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2.
J Cardiovasc Med (Hagerstown) ; 23(8): 546-550, 2022 08 01.
Article in English | MEDLINE | ID: covidwho-1974565

ABSTRACT

BACKGROUND: The 2020 severe acute respiratory syndrome coronavirus 2 outbreak entailed reduced availability of traditional (in-office) cardiology consultations. Remote monitoring is an alternative way of caring that may potentially mitigate the negative effects of the epidemic to the care of cardiovascular diseases. We evaluated the outcome of implantable cardioverter defibrillator (ICD) carriers followed up remotely in 2020 (epidemic period) versus 2019 (control). METHODS: We included all patients with an ICD who remained remotely monitored from the beginning to the end of each year. The combined end point included: new-onset atrial fibrillation; sustained ventricular tachycardia >170 bpm without ICD intervention; appropriate ICD intervention (either shock or antitachycardia pacing); any-cause death. Multiple events in the same patients were counted separately if occurring ≥48 h apart. RESULTS: In 2020, 52 end points occurred in 37 of 366 (10%) ICD carriers [0.14/patient (95% confidence interval [CI] = 0.11-0.19)] versus 43 end points in 32 of 325 (10%) ICD carriers in 2019 [0.13/patient (95% CI = 0.10-0.18) P  = 0.75]. There was no difference between the distribution of any individual end point in 2020 versus 2019 although a nonsignificant mortality increase was observed (from 2.8% to 4.6%, P  = 0.19). The lowest weekly event rate occurred during the national lock down in spring 2020 but a similar trend occurred also in 2019 suggesting that the effect may not be linked to social distancing measures. CONCLUSIONS: We did not observe an increase in a combined end point including arrhythmic events and mortality in ICD carriers who were remotely monitored in 2020, compared to 2019, despite the negative impact of the coronavirus disease 2019 outbreak on the healthcare system.


Subject(s)
Aftercare/methods , COVID-19/epidemiology , Defibrillators, Implantable , Remote Consultation , SARS-CoV-2 , Aftercare/standards , Arrhythmias, Cardiac/epidemiology , Arrhythmias, Cardiac/prevention & control , COVID-19/complications , Communicable Disease Control/methods , Communicable Disease Control/standards , Disease Outbreaks , Humans , Remote Consultation/standards , Tachycardia, Ventricular/epidemiology , Tachycardia, Ventricular/prevention & control
3.
Lancet ; 399(10325): 678-690, 2022 02 12.
Article in English | MEDLINE | ID: covidwho-1721141

ABSTRACT

Measles is a highly contagious, potentially fatal, but vaccine-preventable disease caused by measles virus. Symptoms include fever, maculopapular rash, and at least one of cough, coryza, or conjunctivitis, although vaccinated individuals can have milder or even no symptoms. Laboratory diagnosis relies largely on the detection of specific IgM antibodies in serum, dried blood spots, or oral fluid, or the detection of viral RNA in throat or nasopharyngeal swabs, urine, or oral fluid. Complications can affect many organs and often include otitis media, laryngotracheobronchitis, pneumonia, stomatitis, and diarrhoea. Neurological complications are uncommon but serious, and can occur during or soon after the acute disease (eg, acute disseminated encephalomyelitis) or months or even years later (eg, measles inclusion body encephalitis and subacute sclerosing panencephalitis). Patient management mainly involves supportive therapy, such as vitamin A supplementation, monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhoea. There is no specific antiviral therapy for the treatment of measles, and disease control largely depends on prevention. However, despite the availability of a safe and effective vaccine, measles is still endemic in many countries and causes considerable morbidity and mortality, especially among children in resource-poor settings. The low case numbers reported in 2020, after a worldwide resurgence of measles between 2017 and 2019, have to be interpreted cautiously, owing to the effect of the COVID-19 pandemic on disease surveillance. Disrupted vaccination activities during the pandemic increase the potential for another resurgence of measles in the near future, and effective, timely catch-up vaccination campaigns, strong commitment and leadership, and sufficient resources will be required to mitigate this threat.


Subject(s)
COVID-19/epidemiology , Endemic Diseases/prevention & control , Mass Vaccination/organization & administration , Measles Vaccine/administration & dosage , Measles/prevention & control , COVID-19/prevention & control , Communicable Disease Control/organization & administration , Communicable Disease Control/standards , Endemic Diseases/statistics & numerical data , Humans , Mass Vaccination/standards , Mass Vaccination/statistics & numerical data , Measles/epidemiology , Measles/immunology , Measles/virology , Measles virus/immunology , Measles virus/pathogenicity , Pandemics/prevention & control
5.
J Infect Dev Ctries ; 15(12): 1816-1824, 2021 12 31.
Article in English | MEDLINE | ID: covidwho-1635712

ABSTRACT

INTRODUCTION: During the second wave of the coronavirus disease 19 (COVID-19) pandemic, Malaysia reported several COVID-19 clusters related to healthcare workers. Thus, addressing and understanding the risk of exposure in healthcare workers is important to prevent future infection and reduce secondary COVID-19 transmission within the healthcare settings. In this study, we aim to assess exposure and prevention practices against COVID-19 among healthcare workers at the Hospital Canselor Tuanku Muhriz, a university teaching hospital based in Kuala Lumpur, Malaysia. METHODOLOGY: A total of 571 healthcare workers at COVID-19 and non-COVID-19 wards as well as the emergency department and laboratory staff at COVID-19 testing labs were recruited. The presence of novel human coronavirus (SARS-CoV-2) and IgM/IgG antibodies were confirmed in all healthcare workers. The healthcare workers responded to an online Google Forms questionnaire that evaluates demographic information and comorbidities, exposure and adherence to infection prevention and control measures against COVID-19. Descriptive analysis was performed using Statistical Package for the Social Sciences 24.0. RESULTS: Three healthcare workers (0.5%) tested positive for SARS-CoV-2, while the remaining 568 (99.5%) were negative. All were negative for IgM and IgG antibodies during recruitment (day 1) and follow-up (day 15). More than 90% of the healthcare workers followed infection prevention and control practices recommendations regardless of whether they have been exposed to occupational risk for COVID-19. CONCLUSIONS: The healthcare workers' high level of adherence to infection prevention practices at this hospital helped reduce and minimize their occupational exposure to COVID-19.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control/standards , Health Personnel/statistics & numerical data , Occupational Exposure/prevention & control , Adult , COVID-19/transmission , COVID-19 Testing/statistics & numerical data , Cross-Sectional Studies , Female , Humans , Malaysia/epidemiology , Male , Occupational Exposure/statistics & numerical data , Pandemics , Personal Protective Equipment/statistics & numerical data , Risk Assessment , SARS-CoV-2
7.
Eur Rev Med Pharmacol Sci ; 25(24): 7829-7832, 2021 12.
Article in English | MEDLINE | ID: covidwho-1604716

ABSTRACT

OBJECTIVE: As a result of COVID-19 pandemic, the 2021 US residency MATCH was devoid of the traditional in-person interviews. Herein, we assess the impact of Virtual Interviews (VIs) on resident selection, from the perspectives of Orthopedic Surgery (OS) Program Directors (PDs). MATERIALS AND METHODS: A 14-item survey was sent to PDs of ACGME-accredited OS residencies. Questions were designed to assess the pros, cons, and robustness of VIs compared to their antecedent in-person format. RESULTS: Forty-seven PDs responded to our survey. VIs antagonized PDs' ability to assess applicants' fit to program (76.6%), commitment to specialty (64%), and interpersonal skills (68.1%). This led to heavier dependence upon applicants' portfolios (64%). Almost all respondents (97.9%) found VIs to be more cost-efficient, saving a median of $3000 in interview-related expenses. Overall, only 8.5% of PDs were willing to conduct exclusive VIs in future cycles, compared to the majority in favor of dual formats (51.5%) or exclusive in-person interviews (40.4%). CONCLUSIONS: VIs have been an overall success, making most PDs opt for dual interview formats in future cycles. How this technology is further implemented in the future remains to be seen.


Subject(s)
COVID-19/prevention & control , Internship and Residency/organization & administration , Orthopedic Procedures/education , Physician Executives/statistics & numerical data , Telecommunications/statistics & numerical data , COVID-19/epidemiology , Communicable Disease Control/standards , Cross-Sectional Studies , Humans , Internship and Residency/standards , Internship and Residency/statistics & numerical data , Internship and Residency/trends , Orthopedic Procedures/standards , Pandemics/prevention & control , Personnel Selection/methods , Personnel Selection/standards , Personnel Selection/statistics & numerical data , Personnel Selection/trends , Surveys and Questionnaires/statistics & numerical data , Telecommunications/standards , Telecommunications/trends
13.
Pediatr Infect Dis J ; 40(12): e455-e458, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1504650

ABSTRACT

BACKGROUND: Early Years' Settings (EYSs) provide childcare and education for children 0-5 years old. They remained fully open in England during the third National lockdown when other educational settings were only open for selected children. EYSs are generally considered to be low-risk settings for transmission of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). METHODS: An observational study describing a large outbreak of SARS CoV-2 within an EYS in Cambridgeshire, United Kingdom. RESULTS: Overall 45 cases of SARS-CoV-2 were identified; 24 adults (71% of staff members) and 21 children (25% of nursery attendees). One case was identified as the alpha variant (B.1.1.7 [VOC-20-DEC-01]). One staff member became critically unwell. CONCLUSIONS: Transmission of SARS-CoV-2 occurred quickly, with a high attack rate; likely a consequence of a variant with enhanced transmissibility and an inability of the setting to adhere to infection control measures.


Subject(s)
COVID-19/epidemiology , COVID-19/pathology , Child Day Care Centers , Disease Outbreaks , SARS-CoV-2 , Child , Child, Preschool , Communicable Disease Control/methods , Communicable Disease Control/standards , Female , Humans , Infant , Male
15.
Ann Med ; 53(1): 1924-1934, 2021 12.
Article in English | MEDLINE | ID: covidwho-1493393

ABSTRACT

INTRODUCTION: The SARS-CoV-2 pandemic has forced healthcare providers to reorganize their activities to protect the population from infection, postponing or suspending many medical procedures. Patients affected by chronic conditions were among the most affected. In the case of catastrophes, women have a higher lifetime prevalence of post-traumatic stress disorder (PTSD), and those with endometriosis have higher anxiety levels, making them fragile in such circumstances. MATERIALS AND METHODS: In this cross-sectional study, conducted in May 2020, we considered all women aged ≥18 years, followed up at our referral centre for endometriosis. Patients were sent an anonymous 6-section questionnaire via email, containing different validated tools for the evaluation of anxiety levels and the risk of PTSD. A multivariable linear regression was performed to assess the impact of patients' characteristics on the distress caused by the SARS-COV-2 pandemic. RESULTS: Among the 468 women recruited, 68.8% were quite-to-extremely worried about not being able to access gynaecologic care, with almost one-third of them scoring ≥33 on the IES-R. Older age and increased levels of anxiety were associated with higher risks of PTSD (age: b = 0.28, 95% CI = 0.12 - 0.44; GAD-7: b = 1.71, 95% CI = 1.38 - 2.05), with up to 71.8% of patients with severe anxiety (GAD-7 > 15) having an IES-R score ≥33 suggestive for PTSD. Women who could leave home to work showed lower levels of PTSD (b = -4.79, 95% CI = -8.44 to - 1.15, ref. unemployed women). The implementation of telemedicine in routine clinical practice was favourably viewed by 75.6% of women. DISCUSSION: Women with endometriosis are particularly exposed to the risk of PTSD during the SARS-CoV-2 pandemic, especially if they are older or have higher levels of anxiety. Gynaecologists should resort to additional strategies, and telemedicine could represent a feasible tool to help patients cope with this situation.KEY MESSAGESThe COVID-19 pandemic significantly impacted the lives of women with endometriosis, who appeared to have a considerable risk of PTSD.Older age, higher anxiety levels and unemployment were independently associated with the risk of developing PTSD.Clinicians should develop successful alternative strategies to help patients cope with this situation, and telemedicine might represent an applicable and acceptable solution.


Subject(s)
Anxiety/epidemiology , COVID-19/prevention & control , Endometriosis/therapy , Health Services Accessibility/standards , Stress Disorders, Post-Traumatic/epidemiology , Adult , Age Factors , Anxiety/diagnosis , Anxiety/etiology , Anxiety/psychology , COVID-19/epidemiology , COVID-19/transmission , Communicable Disease Control/standards , Cross-Sectional Studies , Endometriosis/psychology , Female , Health Services Accessibility/organization & administration , Humans , Internet/statistics & numerical data , Male , Middle Aged , Pandemics/prevention & control , Prevalence , Risk Management , SARS-CoV-2/pathogenicity , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/psychology , Surveys and Questionnaires/statistics & numerical data , Telemedicine/organization & administration , Telemedicine/standards , Young Adult
18.
Sci Rep ; 11(1): 20140, 2021 10 11.
Article in English | MEDLINE | ID: covidwho-1462038

ABSTRACT

The global economic activities were completely stopped during COVID-19 lockdown and continuous lockdown partially brought some positive effects for the health of the total environment. The multiple industries, cities, towns and rural people are completely depending on large tropical river Damodar (India) but in the last few decades the quality of the river water is being significantly deteriorated. The present study attempts to investigate the river water quality (RWQ) particularly for pre- lockdown, lockdown and unlock period. We considered 20 variables per sample of RWQ data and it was analyzed using novel Modified Water Quality Index (MWQI), Trophic State Index (TSI), Heavy Metal Index (HMI) and Potential Ecological Risk Index (RI). Principal component analysis (PCA) and Pearson's correlation (r) analysis are applied to determine the influencing variables and relationship among the river pollutants. The results show that during lockdown 54.54% samples were brought significantly positive changes applying MWQI. During lockdown, HMI ranged from 33.96 to 117.33 with 27.27% good water quality which shows the low ecological risk of aquatic ecosystem due to low mixing of toxic metals in the river water. Lockdown effects brought river water to oligotrophic/meso-eutrophic condition from eutrophic/hyper-eutrophic stage. Rejuvenation of river health during lockdown offers ample scope to policymakers, administrators and environmentalists for restoration of river health from huge anthropogenic stress.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/standards , Rivers/chemistry , Water Pollutants, Chemical/analysis , Water Quality , COVID-19/epidemiology , COVID-19/transmission , Environmental Monitoring/statistics & numerical data , Environmental Restoration and Remediation/statistics & numerical data , Humans , Metals, Heavy/analysis
19.
Sci Rep ; 11(1): 20124, 2021 10 11.
Article in English | MEDLINE | ID: covidwho-1462024

ABSTRACT

The Novel Coronavirus which emerged in India on January/30/2020 has become a catastrophe to the country on the basis of health and economy. Due to rapid variations in the transmission of COVID-19, an accurate prediction to determine the long term effects is infeasible. This paper has introduced a nonlinear mathematical model to interpret the transmission dynamics of COVID-19 infection along with providing vaccination in the precedence. To minimize the level of infection and treatment burden, the optimal control strategies are carried out by using the Pontryagin's Maximum Principle. The data validation has been done by correlating the estimated number of infectives with the real data of India for the month of March/2021. Corresponding to the model, the basic reproduction number [Formula: see text] is introduced to understand the transmission dynamics of COVID-19. To justify the significance of parameters we determined the sensitivity analysis of [Formula: see text] using the parameters value. In the numerical simulations, we concluded that reducing [Formula: see text] below unity is not sufficient enough to eradicate the COVID-19 disease and thus, it is required to increase the vaccination rate and its efficacy by motivating individuals to take precautionary measures.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/epidemiology , Communicable Disease Control/organization & administration , Models, Biological , Pandemics/prevention & control , Basic Reproduction Number , COVID-19/prevention & control , COVID-19/transmission , COVID-19/virology , Communicable Disease Control/standards , Computer Simulation , Humans , India/epidemiology , Nonlinear Dynamics , Pandemics/statistics & numerical data , SARS-CoV-2/pathogenicity , Vaccination/statistics & numerical data
20.
Int J Prison Health ; ahead-of-print(ahead-of-print)2021 10 03.
Article in English | MEDLINE | ID: covidwho-1447742

ABSTRACT

PURPOSE: The purpose of the paper was to conduct a legal-realist assessment of the South African prison system response to COVID-19. Severely congested and ill-resourced prison systems in Africa face unprecedented challenges amplified by COVID-19. South Africa has recorded the highest COVID-19 positivity rate in Africa and, on March 15th 2020, declared a national state of disaster. The first prison system case was notified on April 6th 2020. DESIGN/METHODOLOGY/APPROACH: A legal-realist assessment of the South African prison system response to COVID-19 in the 12 months following initial case notification focused on the minimum State obligations to comply with human rights norms, and the extent to which human, health and occupational health rights of prisoners and staff were upheld during disaster measures. FINDINGS: A legal-realist account was developed, which revealed the indeterminate nature of application of South African COVID-19 government directives, ill-resourced COVID-19 mitigation measures, alarming occupational health and prison conditions and inadequate standards of health care in prisons when evaluated against the rule of law during State declaration of disaster. ORIGINALITY/VALUE: This legal-realist assessment is original by virtue of its unique evaluation of the South African prison system approach to tackling COVID-19. It acknowledged State efforts, policymaking processes and outcomes and how these operated within the prison system itself. By moving beyond the deleterious impacts of the COVID-19 pandemic on the already precarious South African prison system, the authors argue for rights assurance for those who live and work in its prisons, improved infrastructure and greater substantive equality of all deprived of their liberty in South Africa.


Subject(s)
COVID-19 , Communicable Disease Control/legislation & jurisprudence , Communicable Disease Control/standards , Prisons/legislation & jurisprudence , Prisons/standards , Communicable Disease Control/organization & administration , Human Rights , Humans , Prisons/organization & administration , SARS-CoV-2 , South Africa/epidemiology
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