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3.
JNMA J Nepal Med Assoc ; 58(225): 355-359, 2020 May 30.
Article in English | MEDLINE | ID: covidwho-601567

ABSTRACT

The COVID-19 pandemic is unfolding at an unprecedented pace. The unprecedented threat provides an opportunity to emerge with robust health systems. Nepal has implemented several containment measures such as Rapid Response Team formulation; testing; isolation; quarantine; contact tracing;surveillance, establishment of COVID-19 Crisis Management Centre and designation of dedicated hospitals to gear up for the pandemic. The national public health emergency management mechanisms need further strengthening with the proactive engagement of relevant ministries; we need a strong, real-time national surveillance system and capacity building of a critical mass of health care workers; there is a need to further assess infection prevention and control capacity; expand the network of virus diagnostic laboratories in the private sector with adequate surge capacity;implement participatory community engagement interventions and plan for a phased lockdown exit strategy enabling sustainable suppression of transmission at low-level and enabling in resuming some parts of economic and social life.


Subject(s)
Civil Defense , Communicable Disease Control , Coronavirus Infections , Emergency Medical Services/organization & administration , Pandemics/prevention & control , Pneumonia, Viral , Betacoronavirus/isolation & purification , Civil Defense/legislation & jurisprudence , Civil Defense/methods , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Government Regulation , Humans , Nepal/epidemiology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Public Health/methods
4.
Nat Med ; 26(7): 1005-1008, 2020 07.
Article in English | MEDLINE | ID: covidwho-595980
7.
J Am Geriatr Soc ; 68(6): 1150-1154, 2020 06.
Article in English | MEDLINE | ID: covidwho-133566

ABSTRACT

Coronavirus disease 2019 (COVID-19) has led to a surge of patients requiring post-acute care. In order to support federal, state and corporate planning, we offer a four-stage regionally oriented approach to achieving optimal systemwide resource allocation across a region's post-acute service settings and providers over time. In the first stage, the post-acute care system must, to the extent possible, help relieve acute hospitals of non-COVID-19 patients to create as much inpatient capacity as possible over the surge period. In the second stage after the initial surge as subsided, post-acute providers must protect vulnerable populations from COVID-19, prepare treat-in-place protocols for non-COVID-19 admissions, and create and formalize COVID-19 specific settings. In the third stage after a vaccine has been developed or an effective prophylactic option is available, post-acute care providers must assist with distribution and administration of vaccinations and prophylaxis, develop strategies to deliver non-COVID-19 related medical care, and begin to transition to the post-COVID-19 landscape. In the final stage, we must create health advisory bodies to review post-acute sector's response, identify opportunities to improve performance going forward, and develop a pandemic response plan for post-acute care providers. J Am Geriatr Soc 68:1150-1154, 2020.


Subject(s)
Betacoronavirus , Civil Defense/methods , Coronavirus Infections , Health Care Rationing , Pandemics , Pneumonia, Viral , Subacute Care/methods , Humans , United States/epidemiology
8.
J Nepal Health Res Counc ; 18(1): 142-143, 2020 Apr 20.
Article in English | MEDLINE | ID: covidwho-127689

ABSTRACT

Patan Academy of Health Sciences started preparedness for COVID-19 in response to increasing number of patient in neighboring country. Outbreak preparedness in resource limited setup is challenging. Despite this, preparedness was done in reference to WHO interim guidance utilizing best available resources. During this preparedness, one patient was isolated as suspected COVID-19. This paper presents level of preparedness achieved with the limited resources and the lesson learned while isolating the patient. Keywords: COVID-19; Disaster; hospital preparedness.


Subject(s)
Civil Defense/methods , Coronavirus Infections/epidemiology , Coronavirus , Disaster Planning , Disease Outbreaks/prevention & control , Emergency Medicine/organization & administration , Pneumonia, Viral/epidemiology , Betacoronavirus , Global Health , Hospitals , Humans , Nepal , Pandemics , Public Health
9.
J Am Coll Cardiol ; 76(1): 72-84, 2020 07 07.
Article in English | MEDLINE | ID: covidwho-92085

ABSTRACT

The COVID-19 pandemic has presented a major unanticipated stress on the workforce, organizational structure, systems of care, and critical resource supplies. To ensure provider safety, to maximize efficiency, and to optimize patient outcomes, health systems need to be agile. Critical care cardiologists may be uniquely positioned to treat the numerous respiratory and cardiovascular complications of the SARS-CoV-2 and support clinicians without critical care training who may be suddenly asked to care for critically ill patients. This review draws upon the experiences of colleagues from heavily impacted regions of the United States and Europe, as well as lessons learned from military mass casualty medicine. This review offers pragmatic suggestions on how to implement scalable models for critical care delivery, cultivate educational tools for team training, and embrace technologies (e.g., telemedicine) to enable effective collaboration despite social distancing imperatives.


Subject(s)
Cardiology Service, Hospital , Coronavirus Infections , Critical Care , Delivery of Health Care , Organizational Innovation , Pandemics/prevention & control , Pneumonia, Viral , Betacoronavirus/isolation & purification , Cardiology Service, Hospital/organization & administration , Cardiology Service, Hospital/trends , Civil Defense/methods , Civil Defense/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Critical Care/methods , Critical Care/organization & administration , Critical Care/trends , Delivery of Health Care/methods , Delivery of Health Care/organization & administration , Delivery of Health Care/trends , Humans , Organizational Objectives , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy
11.
Can J Cardiol ; 36(6): 956-960, 2020 06.
Article in English | MEDLINE | ID: covidwho-77140

ABSTRACT

The novel coronavirus 2019 disease (COVID-19) pandemic has placed intense pressure on health care organizations around the world. Among other concerns, there has been an increasing recognition of common and deleterious cardiovascular effects of COVID-19 based on preliminary studies. Furthermore, patients with preexisting cardiac disease are likely to experience a more severe disease course with COVID-19. As case numbers continue to increase exponentially, a surge in the number of patients with new or comorbid cardiovascular disease will translate into more frequent and, in some cases, prolonged rehabilitation needs after acute hospitalization. This report describes the current status of post-discharge cardiac care in Canada and provides suggestions regarding steps that policymakers and health care organizations can take to prepare for the COVID-19 pandemic.


Subject(s)
Aftercare , Cardiac Rehabilitation/methods , Cardiovascular Diseases , Civil Defense , Coronavirus Infections , Infection Control/organization & administration , Pandemics , Patient Discharge/standards , Pneumonia, Viral , Aftercare/methods , Aftercare/organization & administration , Canada , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/therapy , Civil Defense/methods , Civil Defense/organization & administration , Comorbidity , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Risk Management
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