thoracic cavity, mainly the lung parenchyma and pleura. TES presents as catamenial pneumothorax (CP), catamenial hemothorax (CH), pulmonary nodules or hemoptysis. Hormonal therapy is considered first line treatment followed by operative thoracoscopy for removal of ectopic endometrial implants. Our case highlights the limited number of treatment options in a young patient with recurrent catamenial disease.Description: A 37-year-old G4P0040 female presented to the emergency department (ED) with worsening shortness of breath (SOB) for 5 days. Her SOB was sudden in onset, progressively worsening, and associated with cough and right-sided chest pain. Patient was admitted 5 months ago for similar symptoms. She has a past medical history significant for hypertension, obesity, iron deficiency anemia, severe endometriosis and TES manifesting as recurrent, right sided pleural effusions, CPs and CHs requiring surgical treatment. Previous biopsies of the ectopic endometrial tissue revealed dense fibroconnective tissue with focal endometriosis and no indication for malignancy. In the ED, she appeared in distress and had a BP of 166/102. Physical examination revealed tachypnea, accessory muscle usage, respiratory distress and retractions. Breath sounds were decreased in the right lung. EKG revealed normal sinus rhythm, and a COVID-19 test yielded negative results. Chest x-ray and CT were consistent with findings for right tension hemothorax. She was started on BiPAP initially and thoracic surgery was consulted. A tube thoracostomy was performed in the ED and a chest tube was placed. Moreover, a CBC revealed Hb of 5.7g/dl. She was transfused 4 units pRBC and admitted to the ICU for further monitoring. Ob/gyn was consulted and leuprolide was administered to prevent recurrence of a hemothorax. She remained in the hospital for 3 days and was subsequently discharged after resolution of symptoms confirmed by imaging.Conclusion: Catamenial hemothoraces are a late finding of TES. There is mixed data regarding the effectiveness of GnRH agonists on recurrence rates of CH, however subsequent surgery has shown to be preventative in resistant cases. This unique case illustrates the insufficiency in both mainstay treatments. Despite the fact the patient had previous lobectomies using VATS, lysis of adhesions and hormonal therapy, she continued to have recurrent manifestations of TES. Novel treatments in conjunction with a multidisciplinary team approach should be used to effectively treat TES and prevent disease relapse.

12.
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277086

ABSTRACT

Introduction: COVID-19 changed normal routines across the world. During the beginning of the pandemic, everyone wanted to learn more about the virus. After 4 months, with death-tolls rising and isolation not being over anytime soon, psychological fatigue may have set in. To what degree has this psychological fatigue, with perspective of age groups along with the factor of personally knowing someone affected by COVID-19, impacted people's interest in the virus? Methods: We conducted an online survey using a Likert Scale from 1-5 to rate interest in hearing about COVID-19 related news when the pandemic started, around early March, and then to rate their interest in hearing about COVID-19 related news at the end of June. We divided respondents between two age groups, 25 and younger or older than 25, and whether or not they knew someone that has been affected by the virus. The survey was done online and was open to everyone who could access the survey online. Each participant answered the same two questions assessing their interest in March and then in June. Results: We received 410 survey responses which were divided into two groups according to age limit i.e., Younger Group (YG) with age ≤ 25 (n =133), and Older Group (OG) with age > 25 (n = 277). We found that both groups were interested (level 4/5 at a scale of 1-5) at the beginning of the pandemic (around the end of March) with a frequency of 65.4% (87/133) and 77.2% (214/277). In the span of 12 weeks, both groups' interest dropped drastically to 32.3% (43/133) and 41.5% (115/277) respectively with no statistically significant difference between the two groups when calculated with 2x2 Fischer exact test (P=0.7). When a variable of a loved one or an acquaintance known to have COVID-19 is applied, both groups behaved differently with a frequency of 26.2% (n= 20 vs 23 /87) and 41.1% (n= 27 vs 88/214) within the group with chi-square statistic of 7.8983, and p-value =.02 (significant at p < .05 with two-tailed analysis). Conclusions: Our results indicate fatigue from pandemic news all throughout our tested population. This fatigue persisted in the younger age group despite knowing someone with COVID-19, indicating either apathy or lack of awareness towards the pandemic. This needs to be further investigated as due to their asymptomatic carrier state accompanied by persistently low interest may result in a higher spread rate within the community.

13.
Critical Care Medicine ; 49(1 SUPPL 1):520, 2021.
Article in English | EMBASE | ID: covidwho-1194045

ABSTRACT

INTRODUCTION: 17 million cases & 0.6 million deaths are attributed to the novel Coronavirus disease (COVID 19). After decades of reluctance to implement pathogenreporting systems, the current pandemic has resulted in the formulation of comprehensive national reporting systems. We hypothesized that despite all efforts to improve reporting, fewer number of deaths are reported on weekends when compared to weekdays due to closure of health offices or lack of staffing on weekends, as reporting being highly dynamic. METHODS: Worldometer, a reliable database that reports real-time statistics on COVID-19 was used to retrieve the number of COVID-19 related deaths. We selected 9 worsthit countries from across the globe where reporting systems assumed to be robust. We observed the number of daily deaths over the course of 9 weeks, 4 weeks prior to their peak week, and 4 weeks afterwards. The average number of deaths/day on weekdays (WDs) and weekends (WEs) were recorded and compared. RESULTS: The WDs/WEs deaths/day for the USA, Sweden, Canada, Germany Spain, Italy, UK, Belgium and Netherlands were 1748/1142, 84/27, 150/113, 149/76, 445/386, 452/387, 594/441, 150/127 and 87/70. All countries showed data leaning towards fewer deaths on weekends. Data was first confirmed with the Kolmogorov-Smirnov Test of Normality. The test statistic (D) for Both Weekdays (WDs) and Weekends (WDs) was 0.27 & 0.26 with p values of 0.46 & 0.48 respectively, confirming that our data does not differ significantly from that which is normally distributed. T-value was calculated using the formula t = (M - μ)/SM. T-Test for two dependent means while comparing WDs and WEs deaths were significant at p < .05 (Two-tailed) for all countries except Canada and Spain. Our study was limited by data collection from a single-site though reliable, continuous updating of death counts by some countries, and limited number of countries though supposed to have proper reporting. CONCLUSIONS: Our review showed a statistically significant less number of deaths being reported on Weekends in all countries other than Spain and Canada, which may be due to the closure of administrative offices and the continuous mounting of high death counts. More research is warranted to quantify the extent of under-reporting of weekend deaths to effectively rectify the problem.

14.
Critical Care Medicine ; 49(1 SUPPL 1):43, 2021.
Article in English | EMBASE | ID: covidwho-1193805

ABSTRACT

INTRODUCTION: During COVID-19, the surges in cases can be attributed to the lack of safety precautions. Health officials highly recommend use of face masks as a form of protection to curb the spread of the virus. Younger people may have less tendency to wear masks but did this attitude change if they knew someone affected with COVID-19? METHODS: We send an e-survey in the community regarding how mask habits have changed between early months of COVID-19 and now. These participants answered dichotomous questions about wearing a mask outside during the beginning of the pandemic, wearing a mask outside now, and whether anyone they know had been affected by the virus. They were also grouped in age categories that were 25 and under or above 25. Referencing the participant's age and their acquaintance's exposure to COVID-19, we used this data to determine the change in prevalence of wearing masks throughout the studied time period. RESULTS: We received 310 responses. Responders were divided into 2 groups i.e., Younger Group (YG) ≤ 25 (n=123) and Older Group (OG) > 25 (n=187). At the start of the pandemic (around 1st week of March), the YG and OG start wearing masks with a frequency of 52% (64/123) and 63.1% (118/187). After 12 weeks, this frequency increased to 82.1% (101/123) and 95.1% (178/187) respectively. Although the trend appears higher in the older group, it was statistically not significant (p=0.8) when Fischer exact 2x2 test is applied due to sampling size < 1000. When a variable of a loved one or an acquaintance known to have COVID-19 is applied, both groups behaved differently with a frequency of 53.46% (n= 54 vs 47 /101) & 76.96% (n= 137 vs 41 /178). With χ2 contingency table further analyzing 8 subgroups with dependent of COVID-19 news exposure, the χ2 statistic was 45.47 with a p-value < 0.00001 (significant at p < .05 with two-tailed analysis). CONCLUSIONS: Masks were adopted largely across the population as the pandemic got worse. Younger group still stayed below older group. This behavior gets reinforced in older group but didn't affect the younger group with news of someone known to be COVID positive. This needs to be further investigated as due to their possible asymptomatic carrier state accompanied by low interest may result in a higher spread rate, with more burden on healthcare and ICUs.

15.
Chest ; 158(4):A314, 2020.
Article in English | EMBASE | ID: covidwho-866523

ABSTRACT

SESSION TITLE: Chest Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: The covid19 crisis has rapidly become the most significant public health crisis of our times. It has particularly impacted students due to cancellation of school and having to adjust to online learning and anxiety about their future, as well as prolonged social isolation. All these factors has likely led to significant stress and anxiety. The purpose of this study was to study the prevalence and severity of covid19 associated anxiety and stress in high school (HS) students and undergraduate (UG) college students in the US during the period of the Covid19 pandemic METHODS: We created a covid19 anxiety and stress survey (CASS) by combining 2 abbreviated instruments – the Perceived Stress Scale (PSS-4) and the Patient Health Questionnaire for Depression and Anxiety (PHQ-4). We distributed the CASS survery in electronic format during the month of March/April at the peak of the covid19 pandemic, both directly, as well as through use of social media to students in HS and UG. We also collected limited information about grade level, age, gender, ethnicity and location. RESULTS: A total of 116 (72Male;44 Female) students completed the questionnaire - Grade distribution was15 HS (Gr 9,10), 41 HS (Gr 11,12), 41 UG (Yr 1,2), & 19 UG (Yr 3,4). 56 (48.2%) had an elevated perceived stress level (PSS-4 of >8). 66 of students (56.9%) screened positive for a mood disorder depression/anxiety based on PSQ4 of >4. When we examined the subscales we found 43(37%) had anxiety (PSQ-2 for anxiety of >3) and 36 (31%) had depression (PSQ-2 for depression >3). Both HS and UG had similar levels of stress, but both overall PSQ4 as well as subscales for anxiety and depression was significantly more prevalent in college than in high school students (Mean total PSQ4 scores was 5.4 +/- 4 for UG vs 3.9 +/- 3.3 HS respectively) Strong gender influence in both PSS and PSQ was seen – mean PSS for girls and boys was 8.7 +/- 2.6 vs 7.2 +/- 2.8;p <0.05 and PSQ4 was 6.1 +/- 3.2 vs 4.2 +/- 3.8 respectively) There was a strong correlation between PSS and PSQ scores (r = 0.68) CONCLUSIONS: The Covid19 pandemic has resulted in an extremely high level of stress and mental health morbidity in both high school and especially college students. There is a high prevalence of depression and anxiety in students, and this is more pronounced in girls. CLINICAL IMPLICATIONS: Specific screening measures and interventions to improve mental health of students especially in college is urgently warranted with a particular focus on women, due to the covid19 pandemic. DISCLOSURES: No relevant relationships by Akshar Aiyer, source=Web Response No relevant relationships by Yashdeep Gill, source=Web Response No relevant relationships by Iqbal Ratnani, source=Web Response No relevant relationships by Shaleen Sunesara, source=Web Response No relevant relationships by Salim Surani, source=Web Response

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