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HERD ; 14(2): 38-48, 2021 04.
Article in English | MEDLINE | ID: covidwho-975844


OBJECTIVES, PURPOSES, OR AIM: To identify design strategies utilized in airborne infection isolation and biocontainment patient rooms that improve infection control potential in an alternative care environment. BACKGROUND: As SARS-CoV-2 spreads and health care facilities near or exceed capacity, facilities may implement alternative care sites (ACSs). With COVID-19 surges predicted, developing additional capacity in alternative facilities, including hotels and convention centers, into patient care environments requires early careful consideration of the existing space constraints, infrastructure, and modifications needed for patient care and infection control. Design-based strategies utilizing engineering solutions have the greatest impact, followed by medical and operational strategies. METHODS: This article evaluates infection control and environmental strategies in inpatient units and proposes system modifications to ACS surge facilities to reduce infection risk and improve care environments. RESULTS: Although adequate for an acute infectious disease outbreak, existing capacity in U.S. biocontainment units and airborne infection isolation rooms is not sufficient for widespread infection control and isolation during a pandemic. To improve patients' outcomes and decrease infection transmission risk in the alternative care facility, hospital planners, administrators, and clinicians can take cues from evidence-based strategies implemented in biocontainment units and standard inpatient rooms. CONCLUSIONS: Innovative technologies, including optimized air-handling systems with ultraviolet and particle filters, can be an essential part of an infection control strategy. For flexible surge capacity in future ACS and hospital projects, interdisciplinary design and management teams should apply strategies optimizing the treatment of both infectious patients and minimizing the risk to health care workers.

Built Environment/organization & administration , COVID-19/epidemiology , COVID-19/prevention & control , Infection Control/organization & administration , Patients' Rooms/organization & administration , Built Environment/standards , Humans , Infection Control/standards , Pandemics , Patient Isolation/standards , Patients' Rooms/standards , SARS-CoV-2 , Ventilation/standards
J Travel Med ; 28(2)2021 02 23.
Article in English | MEDLINE | ID: covidwho-745783


BACKGROUND: Low-wage dormitory-dwelling migrant workers in Singapore were disproportionately affected by coronavirus disease 2019 (COVID-19) infection. This was attributed to communal living in high-density and unhygienic dormitory settings and a lack of inclusive protection systems. However, little is known about the roles of social and geospatial networks in COVID-19 transmission. The study examined the networks of non-work-related activities among migrant workers to inform the development of lockdown exit strategies and future pandemic preparedness. METHODS: A population-based survey was conducted with 509 migrant workers across the nation, and it assessed dormitory attributes, social ties, physical and mental health status, COVID-19-related variables and mobility patterns using a grid-based network questionnaire. Mobility paths from dormitories were presented based on purposes of visit. Two-mode social networks examined the structures and positions of networks between workers and visit areas with individual attributes. RESULTS: COVID-19 risk exposure was associated with the density of dormitory, social ties and visit areas. The migrant worker hub in the city centre was the most frequently visited for essential services of grocery shopping and remittance, followed by south central areas mainly for social gathering. The hub was positioned as the core with the highest degree of centrality with a cluster of workers exposed to COVID-19. CONCLUSIONS: Social and geospatial networks of migrant workers should be considered in the implementation of lockdown exit strategies while addressing the improvement of living conditions and monitoring systems. Essential services, like remittance and grocery shopping at affordable prices, need to be provided near to dormitories to minimize excess gatherings.

COVID-19/epidemiology , Health Equity/standards , Transients and Migrants/statistics & numerical data , Adult , Built Environment/standards , COVID-19/transmission , Female , Humans , Male , Pandemics , Population Density , Prevalence , Risk Assessment , SARS-CoV-2 , Singapore/epidemiology , Social Network Analysis , Spatial Analysis , Surveys and Questionnaires , Young Adult