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2.
Rev Esp Quimioter ; 35 Suppl 1: 104-110, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1836624

ABSTRACT

Adults with lung diseases, comorbidities, smokers, and elderly are at risk of lung infections and their consequences. Community-acquired pneumonia happen in more than 1% of people each year. Possible pathogens of community-acquired pneumonia include viruses, pneumococcus and atypicals. The CDC recommend vaccination throughout life to provide immunity, but vaccination rates in adults are poor. Tetravalent and trivalent influenza vaccine is designed annually during the previous summer for the next season. The available vaccines include inactivated, adjuvant, double dose, and attenuated vaccines. Their efficacy depends on the variant of viruses effectively responsible for the outbreak each year, and other reasons. Regarding the pneumococcal vaccine, there coexist the old polysaccharide 23-valent vaccine with the new conjugate 10-valent and 13-valent conjugate vaccines. Conjugate vaccines demonstrate their usefulness to reduce the incidence of pneumococcal pneumonia due to the serotypes present in the vaccine. Whooping cough is still present, with high morbidity and mortality rates in young infants. Adult's pertussis vaccine is available, it could contribute to the control of whooping cough in the most susceptible, but it is not present yet in the calendar of adults around the world. About 10 vaccines against SARS-CoV-2 have been developed in a short time, requiring emergency use authorization. A high rate of vaccination was observed in most of the countries. Booster doses became frequent after the loss of effectiveness against new variants. The future of this vaccine is yet to be written.


Subject(s)
COVID-19 , Community-Acquired Infections , Pneumonia, Pneumococcal , Whooping Cough , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Community-Acquired Infections/epidemiology , Community-Acquired Infections/prevention & control , Humans , Infant , Pneumonia, Pneumococcal/epidemiology , Pneumonia, Pneumococcal/prevention & control , Prognosis , SARS-CoV-2 , Vaccination , Vaccines, Conjugate
5.
MMWR Morb Mortal Wkly Rep ; 69(49): 1860-1867, 2020 Dec 11.
Article in English | MEDLINE | ID: covidwho-1389860

ABSTRACT

In the 10 months since the first confirmed case of coronavirus disease 2019 (COVID-19) was reported in the United States on January 20, 2020 (1), approximately 13.8 million cases and 272,525 deaths have been reported in the United States. On October 30, the number of new cases reported in the United States in a single day exceeded 100,000 for the first time, and by December 2 had reached a daily high of 196,227.* With colder weather, more time spent indoors, the ongoing U.S. holiday season, and silent spread of disease, with approximately 50% of transmission from asymptomatic persons (2), the United States has entered a phase of high-level transmission where a multipronged approach to implementing all evidence-based public health strategies at both the individual and community levels is essential. This summary guidance highlights critical evidence-based CDC recommendations and sustainable strategies to reduce COVID-19 transmission. These strategies include 1) universal face mask use, 2) maintaining physical distance from other persons and limiting in-person contacts, 3) avoiding nonessential indoor spaces and crowded outdoor spaces, 4) increasing testing to rapidly identify and isolate infected persons, 5) promptly identifying, quarantining, and testing close contacts of persons with known COVID-19, 6) safeguarding persons most at risk for severe illness or death from infection with SARS-CoV-2, the virus that causes COVID-19, 7) protecting essential workers with provision of adequate personal protective equipment and safe work practices, 8) postponing travel, 9) increasing room air ventilation and enhancing hand hygiene and environmental disinfection, and 10) achieving widespread availability and high community coverage with effective COVID-19 vaccines. In combination, these strategies can reduce SARS-CoV-2 transmission, long-term sequelae or disability, and death, and mitigate the pandemic's economic impact. Consistent implementation of these strategies improves health equity, preserves health care capacity, maintains the function of essential businesses, and supports the availability of in-person instruction for kindergarten through grade 12 schools and preschool. Individual persons, households, and communities should take these actions now to reduce SARS-CoV-2 transmission from its current high level. These actions will provide a bridge to a future with wide availability and high community coverage of effective vaccines, when safe return to more everyday activities in a range of settings will be possible.


Subject(s)
COVID-19/prevention & control , Guidelines as Topic , Public Health Practice , COVID-19/mortality , COVID-19/transmission , Community-Acquired Infections/mortality , Community-Acquired Infections/prevention & control , Community-Acquired Infections/transmission , Humans , United States/epidemiology
6.
Semergen ; 47(6): 411-425, 2021 Sep.
Article in Spanish | MEDLINE | ID: covidwho-1336932

ABSTRACT

Community-acquired pneumonia (CAP) continues to be an important cause of morbidity and mortality in adults. The aim of this study is to update the practical prevention guide for CAP through vaccination in Spain developed in 2016 and updated in 2018, based on available vaccines and evidence through bibliographic review and expert opinion. The arrival of COVID-19 as a new cause of CAP and the recent availability of safe and effective vaccines constitutes the most significant change. Vaccines against pneumococcus, influenza, pertussis and COVID-19 can help to reduce the burden of disease from CAP and its associated complications. The available evidence supports the priority indications established in this guide, and it would be advisable to try to achieve a widespread dissemination and implementation of these recommendations in routine clinical practice.


Subject(s)
COVID-19 , Community-Acquired Infections , Pneumonia, Pneumococcal , Adult , Community-Acquired Infections/prevention & control , Humans , Pneumococcal Vaccines , Pneumonia, Pneumococcal/prevention & control , SARS-CoV-2 , Vaccination
7.
Int J Infect Dis ; 109: 182-188, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1333472

ABSTRACT

OBJECTIVE: To evaluate the indirect effect of COVID-19 large-scale containment measures on the incidence of community-acquired pneumonia (CAP) in older people during the first epidemic wave of COVID-19 in Tuscany, Italy. METHODS: A population-based study was carried out on data from the Tuscany healthcare system. The outcome measures were: hospitalization rate for CAP, severity of CAP hospitalizations, and outpatient consumption of antibacterials for CAP in people aged 65 and older. Outcomes were compared between corresponding periods in 2020 (week 1 to 27) and previous years. RESULTS: Compared with the average of the corresponding periods in the previous 3 years, significant reductions in weekly hospitalization rates for CAP were observed from the week in which the national containment measures were imposed (week 10) until the end of the first COVID-19 wave in July (week 27). There was also a significant decrease in outpatient consumption in all antibacterial classes for CAP. CONCLUSIONS: The implementation of large-scale COVID-19 containment measures likely reduced the incidence of CAP in older people during the first wave of the COVID-19 pandemic in Tuscany, Italy. Considering this indirect impact of pandemic containment measures on respiratory tract infections may improve the planning of health services during a pandemic in the future.


Subject(s)
COVID-19 , Community-Acquired Infections , Pneumonia , Aged , Community-Acquired Infections/epidemiology , Community-Acquired Infections/prevention & control , Hospitalization , Humans , Incidence , Italy/epidemiology , Pandemics , SARS-CoV-2
8.
Pediatrics ; 148(4)2021 10.
Article in English | MEDLINE | ID: covidwho-1332046

ABSTRACT

OBJECTIVES: When the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic began, experts raised concerns about in-person instruction in the setting of high levels of community transmission. We describe secondary transmission of SARS-CoV-2 within North Carolina kindergarten through 12th-grade school districts during a winter surge to determine if mitigation strategies can hinder within-school transmission. METHODS: From October 26, 2020, to February 28, 2021, 13 North Carolina school districts participating in The ABC Science Collaborative were open for in-person instruction, adhered to basic mitigation strategies, and tracked community- and school-acquired SARS-CoV-2 cases. Public health officials adjudicated each case. We combined these data with that from August 2020 to evaluate the effect of the SARS-CoV-2 winter surge on infection rates as well as weekly community- and school-acquired cases. We evaluated the number of secondary cases generated by each primary case as well as the role of athletic activities in school-acquired cases. RESULTS: More than 100 000 students and staff from 13 school districts attended school in person; of these, 4969 community-acquired SARS-CoV-2 infections were documented by molecular testing. Through contact tracing, North Carolina local health department staff identified an additional 209 infections among >26 000 school close contacts (secondary attack rate <1%). Most within-school transmissions in high schools (75%) were linked to school-sponsored sports. School-acquired cases slightly increased during the surge; however, within-school transmission rates remained constant, from presurge to surge, with ∼1 school-acquired case for every 20 primary cases. CONCLUSIONS: With adherence to basic mitigation strategies, within-school transmission of SARS-CoV-2 can be interrupted, even during a surge of community infections.


Subject(s)
COVID-19/transmission , Schools , Adolescent , COVID-19/ethnology , COVID-19/prevention & control , Child , Child, Preschool , Community-Acquired Infections/ethnology , Community-Acquired Infections/prevention & control , Community-Acquired Infections/transmission , Contact Tracing , Humans , Masks , North Carolina/epidemiology , Pandemics , Physical Distancing , Race Factors , SARS-CoV-2
9.
MMWR Morb Mortal Wkly Rep ; 70(20): 744-748, 2021 May 21.
Article in English | MEDLINE | ID: covidwho-1237003

ABSTRACT

The occurrence of cases of COVID-19 reported by child care facilities among children, teachers, and staff members is correlated with the level of community spread (1,2). To describe characteristics of COVID-19 cases at child care facilities and facility adherence to guidance and recommendations, the District of Columbia (DC) Department of Health (DC Health) and CDC reviewed COVID-19 case reports associated with child care facilities submitted to DC Health and publicly available data from the DC Office of the State Superintendent of Education (OSSE) during July 1-December 31, 2020. Among 469 licensed child care facilities, 112 (23.9%) submitted 269 reports documenting 316 laboratory-confirmed cases and three additional cases identified through DC Health's contact tracers. Outbreaks associated with child care facilities,† defined as two or more laboratory-confirmed and epidemiologically linked cases at a facility within a 14-day period (3), occurred in 27 (5.8%) facilities and accounted for nearly one half (156; 48.9%) of total cases. Among the 319 total cases, 180 (56.4%) were among teachers or staff members. The majority (56.4%) of facilities reported cases to DC Health on the same day that they were notified of a positive test result for SARS-CoV-2, the virus that causes COVID-19, by staff members or parents.§ Facilities were at increased risk for an outbreak if they had been operating for <3 years, if symptomatic persons sought testing ≥3 days after symptom onset, or if persons with asymptomatic COVID-19 were at the facility. The number of outbreaks associated with child care facilities was limited. Continued implementation and maintenance of multiple prevention strategies, including vaccination, masking, physical distancing, cohorting, screening, and reporting, are important to reduce transmission of SARS-CoV-2 in child care facilities and to facilitate a timely public health response to prevent outbreaks.¶.


Subject(s)
COVID-19/epidemiology , Child Day Care Centers , Disease Outbreaks , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Testing/statistics & numerical data , Child , Child Day Care Centers/statistics & numerical data , Child, Preschool , Community-Acquired Infections/epidemiology , Community-Acquired Infections/prevention & control , Disease Outbreaks/prevention & control , District of Columbia/epidemiology , Humans , Risk Assessment , SARS-CoV-2/isolation & purification
11.
MMWR Morb Mortal Wkly Rep ; 70(1): 20-23, 2021 Jan 08.
Article in English | MEDLINE | ID: covidwho-1055331

ABSTRACT

Preventing transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), in colleges and universities requires mitigation strategies that address on- and off-campus congregate living settings as well as extracurricular activities and other social gatherings (1-4). At the start of the academic year, sorority and fraternity organizations host a series of recruitment activities known as rush week; rush week culminates with bid day, when selections are announced. At university A in Arkansas, sorority rush week (for women) was held during August 17-22, 2020, and consisted of on- and off-campus social gatherings, including an outdoor bid day event on August 22. Fraternity rush week (for men) occurred during August 27-31, with bid day scheduled for September 5. During August 22-September 5, university A-associated COVID-19 cases were reported to the Arkansas Department of Health (ADH). A total of 965 confirmed and probable COVID-19 cases associated with university A were identified, with symptom onset occurring during August 20-September 5, 2020; 31% of the patients with these cases reported involvement in any fraternity or sorority activity. Network analysis identified 54 gatherings among all linkages of cases to places of residence and cases to events, 49 (91%) were linked by participation in fraternity and sorority activities accounting for 42 (72%) links among gatherings. On September 4, university A banned gatherings of ≥10 persons, and fraternity bid day was held virtually. The rapid increase in COVID-19 cases was likely facilitated by on- and off-campus congregate living settings and activities, and health departments should work together with student organizations and university leadership to ensure compliance with mitigation measures.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , College Fraternities and Sororities/organization & administration , Community-Acquired Infections/epidemiology , Adolescent , Adult , Aged , Arkansas/epidemiology , COVID-19/prevention & control , Child , Child, Preschool , Community-Acquired Infections/prevention & control , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Universities , Young Adult
12.
Curr Opin Infect Dis ; 34(2): 175-179, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1045793

ABSTRACT

PURPOSE OF REVIEW: Coronavirus disease 2019 (COVID-19) has produced an extraordinary amount of literature in a short time period. This review focuses on what the new literature has provided in terms of more general information about the management of community-acquired pneumonia (CAP). RECENT FINDINGS: Measures taken to reduce the spread of COVID-19 have caused a significant drop in influenza worldwide. Improvements in imaging, especially ultrasound, and especially in the application of rapid molecular diagnosis are likely to have significant impact on the management of CAP. Therapeutic advances are so far limited. SUMMARY: COVID-19 has taught us that we can do far more to prevent seasonal influenza and its associated mortality, morbidity and economic cost. Improvements in imaging and pathogen diagnosis are welcome, as is the potential for secondary benefits of anti-COVID-19 therapies that may have reach effect on respiratory viruses other than severe acute respiratory syndrome coronavirus 2. As community-transmission is likely to persist for many years, recognition and treatment of severe acute respiratory syndrome coronavirus 2 will need to be incorporated into CAP guidelines moving forward.


Subject(s)
COVID-19/diagnosis , COVID-19/prevention & control , COVID-19/epidemiology , COVID-19/therapy , Clinical Laboratory Techniques , Community-Acquired Infections/diagnosis , Community-Acquired Infections/prevention & control , Community-Acquired Infections/therapy , Diagnostic Imaging , Humans , Infection Control , Pneumonia/diagnosis , Pneumonia/prevention & control , Pneumonia/therapy , SARS-CoV-2
16.
Influenza Other Respir Viruses ; 15(4): 439-445, 2021 07.
Article in English | MEDLINE | ID: covidwho-862264

ABSTRACT

BACKGROUND: Clusters of COVID-19 cases amplify the pandemic and are critical targets for intervention, but comprehensive cluster-level data are not collected systematically by federal or most state public health entities. This analysis characterizes COVID-19 clusters among vulnerable populations housed in congregate living settings across an entire community and describes early mitigation efforts. METHODS: The Cuyahoga County Board of Health identified and interviewed COVID-19 cases and exposed contacts, assessing possible connections to congregate living facilities within its jurisdiction from March 7, 2020, to May 15, 2020, during the first phase of the pandemic, while state of Ohio stay-at-home orders were in effect. A multi-disciplinary team-based response network was mobilized to support active case finding and develop facility-focused containment strategies. RESULTS: We identified a cascade of 45 COVID-19 clusters across community facilities (corrections, nursing, assisted living, intermediate care, extended treatment, shelters, group homes). Attack rates were highest within small facilities (P < .01) and large facilities requiring extensive support to implement effective containment measures. For 25 clusters, we identified an index case who frequently (88%) was a healthcare worker. Engagement of clinical, community, and government partners through public health coordination efforts created opportunities to rapidly develop and coordinate effective response strategies to support the facilities facing the dawning impact of the pandemic. CONCLUSIONS: Active cluster investigations can uncover the dynamics of community transmission affecting both residents of congregate settings and their caregivers and help to target efforts toward populations with ongoing challenges in access to detection and control resources.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Public Health Practice , Residential Facilities/statistics & numerical data , COVID-19/prevention & control , Community-Acquired Infections/epidemiology , Community-Acquired Infections/prevention & control , Community-Acquired Infections/transmission , Contact Tracing , Disease Transmission, Infectious/prevention & control , Disease Transmission, Infectious/statistics & numerical data , Health Personnel , Humans , Incidence , Ohio/epidemiology , SARS-CoV-2
18.
JAMA Intern Med ; 180(12): 1665-1671, 2020 12 01.
Article in English | MEDLINE | ID: covidwho-738931

ABSTRACT

Importance: Evidence of whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), can be transmitted as an aerosol (ie, airborne) has substantial public health implications. Objective: To investigate potential transmission routes of SARS-CoV-2 infection with epidemiologic evidence from a COVID-19 outbreak. Design, Setting, and Participants: This cohort study examined a community COVID-19 outbreak in Zhejiang province. On January 19, 2020, 128 individuals took 2 buses (60 [46.9%] from bus 1 and 68 [53.1%] from bus 2) on a 100-minute round trip to attend a 150-minute worship event. The source patient was a passenger on bus 2. We compared risks of SARS-CoV-2 infection among at-risk individuals taking bus 1 (n = 60) and bus 2 (n = 67 [source patient excluded]) and among all other individuals (n = 172) attending the worship event. We also divided seats on the exposed bus into high-risk and low-risk zones according to the distance from the source patient and compared COVID-19 risks in each zone. In both buses, central air conditioners were in indoor recirculation mode. Main Outcomes and Measures: SARS-CoV-2 infection was confirmed by reverse transcription polymerase chain reaction or by viral genome sequencing results. Attack rates for SARS-CoV-2 infection were calculated for different groups, and the spatial distribution of individuals who developed infection on bus 2 was obtained. Results: Of the 128 participants, 15 (11.7%) were men, 113 (88.3%) were women, and the mean age was 58.6 years. On bus 2, 24 of the 68 individuals (35.3% [including the index patient]) received a diagnosis of COVID-19 after the event. Meanwhile, none of the 60 individuals in bus 1 were infected. Among the other 172 individuals at the worship event, 7 (4.1%) subsequently received a COVID-19 diagnosis. Individuals in bus 2 had a 34.3% (95% CI, 24.1%-46.3%) higher risk of getting COVID-19 compared with those in bus 1 and were 11.4 (95% CI, 5.1-25.4) times more likely to have COVID-19 compared with all other individuals attending the worship event. Within bus 2, individuals in high-risk zones had moderately, but nonsignificantly, higher risk for COVID-19 compared with those in the low-risk zones. The absence of a significantly increased risk in the part of the bus closer to the index case suggested that airborne spread of the virus may at least partially explain the markedly high attack rate observed. Conclusions and Relevance: In this cohort study and case investigation of a community outbreak of COVID-19 in Zhejiang province, individuals who rode a bus to a worship event with a patient with COVID-19 had a higher risk of SARS-CoV-2 infection than individuals who rode another bus to the same event. Airborne spread of SARS-CoV-2 seems likely to have contributed to the high attack rate in the exposed bus. Future efforts at prevention and control must consider the potential for airborne spread of the virus.


Subject(s)
COVID-19 , Communicable Disease Control/methods , Community-Acquired Infections , Motor Vehicles/statistics & numerical data , SARS-CoV-2 , Transportation/methods , Air Pollution , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , China/epidemiology , Cohort Studies , Community-Acquired Infections/diagnosis , Community-Acquired Infections/epidemiology , Community-Acquired Infections/prevention & control , Community-Acquired Infections/transmission , Disease Transmission, Infectious/prevention & control , Disease Transmission, Infectious/statistics & numerical data , Female , Humans , Male , Middle Aged , Risk Assessment , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity
19.
Acta Med Port ; 33(9): 583-592, 2020 Sep 01.
Article in Portuguese | MEDLINE | ID: covidwho-612476

ABSTRACT

The new SARS-CoV-2 pandemic is an example of an international public health emergency, which is associated with considerable social and economic challenges. At the healthcare level there is the risk that nosocomial outbreaks can be local amplifiers. Adequate infection control practices are of critical importance, which include proper use of personal protective equipment. This equipment must be appropriate to the pathogen transmission route that, in the case of SARS-CoV-2, occurs through droplet and contact routes. The infected individual, when talking, coughing or sneezing, spreads droplets containing the virus, directly contaminating other individuals within one to two meters of distance, as well as the surrounding environment. Airborne transmission may occur when aerosol-generating procedures are performed. Concerning respiratory protection, there is currently weak evidence that the use of respirators provides better protection than surgical masks for SARS-CoV-2 or other viruses (with the exception of aerosol-generating procedures, in which case the use of a respirator is recommended). Eye protection should be guaranteed whenever there is a risk of splashes, droplets or aerosols. The use of different, or higher than necessary, level of personal protective equipment, for the transmission route of the agent, is a form of misuse and can affect its supply for situations when it is clearly indicated. The adequate provision of protective equipment, as well as training of healthcare professionals in its correct use, is highly recommended to ensure safety of care.


A nova pandemia por SARS-CoV-2 é um exemplo de uma emergência de saúde pública de âmbito internacional, associada a consideráveis desafios sociais e económicos. A nível das unidades de saúde há o risco que surtos nosocomiais sejam amplificadores locais. Perante tal, práticas de controlo de infeção são de importância crítica no funcionamento destes serviços, de que faz parte a utilização adequada de equipamento de proteção individual. Este deve ser adequado à via de transmissão do agente que, no caso do SARS-CoV-2, é através de gotícula e contacto. O indivíduo infetado, ao falar, tossir ou espirrar, dissemina gotículas que contêm o vírus, contaminando diretamente outros indivíduos, que estão num raio de um a dois metros, assim como o ambiente. A transmissão por via aérea também poderá ocorrer, no caso de procedimentos geradores de aerossóis. A nível da proteção respiratória existe, atualmente, fraca evidência que a utilização de respiradores permita maior proteção que máscara cirúrgica para o SARS-CoV-2 ou outros vírus(com exceção dos procedimentos geradores de aerossóis, em que a utilização de um respirador é recomendada). A proteção ocular deverá ser garantida sempre que houver risco de salpicos, gotículas ou aerossóis. A utilização incorreta de equipamento de proteção individual, para a via de transmissão do agente ou superior ao necessário, é uma forma de uso indevido e pode afetar o seu suprimento para as situações em que é realmente indicado. A disponibilização deste equipamento de proteção, e formação dos profissionais de saúde na sua correta utilização, é fortemente recomendado para garantir a prestação de cuidados seguros.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Cross Infection/prevention & control , Eye Protective Devices , Health Personnel , Infection Control , Pandemics/prevention & control , Personal Protective Equipment , Pneumonia, Viral/prevention & control , Air Microbiology , Bronchoscopy/adverse effects , COVID-19 , Community-Acquired Infections/prevention & control , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Cross Infection/epidemiology , Cross Infection/transmission , Face , Humans , Hygiene , Infection Control/instrumentation , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Intubation, Intratracheal/adverse effects , Masks/classification , Masks/supply & distribution , Personal Protective Equipment/supply & distribution , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , SARS-CoV-2 , Surgical Equipment/adverse effects
20.
Farm Hosp ; 44(7): 43-48, 2020 06 12.
Article in English | MEDLINE | ID: covidwho-599564

ABSTRACT

The COVID-19 pandemic is having a devastating effect on the nursing homes for dependent older people. The difficulty of management of this crisis is aggravated by the frailty of the people served and by the specific characteristics of the care  area, mainly the fact of not being integrated into the health system. The  objective of this work is to describe the pharmaceutical care developed by a  hospital pharmacy service established in a nursing home and, from a more  global perspective, analyze the strengths and weaknesses found from the  various experiences of hospital pharmacy in all spanish autonomous  communities to deal with this pandemic. Specialized pharmaceutical care has  provided rigor in the validation and treatments review processes from a  comprehensive perspective, maximizing safety and collaborating in the  establishment of the therapeutic intensity degree most appropriate to the  individual situation, has ensured the availability of all necessary medications,  has collaborated in the acquisition and management of personal protective equipment, has been able to adapt the dispensation processes to the internal  nursing homes sectorization and has facilitated the coordination between the  nursing home and the health system. It is clear that the crisis casued by COVID- 19 has put relevance of the need to integrate the social-health level into the  health system. And also, the contribution of specialized pharmaceutical care in  improving healthcare coverage and coordination with health services has  highlighted the urgency of developing the current legislation, prioritizing the  establishment of pharmacy services able to provid specialized and specific care  for this area, so that it meets healthcare needs and is integrated into the health  system.


La pandemia COVID-19 está teniendo un efecto devastador en las residencias de personas mayores dependientes. La dificultad de la gestión de la crisis se ve  agravada por la fragilidad de las personas atendidas y por las propias  características del ámbito asistencial, principalmente el hecho de no estar  integrado en el sistema de salud. El objetivo del presente trabajo es describir la  atención farmacéutica especializada desarrollada por un servicio de farmacia  hospitalario establecido en un centro sociosanitario y, desde una perspectiva  más global, analizar las fortalezas y debilidades encontradas desde las diversas experiencias de la farmacia hospitalaria en el conjunto de comunidades autónomas para hacer frente a esta pandemia. La atención  farmacéutica especializada ha aportado rigor en los procesos de validación y  revisión de los tratamientos desde una perspectiva integral, maximizando la  seguridad y colaborando en el establecimiento del grado de intensidad  terapéutica más adecuado a la situación individual de la persona afectada, ha  asegurado la disponibilidad de todos los medicamentos necesarios, ha  colaborado en la adquisición y gestión de los equipos de protección individual, ha  sido capaz de adaptar los procesos de dispensación a la sectorización interna de las residencias y ha facilitado la coordinación entre la residencia y el sistema  de salud. Resulta evidente que la crisis provocada por la COVID-19 ha puesto de relevancia la necesidad de integrar el ámbito sociosanitario en el sistema de  salud. Y asimismo, la contribución de la atención farmacéutica especializada en  la mejora de la cobertura asistencial y de la coordinación con los servicios  sanitarios ha puesto de manifiesto la urgencia de desarrollar la legislación  vigente, priorizando el establecimiento de servicios de farmacia capaces de  proporcionar una atención especializada y específica para este ámbito  asistencial, de forma que cubra las necesidades asistenciales y quede integrada  en la estructura sanitaria.


Subject(s)
Ambulatory Care/organization & administration , Betacoronavirus , Coronavirus Infections/drug therapy , Nursing Homes/organization & administration , Pandemics , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Aged , COVID-19 , Community-Acquired Infections/epidemiology , Community-Acquired Infections/prevention & control , Community-Acquired Infections/transmission , Comorbidity , Coronavirus Infections/nursing , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Disease Outbreaks , Drug Interactions , Female , Frail Elderly , Humans , Infection Control/organization & administration , Male , Medication Systems, Hospital/organization & administration , Pandemics/prevention & control , Personal Protective Equipment , Personnel Staffing and Scheduling , Pneumonia, Viral/nursing , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Polypharmacy , SARS-CoV-2 , Spain/epidemiology
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