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1.
Colomb Med (Cali) ; 51(2): e4277, 2020 Jun 30.
Article in English | MEDLINE | ID: covidwho-875102

ABSTRACT

Currently, there are several mathematical models that have been developed to understand the dynamics of COVID-19 infection. However, the difference in the sociocultural contexts between countries requires the specific adjustment of these estimates to each scenario. This article analyses the main elements used for the construction of models from epidemiological patterns, to describe the interaction, explain the dynamics of infection and recovery, and to predict possible scenarios that may arise with the introduction of public health measures such as social distancing and quarantines, specifically in the case of the pandemic unleashed by the new SARS-CoV-2/COVID-19 virus. Comment: Mathematical models are highly relevant for making objective and effective decisions to control and eradicate the disease. These models used for COVID-19 have supported and will continue to provide information for the selection and implementation of programs and public policies that prevent associated complications, reduce the speed of the virus spread and minimize the occurrence of severe cases of the disease that may collapse health systems.


Subject(s)
Coronavirus Infections/epidemiology , Health Policy , Models, Theoretical , Pneumonia, Viral/epidemiology , Coronavirus Infections/prevention & control , Delivery of Health Care/organization & administration , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Public Health , Quarantine , Social Isolation
2.
Int J Equity Health ; 19(1): 184, 2020 10 19.
Article in English | MEDLINE | ID: covidwho-873998

ABSTRACT

In healthcare, we find an industry that typifies the unique blend of racism, classism, and other forms of structural discrimination that comprise the U.S. caste system-the artificially-constructed and legally-reinforced social hierarchy for assigning worth and determining opportunity for individuals based on race, class, and other factors. Despite myths of meritocracy, healthcare is actually a casteocracy; and conversations about racism in healthcare largely occupy an echo chamber among the privileged upper caste of hospital professionals. To address racism in healthcare, we must consider the history that brought us here and understand how we effectively perpetuate an employee caste system within our own walls.


Subject(s)
Coronavirus Infections/epidemiology , Delivery of Health Care/organization & administration , Pneumonia, Viral/epidemiology , Racism/prevention & control , Social Class , Humans , Pandemics , United States/epidemiology
4.
Int J Health Plann Manage ; 35(5): 988-992, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-812746

ABSTRACT

Coping with the COVID-19 pandemic has been painful and no single model for such a purpose is perfect. However, sharing experiences is the best way for countries to learn real-time lessons and adapt to this rapidly changing pandemic. This commentary shares with the international community how an adaptive model of health system organization and responses helped Vietnam to break transmission of coronavirus. We find that an effective model is adaptive to time and context, and mobilizes and engages the wider society. We identify merging of different health system units into Center for Diseases Controls as a health system organization that saved massive resources. The early establishment of a formal committee responding to the pandemic helped unify every public health strategy. The mobilization of different stakeholders and communities added resources and facilitated a synchronous implementation of response strategies, even where those strategies involved significant personal or financial sacrifice. National training on Covid-19 treatment for healthcare professionals across the entire hospital system was useful to expand the health service availability. Quickly published response guidelines helped to activate every level of the health system and involve every sector of society. A strategy of keeping high alert and preemptive action is also essential for coping with the pandemic.


Subject(s)
Coronavirus Infections/prevention & control , Delivery of Health Care/organization & administration , Developing Countries , Infection Control/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus , Coronavirus Infections/epidemiology , Delivery of Health Care/methods , Humans , Pneumonia, Viral/epidemiology , Vietnam/epidemiology
6.
Colomb Med (Cali) ; 51(2): e4277, 2020 Jun 30.
Article in English | MEDLINE | ID: covidwho-790167

ABSTRACT

Currently, there are several mathematical models that have been developed to understand the dynamics of COVID-19 infection. However, the difference in the sociocultural contexts between countries requires the specific adjustment of these estimates to each scenario. This article analyses the main elements used for the construction of models from epidemiological patterns, to describe the interaction, explain the dynamics of infection and recovery, and to predict possible scenarios that may arise with the introduction of public health measures such as social distancing and quarantines, specifically in the case of the pandemic unleashed by the new SARS-CoV-2/COVID-19 virus. Comment: Mathematical models are highly relevant for making objective and effective decisions to control and eradicate the disease. These models used for COVID-19 have supported and will continue to provide information for the selection and implementation of programs and public policies that prevent associated complications, reduce the speed of the virus spread and minimize the occurrence of severe cases of the disease that may collapse health systems.


Subject(s)
Coronavirus Infections/epidemiology , Health Policy , Models, Theoretical , Pneumonia, Viral/epidemiology , Coronavirus Infections/prevention & control , Delivery of Health Care/organization & administration , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Public Health , Quarantine , Social Isolation
7.
Colomb Med (Cali) ; 51(2): e4271, 2020 Jun 30.
Article in English | MEDLINE | ID: covidwho-790165

ABSTRACT

Coronavirus illness 2019 (COVID-19) is an airways infection caused by the new coronavirus (SARS-CoV-2) which has been quickly disseminated all over the world, affecting to the general population including women in pregnancy time. As being a recent infection, the evidence that supports the best practices for the management of the infection during pregnancy is limited, and most of the questions have not been completely solved yet. This publication offers general guidelines focused on decision-making people, managers, and health's teams related to pregnant women attention and newborn babies during COVID-19 pandemic. Its purpose is to promote useful interventions to prevent new infections as well as prompt and adequate attention to avoid serious complications or deaths, trying to be adapted to the different contexts in which attention to expectant mothers is provided. Guidelines are set within a well-scientific evidence and available recommendations up to date.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Pregnancy Complications, Infectious/epidemiology , Coronavirus Infections/virology , Delivery of Health Care/organization & administration , Female , Humans , Infant, Newborn , Pandemics , Pneumonia, Viral/virology , Practice Guidelines as Topic , Pregnancy , Pregnancy Complications, Infectious/virology
8.
Colomb Med (Cali) ; 51(2): e4266, 2020 Jun 30.
Article in English | MEDLINE | ID: covidwho-790163

ABSTRACT

Background: The best scientific evidence is required to design effective Non-pharmaceutical interventions to help policymakers to contain COVID-19. Aim: To describe which Non-pharmaceutical interventions used different countries and a when they use them. It also explores how Non-pharmaceutical interventions impact the number of cases, the mortality, and the capacity of health systems. Methods: We consulted eight web pages of transnational organizations, 17 of international media, 99 of government institutions in the 19 countries included, and besides, we included nine studies (out of 34 identified) that met inclusion criteria. Result: Some countries are focused on establishing travel restrictions, isolation of identified cases, and high-risk people. Others have a combination of mandatory quarantine and other drastic social distancing measures. The timing to implement the interventions varied from the first fifteen days after detecting the first case to more than 30 days. The effectiveness of isolated non-pharmaceutical interventions may be limited, but combined interventions have shown to be effective in reducing the transmissibility of the disease, the collapse of health care services, and mortality. When the number of new cases has been controlled, it is necessary to maintain social distancing measures, self-isolation, and contact tracing for several months. The policy decision-making in this time should be aimed to optimize the opportunities of saving lives, reducing the collapse of health services, and minimizing the economic and social impact over the general population, but principally over the most vulnerable. The timing of implementing and lifting interventions could have a substantial effect on those objectives.


Subject(s)
Coronavirus Infections/prevention & control , Health Policy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Policy Making , Coronavirus Infections/epidemiology , Coronavirus Infections/mortality , Delivery of Health Care/organization & administration , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/mortality , Quarantine , Social Isolation , Time Factors
10.
Recenti Prog Med ; 111(9): 487-491, 2020 09.
Article in Italian | MEDLINE | ID: covidwho-776172

ABSTRACT

CoViD-19 pandemic heavily impacted most on-going research activities, causing delays and need of re-programming. EASY-NET (NET-2016-02364191) is a network project, started in April 2019, co-funded by the Italian Ministry of Health and the participating regions. Within the general project, centred on the evaluation of Audit and Feedback (A&F) strategies in improving quality and equity in different health care contexts, the Piedmont region is responsible of the work package 3 (WP3) on specific oncology pathways and procedures. After a thorough evaluation of the impact of the CoViD-19 emergency on the WP3 activities, at the beginning of March 2020, the decision was to continue, with some adaptations, the audits already started, and to delay those in the early planning phase. The provisional availability of part of the time-persons involved in EASY-NET on one side, and the urgency of acquiring data on the management of the large number of CoViD-19 patients admitted to the study coordinator hospital on the other side, determined the personnel responsible of the WP3, in accordance with the hospital management, to invest these resources in monitoring the CoViD-19 hospitalized patients with both A&F activity and research objectives. Besides periodic reports, a web site, with restricted access to the involved health care personnel, was developed to allow a direct and timely consultation of graphics describing the flow of the patients, their management, and outcomes. This experience was made possible thanks to a favourable combination of different factors: the presence within the hospital of a group of experienced epidemiologists in A&F, the availability of extra resources, the strong support and collaboration by the hospital management and the readiness for authorisation by the Ethics Committee. We underline the need to provide a certain degree of flexibility in the long-term projects funded by the Ministry of Health, the extraordinary adaptability of the A&F approach also to emergency situations and the possibility of combining audit activities and research objectives in the same project.


Subject(s)
Coronavirus Infections/epidemiology , Delivery of Health Care/organization & administration , Hospitalization/statistics & numerical data , Medical Audit/organization & administration , Pneumonia, Viral/epidemiology , Biomedical Research/organization & administration , Delivery of Health Care/standards , Humans , Italy/epidemiology , Pandemics , Quality of Health Care
14.
Pan Afr Med J ; 36: 179, 2020.
Article in English | MEDLINE | ID: covidwho-743013

ABSTRACT

As SARS-CoV-2 rapidly spread across the globe, short-term modeling forecasts provided time-critical information for containment and mitigation strategies. Global projections had so far incorrectly predicted large numbers of COVID-19 cases in Africa and that its health systems would be overwhelmed. Significantly higher COVID-19-related mortality were expected in Africa mainly because of its poor socio-economic determinants that make it vulnerable to public health threats, including diseases of epidemic potential. Surprisingly as SARS-CoV-2 swept across the globe, causing tens of thousands of deaths and massive economic disruptions, Africa has so far been largely spared the impact that threw China, USA, and Europe into chaos. To date, 42 African countries imposed lockdowns on movements and activities. Experience from around the world suggests that such interventions effectively suppressed the spread of COVID-19. However, lockdown measures posed considerable economic costs that, in turn, threatened lives, put livelihoods at risk, exacerbated poverty and the deleterious effects on cultures, health and behaviours. Consequently, there has been great interest in lockdown exit strategies that preserve lives while protecting livelihoods. Nonetheless in the last few weeks, African countries have started easing restrictions imposed to curb the spread of SARS-CoV-2. WHO recommends lifting of lockdowns should depend on the ability to contain SARS-CoV-2 and protect the public once restrictions are lifted. Yet, the greatest challenge is the critical decision which must be made in this time of uncertainties. We propose simple strategies on how to ease lockdowns in Africa based on evidence, disease dynamics, situational analysis and ability of national governments to handle upsurges.


Subject(s)
Coronavirus Infections/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Public Health/legislation & jurisprudence , Quarantine/legislation & jurisprudence , Africa/epidemiology , Coronavirus Infections/economics , Coronavirus Infections/epidemiology , Delivery of Health Care/organization & administration , Humans , Pandemics/economics , Pneumonia, Viral/economics , Pneumonia, Viral/epidemiology , Poverty , Public Health/economics , Quarantine/economics , Socioeconomic Factors
19.
J Subst Abuse Treat ; 118: 108124, 2020 11.
Article in English | MEDLINE | ID: covidwho-733730

ABSTRACT

OBJECTIVE: The COVID-19 pandemic has transformed care delivery for patients with opioid use disorder (OUD); however, little is known about the experiences of front-line clinicians in the transition to telemedicine. This study described how, in the context of the early stages of the pandemic, clinicians used telemedicine for OUD in conjunction with in-person care, barriers encountered, and implications for quality of care. METHODS: In April 2020, we conducted semistructured interviews with clinicians waivered to prescribe buprenorphine. We used maximum variation sampling. We used standard qualitative analysis techniques, consisting of both inductive and deductive approaches, to identify and characterize themes. RESULTS: Eighteen clinicians representing 10 states participated. Nearly all interview participants were doing some telemedicine, and more than half were only doing telemedicine visits. Most participants reported changing their typical clinical care patterns to help patients remain at home and minimize exposure to COVID-19. Changes included waiving urine toxicology screening, sending patients home with a larger supply of OUD medications, and requiring fewer visits. Although several participants were serving new patients via telemedicine during the early weeks of the pandemic, others were not. Some clinicians identified positive impacts of telemedicine on the quality of their patient interactions, including increased access for patients. Others noted negative impacts including less structure and accountability, less information to inform clinical decision-making, challenges in establishing a connection, technological challenges, and shorter visits. CONCLUSIONS: In the context of the pandemic, buprenorphine prescribers quickly transitioned to providing telemedicine visits in high volume; nonetheless, there are still many unknowns, including the quality and safety of widespread use of telemedicine for OUD treatment.


Subject(s)
Buprenorphine/administration & dosage , Coronavirus Infections/epidemiology , Opioid-Related Disorders/therapy , Pneumonia, Viral/epidemiology , Telemedicine/statistics & numerical data , Clinical Decision-Making , Coronavirus Infections/prevention & control , Delivery of Health Care/organization & administration , Delivery of Health Care/statistics & numerical data , Health Personnel/statistics & numerical data , Humans , Interviews as Topic , Opiate Substitution Treatment/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Substance Abuse Detection/statistics & numerical data
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