Assessing efficacy of instructor based orientation to donning doffing protocols and modifications to doffing area infrastructure in reducing SARS-CoV-2 infection among Doctors assigned to COVID-19 patient care.

Background: We assess the efficacy of orientation programmes for doctors of proper donning, doffing techniques for personal protective equipment (PPE) and safe practices inside the COVID-19 hospital in reducing the COVID-19 infection rate among doctors. Methods: A total of 767 resident doctors and 197 faculty visits on weekly rotation were recorded over a six month period. Doctors were guided through orientation sessions before their entry into the COVID-19 hospital from 1 August 2020. The infection rate among doctors was used to study the efficacy of the programme. McNemars Chi-square test was used to compare the infection rate in the two groups before and after orientation sessions were commenced. Discussion: A statistically significant reduction in SARS-CoV-2 infection was seen among resident doctors after orientation programmes and infrastructure modification (3% vs 7.4%, P=0.03). Twenty-eight of 32 (87.5%) doctors who tested positive developed asymptomatic to mild infection. The infection rate was 3.65% and 2.1% among residents and faculty respectively. There was no mortality recorded. Conclusion: Orientation programme for healthcare workers for PPE donning and doffing protocols with practical demonstration and trial of PPE usage can significantly reduce COVID-19 infection. Such sessions should be mandatory for all workers on deputation in designated area for Infectious Diseases and in pandemic situations.

Burnout syndrome (BOS) among resident doctors in an Egyptian tertiary care university hospital: Prevalence and determinants during the COVID-19 pandemic.

OBJECTIVES: The current study aimed to detect the BOS prevalence and determinants among residents working during the second wave of the COVID-19 pandemic in an Egyptian tertiary university referral hospital. METHODS: A cross-sectional study evaluating the working period from June to November 2020 during the COVID-19 pandemic second wave, through a five sections questionnaire evaluating: 1 - sociodemographic characteristics, 2 - job characteristics, 3 - negative thoughts related to their job, 4 - resident's health problems, and 5 - evaluating BOS through Maslach Burnout Inventory (MBI) scale (including emotional exhaustion [EE], depersonalization [DP], and personal accomplishment [PA] as subscales). RESULTS: We included 230 residents with a median age of 27 years. The median MBI sub-scales (IQ Range) values were 30.0 (20, 39), 21.0 (15, 30), and 29.5 (22, 36) for EE, DP, and PA, respectively. About 51.0% and 83.0% of the residents were high in EE and DP, while 8.7% were low in PA. The median EE and DP were higher in younger age (⩽27 years; p = .002 and .024), males (p = .001 and <.001), working >90 hours weekly (p = .016 and <.001), exposure to harassment (p < .001), and having COVID-19 infection (p = .002 and .001). Residents working in surgical departments reported higher DP scores than those in non-surgical departments (p = .03). There was a mild positive correlation between working hours per week and the total scores in EE and DP, r = .24 (p < .001) and r = .23 (p = .001) respectively, while it was found to have a negative correlation with the PA (r = -.133 and p = .044). CONCLUSIONS: The BOS is evident and considerably high among the residents working during the COVID-19 pandemic. Younger age, males, working in surgical departments, and those who got COVID-19 infection were most vulnerable.

Mental Health and Wellbeing in Lithuanian Medical Students and Resident Doctors During COVID-19 Pandemic.

Background: The coronavirus disease 2019 (COVID-19) pandemic has had a negative effect on mental health and subjective psychological wellbeing. One of the most affected population is medical students, reporting higher levels of depression, anxiety, sleep difficulties, and overall poorer wellbeing. However, the relationship between depression, anxiety, and sleep difficulties, and subjective psychological wellbeing has not been extensively researched in medical students in the context of COVID-19 pandemic. The aim of this study was to investigate the associations between depression, anxiety, and sleep quality, and subjective psychological wellbeing. Methods: In total, 524 medical students and resident doctors (78.6% female, mean age 24 ± 3 years old) participated in an online survey between December 2020 and February 2021. Participants completed the WHO-Five Wellbeing Index Questionnaire, the Pittsburgh Sleep Quality Index questionnaire, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder Assessment-7. Results: Multivariable logistic regression analysis showed that female participants' worse subjective psychological wellbeing was associated with sleep difficulties [odds ratio (OR) = 2.39, 95% CI = 1.37-4.18, p = 0.002], higher depression (OR = 6.13, 95% CI = 3.46-10.88, p < 0.001), and anxiety symptoms (OR = 2.95, 95% CI = 1.66-5.22, p < 0.001). In male participants, analysis revealed an association between worse subjective psychological wellbeing and higher depression scores (OR = 9.94, 95% CI = 3.29-30.03, p < 0.001). Conclusion: Sex differences are an important factor to consider when evaluating subjective psychological wellbeing. Clinicians should be aware of significant contributors, such as sleep patterns anxiety, and depression, to subjective psychological wellbeing.

Predictive Factors of Covid-19 Infection in Resident Doctors at Specialized Isolation Center of Covid-19 Hospital

Introduction: The COVID-19 pandemic is a global emergency. Many changes have occurred in social and professional scenario, including medical education system, especially among resident doctors. Aim of this study is to investigate the predictive factors of COVID-19 infection in resident doctors at a specialized isolation center for COVID-19 hospital. Methods: This study used a cross-sectional study design with sampling method which was conducted from March 2020 to February 2021. A total of 287 out of the 434 resident doctors were included in the study. Competency level, period of work, working duration, place of assignment, level of PPE kit was compared with rRT-PCR result. Significant variables were entered, and logistic regression analysis was conducted to predict factors that can affect the infection. A p-values <0.05 was considered to be statistically significant. Results: Among the total participants, 164 (57.1%) had junior level competency;156 (54.4%) were assigned for more than 4 weeks;133 (46.3%) worked in isolation ward;277 (96.5%) used PPE level 3 and 30 (10.5%) had positive rRT-PCR result. Bivariate analysis showed that individuals working at laboratory (p=0.013), level of PPE (p=0.013), enrollment in certain months {(August (p=0.001), September (p=0.011), and November (p=0.005)} were related to a positive rRT-PCR result. Conclusion: There was an association between COVID-19 infection in resident doctors with level of PPE kit, place of assignment and enrollment in certain months (August and November 2020). © 2022 UPM Press. All rights reserved.

Assessment on risk and stress of resident doctors during the COVID-19 pandemic.

INTRODUCTION: It has been noted that post-traumatic stress disorder symptoms could be common in physicians who have experienced a traumatic event. The aim of this study was to determine the prevalence of post-traumatic stress disorder and contributing risk factors among resident doctors working in a tertiary care hospital during the COVID-19 pandemic. METHODOLOGY: A cross-sectional study was conducted via an online survey from May to July 2020. Sociodemographic characteristics, exposure to the coronavirus, application of personal hygiene rules, presence and use of personal protective equipment, anxiety and prevalence of post-traumatic stress disorder were investigated. RESULTS: In total, 17.8% (n = 40) of 225 resident doctors who participated in the study had post-traumatic stress disorder. Working at a department serving to COVID-19 patients increased the risk of post-traumatic stress disorder by 2.9 times (OR = 2.936, p = 0.003) while contacting positive patients increased this risk by 2.6 times (OR = 2.607, p = 0.023) and lack of personal protective equipment by 3.6 times (OR = 3.656, p = 0.018). Anxiety scores were statistically significantly higher in women, married and those living with their parents or spouses and children (p = 0.049; p = 0.011; p = 0.004, respectively). CONCLUSIONS: Working in a department serving to COVID-19 patients, contact with positive patients and lack of personal protective equipment were risk factors in the emergence of post-traumatic stress disorder in resident doctors. Anxiety was also found to be greater in women, married and those living with their families.

COVID-19 and healthcare-associated infections.

National Health Systems are facing a very serious health emergency related to COVID-19. In this phase of emergency, it is essential to ensure the care of all affected patients but also to ensure the economic stability of the National Health System. This stability is undermined by the potential exponential increase in claims caused by healthcare-associated infections related to COVID-19. That is why it will be essential to use all means necessary to prevent this economic crisis, which could overlap with the health crisis.

Field notes from the Nigeria Centre for Disease Control 2019 pilot internship program for resident doctors.

The 10-week internship for the pilot cohort of resident doctors from various teaching hospitals in Nigeria was a very rewarding experience. The internship was a beautiful immersion into field epidemiology, rumor surveillance, risk communication, digital tools for surveillance, developing strategic documents, line lists interpretation, weekly presentations and outbreak response coordination alongside working briefly as an incident manager for the Yellow Fever technical working group. Some of the learning points included: meeting coordination, contributions to ongoing research, review of training documents for surveillance officers and the mechanisms of escalating and de-escalating technical working groups in the face of outbreaks and working as an incident manager. There is the need to continue this internship to strengthen the capacity of our emerging health workforce in residency training to address our public health priorities in Nigeria.