ABSTRACT
BACKGROUND: During the first wave of the COVID-19 pandemic various ambulatory health care models (SARS-CoV-2 contact points: Subspecialised Primary Care Practices, Fever Clinics, and Special Places for Corona-Testing) were organised in a short period in Baden-Wuerttemberg, a region in Southern Germany. The aim of these SARS-CoV-2 contact points was to ensure medical treatment for patients with (suspected) and without SARS-CoV-2 infection. The present study aimed to assess the beliefs and practices of primary care physicians who either led a Subspecialised Primary Care Practice or a Primary Care Practice providing care as usual in Baden-Wuerttemberg during the first wave of the COVID-19 pandemic. METHODS: This cross-sectional study was based on a paper-based questionnaire in primary care physicians during the first wave of the pandemic. Participants were identified via the web page of the Association of Statutory Health Insurance Physicians Baden-Wuerttemberg. The questionnaire was distributed in June and July 2020. It measured knowledge, practices, self-efficacy and fears towards SARS-CoV-2, using newly developed questions. Data was descriptively analysed. RESULTS: One hundred fifty-five participants (92 leads of SARS-CoV-2 contact points/ 63 leads of primary care practices) completed the questionnaire. Out of 92 leads of SARS-CoV-2 contact points 74 stated to lead n Subspecialised Primary Care Practices. About half participants of both groups did not fear an own infection with the novel virus (between 50.8% and 62.2%), however about 75% feared financial loss. Knowledge was gained using various sources; main sources were the Association of Statutory Health Insurance Physicians (between 82.5% and 83.8%) and the German Society for Hygiene and Microbiology (RKI) (between 88.9% and 95.9%). Leads of Subspecialised Primary Care Practice felt more confident to perform anamnestic/diagnostic procedures (p < 0.001). The same was found for the confidence level regarding decision-making concerning the further treatment (p < 0.001). Several prevention measures to contain the spread of SARS-CoV-2 were adopted. Subspecialised Primary Care Practice had treated on average more patients with (suspected) COVID-19 (mean 408.12) than primary care practices (mean 83.8) (p < 0.001). CONCLUSION: The results of this study suggest that the Subspecialised Primary Care Practice that were implemented during the first wave of the SARS-CoV-2 pandemic contributed containment of the pandemic. Leads of Subspecialised Primary Care Practice indicated that physical separation of patients with potential SARS-CoV-2 infection was easier compared to those who continued working in their own practice. Additionally, leads of Subspecialised Primary Care Practice felt more confident in dealing with patients with SARS-CoV-2 infection. TRIAL REGISTRATION: The study has been prospectively registered at the German Clinical Trial Register (DRKS00022224).
Subject(s)
COVID-19/epidemiology , Health Knowledge, Attitudes, Practice , Physicians, Primary Care/psychology , Adult , Attitude of Health Personnel , COVID-19/therapy , Cross-Sectional Studies , Delivery of Health Care/organization & administration , Female , Germany/epidemiology , Humans , Male , Medicine/organization & administration , Middle Aged , Physicians, Primary Care/statistics & numerical data , Surveys and QuestionnairesABSTRACT
The Covid-19 pandemic must serve as a wake-up call to work more collaboratively between medical and veterinary practitioners, biologists and environmentalists say Camilla Benfield, David Heymann, Judy MacArthur Clark, AJ Trees and Babulal Sethia.
Subject(s)
Communicable Disease Control/methods , One Health , Pandemics/prevention & control , Animals , COVID-19 , Cooperative Behavior , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Humans , Interprofessional Relations , Medicine/organization & administration , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , United Kingdom/epidemiology , Veterinary Medicine/organization & administrationSubject(s)
Coronavirus Infections/epidemiology , Medicine , Pandemics , Personnel Staffing and Scheduling , Physicians/supply & distribution , Pneumonia, Viral/epidemiology , COVID-19 , Coronavirus Infections/therapy , Humans , Medicine/organization & administration , Medicine/statistics & numerical data , Pneumonia, Viral/therapy , United Kingdom/epidemiologySubject(s)
Betacoronavirus , Coronavirus Infections , Hospital Planning/organization & administration , Intensive Care Units/organization & administration , Pandemics , Pneumonia, Viral , Anesthesiology/organization & administration , Bed Conversion , COVID-19 , Coronavirus Infections/epidemiology , Emergency Medical Service Communication Systems/organization & administration , Extracorporeal Membrane Oxygenation , France/epidemiology , Hospital Bed Capacity , Hospital Communication Systems/organization & administration , Hospitals, University/organization & administration , Hotlines , Humans , Intensive Care Units/supply & distribution , Medicine/organization & administration , Mobile Applications , Mobile Health Units/organization & administration , Patient Transfer/organization & administration , Pneumonia, Viral/epidemiology , SARS-CoV-2 , SoftwareABSTRACT
The COVID-19 pandemic has stretched health care resources to a point of crisis throughout the world. To answer the call for care, health care workers in a diverse range of specialties are being retasked to care for patients with COVID-19. Consequently, specialty services have had to adapt to decreased staff available for coverage coupled with a need to remain available for specialty-specific emergencies, which now require a dynamic definition. In this Invited Commentary, the authors describe their experiences and share lessons learned regarding triage of patients, staff safety, workforce management, and the psychological impact as they have adapted to a new reality in the Department of Neurosurgery at Montefiore Medical Center, a COVID-19 hot spot in New York City.