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1.
PLoS One ; 16(2): e0247029, 2021.
Article in English | MEDLINE | ID: covidwho-1088761

ABSTRACT

Strategies to return to dental practice in pandemic times is a new challenge due to the generation and spread of potentially contaminated dispersion particles (PCDP) that may contain the SARS-CoV-2, the etiological factor of the COVID-19 disease. Due to the significant dispersion of PCDP in the dental environment, the use of equipment such as ultrasonic tips have been inadvisable during the pandemic. Several clinical procedures, however, benefit from the use of such equipment. Thus, using a microbial dispersion model of PCDP, the aim of this study was to compare the dispersion caused by the dental drill (DD) an ultrasonic tip (UT) alone and the UT coupled with a Spray control (SC) device. The DD, UT (with or without the SC) were activated for one minute having had the water from the reservoir replaced with a suspension of Lactobacillus casei Shirota (1.5 x 108 CFU/mL). Petri dishes containing MRS agar were positioned at 50cm, 100cm and 150cm from the headrest of the dental chair at different angles (0 degree and 90 degrees). At 50 cm, the mean CFU (standard deviation) of L. casei Shirota was 13554.60 (4071.03) for the DD, 286.67 (73.99) for the US (97.89% reduction), and 4.5 (0.58) CFU for the UT-SC (p < 0.0001), establishing a further 98.43% reduction between UT and UT with SC. The UT with SC model proved effective in reducing dispersion from the UT, endorsing its use as an additional strategy to reduce PCDP in the dental environment in times of pandemic.


Subject(s)
Air Pollution, Indoor/prevention & control , Dental Scaling/instrumentation , /transmission , Containment of Biohazards/instrumentation , Humans , Lactobacillus casei , Ultrasonics
2.
Arq. odontol ; 56: 1-9, jan.-dez. 2020. ilus
Article in Portuguese | LILACS (Americas) | ID: covidwho-1022754

ABSTRACT

Objetivo: O presente trabalho visa orientar o odontólogo sobre as novas regras de uso de EPIs, normas de biossegurança, técnicas odontológicas utilizadas no atendimento da criança, para que possamos realizar os procedimentos odontológicos com segurança antes, durante e após a pandemia da COVID-19. Métodos: Após busca em diversos bancos de dados (Google, SciELO, Bireme, Portal de Periódicos da CAPES, PubMed), em 30/03/2020, 21 artigos relacionados ao atendimento odontológico durante a pandemia foram selecionados. O critério de inclusão dos artigos foi se relacionar às normas específicas de biossegurança para o atendimento odontológico durante a pandemia, especialmente em crianças. Resultados: Vinte e um artigos foram incluídos no trabalho sendo sete deles, específicos do atendimento odontopediátrico. As consultas odontopediátricas devem ser marcadas de forma espaçada, evitando o encontro de pessoas na sala de espera. A criança deve vir acompanhada de apenas um acompanhante. Algumas barreiras devem ser usadas nas crianças como máscara, gorro e óculos. O odontólogo deve usar máscara N95 e protetor facial, além dos outros EPI's. Previamente ao atendimento, bochecho de peróxido de hidrogênio a 1% deve ser realizado pela criança. Técnicas operatórias (ART, aplicação de diamino fluoreto de prata e técnica Hall) que gerem menos aerossóis dever ser priorizadas. Se necessário o uso de baixa e alta rotação, estas deverão ser com sistema anti-reflexo e esterilizadas a cada paciente. Um intervalo de 1 a 2 horas deve ser dado entre pacientes, permitindo a ventilação da sala, diminuição dos aerossóis e desinfecção de todo o ambiente clínico. Conclusão: A pandemia do COVID-19 se tornou um risco ocupacional para odontólogos, crianças e responsáveis. Para evitar contágio e transmissão da doença, os odontólogos devem se capacitar por meio de informações seguras e cumprir as normas de biossegurança sugeridas.


Aim: The present work aims to guide the dentist as regards the new rules for the use of PPEs, biosafety standards, and dental techniques used in pediatric dental care, so that we can safely perform dental procedures before, during, and after the COVID-19 pandemic. Methods:After searching several databases (Google, SciELO, Bireme, Portal de Periódicos da CAPES, PubMed), on March 30, 2020, 21 articles related to dental care during the pandemic were selected. The inclusion criteria for the articles was to relate to specific biosafety standards for dental care during the pandemic, especially in children. Results: Twenty-one articles were included in the work, with seven of these specifically treating pediatric dental care. Dental appointments should be scheduled in a staggered manner, avoiding the meeting of people in the waiting room. The child must be accompanied by only one family member or guardian. Some barriers should be used with children, such as a mask, hat, and glasses. The dentist must wear an N95 mask and face shield, in addition to the other PPEs. Before attending, 1% hydrogen peroxide mouthwash must be used by the child. Operative techniques (ART, application of silver diamine fluoride and Hall technique), which generate less aerosols, should be given priority. If the use of low and high speed is necessary, they must be with an anti-reflective system and sterilized for each patient. An interval of 1 to 2 hours must be given between patients, allowing for the ventilation of the room, a reduction in aerosols, and the disinfection of the entire clinical environment. Conclusion: The COVID-19 pandemic has become an occupational hazard for dentists, children, and guardians. To avoid contagion and transmission of the disease, dentists must train themselves through secure information and comply with the suggested biosafety rules.


Subject(s)
Child , Coronavirus Infections/prevention & control , Containment of Biohazards , Dental Facilities , Dentists , Pandemics/prevention & control , Occupational Health , Dental Care , Dental Care for Children
3.
PLoS One ; 15(10): e0240578, 2020.
Article in English | MEDLINE | ID: covidwho-881157

ABSTRACT

The initial phase dynamics of an epidemic without containment measures is commonly well modelled using exponential growth models. However, in the presence of containment measures, the exponential model becomes less appropriate. Under the implementation of an isolation measure for detected infectives, we propose to model epidemic dynamics by fitting a flexible growth model curve to reported positive cases, and to infer the overall epidemic dynamics by introducing information on the detection/testing effort and recovery and death rates. The resulting modelling approach is close to the Susceptible-Infectious-Quarantined-Recovered model framework. We focused on predicting the peaks (time and size) in positive cases, active cases and new infections. We applied the approach to data from the COVID-19 outbreak in Italy. Fits on limited data before the observed peaks illustrate the ability of the flexible growth model to approach the estimates from the whole data.


Subject(s)
Betacoronavirus , Containment of Biohazards/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Models, Statistical , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Quarantine/methods , Coronavirus Infections/virology , Humans , Incidence , Italy/epidemiology , Pneumonia, Viral/virology , Retrospective Studies , Time Factors
4.
J Forensic Leg Med ; 76: 102036, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-863229

ABSTRACT

The COVID-19 pandemic has forced forensic practitioners to consider how we perform our normal duties, especially when those duties involve humans. The potential for contracting the virus from working in close contact with living sufferers is high, and we have yet to fully determine the risk of infection from the deceased. In an attempt to support the community, the Journal of Forensic & Legal Medicine has drawn together three articles which underline the importance of continued forensic medical practice during the pandemic and highlight some factors to consider in a Roadmap towards safe practice. Our Roadmap has intentionally taken an international perspective and supports other work we have published in the Journal on our collective response to the COVID-19 crisis.


Subject(s)
Betacoronavirus , Coronavirus Infections/pathology , Infection Control/organization & administration , Mortuary Practice/organization & administration , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/pathology , Containment of Biohazards/methods , Coronavirus Infections/prevention & control , Forensic Medicine/organization & administration , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control
5.
Enferm. foco (Brasília) ; 11(1,n.esp): 78-83, ago. 2020.
Article in Portuguese | LILACS (Americas) | ID: covidwho-861744

ABSTRACT

Objetivo: Refletir sobre desafios enfrentados pela Enfermagem brasileira no combate ao COVID-19. Método: Artigo reflexivo acerca dos desafios da Enfermagem nos serviços de saúde brasileiros em tempos de pandemia. Resultados: Em um país com grandes diferenças econômicas, culturais e sociais são diversos desafios enfrentados pela Enfermagem nas dimensões: institucionais, profissionais e pessoais. A categoria profissional encontra-se na linha de frente no combate a pandemia, com alto risco de exposição ao vírus. Os trabalhadores, maioria sexo feminino, estão trabalhando com medo, sob pressão, adoecendo e muitos morrendo. Indicadores do Conselho Federal de Enfermagem evidenciaram maioria dos óbitos na faixa etária entre 31 e 40 anos. Recomendações sobre medidas de prevenção não estão sendo suficientes para barrar as infecções entre os funcionários, é necessário o serviço de saúde fornecer infraestrutura material e pessoal, associado ao diálogo e capacitação contínua dos trabalhadores. Conclusão: A pandemia marcou o ano internacional de comemorações da Enfermagem dando visibilidade a profissão. A história da profissão é permeada por lutas pela dignidade e reconhecimento. O cenário pandêmico acentuou os mais diversos riscos e problemas enfrentados diariamente pelos trabalhadores, entretanto, o compromisso com o cuidado biopsicossocial dos pacientes, família e comunidade sempre se mantém independentemente da situação vivenciada. (AU)


Objective: To reflect on the challenges faced by Brazilian Nursing in the fight against COVID-19. Method: Reflective article about the challenges of Nursing in Brazilian health services in times of pandemic. Results: In a country with great economic, cultural and social differences, there are several challenges faced by Nursing in the following dimensions: institutional, professional and personal. The professional category is at the frontline in fighting the pandemic, with a high risk of exposure to the virus. The workers, mostly female, are working in fear, under pressure, getting sick and many dying. Indicators of the Federal Nursing Council showed the majority of deaths in the age group between 31 and 40 years old. Recommendations on preventive measures are not being enough to stop infections among employees, it is necessary for the health service to provide material and personal infrastructure, associated with dialogue and continuous training of workers. Conclusion: The pandemic marked the international year of Nursing celebrations, giving visibility to the profession. The history of the profession is permeated by struggles for dignity and recognition. The pandemic scenario accentuated the most diverse risks and problems faced daily by workers, however, the commitment to the biopsychosocial care of patients, family and community always remains independent of the situation experienced. (AU)


Objetivo: Reflexionar sobre los desafíos que enfrenta la Enfermería brasileña en la lucha contra COVID-19. Método: Artículo reflexivo sobre los desafíos de la enfermería en los servicios de salud brasileños en tiempos de pandemia. Resultados: En un país con grandes diferencias económicas, culturales y sociales, la Enfermería enfrenta varios desafíos en las siguientes dimensiones: institucional, profesional y personal. La categoría profesional está a la vanguardia en la lucha contra la pandemia, con un alto riesgo de exposición al virus. Los trabajadores, en su mayoría mujeres, trabajan con miedo, bajo presión, enfermándose y muchos muriendo. Los indicadores del Consejo Federal de Enfermería mostraron la mayoría de las muertes en el grupo de edad entre 31 y 40 años. Las recomendaciones sobre medidas preventivas no son suficientes para detener las infecciones entre los empleados, es necesario que el servicio de salud brinde infraestructura material y personal, asociada con el diálogo y la capacitación continua de los trabajadores. Conclusión: La pandemia marcó el año internacional de las celebraciones de enfermería, dando visibilidad a la profesión. La historia de la profesión está impregnada de luchas por la dignidad y el reconocimiento. El escenario de la pandemia acentuó los riesgos y problemas más diversos que enfrentan diariamente los trabajadores, sin embargo, el compromiso con la atención biopsicosocial de los pacientes, la familia y la comunidad siempre es independiente de la situación experimentada. (AU)


Subject(s)
Pandemics , Public Health Nursing , Nursing , Coronavirus , Containment of Biohazards
6.
Braz. dent. sci ; 23(2,supl): 1-10, 2020. ilus
Article in English | LILACS (Americas) | ID: covidwho-860699

ABSTRACT

The current outbreak of coronavirus 2019 (COVID-19) challenges how professional standards have been defined so far. In Dentistry, biosafety measures already taken by professionals have been intensified, aiming to offer the patient urgent and emergency treatment with safety for both. In this context, Restorative Dentistry is responsible for the care of patients with caries injuries, with or without symptoms and, fractures of teeth and existing restorations. This article guides professionals, during the pandemic period, on the risks involved in adult and pediatric dental care for patients with restorative needs. It also discusses strategies to optimize clinical practice, reducing risks of contamination and virus transmission. (AU)


O atual surto de coronavírus 2019 (COVID-19), fez com que muitos profissionais repensassem sua postura de trabalho. Na Odontologia, medidas de biossegurança já realizadas pelos profissionais, foram intensificadas, com o objetivo de oferecer ao paciente um tratamento de urgência e emergência com segurança para ambos. Neste contexto, a Odontologia Restauradora é responsável pelo atendimento de pacientes com lesões de cárie, com ou sem sintomatologia, e fraturas de dentes e restaurações já existentes. Este trabalho orienta os profissionais quanto aos riscos envolvidos no atendimento odontológico, adulto e pediátrico, de paciente com necessidades restauradoras durante o período de pandemia. O artigo também discute estratégias para otimizar o atendimento, diminuindo riscos de contaminação e transmissão do vírus. (AU)


Subject(s)
Coronavirus Infections , Containment of Biohazards , Dentistry , Pandemics
7.
Curr Protoc Microbiol ; 59(1): e126, 2020 12.
Article in English | MEDLINE | ID: covidwho-847847

ABSTRACT

SARS-CoV-2, the causative agent of COVID-19, has been responsible for a million deaths worldwide as of September 2020. At the time of this writing, there are no available US FDA-approved therapeutics for the treatment of SARS-CoV-2 infection. Here, we describe a detailed protocol to generate recombinant (r)SARS-CoV-2 using reverse-genetics approaches based on the use of a bacterial artificial chromosome (BAC). This method will allow the production of mutant rSARS-CoV-2-which is necessary for understanding the function of viral proteins, viral pathogenesis and/or transmission, and interactions at the virus-host interface-and attenuated SARS-CoV-2 to facilitate the discovery of effective countermeasures to control the ongoing SARS-CoV-2 pandemic. © 2020 Wiley Periodicals LLC. Basic Protocol: Generation of recombinant SARS-CoV-2 using a bacterial artificial chromosome Support Protocol: Validation and characterization of rSARS-CoV-2.


Subject(s)
Betacoronavirus/genetics , Chromosomes, Artificial, Bacterial/genetics , Animals , Betacoronavirus/growth & development , Chlorocebus aethiops , Containment of Biohazards , Transfection , Vero Cells
8.
Rev. enferm. UERJ ; 28: e50360, jan.-dez. 2020.
Article in English, Portuguese | LILACS (Americas) | ID: covidwho-831603

ABSTRACT

Objetivo: descrever as recomendações sobre o uso racional e seguro dos equipamentos de proteção individual (EPI) no transcorrer da cadeia assistencial de pessoas com suspeita ou confirmação de contaminação pelo novo coronavírus. Conteúdo: o novo coronavírus é responsável pela doença Covid-19, e dentre as pessoas com maior risco de desenvolver a infecção estão os trabalhadores de saúde, devido ao contato muito próximo a pacientes. Desse modo, a utilização de EPI é recomendação prioritária a estes trabalhadores. Todavia, em função do desabastecimento internacional e nacional relacionado a estes equipamentos, o uso racional é fundamental a fim de evitar que o impacto do desabastecimento seja ainda maior. Conclusão: o uso de EPI é indispensável aos trabalhadores de saúde durante a pandemia de Covid-19, contudo, é imprescindível coordenar a cadeia de fornecimento destes insumos, implementar estratégias que minimizem a necessidade de EPI e garantir o uso de maneira adequada.


Objective: to describe the recommendations on the rational, safe use of personal protective equipment (PPE) throughout the chain of care for people with suspected or confirmed contamination by the new coronavirus. Content: the new coronavirus is responsible for the disease Covid-19, and among those at high risk of infection are health workers in very close contact with patients. It is thus a priority recommendation for these workers to use PPE. However, international and national shortages of this equipment make rational use essential in order to prevent even greater impact from these shortages. Conclusion: it is essential that health workers use PPE during the Covid-19 pandemic, but it is also essential to coordinate the supply chain for these inputs, implement strategies that minimize the need for PPE and ensure proper use.


Objetivo: describir las recomendaciones sobre el uso racional y seguro del equipo de protección personal (EPP) en toda la cadena de atención para las personas con sospecha o confirmación de contaminación por el nuevo coronavirus. Contenido: el nuevo coronavirus es responsable de la enfermedad de Covid-19, y entre aquellos con alto riesgo de infección se encuentran los trabajadores de la salud en contacto muy cercano con los pacientes. Por lo tanto, es una recomendación prioritaria para estos trabajadores usar EPP. Sin embargo, la escasez internacional y nacional de este equipo hace que el uso racional sea esencial para evitar un impacto aún mayor de esta escasez. Conclusión: es esencial que los trabajadores de la salud usen EPP durante la pandemia de Covid-19, pero también es esencial coordinar la cadena de suministro para estos insumos, implementar estrategias que minimicen la necesidad de EPP y garantizar un uso adecuado.


Subject(s)
Coronavirus Infections/prevention & control , Personal Protective Equipment/supply & distribution , Betacoronavirus , Masks/supply & distribution , Occupational Risks , Containment of Biohazards/standards , Personal Protective Equipment/standards , Masks/standards
9.
Rev. enferm. UERJ ; 28: e50721, jan.-dez. 2020.
Article in English, Portuguese | LILACS (Americas) | ID: covidwho-828134

ABSTRACT

Objetivo: apresentar atualizações para a ressuscitação cardiopulmonar em pacientes suspeitos e confirmados com COVID-19. Método: revisão compreensiva da literatura, com síntese narrativa das evidências de diretrizes e recomendações da Organização Mundial de Saúde, Associação de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma e National Association of Emergency Medical Technicians. Resultados: as principais atualizações trazem informações sobre especificidades das manobras de ressuscitação cardiopulmonar; preparação do ambiente, recursos humanos e materiais, reconhecimento da parada cardiorrespiratória e ações iniciais; estratégias de ventilação e acesso invasivo da via aérea; ajustes do ventilador mecânico e manobras de ressuscitação cardiopulmonar em pacientes pronados. Considerações finais: profissionais de saúde envolvidos no atendimento à parada cardiorrespiratória de pacientes suspeitos e/ou confirmados com COVID-19 podem encontrar inúmeros desafios, portanto devem seguir com rigor o protocolo estabelecido para maximizar a efetividade das manobras de ressuscitação e minimizar o risco de contágio pelo vírus e sua disseminação.


Objective: to present updates for cardiopulmonary resuscitation in suspected and confirmed patients with COVID-19. Method: comprehensive literature review with narrative synthesis of the evidence of guidelines and recommendations from World Health Organization, Associação de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma and National Association of Emergency Medical Technicians. Results: the main updates bring information about the specifics of cardiopulmonary resuscitation maneuvers; preparation of the environment and human and material resources, recognition of cardiorespiratory arrest and initial actions; ventilation and invasive airway access strategies; mechanical ventilator adjustments and cardiopulmonary resuscitation maneuvers in patients in the prone position. Final considerations: health professionals involved in the care of cardiorespiratory arrest of suspected and/or confirmed patients with COVID-19 can face numerous challenges, so they must strictly follow the protocol established to maximize the effectiveness of resuscitation maneuvers and minimize the risk of contagion by the virus and its spread.


Objetivo: apresentar actualizaciones para la reanimación cardiopulmonar en pacientes sospechos os y confirmados con COVID-19. Método: revisión exhaustiva de la literatura con síntesis narrativa de la evidencia de guías y recomendaciones de la Organización Mundial de la Salud, Associação de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma and National Association of Emergency Medical Technicians. Resultados: las principales actualizaciones aportan información sobre los detalles de las maniobras de reanimación cardiopulmonar; preparación del medio ambiente y recursos humanos y materiales, reconocimiento de paro cardiorrespiratorio y acciones iniciales; estrategias de ventilación y acceso invasivo a las vías aéreas; ajustes del ventilador mecánico y maniobras de reanimación cardiopulmonar en pacientes en decúbito prono. Consideraciones finales: los profesionales de la salud involucrados en la atención del paro cardiorrespiratorio de pacientes sospechosos y/o confirmados con COVID-19 pueden enfrentar numerosos desafíos, por lo que deben seguir estrictamente el protocolo establecido para maximizar la efectividad de las maniobras de reanimación y minimizar el riesgo de contagio por el virus y supropagación.


Subject(s)
Humans , Male , Female , Cardiopulmonary Resuscitation/standards , Coronavirus Infections/complications , Betacoronavirus , Heart Arrest/etiology , Respiration, Artificial/methods , Clinical Protocols/standards , Cardiopulmonary Resuscitation/methods , Containment of Biohazards/standards , Heart Arrest/rehabilitation , Heart Massage/methods , Nursing, Team/standards
10.
Curr Med Sci ; 40(5): 985-988, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-802087

ABSTRACT

At the end of 2019, the novel coronavirus infection outbroke in Wuhan, Hubei Province. On Feb. 2, 2020, Wuhan, as the worst-hit region, began to build "shelter hospital" rapidly to treat patients with mild illness. The shelter hospital has multiple functions such as emergency treatment, surgical treatment and clinical test, which can adapt to emergency medical rescue tasks. Based on the characteristics that shelter hospital only treats patients with mild illness, tests of shelter laboratory, including coronavirus nucleic acid detection, IgM/IgG antibody serology detection, monitoring and auxiliary diagnosis and/or a required blood routine, urine routine, C-reactive protein, calcitonin original, biochemical indicators (liver enzymes, myocardial enzymes, renal function, etc.) and blood coagulation function test etc, were used to provide important basis for the diagnosis and treatment of the disease. In order to ensure laboratory biosafety, it is necessary to first evaluate the harm level of various specimens. In the laboratory biosafety management, the harm level assessment of microorganisms is the core work of biosafety, which is of great significance to guarantee biosafety. As an emergency deployment affected by the environment, shelter laboratory must possess strong mobility. This paper will explore how to combine the biosafety model of traditional laboratory with the particularity of shelter laboratory to carry out effective work in response to the current epidemic.


Subject(s)
Betacoronavirus/pathogenicity , Containment of Biohazards/methods , Coronavirus Infections/virology , Pneumonia, Viral/virology , China , Containment of Biohazards/instrumentation , Disease Outbreaks/prevention & control , Hospitals/standards , Humans , Pandemics
11.
Viruses ; 12(7)2020 07 07.
Article in English | MEDLINE | ID: covidwho-639283

ABSTRACT

Standard precautions to minimize the risk of SARS-CoV-2 transmission implies that infected cell cultures and clinical specimens may undergo some sort of inactivation to reduce or abolish infectivity. We evaluated three heat inactivation protocols (56 °C-30 min, 60 °C-60 min and 92 °C-15 min) on SARS-CoV-2 using (i) infected cell culture supernatant, (ii) virus-spiked human sera (iii) and nasopharyngeal samples according to the recommendations of the European norm NF EN 14476-A2. Regardless of the protocol and the type of samples, a 4 Log10 TCID50 reduction was observed. However, samples containing viral loads > 6 Log10 TCID50 were still infectious after 56 °C-30 min and 60 °C-60 min, although infectivity was < 10 TCID50. The protocols 56 °C-30 min and 60 °C-60 min had little influence on the RNA copies detection, whereas 92 °C-15 min drastically reduced the limit of detection, which suggests that this protocol should be avoided for inactivation ahead of molecular diagnostics. Lastly, 56 °C-30 min treatment of serum specimens had a negligible influence on the results of IgG detection using a commercial ELISA test, whereas a drastic decrease in neutralizing titers was observed.


Subject(s)
Betacoronavirus , Containment of Biohazards/methods , Coronavirus Infections/virology , Pneumonia, Viral/virology , Serologic Tests/methods , Virus Inactivation , Antibodies, Neutralizing/immunology , Betacoronavirus/immunology , Containment of Biohazards/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Enzyme-Linked Immunosorbent Assay , Hot Temperature , Humans , Neutralization Tests , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Serologic Tests/standards
12.
J Korean Med Sci ; 35(33): e310, 2020 Aug 24.
Article in English | MEDLINE | ID: covidwho-729634

ABSTRACT

With the rapidly spreading coronavirus disease 2019 (COVID-19) pandemic over the past few months, the world is facing an unprecedented crisis. Innumerable lives have been lost to this novel infectious disease, the nature of which supersedes conventional medical understanding. The COVID-19 pandemic is not just a global health crisis, several aspects of life in the post-COVID-19 era are also being contemplated. Experts in unison are warning that the upcoming changes in all areas of life could potentially be far more drastic than ever experienced in the entire human civilization. The medical community is no exception, and therefore, personnel involved in forensic medicine also need to be adequately prepared for the future. Forensic medicine is a branch of medicine dedicated to one of the most important stages of the human lifecycle and has always been at the forefront in times of unprecedented social change. The autopsy, one of the most important tools of forensic medicine, is also useful to infectious diseases because it identifies the causal relationship between death and infection, reveals medical and epidemiological knowledge, and provides objective evidence for legal disputes. We present new autopsy guidelines in forensic medicine, formulated based on the various infectious diseases that we presently live with and may encounter in the future. In formulation of these guidelines several considerations have been taken into account, namely, the role forensic pathologists should play in the post-COVID-19 era and the necessary preparations as well as the support needed from society to fulfill that role. The present COVID-19 outbreak should be a starting point for formulating improvements in current practices in forensic science, including autopsy biosafety practices and the medicolegal death investigation system.


Subject(s)
Autopsy/methods , Betacoronavirus , Coronavirus Infections/pathology , Pneumonia, Viral/pathology , Practice Guidelines as Topic , Containment of Biohazards , Coronavirus Infections/prevention & control , Forensic Medicine , Health Resources , Humans , Pandemics/prevention & control , Personal Protective Equipment , Pneumonia, Viral/prevention & control , Republic of Korea
13.
Indian J Pathol Microbiol ; 63(3): 350-357, 2020.
Article in English | MEDLINE | ID: covidwho-706335

ABSTRACT

Declared as a pandemic by WHO on March 11, 2020, COVID-19 has brought about a dramatic change in the working of different laboratories across the country. Diagnostic laboratories testing different types of samples play a vital role in the treatment management. Irrespective of their size, each laboratory has to follow strict biosafety guidelines. Different sections of the laboratory receive samples that are variably infectious. Each sample needs to undergo a proper and well-designed processing system so that the personnel involved are not infected and also their close contacts. It takes a huge effort so as to limit the risk of exposure of the working staff during the collection, processing, reporting or dispatching of biohazard samples. Guidelines help in preventing the laboratory staff and healthcare workers from contracting the disease which has a known human to human route of transmission and high rate of mortality. A well-knit approach is the need of the hour to combat this fast spreading disease. We anticipate that the guidelines described in this article will be useful for continuing safe work practices by all the laboratories in the country.


Subject(s)
Containment of Biohazards/methods , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Occupational Exposure/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Specimen Handling/methods , Betacoronavirus , Disinfection/methods , Guidelines as Topic , Hazardous Substances , Health Personnel/standards , Humans , Laboratories/standards , Pathologists/standards , Waste Management/methods
14.
mBio ; 11(4)2020 08 07.
Article in English | MEDLINE | ID: covidwho-705638

ABSTRACT

Proponents of the use of gain-of-function (GOF) experiments with pathogens with pandemic potential (PPP) have argued that such experiments are necessary because they reveal important facets of pathogenesis and can be performed safely. Opponents of GOF experiments with PPP have argued that the risks outweigh the knowledge gained. The COVID-19 pandemic demonstrates the vulnerability of human societies to a new PPP, while also validating some arguments of both camps, questioning others, and suggesting the need to rethink how we approach this class of experiments.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/virology , Gain of Function Mutation , Pneumonia, Viral/virology , Biomedical Research/ethics , Biomedical Research/standards , Bioterrorism , Containment of Biohazards/ethics , Containment of Biohazards/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Humans , Influenza A Virus, H5N1 Subtype/genetics , Influenza, Human/epidemiology , Influenza, Human/virology , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control
17.
Rev. enferm. UERJ ; 28: e50360, jan.-dez. 2020.
Article in English, Portuguese | LILACS (Americas) | ID: covidwho-656992

ABSTRACT

Objetivo: descrever as recomendações sobre o uso racional e seguro dos equipamentos de proteção individual (EPI) no transcorrer da cadeia assistencial de pessoas com suspeita ou confirmação de contaminação pelo novo coronavírus. Conteúdo: o novo coronavírus é responsável pela doença Covid-19, e dentre as pessoas com maior risco de desenvolver a infecção estão os trabalhadores de saúde, devido ao contato muito próximo a pacientes. Desse modo, a utilização de EPI é recomendação prioritária a estes trabalhadores. Todavia, em função do desabastecimento internacional e nacional relacionado a estes equipamentos, o uso racional é fundamental a fim de evitar que o impacto do desabastecimento seja ainda maior. Conclusão: o uso de EPI é indispensável aos trabalhadores de saúde durante a pandemia de Covid-19, contudo, é imprescindível coordenar a cadeia de fornecimento destes insumos, implementar estratégias que minimizem a necessidade de EPI e garantir o uso de maneira adequada.


Objective: to describe the recommendations on the rational, safe use of personal protective equipment (PPE) throughout the chain of care for people with suspected or confirmed contamination by the new coronavirus. Content: the new coronavirus is responsible for the disease Covid-19, and among those at high risk of infection are health workers in very close contact with patients. It is thus a priority recommendation for these workers to use PPE. However, international and national shortages of this equipment make rational use essential in order to prevent even greater impact from these shortages. Conclusion: it is essential that health workers use PPE during the Covid-19 pandemic, but it is also essential to coordinate the supply chain for these inputs, implement strategies that minimize the need for PPE and ensure proper use.


Objetivo: describir las recomendaciones sobre el uso racional y seguro del equipo de protección personal (EPP) en toda la cadena de atención para las personas con sospecha o confirmación de contaminación por el nuevo coronavirus. Contenido: el nuevo coronavirus es responsable de la enfermedad de Covid-19, y entre aquellos con alto riesgo de infección se encuentran los trabajadores de la salud en contacto muy cercano con los pacientes. Por lo tanto, es una recomendación prioritaria para estos trabajadores usar EPP. Sin embargo, la escasez internacional y nacional de este equipo hace que el uso racional sea esencial para evitar un impacto aún mayor de esta escasez. Conclusión: es esencial que los trabajadores de la salud usen EPP durante la pandemia de Covid-19, pero también es esencial coordinar la cadena de suministro para estos insumos, implementar estrategias que minimicen la necesidad de EPP y garantizar un uso adecuado.


Subject(s)
Coronavirus Infections/prevention & control , Personal Protective Equipment/supply & distribution , Betacoronavirus , Masks/supply & distribution , Occupational Risks , Containment of Biohazards/standards , Personal Protective Equipment/standards , Masks/standards
18.
J Gen Intern Med ; 35(9): 2732-2737, 2020 09.
Article in English | MEDLINE | ID: covidwho-640978

ABSTRACT

Hospitalists are well poised to serve in key leadership roles and in frontline care in particular when facing a pandemic such as the SARS-CoV-2 (COVID-19) infection. Much of the disaster planning in hospitals around the country addresses overcrowded emergency departments and decompressing these locations; however, in the case of COVID-19, intensive care units, emergency departments, and medical wards ran the risk of being overwhelmed by a large influx of patients needing high-level medical care. In a matter of days, our Division of Hospital Medicine, in partnership with our hospital, health system, and academic institution, was able to modify and deploy existing disaster plans to quickly care for an influx of medically complex patients. We describe a scaled approach to managing hospitalist clinical operations during the COVID-19 pandemic.


Subject(s)
Betacoronavirus , Capacity Building/methods , Coronavirus Infections/prevention & control , Disaster Planning/methods , Hospitalists , Hospitals , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Capacity Building/trends , Containment of Biohazards/methods , Containment of Biohazards/trends , Coronavirus Infections/epidemiology , Disaster Planning/trends , Hospitalists/trends , Hospitals/trends , Humans , Intersectoral Collaboration , Pneumonia, Viral/epidemiology
19.
Odontoestomatol ; 22(supl.1): 4-24, 2020. tab, graf
Article in Spanish | LILACS (Americas) | ID: covidwho-638467
20.
mSphere ; 5(3)2020 06 24.
Article in English | MEDLINE | ID: covidwho-616597

ABSTRACT

The contamination of patients' surroundings by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains understudied. We sampled the surroundings and the air of six negative-pressure non-intensive care unit (non-ICU) rooms in a designated isolation ward in Chengdu, China, that were occupied by 13 laboratory-confirmed coronavirus disease 2019 (COVID-19) patients who had returned from overseas travel, including 2 asymptomatic patients. A total of 44 of 112 (39.3%) surface samples were positive for SARS-CoV-2 as detected by real-time PCR, suggesting extensive contamination, although all of the air samples were negative. In particular, in a single room occupied by an asymptomatic patient, four sites were SARS-CoV-2 positive, highlighting that asymptomatic COVID-19 patients do contaminate their surroundings and impose risks for others with close contact. Placement of COVID-19 patients in rooms with negative pressure may bring a false feeling of safety, and the importance of rigorous environment cleaning should be emphasized.IMPORTANCE Although it has been well recognized that the virus SARS-CoV-2, the causative agent of COVID-19, can be acquired by exposure to fomites, surprisingly, the contamination of patients' surroundings by SARS-CoV-2 is largely unknown, as there have been few studies. We performed an environmental sampling study for 13 laboratory-confirmed COVID-19 patients and found extensive contamination of patients' surroundings. In particular, we found that asymptomatic COVID-19 patients contaminated their surroundings and therefore imposed risks for other people. Environment cleaning should be emphasized in negative-pressure rooms. The findings may be useful to guide infection control practice to protect health care workers.


Subject(s)
Asymptomatic Infections/epidemiology , Betacoronavirus/isolation & purification , Coronavirus Infections/epidemiology , Environmental Exposure , Environmental Microbiology , Pneumonia, Viral/epidemiology , Containment of Biohazards/methods , Coronavirus Infections/pathology , Environment , Humans , Pandemics , Pneumonia, Viral/pathology
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