Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 61
Filter
2.
Can J Cardiol ; 38(2): 279-291, 2022 02.
Article in English | MEDLINE | ID: covidwho-1604002

ABSTRACT

While COVID-19 is still ongoing and associated with more than 5 million deaths, the scope and speed of advances over the past year in terms of scientific discovery, data dissemination, and technology have been staggering. It is not a matter of "if" but "when" we will face the next pandemic, and how we leverage technology and data management effectively to create flexible ecosystems that facilitate collaboration, equitable care, and innovation will determine its severity and scale. The aim of this review is to address emerging challenges that came to light during the pandemic in health care and innovations that enabled us to adapt and continue to care for patients. The pandemic highlighted the need for seismic shifts in care paradigms and technology with considerations related to the digital divide and health literacy for digital health interventions to reach full potential and improve health outcomes. We discuss advances in telemedicine, remote patient monitoring, and emerging wearable technologies. Despite the promise of digital health, we emphasise the importance of addressing its limitations, including interpretation challenges, accuracy of findings, and artificial intelligence-driven algorithms. We summarise the most recent recommendation of the Virtual Care Task Force to scaling virtual medical services in Canada. Finally, we propose a model for optimal implementation of health digital innovations with 5 tenets including data management, data security, digital biomarkers, useful artificial intelligence, and clinical integration.


Subject(s)
Biomedical Technology , Civil Defense/methods , Telemedicine/methods , Artificial Intelligence , Biomedical Technology/standards , Biomedical Technology/trends , COVID-19/epidemiology , Digital Technology , Humans , Quality Improvement , SARS-CoV-2
3.
Br J Anaesth ; 128(2): e97-e100, 2022 02.
Article in English | MEDLINE | ID: covidwho-1556064

ABSTRACT

With healthcare systems rapidly becoming overwhelmed and occupied by patients during a pandemic, effective and safe care for patients is easily compromised. During the course of the current pandemic, numerous treatment guidelines have been developed and published that have improved care for patients with COVID-19. Certain lessons have only been learned during the course of the outbreak, from which we can learn for future pandemics. This editorial aims to raise awareness about the importance of timely stockpiling of sufficient amounts of personal protection equipment and medications, adequate oxygen supplies, uninterrupted electricity, and fair locally adapted triage strategies.


Subject(s)
COVID-19/therapy , Civil Defense/methods , Mass Casualty Incidents/prevention & control , Triage/methods , COVID-19/epidemiology , COVID-19/prevention & control , Delivery of Health Care/methods , Global Health , Humans , Personal Protective Equipment
5.
Br J Anaesth ; 128(2): e100-e103, 2022 02.
Article in English | MEDLINE | ID: covidwho-1439905

ABSTRACT

Efficiency is an essential part of sustainable healthcare, especially in emergency and acute care (including surgical) settings. Waste minimisation, streamlined processes, and lean principles are all important for responsible stewardship of finite health resources. However, the promotion of efficiency above all else has effectively subordinated preparedness as a form of waste. Investment in preparedness is an essential part of resilient healthcare. The ongoing COVID-19 pandemic has exposed the gap between efficient processes and resilient systems in many health settings. In anticipation of future pandemics, natural disasters, and mass casualty incidents, health systems, and individual healthcare workers, must prioritise preparedness to be ready for the unexpected or for crises. This requires a reframing of priorities to view preparedness as crucial insurance against system failure during disasters, by taking advantage of lessons learnt preparing for war and mass casualty incidents.


Subject(s)
COVID-19/therapy , Civil Defense/methods , Delivery of Health Care/methods , Health Personnel , Mass Casualty Incidents/prevention & control , COVID-19/epidemiology , Civil Defense/trends , Delivery of Health Care/trends , Health Personnel/trends , Humans
6.
Infect Dis Clin North Am ; 35(3): 697-716, 2021 09.
Article in English | MEDLINE | ID: covidwho-1340668

ABSTRACT

The built environment has been integral to response to the global pandemic of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In particular, engineering controls to mitigate risk of exposure to SARS-CoV-2 and other newly emergent respiratory pathogens in the future will be important. Anticipating emergence from this pandemic, or at least adaptation given increasing administration of effective vaccines, and the safety of patients, personnel, and others in health care facilities remain the core goals. This article summarizes known risks and highlights prevention strategies for daily care as well as response to emergent infectious diseases and this parapandemic phase.


Subject(s)
COVID-19 , Civil Defense , Health Facilities/trends , Infection Control , Safety Management/organization & administration , COVID-19/epidemiology , COVID-19/prevention & control , Civil Defense/methods , Civil Defense/organization & administration , Environment, Controlled , Hospital Design and Construction/methods , Humans , Infection Control/methods , Infection Control/organization & administration , SARS-CoV-2
7.
J Cardiovasc Med (Hagerstown) ; 22(9): 701-705, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1339452

ABSTRACT

The Coronavirus disease 2019 (COVID-19) pandemic has thoroughly and deeply affected the provision of healthcare services worldwide. In order to limit the in-hospital infections and to redistribute the healthcare professionals, cardiac percutaneous intervention in Pediatric and Adult Congenital Heart Disease (ACHD) patients were limited to urgent or emergency ones. The aim of this article is to describe the impact of the COVID-19 pandemic on Pediatric and ACHD cath laboratory activity during the so-called 'hard lockdown' in Italy. Eleven out of 12 Italian institutions with a dedicated Invasive Cardiology Unit in Congenital Heart Disease actively participated in the survey. The interventional cardiology activity was reduced by more than 50% in 6 out of 11 centers. Adolescent and ACHD patients suffered the highest rate of reduction. There was an evident discrepancy in the management of the hard lockdown, irrespective of the number of COVID-19 positive cases registered, with a higher reduction in Southern Italy compared with the most affected regions (Lombardy, Piedmont, Veneto and Emilia Romagna). Although the pandemic was brilliantly addressed in most cases, we recognize the necessity for planning new, and hopefully homogeneous, strategies in order to be prepared for an upcoming new outbreak.


Subject(s)
COVID-19 , Cardiac Surgical Procedures , Emergency Medical Services , Heart Defects, Congenital , Infection Control , Risk Management/methods , Adolescent , Adult , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Cardiac Surgical Procedures/methods , Cardiac Surgical Procedures/statistics & numerical data , Civil Defense/methods , Civil Defense/trends , Disease Transmission, Infectious/prevention & control , Emergency Medical Services/methods , Emergency Medical Services/statistics & numerical data , Female , Heart Defects, Congenital/epidemiology , Heart Defects, Congenital/surgery , Humans , Infection Control/methods , Infection Control/organization & administration , Italy/epidemiology , Male , Organizational Innovation , SARS-CoV-2
9.
Lupus Sci Med ; 8(1)2021 04.
Article in English | MEDLINE | ID: covidwho-1194228

ABSTRACT

OBJECTIVE: To report the results of a survey exploring the experience of patients with SLE facing hydroxychloroquine (HCQ) shortage that occurred during the early phases of the COVID-19 pandemic. METHODS: A survey was designed by Lupus Europe's patient advisory network and distributed through its social media, newsflash and members' network. People with lupus were asked about their last HCQ purchases and their level of anxiety (on a 0-10 scale) with regard to not being able to have access to HCQ, once in April 2020 (first wave) and after 11 August (second wave). The results were compared. RESULTS: 2075 patients responded during the first wave; 1001 (48.2%) could get HCQ from the first place they asked, 230 (11.1%) could get the drug by going to more than one pharmacy, 498 (24.0%) obtained HCQ later from their usual pharmacy and 126 (6.1%) from other sources. 188 (9.1%) could not get any; 32 (1.5%) did not respond to this question. All countries showed significant improvement in HCQ availability during the second wave. 562 (27.4%) patients reported an extremely high level of anxiety in wave 1 and 162 (10.3%) patients in wave 2; 589 (28.7%) and 268 (17.1%) patients reported a high level of anxiety in wave 1 and wave 2, respectively. CONCLUSIONS: The HCQ shortage had a significant impact on patients with SLE and has been responsible for psychological consequences including anxiety. Indeed, despite an objective improvement in drug availability, the event is leaving significant traces in patients' mind and behaviours.


Subject(s)
Anxiety , COVID-19 , Community Pharmacy Services/statistics & numerical data , Health Services Accessibility , Hydroxychloroquine , Lupus Erythematosus, Systemic , Antirheumatic Agents/supply & distribution , Antirheumatic Agents/therapeutic use , Anxiety/diagnosis , Anxiety/etiology , COVID-19/drug therapy , COVID-19/epidemiology , Civil Defense/methods , Civil Defense/standards , Europe/epidemiology , Health Services Accessibility/standards , Health Services Accessibility/statistics & numerical data , Humans , Hydroxychloroquine/supply & distribution , Hydroxychloroquine/therapeutic use , Lupus Erythematosus, Systemic/drug therapy , Lupus Erythematosus, Systemic/epidemiology , Lupus Erythematosus, Systemic/psychology , Psychological Distress , SARS-CoV-2 , Self Report/statistics & numerical data , Surveys and Questionnaires
15.
Value Health ; 24(5): 625-631, 2021 05.
Article in English | MEDLINE | ID: covidwho-1087117

ABSTRACT

The potential health and economic value of a vaccine for coronavirus disease (COVID-19) is self-evident given nearly 2 million deaths, "collateral" loss of life as other conditions go untreated, and massive economic damage. Results from the first licensed products are very encouraging; however, there are important reasons why we will likely need second and third generation vaccines. Dedicated incentives and funding focused explicitly on nurturing and advancing competing second and third generation vaccines are essential. This article proposes a collaborative, market-based financing mechanism for the world to incentivize and pay for the development of, and provide equitable access to, second and third generation COVID-19 vaccines. Specifically, we propose consideration of a Benefit-Based Advance Market Commitment (BBAMC). The BBAMC uses health technology assessment to determine value-based prices to guarantee overall market revenues, not revenue for any specific product or company. The poorest countries would not pay a value-based price but a discounted "tail-price." Innovators must agree to supply them at this tail price or to facilitate technology transfer to local licensees at low or zero cost to enable them to supply at this price. We expect these purchases to be paid for in full or large part by global donors. The BBAMC therefore sets prices in relation to value, protects intellectual property rights, encourages competition, and ensures all populations get access to vaccines, subject to agreed priority allocation rules.


Subject(s)
COVID-19/prevention & control , Global Health/economics , Immunization Programs/economics , COVID-19/drug therapy , COVID-19/economics , COVID-19 Vaccines/economics , COVID-19 Vaccines/therapeutic use , Civil Defense/methods , Civil Defense/trends , Economic Competition/standards , Economic Competition/trends , Global Health/trends , Humans , Immunization Programs/methods
17.
Nurs Forum ; 56(2): 439-443, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1066744

ABSTRACT

COVID-19 emerged in Wuhan, China, and began its worldwide journey. As the severity of the virus became known, the Chinese National Government mobilized resources, and their centralized management was critical to the containment of the epidemic. Healthcare agencies and providers were overwhelmed with patients, many of whom were critically ill and died. Nurses adapted to the work using personal protective equipment, but its initial scarcity contributed to stressful working conditions. Nurses in the United States can take several lessons from the experiences of their Chinese nurse colleagues, including the benefit of centralized management of the epidemic, the need for specialized treatment facilities, and the importance of a national stockpile of critical equipment and supplies. A fully funded United States Department of Health and Human Services Office of Pandemics and Emerging Threats is necessary. A nursing department within the office and a national mobilization plan to send nurses to support local efforts during a pandemic or other threat are likewise essential. Continuous training for nurses, especially caring for patients with infectious diseases in intensive care units, stress management, and how to comfort the dying, are also useful lessons.


Subject(s)
COVID-19/nursing , Education, Nursing/methods , China , Civil Defense/methods , Civil Defense/trends , Education, Nursing/trends , Humans , Pandemics/prevention & control , Personal Protective Equipment/standards , Personal Protective Equipment/supply & distribution , United States
18.
Disaster Med Public Health Prep ; 14(3): 377-383, 2020 06.
Article in English | MEDLINE | ID: covidwho-1041493

ABSTRACT

Disasters such as an earthquake, a flood, and an epidemic usually lead to large numbers of casualties accompanied by disruption of the functioning of local medical institutions. A rapid response of medical assistance and support is required. Mobile hospitals have been deployed by national and international organizations at disaster situations in the past decades, which play an important role in saving casualties and alleviating the shortage of medical resources. In this paper, we briefly introduce the types and characteristics of mobile hospitals used by medical teams in disaster rescue, including the aspects of structural form, organizational form, and mobile transportation. We also review the practices of mobile hospitals in disaster response and summarize the problems and needs of mobile hospitals in disaster rescue. Finally, we propose the development direction of mobile hospitals, especially on the development of intelligence, rapid deployment capabilities, and modularization, which provide suggestions for further research and development of mobile hospitals in the future.


Subject(s)
Civil Defense/instrumentation , Disasters , Mobile Health Units/trends , Civil Defense/methods , Civil Defense/trends , Humans
19.
Tunis Med ; 98(10): 657-663, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1040299

ABSTRACT

OBJECTIVE: To compile the lessons learned in the Greater Maghreb, during the first six months of the fight against the COVID-19 pandemic, in the field of "capacity building" of community resilience. METHODS: An expert consultation was conducted during the first week of May 2020, using the "Delphi" technique. An email was sent requesting the formulation of a lesson, in the form of a "Public Health" good practice recommendation. The final text of the lessons was finalized by the group coordinator and validated by the signatories of the manuscript. RESULTS: A list of five lessons of resilience has been deduced and approved : 1. Elaboration of "white plans" for epidemic management; 2. Training in epidemic management; 3. Uniqueness of the health system command; 4. Mobilization of retirees and volunteers; 5. Revision of the map sanitary. CONCLUSION: Based on the evaluation of the performance of the Maghreb fight against COVID-19, characterized by low resilience, this list of lessons could constitute a roadmap for the reform of Maghreb health systems, towards more performance to manage possible waves of COVID-19 or new emerging diseases with epidemic tendency.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Delivery of Health Care/organization & administration , Delivery of Health Care/standards , Health Care Reform , Africa, Northern/epidemiology , Algeria/epidemiology , Attitude of Health Personnel , Civil Defense/methods , Civil Defense/organization & administration , Civil Defense/standards , Community Participation/methods , Conflict of Interest , Delivery of Health Care/statistics & numerical data , Delphi Technique , Expert Testimony , Global Health/standards , Health Care Reform/organization & administration , Health Care Reform/standards , Hospital Bed Capacity/standards , Hospital Bed Capacity/statistics & numerical data , Humans , Mauritania/epidemiology , National Health Programs/organization & administration , National Health Programs/standards , Pandemics , Public Health/methods , Public Health/standards , SARS-CoV-2/physiology , Tunisia/epidemiology
20.
Disaster Med Public Health Prep ; 14(3): 372-376, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1028605

ABSTRACT

The novel coronavirus (COVID-19) began in China in early December 2019 and rapidly has spread to many countries around the globe, with the number of confirmed cases increasing every day. An epidemic has been recorded since February 20 in a middle province in Northern Italy (Lodi province, in the low Po Valley). The first line hospital had to redesign its logistical and departmental structure to respond to the influx of COVID-19-positive patients who needed hospitalization. Logistical and structural strategies were guided by the crisis unit, managing in 8 days from the beginning of the epidemic to prepare the hospital to be ready to welcome more than 200 COVID-19-positive patients with different ventilatory requirements, keeping clean emergency access lines, and restoring surgical interventions and deferred urgent, routine activity.


Subject(s)
Coronavirus Infections/complications , Organization and Administration/standards , Pandemics/statistics & numerical data , Pneumonia, Viral/complications , COVID-19 , Civil Defense/methods , Civil Defense/trends , Coronavirus Infections/epidemiology , Health Resources/statistics & numerical data , Health Resources/supply & distribution , Hospitalization/statistics & numerical data , Hospitals/statistics & numerical data , Humans , Italy/epidemiology , Organization and Administration/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL