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1.
Lancet Psychiatry ; 7(9): 813-824, 2020 09.
Article in English | MEDLINE | ID: covidwho-652455

ABSTRACT

The unpredictability and uncertainty of the COVID-19 pandemic; the associated lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown could increase the risk of mental health problems and exacerbate health inequalities. Preliminary findings suggest adverse mental health effects in previously healthy people and especially in people with pre-existing mental health disorders. Despite the heterogeneity of worldwide health systems, efforts have been made to adapt the delivery of mental health care to the demands of COVID-19. Mental health concerns have been addressed via the public mental health response and by adapting mental health services, mostly focusing on infection control, modifying access to diagnosis and treatment, ensuring continuity of care for mental health service users, and paying attention to new cases of mental ill health and populations at high risk of mental health problems. Sustainable adaptations of delivery systems for mental health care should be developed by experts, clinicians, and service users, and should be specifically designed to mitigate disparities in health-care provision. Thorough and continuous assessment of health and service-use outcomes in mental health clinical practice will be crucial for defining which practices should be further developed and which discontinued. For this Position Paper, an international group of clinicians, mental health experts, and users of mental health services has come together to reflect on the challenges for mental health that COVID-19 poses. The interconnectedness of the world made society vulnerable to this infection, but it also provides the infrastructure to address previous system failings by disseminating good practices that can result in sustained, efficient, and equitable delivery of mental health-care delivery. Thus, the COVID-19 pandemic could be an opportunity to improve mental health services.


Subject(s)
Coronavirus Infections/epidemiology , Mental Disorders/therapy , Mental Health Services/standards , Pneumonia, Viral/epidemiology , Telemedicine/methods , Betacoronavirus , Coronavirus Infections/psychology , Health Personnel/psychology , Humans , Mental Disorders/virology , Pandemics , Pneumonia, Viral/psychology
2.
Medicine (Baltimore) ; 99(30): e21396, 2020 Jul 24.
Article in English | MEDLINE | ID: covidwho-684031

ABSTRACT

A large number of healthcare workers have been infected with coronavirus disease-2019 (COVID-19). We aimed to investigate their clinical and chest computed tomography (CT) characteristics.The clinical, laboratory test and CT features of 43 medical and hospital staff with confirmed COVID-19 (MP group, 26-70 years old) were retrospectively analyzed, and compared to 43 non-medical related patients (non-MP group, 26-71 years old). Follow-up CT characteristics were analyzed to assess the disease progression in the period of hospitalization.At admission, the main complaints of the MP group, including fever (81.4%), fatigue (48.8%) and cough (41.9%), were similar to the non-MP group. The C-reactive protein, erythrocyte sedimentation rate, and lactate dehydrogenase levels were higher in the non-MP group than the MP group (17.5 ±â€Š22.4 mg/L, 20.2 ±â€Š23.4 mm/H and 219 ±â€Š66U/L, respectively, P < .05). Ground-grass opacities, consolidation, interstitial thickening were common CT features of both groups. The severity of opacities on initial CT were less in the MP group (5.3 ±â€Š3.9 scores) than in the non-MP group (9.1 ±â€Š4.8 scores, P < .05). Before regular treatments, the sum score of the opacities showed weak to moderate correlations with duration, C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase levels (R ranged from 0.341-0.651, P < .05). In the study time window, the duration from illness onset to when the most obvious pulmonary opacities were observed, according to CT findings, were similar in the MP group (13.3 ±â€Š6.6 days) and the non-MP group (13.8 ±â€Š5.1 days, P = .69). Mild to moderate anxiety and depression were observed in both groups.Despite greater knowledge of how to protect themselves than the general population, healthcare workers are also susceptible to COVID-19 infection. Occupational exposure is a very important factor. Healthcare workers have a higher vigilance about the infection in the early stage of the disease.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnostic imaging , Occupational Diseases/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Aged , Coronavirus Infections/transmission , Coronavirus Infections/virology , Female , Health Personnel/statistics & numerical data , Humans , Infectious Disease Transmission, Patient-to-Professional , Lung/diagnostic imaging , Lung/pathology , Male , Middle Aged , Occupational Diseases/virology , Occupational Exposure/adverse effects , Pandemics , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Retrospective Studies
5.
Geriatr Psychol Neuropsychiatr Vieil ; 18(3): 238-240, 2020 Sep 01.
Article in English | MEDLINE | ID: covidwho-749031

ABSTRACT

The Coronarovirus disease 2019 (Covid-19) outbreak strongly affected nursing and was responsible for a high mortality rate. During the pandemic of March-May 2020, 17 French nursing homes organized staff confinement periods with residents 24 hours a day and 7 days a week, to reduce the risk of entry of the SARS-CoV-2 virus into their facilities, in a context where visits to residents were prohibited. By means of a telephone survey of their directors, we observed that 16 nursing homes (94%) had no cases of COVID-19 among the residents, and that mortality from COVID-19 was very low compared to that recorded at the national level by Santé publique France (p<10-4). Moreover, the number of cases of Covid-19 among the staff of these nursing homes was also lower than that recorded by Santé publique France (p<10-4). These establishments experienced certain difficulties which the directors managed to overcome and the investment of these teams was widely appreciated by the families of the residents and through the press.


Subject(s)
Coronavirus Infections , Nursing Homes , Pandemics , Pneumonia, Viral , Quarantine , Aged , Betacoronavirus , Disease Outbreaks , Female , France , Health Personnel , Humans
6.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(6): 627-632, 2020 Jun 28.
Article in English, Chinese | MEDLINE | ID: covidwho-745330

ABSTRACT

OBJECTIVES: To investigate the attitudes and skills of grief counseling in the front-line medical workers from coronavirus disease 2019 (COVID-19) designated hospitals in Wuhan for the bereaved family members and to provide the basis for proper hospital management strategies. METHODS: The convenience sampling method was applied to select 422 medical workers who kept touch with the bereaved family members in five COVID-19 designated hospitals in Wuhan from January to February 2020. Questionnaire regarding grief counseling attitudes and questionnaire regarding grief counseling skills were used to evaluate the attitudes and skills of grief counseling in medical workers. The scores of grief counseling attitudes and skills in group of different characteristics were further compared. Pearson correlation was used to analyze the attitudes and skills of grief counseling in medical workers. RESULTS: The scores of grief counseling attitudes in medical workers were 15-46 (33.00±9.31). Length of service, professional title, whether or not receiving relevant training, frequency of contact with bereaved family members contributed to impacting the medical workers' attitudes of grief counseling (all P<0.05). The scores of grief counseling skills in medical workers were 9-30 (19.30±4.42). Length of service, professional title, religion, whether or not receiving relevant training, frequency of contact with bereaved family members contributed to impacting the medical workers' skills of grief counseling (all P<0.05). There was a significant positive correlation between the attitudes and skills of grief counseling in the medical workers (r=0.608, P<0.01). CONCLUSIONS: The attitudes and skills of grief counseling in the medical workers from COVID-19 designated hospitals in Wuhan still need to be improved. Grief counseling group and a long-term, comprehensive training system are recommended.


Subject(s)
Coronavirus Infections/psychology , Counseling , Grief , Health Personnel/psychology , Pneumonia, Viral/psychology , Attitude of Health Personnel , Betacoronavirus , China , Hospitals , Humans , Pandemics
7.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(6): 613-619, 2020 Jun 28.
Article in English, Chinese | MEDLINE | ID: covidwho-745322

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic is a global public health crisis, which elicits psychological problems in different population. This study is to investigate the impact of COVID-19 on mental health in the front-line staff. METHODS: Patient Health Questionnare-9 (PHQ-9), Self-Rating Anxiety Scale (SAS), and Fatigue Self-assessment Scale (FSAS) were used to assess the depression, anxiety, and fatigue in front-line staff. RESULTS: The detection rates of depression, anxiety, and fatigue were 49.1%, 21.8%, and 76.0% among the front-line staff. The rates of depression, anxiety, and fatigue in community workers were higher than those in medical workers and other occupational staff (P<0.01). The PHQ-9 of front-line staffs was negatively correlated with age, family income, family members' support, satisfaction of service objects, and sleep quality (all P<0.01), while positively correlated with education level, fatigue, fear of pneumonia, and the duration of daily attention to the COVID-19 (all P<0.01). SAS was negatively correlated with age, family income, family support, satisfaction of objects service, and sleep quality (all P<0.01), while positively correlated with gender, fatigue, fear of pneumonia, and duration of daily attention to the COVID-19 (all P<0.01). CONCLUSIONS: The front-line workers should manage work and rest time reasonably to adjust their negative mood and fatigue. The government and the society should pay more attention to the psychological state of the front-line staff, particularly for the staff working in the community or villages and towns in preventing the COVID-19 pandemic. Thus, front-line staff can be obtained mental intervention or be taken a rest from the high-intensive work.


Subject(s)
Coronavirus Infections/psychology , Health Personnel/psychology , Mental Health , Pneumonia, Viral/psychology , Anxiety/diagnosis , Betacoronavirus , Coronavirus Infections/prevention & control , Depression/diagnosis , Fatigue/diagnosis , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control
8.
Psychiatr Danub ; 32(Suppl 1): 5-9, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-743579

ABSTRACT

The COVID-19 epidemic has been a major global public health problem during past months in Italy and in several other Countries and on the date of publication of this article, is still a serious public health problem. The health staff, engaged in the care of the sick and in the prevention of the spread of the infection have been subjected to a further increase in psychological difficulties and work-related stress, related to the workload for the continuous influx of sick and intense and close working shifts for the viral emergency. The SAVE-9 (Stress and Anxiety to Viral Epidemics - 9 items) scale has been developed as a tool for assessing work anxiety and stress in response to the viral epidemic of health professionals working to prevent the spread of the virus and to treat infected people.


Subject(s)
Anxiety/diagnosis , Coronavirus Infections/psychology , Health Personnel/psychology , Occupational Stress/diagnosis , Pneumonia, Viral/psychology , Betacoronavirus , Humans , Italy , Pandemics
9.
Rev Esp Salud Publica ; 942020 Sep 03.
Article in Spanish | MEDLINE | ID: covidwho-743521

ABSTRACT

OBJECTIVE: The Covid-19 pandemic is testing the resistance of health systems, the preservation of health professionals is a priority in processes of this type. The professionals' exposure to suspicious contacts often requires their confinement. The objective was to know the epidemiological characteristics of the primary care professionals who required confinement. METHODS: The research was carried out in the North Metropolitan Primary Care Area of Barcelona, from February 17 to May 3, 2020. 1,418 professionals who required confinement due to the epidemic by Covid-19 participated. The reasons for confinement, symptomatology, the confinement time and the results of PCR tests results were recorded. Univariate descriptive analysis was performed. RESULTS: 78.8% of the professionals were women and the mean age was 45.2 years. 67.8% were doctors and nurses, in the remaining 32.2% there were different healthcare and non-care professionals. 64.1% of the sample presented symptoms compatible with Covid-19. Participants described multiple symptoms during confinement. 1,050 diagnostic RT- PCR tests were performed, being positive in 323 cases, of which 33 were in asymptomatic people. CONCLUSIONS: The impact of the epidemic by Covid-19 is anticipated in health personnel compared to the general population. The distribution of symptoms in healthcare professionals is similar to that of other studies in the general population. Of the total number of professionals requiring isolation, 22.7% confirmed the diagnosis.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Health Personnel , Occupational Diseases/epidemiology , Pneumonia, Viral/epidemiology , Primary Health Care , Quarantine , Adult , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Occupational Diseases/diagnosis , Occupational Diseases/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Spain/epidemiology
10.
Psychiatr Danub ; 32(Suppl 1): 10-14, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-743516

ABSTRACT

BACKGROUND: In the times of serious health alarm, as it is happening in the COVID-19 pandemic, burden of healthcare is likely to explode. The current pandemic is having a profound effect on all aspects of society, including mental health and physical health. In a previous study we showed interaction between compassion fatigue, burnout and workload. METHODS: In our study, we have evaluated stress levels in 102 healthcare workers recruited in different rehabilitation departments (psychiatric and multidisciplinary). In particular, we evaluated the fatigue of compassion, vicarious trauma, burnout and hope (hopelessness) in the first two months of lookdown due to the COVID-19. RESULTS: The results obtained after the administration of the following evaluation scales: sCFs, CBI, Pro QOL, HBS, showed an overall increase in the scores in all professional figures. Significant compassion fatigue and burnout percentage is present in several groups. The highest levels of hopelessness in some professional figures, while higher educational levels can protect workers from the risk of developing high levels of work stress. CONCLUSIONS: The data obtained with this study are similar to those of our previous study, although they may indicate that during the period of the coronavirus pandemic the scores of the several scales used are higher.


Subject(s)
Burnout, Professional , Compassion Fatigue , Coronavirus Infections/psychology , Empathy , Health Personnel/psychology , Pneumonia, Viral/psychology , Betacoronavirus , Hope , Humans , Pandemics , Surveys and Questionnaires
11.
J Med Internet Res ; 22(6): e20586, 2020 06 23.
Article in English | MEDLINE | ID: covidwho-742636

ABSTRACT

BACKGROUND: Frontline health care workers, including physicians, are at high risk of contracting coronavirus disease (COVID-19) owing to their exposure to patients suspected of having COVID-19. OBJECTIVE: The aim of this study was to evaluate the benefits and feasibility of a double triage and telemedicine protocol in improving infection control in the emergency department (ED). METHODS: In this retrospective study, we recruited patients aged ≥20 years referred to the ED of the National Taiwan University Hospital between March 1 and April 30, 2020. A double triage and telemedicine protocol was developed to triage suggested COVID-19 cases and minimize health workers' exposure to this disease. We categorized patients attending video interviews into a telemedicine group and patients experiencing face-to-face interviews into a conventional group. A questionnaire was used to assess how patients perceived the quality of the interviews and their communication with physicians as well as perceptions of stress, discrimination, and privacy. Each question was evaluated using a 5-point Likert scale. Physicians' total exposure time and total evaluation time were treated as primary outcomes, and the mean scores of the questions were treated as secondary outcomes. RESULTS: The final sample included 198 patients, including 93 cases (47.0%) in the telemedicine group and 105 cases (53.0%) in the conventional group. The total exposure time in the telemedicine group was significantly shorter than that in the conventional group (4.7 minutes vs 8.9 minutes, P<.001), whereas the total evaluation time in the telemedicine group was significantly longer than that in the conventional group (12.2 minutes vs 8.9 minutes, P<.001). After controlling for potential confounders, the total exposure time in the telemedicine group was 4.6 minutes shorter than that in the conventional group (95% CI -5.7 to -3.5, P<.001), whereas the total evaluation time in the telemedicine group was 2.8 minutes longer than that in the conventional group (95% CI -1.6 to -4.0, P<.001). The mean scores of the patient questionnaire were high in both groups (4.5/5 to 4.7/5 points). CONCLUSIONS: The implementation of the double triage and telemedicine protocol in the ED during the COVID-19 pandemic has high potential to improve infection control.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Emergency Service, Hospital , Infection Control/methods , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Telemedicine/methods , Triage/methods , Adult , Betacoronavirus/isolation & purification , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Feasibility Studies , Female , Health Personnel , Humans , Infection Control/standards , Male , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Retrospective Studies , Taiwan/epidemiology
12.
Trials ; 21(1): 754, 2020 Aug 31.
Article in English | MEDLINE | ID: covidwho-742452

ABSTRACT

OBJECTIVES: To evaluate the effect of the combination of hydroxychloroquine (HCQ) and standard personal protective equipment (PPE) compared to the use of standard personal protective equipment alone on the proportion of laboratory confirmed COVID-19 infections among frontline healthcare workers(HCWs) in India TRIAL DESIGN: HOPE is an investigator initiated multi-centre open-label parallel group randomized controlled trial. PARTICIPANTS: All HCWs currently working in an environment with direct exposure to patients with confirmed COVID-19 infection are eligible to participate in the trial. The trial aims to be conducted across 20-30 centres (public and private hospitals) in India. HCWs who decline consent, who have a confirmed COVID-19 infection, those who are already on chloroquine/HCQ for any indication, or if pregnant or breast-feeding, or have known QT prolongation or are on medications that when taken with HCQ can prolong the QTc will be excluded. INTERVENTION AND COMPARATOR: The interventions to be compared in this trial are standard practice (use of recommended PPE) and HCQ plus standard practice. In the standard practice arm, HCWs will use recommended PPE as per institutional guidelines and based on their roles. They will be discouraged from taking HCQ to prevent contamination and contacted every week for the duration of the study to ascertain if they have taken any HCQ. Any such use will be reported as a protocol violation. In the intervention arm, HCWs will be administered 800mg of HCQ as a loading dose on the day of randomization (as two 400mg doses 12hrs apart) and subsequently continued on 400mg once a week for 12 weeks. This will be in addition to the use of recommended PPE as per institutional guidelines and based on their roles. HCWs will collect the drug once every week from designated research and pharmacy staff at site. A weekly phone reminder will be provided to participants in this arm to ensure compliance. An ECG will be performed between 4-6 weeks in this arm and if the QTc is prolonged (greater than 450milliseconds), the drug will be stopped. Follow-up will however continue. Participants in both arms will receive a weekly phone call for evaluation of the primary outcome, to monitor protocol compliance and development of any adverse events (in the HCQ group). MAIN OUTCOMES: Participants will be followed on a weekly basis. The primary outcome is the proportion of HCWs developing laboratory confirmed COVID-19 infection within 6 months of randomization. We will also evaluate a number of secondary outcomes, including hospitalization related to suspected/confirmed COVID-19 infection, intensive care unit or high-dependency unit admission due to suspected/confirmed COVID-19 infection, all-cause mortality, need for organ support ( non-invasive or invasive ventilation, vasopressors and renal replacement therapy), ICU and hospital length of stay, readmission, days off work and treatment-related adverse events. RANDOMISATION: Randomisation will be conducted through a password-protected, secure website using a central, computer-based randomisation program. Randomisation will be stratified by participating institutions and by the role of HCW - nursing, medical and other. Participants will be randomised 1:1 to either standard practice only or HCQ plus standard practice. Allocation concealment is maintained by central web-based randomisation BLINDING (MASKING): This is an unblinded study: study assigned treatment will be known to the research team and participant. Bias will be mitigated through an objective end point (laboratory confirmed COVID-19 infection). NUMBERS TO BE RANDOMISED (SAMPLE SIZE): A total of 6,950 HCWs will be enrolled (3475 to the intervention) and (3475 to the standard practice group) to detect a 25% relative reduction, or 2.5% absolute reduction, in the infection rate from an estimated baseline infection rate of 10%, with 80% statistical power using a two-sided test at 5% level of significance. Available data from China and Italy indicate that the rate of infection among frontline healthcare workers varies between 4% to 12%. We therefore assumed a baseline infection rate of 10% among HCWs. This sample size allows for a potential loss to follow-up rate of 10% and a potential non-compliance rate of 10% in both the treatment and control arms. TRIAL STATUS: HOPE protocol version 3.0 dated June 3rd 2020. Recruitment started on 29th June 2020 and currently 56 participants have been enrolled. Planned completion of enrolment is January 31st 2021. TRIAL REGISTRATION: Clinical Trials Registry of India: CTRI/2020/05/025067 (prospectively registered) Date of registration: 6th May 2020 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest of expedited dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).


Subject(s)
Coronavirus Infections/prevention & control , Enzyme Inhibitors/therapeutic use , Health Personnel , Hydroxychloroquine/therapeutic use , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Occupational Diseases/prevention & control , Pandemics/prevention & control , Personal Protective Equipment , Pneumonia, Viral/prevention & control , Betacoronavirus , Chemoprevention , Coronavirus Infections/transmission , Humans , India , Pneumonia, Viral/transmission
15.
Z Psychosom Med Psychother ; 66(3): 220-242, 2020 Sep.
Article in German | MEDLINE | ID: covidwho-740596

ABSTRACT

Psychological stress caused by epidemics among health care workers and implications for coping with the corona crisis: a literature review Objectives: COVID-19 has significantly changed the working and living conditions within a short period. Despite the milder course of the disease in comparison to other countries, employees in the German health care system are particularly affected by the massive impact of the disease on their professional and private lives. From a scientific point of view, summarized empirical evidence made during other epidemics and at the beginning of the COVID-19-pandemic is largely missing. Methods: Narrative review article, literature search on PubMed database. Results: A total of 56 studies were included, 35 of them on the SARS epidemic and seven on COVID-19; included studies reported overall increased stress levels, anxiety and PTSD symptoms due to health care work during various epidemics. Direct contact with patients, quarantine experiences and perceived health risks were further stress factors in epidemics. Participation in intervention studies enabled better management of epidemic-related situations. Conclusions: Healthcare workers are exposed to high workloads because of epidemics, which can have a variety of adverse effects. Recommendations are made for dealing with periods of high exposure during the COVID-19-pandemic.


Subject(s)
Adaptation, Psychological , Coronavirus Infections/epidemiology , Health Personnel/psychology , Health Personnel/statistics & numerical data , Pneumonia, Viral/epidemiology , Stress, Psychological/epidemiology , Betacoronavirus , Humans , Pandemics
16.
J Bras Nefrol ; 42(2 suppl 1): 12-14, 2020 Aug 26.
Article in English, Portuguese | MEDLINE | ID: covidwho-740459

ABSTRACT

Patients with Chronic Kidney Disease are among those individuals at increased risk for developing more serious forms of Covid-19. This increased risk starts in the pre-dialysis phase of the disease. Providing useful information for these patients, in language that facilitates the understanding of the disease, can help nephrologists and other healthcare professionals to establish a more effective communication with these patients and help minimize contagion and the risks of serious illness in this population.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Patient Education as Topic/standards , Pneumonia, Viral/prevention & control , Renal Insufficiency, Chronic/complications , Activities of Daily Living , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Elective Surgical Procedures , Hand Hygiene/methods , Hand Hygiene/standards , Health Facilities , Health Personnel , Humans , Nephrology/standards , Personal Space , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Renal Dialysis , Risk Factors , Symptom Assessment
17.
J Bras Nefrol ; 42(2 suppl 1): 9-11, 2020 Aug 26.
Article in English, Portuguese | MEDLINE | ID: covidwho-740458

ABSTRACT

These recommendations were created after the publication of informative note 3/2020- CGGAP/DESF/SAPS/MS, of April 4, 2020, in which the Brazilian Ministry of Health recommended the use of a cloth mask by the population, in public places. Taking into account the necessary prioritization of the provision of Personal Protective Equipment (PPE) for patients with suspected or confirmed disease, as well as for healthcare professionals, the SBN is favorable concerning the wear of cloth masks by chronic kidney patients in dialysis, in public settings, except in the dialysis setting. The present recommendations have eleven items, related to this rationale, the procedures, indications, contraindications, as well as appropriate fabrics for the mask, and hygiene care to be adopted. These recommendations may change, at any time, in the light of new evidence.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Masks/standards , Pandemics/prevention & control , Personal Protective Equipment/standards , Pneumonia, Viral/prevention & control , Renal Dialysis , Textiles , Brazil , Coronavirus Infections/epidemiology , Health Personnel , Humans , Nephrology/standards , Occupational Diseases/prevention & control , Pneumonia, Viral/epidemiology , Protective Clothing/standards , Renal Insufficiency, Chronic/therapy , Societies, Medical , Urology Department, Hospital/standards
18.
Cien Saude Colet ; 25(9): 3445-3458, 2020 Sep.
Article in English, Portuguese | MEDLINE | ID: covidwho-740438

ABSTRACT

An infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the 2019 Novel Coronavirus Disease (COVID-19) pandemic has unveiled a hitherto hidden reality: the vulnerability of the population living in long-term care facilities for the elderly (LTCF). To date, several scientific publications have revealed a concentration of up to 60% of deaths attributed to COVID-19 in such institutions. Most LTFC residents share the primary risk factors currently associated with increased morbimortality due to the COVID-19 infection. It is crucial to define actions to prevent SARS-CoV-2 spread in this environment, besides the usual measures of social distancing and isolation of the carriers of this disease. This paper proposes strategies for the investigation of this infection in LTCF residents and workers using laboratory tests available in Brazil. The early identification of individuals with SARS-CoV-2, who may actively and continuously spread the virus, allows adopting measures aimed at interrupting the local transmission cycle of this infection.


Subject(s)
Clinical Laboratory Techniques , Coronavirus Infections/epidemiology , Homes for the Aged/statistics & numerical data , Mass Screening/methods , Pneumonia, Viral/epidemiology , Aged , Betacoronavirus/isolation & purification , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Coronavirus Infections/prevention & control , Health Personnel , Humans , Long-Term Care , Pandemics/prevention & control , Pneumonia, Viral/mortality , Pneumonia, Viral/prevention & control , Vulnerable Populations
19.
Cien Saude Colet ; 25(9): 3465-3474, 2020 Sep.
Article in English, Portuguese | MEDLINE | ID: covidwho-740435

ABSTRACT

This work aims to systematize a set of scientific evidence presented in international papers that identify the main problems affecting health professionals directly involved in coping with the COVID-19 pandemic and point out actions and strategies for the protection and healthcare of these professionals. The risk of infection is the main issue and has led to absence from work, illness, death, and intense psychological distress, expressed in generalized anxiety and sleep disorders, fear of becoming ill and infecting colleagues and relatives. In the Brazilian reality, this work revives the analysis of the chronic problems affecting health workers, resulting from the underfinancing of the Brazilian Unified Health System (SUS), the sector's spending freeze, the deterioration of services and workforce's insecurity, and points out the acute challenges of work management and staff training, given the expanded hospital bed infrastructure and reorganization of the work process in primary care to face the pandemic, emphasizing the necessary measures for the protection and promotion of the physical and mental health of health professionals and workers.


Subject(s)
Coronavirus Infections/epidemiology , Health Personnel/psychology , Mental Disorders/epidemiology , Pneumonia, Viral/epidemiology , Adaptation, Psychological , Brazil/epidemiology , Coronavirus Infections/psychology , Coronavirus Infections/therapy , Humans , Mental Health , National Health Programs/organization & administration , Pandemics , Pneumonia, Viral/psychology , Pneumonia, Viral/therapy , Stress, Psychological/epidemiology
20.
Cien Saude Colet ; 25(9): 3555-3556, 2020 Sep.
Article in English, Portuguese | MEDLINE | ID: covidwho-740422

ABSTRACT

We live in a global pandemic unprecedented in our generation. These are challenging times for healthcare workers. We are all in the same storm and join the same collective effort against COVID-19. However, we are not in the same boat. Inequality determines how each category of the health workforce is affected by the new coronavirus in Brazil. Exposed to the disease on the frontlines, nursing technicians and assistants suffer disproportionately the dire effects of the pandemic. More than 1.3 million technicians and almost 420 thousand nursing assistants provide essential care in health units and do not have the assistance and financial backing to mitigate the effects of COVID-19 on themselves and their families. Eight in every ten of these professionals are women, who are providers and also assume, in most cases, the role of primary caregivers for children, older adults, and the sick in their families. Low wages make hinder access to safer transportation and care alternatives for dependents, which is the reality of most professionals who keep the health system running throughout the pandemic.


Subject(s)
Coronavirus Infections/epidemiology , Health Personnel/statistics & numerical data , Health Status Disparities , Pneumonia, Viral/epidemiology , Brazil/epidemiology , Caregivers/statistics & numerical data , Coronavirus Infections/therapy , Delivery of Health Care/organization & administration , Female , Health Personnel/organization & administration , Humans , Male , Pandemics , Pneumonia, Viral/therapy
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