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3.
PLoS One ; 16(9): e0257854, 2021.
Article in English | MEDLINE | ID: covidwho-1440992

ABSTRACT

OBJECTIVES: Most COVID-19 related infections and deaths may occur in healthcare outside hospitals. Here we explored SARS-CoV-2 infections among healthcare workers (HCWs) in this setting. DESIGN: All healthcare providers in Stockholm, Sweden were asked to recruit HCWs at work for a study of past or present SARS-CoV-2 infections among HCWs. Study participants This study reports the results from 839 HCWs, mostly employees of primary care centers, sampled in June 2020. RESULTS: SARS-CoV-2 seropositivity was found among 12% (100/839) of HCWs, ranging from 0% to 29% between care units. Seropositivity decreased by age and was highest among HCWs <40 years of age. Within this age group there was 19% (23/120) seropositivity among women and 11% (15/138) among men (p<0.02). Current infection, as measured using PCR, was found in only 1% and the typical testing pattern of pre-symptomatic potential "superspreaders" found in only 2/839 subjects. CONCLUSIONS: Previous SARS-CoV-2 infections were common among younger HCWs in this setting. Pre-symptomatic infection was uncommon, in line with the strong variability in SARS-CoV-2 exposure between units. Prioritizing infection prevention and control including sufficient and adequate personal protective equipment, and vaccination for all HCWs are important to prevent nosocomial infections and infections as occupational injuries during an ongoing pandemic.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Health Personnel/trends , Adult , Female , Hospitals , Humans , Male , Middle Aged , Pandemics/prevention & control , Personal Protective Equipment , Risk Factors , SARS-CoV-2/genetics , SARS-CoV-2/pathogenicity , Sweden/epidemiology
4.
Rev Esp Quimioter ; 34(3): 214-219, 2021 Jun.
Article in Spanish | MEDLINE | ID: covidwho-1390022

ABSTRACT

OBJECTIVE: Proper hand hygiene is the main measure in the prevention and control of infection associated with healthcare. It describes how the pandemic period of 2020 has influenced the evolution of the degree of compliance with hand hygiene practices in health professionals at the Hospital Universitario Insular de Gran Canaria with respect to previous years. METHODS: Descriptive cross-sectional study of direct observation on compliance with the five moments of hand hygiene in the 2018-2020 period. Adherence is described with the frequency distribution of the different moments in which it was indicated. RESULTS: Total adherence has increased from 42.5% in 2018, to 47.6% in 2019, and 59.2% in 2020 (p <0.05). Total adherence was greater in the moments after contact with the patient (67%) than in the moments before contact (48%). The area with the highest adherence was dialysis (83%). There is a greater adherence in open areas than in hospitalization areas (65% vs 56%). Higher adherence was determined in physicians (73%) and nurses (74%), than in nursing assistants (50%) (p<0.05). CONCLUSIONS: In 2020 there was an increase in adherence to hand hygiene compared to previous years. A higher percentage of adherence was determined in physicians and nurses than in nursing assistants. We consider that the current SARS-CoV-2 pandemic has played a relevant role in this increase in adherence.


Subject(s)
COVID-19/epidemiology , Hand Hygiene/trends , Health Personnel , Pandemics , COVID-19/prevention & control , Cross-Sectional Studies , Hand Hygiene/statistics & numerical data , Health Personnel/statistics & numerical data , Health Personnel/trends , Humans , Medical Staff, Hospital/statistics & numerical data , Medical Staff, Hospital/trends , Nursing Assistants/statistics & numerical data , Nursing Assistants/trends , Nursing Staff, Hospital/statistics & numerical data , Nursing Staff, Hospital/trends , Spain , Tertiary Care Centers
6.
World Neurosurg ; 155: e142-e149, 2021 11.
Article in English | MEDLINE | ID: covidwho-1356487

ABSTRACT

BACKGROUND: The coronavirus disease identified in 2019 (COVID-19) pandemic changed neurosurgery protocols to provide ongoing care for patients while ensuring the safety of health care workers. In Brazil, the rapid spread of the disease led to new challenges in the health system. Neurooncology practice was one of the most affected by the pandemic due to restricted elective procedures and new triage protocols. We aim to characterize the impact of the pandemic on neurosurgery in Brazil. METHODS: We analyzed 112 different types of neurosurgical procedures, with special detail in 11 neurooncology procedures, listed in the Brazilian Hospital Information System records in the DATASUS database between February and July 2019 and the same period in 2020. Linear regression and paired t-test analyses were performed and considered statistically significant at P < 0.05. RESULTS: There was an overall decrease of 21.5% (28,858 cases) in all neurosurgical procedures, impacting patients needing elective procedures (-42.46%) more than emergency surgery (-5.93%). Neurooncology procedures decreased by 14.89%. Nonetheless, the mortality rate during hospitalization increased by 21.26%. Linear regression analysis in hospitalizations (Slope = 0.9912 ± 0.07431; CI [95%] = 0.8231-1.159) and total cost (Slope = 1.03 ± 0.03501; CI [95%] = 0.9511-1.109) in the 11 different types of neurooncology procedures showed a P < 0.0001. The mean cost per type of procedure showed an 11.59% increase (P = 0.0172) between 2019 and 2020. CONCLUSIONS: The COVID-19 pandemic has increased mortality, decreased hospitalizations, and therefore decreased overall costs, despite increased costs per procedure for a variety of neurosurgical procedures. Our study serves as a stark example of the effect of the pandemic on neurosurgical care in settings of limited resources and access to care.


Subject(s)
COVID-19/epidemiology , Delivery of Health Care/trends , Developing Countries , Hospital Information Systems/trends , Neurosurgical Procedures/trends , Brazil/epidemiology , COVID-19/economics , COVID-19/prevention & control , Delivery of Health Care/economics , Developing Countries/economics , Health Personnel/economics , Health Personnel/trends , Hospital Information Systems/economics , Humans , Neurosurgical Procedures/economics , Personal Protective Equipment/economics , Personal Protective Equipment/trends
8.
J Orthop Surg Res ; 16(1): 336, 2021 May 25.
Article in English | MEDLINE | ID: covidwho-1243813

ABSTRACT

BACKGROUND: We report our experiences with COVID-19 in one of the largest referral orthopedic centers in the Middle East and aimed to describe the epidemiology and clinical characteristics of these patients. METHODS: During February 20 and April 20, 2020, patients who underwent orthopedic surgery and healthcare staff who were in contact with these patients were screened for COVID-19. To identify patients who were in the incubation period of COVID-19 during their hospital stay, all patients were tested again for COVID-19 4 weeks after discharge. RESULTS: Overall, 1244 patients underwent orthopedic surgery (1123 emergency and 121 elective) during the study period. Overall, 17 patients were diagnosed with COVID-19 during hospital admission and seven after discharge. Among the total 24 patients with COVID-19, 15 were (62.5%) males with a mean (SD) age of 47.0±1.6 years old. Emergency surgeries were performed in 20 (83.3%) patients, and elective surgery was done in the remaining 4 patients which included one case of posterior spinal fusion, spondylolisthesis, acromioclavicular joint dislocation, and one case of leg necrosis. A considerable number of infections occurred in patients with intertrochanteric fractures (n=7, 29.2%), followed by pelvic fractures (n=2, 8.3%), humerus fractures (n=2, 8.3%), and tibial plateau fractures (n=2, 8.3%). Fever (n=11, 45.8%) and cough (n=10, 37.5%) were the most common symptoms among patients. Laboratory examinations showed leukopenia in 2 patients (8.3%) and lymphopenia in 4 (16.7%) patients. One patient with a history of cancer died 2 weeks after discharge due to myocardial infarction. Among hospital staff, 26 individuals contracted COVID-19 during the study period, which included 13 (50%) males. Physicians were the most commonly infected group (n = 11), followed by operation room technicians (n = 5), nurses (n = 4), and paramedics (n = 4). CONCLUSIONS: Patients who undergo surgical treatment for orthopedic problems, particularly lower limb fractures with limited ambulation, are at a higher risk of acquiring COVID-19 infections, although they may not be at higher risks for death compared to the general population. Orthopedic surgeons in particular and other hospital staff who are in close contact with these patients must be adequately trained and given appropriate personal protective equipment during the COVID-19 outbreak.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Health Personnel/trends , Infectious Disease Transmission, Patient-to-Professional , Orthopedic Procedures/trends , Personal Protective Equipment/trends , Adult , COVID-19/prevention & control , Female , Hospitalization/trends , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Male , Middle Aged , Middle East/epidemiology , Occupational Exposure/prevention & control , Orthopedic Procedures/methods
9.
Pharmacogenomics ; 22(9): 515-517, 2021 06.
Article in English | MEDLINE | ID: covidwho-1242272

ABSTRACT

The Pharmacogenomics Access & Reimbursement Symposium, a landmark event presented by the Golden Helix Foundation and the Pharmacogenomics Access & Reimbursement Coalition, was a 1-day interactive meeting comprised of plenary keynotes from thought leaders across healthcare that focused on value-based strategies to improve patient access to personalized medicine. Stakeholders including patients, healthcare providers, industry, government agencies, payer organizations, health systems and health policy organizations convened to define opportunities to improve patient access to personalized medicine through best practices, successful reimbursement models, high quality economic evaluations and strategic alignment. Session topics included health technology assessment, health economics, health policy and value-based payment models and innovation.


Subject(s)
Congresses as Topic/trends , Health Services Accessibility/trends , Insurance, Health, Reimbursement/trends , Medical Assistance/trends , Pharmacogenetics/trends , District of Columbia , Health Personnel/economics , Health Personnel/trends , Health Services Accessibility/economics , Humans , Insurance, Health, Reimbursement/economics , Medical Assistance/economics , Pharmacogenetics/economics , Precision Medicine/economics , Precision Medicine/trends , Technology Assessment, Biomedical/economics , Technology Assessment, Biomedical/trends
10.
Acad Med ; 96(6): 808-812, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1242112

ABSTRACT

COVID-19 is a worldwide pandemic, with frontlines that look drastically different than in past conflicts: that is, women now make up a sizeable majority of the health care workforce. American women have a long history of helping in times of hardship, filling positions on the home front vacated by men who enlisted as soldiers during World War I and similarly serving in crucial roles on U.S. military bases, on farms, and in factories during World War II. The COVID-19 pandemic has represented a novel battleground, as the first in which women have taken center stage, not only in their roles as physicians, respiratory therapists, nurses, and the like, but also by serving in leadership positions and facilitating innovations in science, technology, and policy. Yet, the pandemic has exacerbated multiple pain points that have disproportionally impacted women in health care, including shortages in correctly sized personal protective equipment and uniforms, inadequate support for pregnant and breastfeeding providers, and challenges associated with work-life balance and obtaining childcare. While the pandemic has facilitated several positive advancements in addressing these challenges, there is still much work to be done for women to achieve equity and optimal support in their roles on the frontlines.


Subject(s)
COVID-19/prevention & control , Health Workforce/statistics & numerical data , Women, Working/history , Workforce/statistics & numerical data , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Empowerment , Female , Gender Equity , Health Personnel/trends , History, 20th Century , Humans , Leadership , Personal Protective Equipment/supply & distribution , SARS-CoV-2/isolation & purification , Women, Working/statistics & numerical data , World War I , World War II
11.
Eur Rev Med Pharmacol Sci ; 25(9): 3632-3639, 2021 May.
Article in English | MEDLINE | ID: covidwho-1232736

ABSTRACT

OBJECTIVE: In the current pandemic, Health Care Workers (HCWs) are at a high risk of developing COVID-19. Preventive methods like the use of personal protective equipment, isolation, social distancing, and chemoprophylaxis show limited benefit. Despite standard prophylaxis, many of the HCWs develop COVID-19. Medical ozone therapy has immunomodulatory, antioxidant and antiviral effect, and, therefore, it can be explored as prophylaxis for COVID-19. PATIENTS AND METHODS: We conducted a retrospective controlled cohort study. IV ozonized saline was administered once a day for a total of 4 days in one month in addition to standard prophylaxis for COVID-19 to HCWs in a dedicated COVID hospital. Fresh ozonized saline was prepared for every administration and was given over 1 hour. RESULTS: There were 235 HCWs, 64 received the ozone prophylaxis and 171 did not. The incidence of COVID-19 was significantly (p=0.04) lesser in HCWs that received ozone prophylaxis (4.6%) as compared to those who did not (14.03%). The benefit was seen irrespective of the risk of exposure. In the red zone, 8.69% of the HCWs who received ozone prophylaxis tested positive as opposed to 15.3% of those who did not. In the orange zone, 4.34% of the HCWs who received ozone prophylaxis tested positive, remarkably lesser than those who did not (20%). In the green zone, none of the HCWs who received ozone prophylaxis tested positive; however, 3.4% of the HCWs who did not receive ozone prophylaxis tested positive. No major adverse events were noted. CONCLUSIONS: IV ozonized saline can be used in addition to the standard prophylactic regimen for the prevention of COVID-19 in HCWs. Prospective larger studies are required to establish the potency of IV ozonized saline as prophylaxis.


Subject(s)
COVID-19/prevention & control , Health Personnel/trends , Hospitalization/trends , Ozone/administration & dosage , Pre-Exposure Prophylaxis/trends , Saline Solution/administration & dosage , Administration, Intravenous , Adult , Anti-Inflammatory Agents/administration & dosage , COVID-19/epidemiology , Cohort Studies , Female , Humans , India/epidemiology , Male , Pre-Exposure Prophylaxis/methods , Retrospective Studies , Young Adult
13.
Indian J Med Ethics ; VI(2): 1-6, 2021.
Article in English | MEDLINE | ID: covidwho-1206579

ABSTRACT

The Covid-19 pandemic has not only highlighted societal inequalities but also shown how a resilient health service is essential for protecting citizens. The NHS was founded in 1948 to provide universal healthcare but has been under sustained attack for the past thirty years. As a seven-year-old patient with osteomyelitis, the NHS almost certainly saved my life. Seventy years later I reflect on the humanising and civilising aspects of the NHS, the need for doctors to be advocates and custodians, as well as clinicians working in the best interests of their individual patients; and the requirement for the medical profession to understand the social determinants of ill health and how these can be ameliorated. The reward for engaging in this struggle: a healthier world in the widest sense and greater satisfaction for all those working in the prevention and treatment of ill health.

.


Subject(s)
COVID-19 , Delivery of Health Care/statistics & numerical data , Delivery of Health Care/trends , Health Personnel/trends , Pandemics , State Medicine/statistics & numerical data , State Medicine/trends , Adult , Female , Forecasting , Health Personnel/statistics & numerical data , Humans , Male , Middle Aged , SARS-CoV-2 , United Kingdom
14.
Med Leg J ; 89(2): 93-98, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1133454

ABSTRACT

National Health Service employers are subject to legal duties to protect the health and safety of their employees and third parties who come into contact with their staff. In order to discharge these duties, National Health Service employers must implement a range of protective measures to mitigate risk. One such measure is to require staff to wear personal protective equipment, including respiratory protective equipment, in certain circumstances. This is of particular importance during the Covid-19 pandemic. However, the presence of facial hair has a negative impact on the effectiveness of respiratory protective equipment. This article discusses whether a requirement to be clean shaven could amount to discrimination under the Equality Act 2010.


Subject(s)
Face/physiology , Hair/physiology , Health Personnel/legislation & jurisprudence , Personal Protective Equipment/standards , COVID-19/prevention & control , COVID-19/transmission , Health Personnel/psychology , Health Personnel/trends , Humans , State Medicine/organization & administration , State Medicine/trends
16.
Prog Neuropsychopharmacol Biol Psychiatry ; 107: 110244, 2021 04 20.
Article in English | MEDLINE | ID: covidwho-1117497

ABSTRACT

During the COVID-19, healthcare workers are exposed to a higher risk of mental health problems, especially anxiety symptoms. The current work aims at contributing to an update of anxiety prevalence in this population by conducting a rapid systematic review and meta-analysis. Medline and Pubmed were searched for studies on the prevalence of anxiety in health care workers published from December 1, 2019 to September 15, 2020. In total, 71 studies were included in this study. The pooled prevalence of anxiety in healthcare workers was 25% (95% CI: 21%-29%), 27% in nurses (95% CI: 20%-34%), 17% in medical doctors (95% CI: 12%-22%) and 43% in frontline healthcare workers (95% CI: 25%-62%). Our results suggest that healthcare workers are experiencing significant levels of anxiety during the COVID-19 pandemic, especially those on the frontline and nurses. However, international longitudinal studies are needed to fully understand the impact of the pandemic on healthcare workers' mental health, especially those working at the frontline.


Subject(s)
Anxiety/epidemiology , Anxiety/psychology , COVID-19/epidemiology , COVID-19/psychology , Health Personnel/psychology , Pandemics , Cross-Sectional Studies , Health Personnel/trends , Humans , Prevalence , Time Factors
17.
Prog Neuropsychopharmacol Biol Psychiatry ; 107: 110247, 2021 04 20.
Article in English | MEDLINE | ID: covidwho-1117496

ABSTRACT

BACKGROUND: Healthcare workers, who are at the forefront of the fight against COVID-19, are particularly susceptible to physical and mental health consequences such as anxiety and depression. The aim of this umbrella review of meta-analyses is to determine the prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic. METHODS: Using relevant keywords, data resources including PubMed, Scopus, Web of Science, Cochrane, ProQuest, Science Direct, Google Scholar and Embase were searched to obtain systematic reviews and meta-analyses reporting the prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic from the beginning of January to the end of October 2020. The random effects model was used for meta-analysis, and the I2 index was employed to assess heterogeneity among studies. Data was analyzed using STATA 14 software. RESULTS: In the primary search, 103 studies were identified, and ultimately 7 studies were included in the umbrella review. The results showed that the overall prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic was 24.94% (95% CI: 21.83-28.05, I2 = 0.0%, P = 0.804) and 24.83% (95% CI: 21.41-28.25, I2 = 0.0%, P = 0.897), respectively. CONCLUSION: This umbrella review shows that the prevalence of anxiety and depression is relatively high among healthcare workers during the COVID-19 pandemic. Healthcare workers should be provided with resources to minimize this risk.


Subject(s)
Anxiety/epidemiology , COVID-19/epidemiology , Depression/epidemiology , Health Personnel , Pandemics , Anxiety/psychology , COVID-19/psychology , Depression/psychology , Health Personnel/psychology , Health Personnel/trends , Humans , Meta-Analysis as Topic , Prevalence , Systematic Reviews as Topic/methods
18.
PLoS One ; 16(3): e0248025, 2021.
Article in English | MEDLINE | ID: covidwho-1115309

ABSTRACT

INTRODUCTION: Healthcare workers (HCW) treating COVID-19 patients are at high risk for infection and may also spread infection through their contact with vulnerable patients. Smell loss has been associated with SARS-CoV-2 infection, but it is unknown whether monitoring for smell loss can be used to identify asymptomatic infection among high risk individuals. In this study we sought to determine if tracking smell sensitivity and loss using an at-home assessment could identify SARS-CoV-2 infection in HCW. METHODS AND FINDINGS: We performed a prospective cohort study tracking 473 HCW across three months to determine if smell loss could predict SARS-CoV-2 infection in this high-risk group. HCW subjects completed a longitudinal, behavioral at-home assessment of olfaction with household items, as well as detailed symptom surveys that included a parosmia screening questionnaire, and real-time quantitative polymerase chain reaction testing to identify SARS-CoV-2 infection. Our main measures were the prevalence of smell loss in SARS-CoV-2-positive HCW versus SARS-CoV-2-negative HCW, and timing of smell loss relative to SARS-CoV-2 test positivity. SARS-CoV-2 was identified in 17 (3.6%) of 473 HCW. HCW with SARS-CoV-2 infection were more likely to report smell loss than SARS-CoV-2-negative HCW on both the at-home assessment and the screening questionnaire (9/17, 53% vs 105/456, 23%, P < .01). 6/9 (67%) of SARS-CoV-2-positive HCW reporting smell loss reported smell loss prior to having a positive SARS-CoV-2 test, and smell loss was reported a median of two days before testing positive. Neurological symptoms were reported more frequently among SARS-CoV-2-positive HCW who reported smell loss compared to those without smell loss (9/9, 100% vs 3/8, 38%, P < .01). CONCLUSIONS: In this prospective study of HCW, self-reported changes in smell using two different measures were predictive of SARS-CoV-2 infection. Smell loss frequently preceded a positive test and was associated with neurological symptoms.


Subject(s)
Anosmia/epidemiology , COVID-19/diagnosis , Health Personnel/trends , Adult , Anosmia/diagnosis , Anosmia/virology , Asymptomatic Infections/epidemiology , COVID-19/epidemiology , Female , Health Personnel/statistics & numerical data , Humans , Male , Middle Aged , Prospective Studies , SARS-CoV-2/pathogenicity , Self Report , Smell/physiology , United States/epidemiology
19.
PLoS One ; 16(3): e0247865, 2021.
Article in English | MEDLINE | ID: covidwho-1115305

ABSTRACT

COVID-19 is a global threat with an increasing number of infections. Research on IgG seroprevalence among health care workers (HCWs) is needed to re-evaluate health policies. This study was performed in three pandemic hospitals in Istanbul and Kocaeli. Different clusters of HCWs were screened for SARS-CoV-2 infection. Seropositivity rate among participants was evaluated by chemiluminescent microparticle immunoassay. We recruited 813 non-infected and 119 PCR-confirmed infected HCWs. Of the previously undiagnosed HCWs, 22 (2.7%) were seropositive. Seropositivity rates were highest for cleaning staff (6%), physicians (4%), nurses (2.2%) and radiology technicians (1%). Non-pandemic clinic (6.4%) and ICU (4.3%) had the highest prevalence. HCWs in "high risk" group had similar seropositivity rate with "no risk" group (2.9 vs 3.5 p = 0.7). These findings might lead to the re-evaluation of infection control and transmission dynamics in hospitals.


Subject(s)
COVID-19/epidemiology , Health Personnel/trends , SARS-CoV-2/immunology , COVID-19/immunology , Hospitals/trends , Humans , Infection Control/methods , Infection Control/trends , Pandemics , Prevalence , Risk Factors , SARS-CoV-2/pathogenicity , Seroepidemiologic Studies , Turkey/epidemiology
20.
Acad Med ; 96(9): 1254-1258, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1104982

ABSTRACT

Amid the COVID-19 pandemic, women in medicine, including faculty, residents, medical students, and other health care workers (HCWs), are facing unparalleled challenges. The burdens of pandemic-associated increases in domestic and caregiving responsibilities, professional demands, health risks associated with contracting COVID-19, and the resulting psychosocial distress have exacerbated existing gender disparities at home, at work, and in academia. School and day care closures have created additional childcare needs, primarily for women, yet little support exists for parents and families. These increased childcare and domestic responsibilities have forced women HCWs, who make up the overwhelming majority of the workforce, to adapt their schedules and, in some cases, leave their jobs entirely. In this article, the authors detail how COVID-19 has exacerbated existing childcare accessibility and affordability issues as well as gender disparities. They argue that unless government and health care organization support for childcare increases, families, specifically women and children, will continue to suffer. Lack of access to affordable childcare can prevent HCWs from doing their jobs, including conducting and publishing academic scholarship. This poses incalculable risks to families, science, and society. COVID-19 should serve as a call to action to all sectors, including the government and health care organizations, to prioritize childcare provision and increase support for women HCWs, both now during the pandemic and going forward.


Subject(s)
COVID-19 , Child Care/trends , Family , Health Personnel , Sexism/trends , COVID-19/prevention & control , Child , Child Care/economics , Child Care/organization & administration , Child Day Care Centers/economics , Child Day Care Centers/trends , Child Health/trends , Child Welfare/economics , Child Welfare/psychology , Child Welfare/trends , Child, Preschool , Female , Health Personnel/psychology , Health Personnel/trends , Humans , Infant , Mental Health/trends , Physicians, Women/psychology , Physicians, Women/supply & distribution , Physicians, Women/trends , United States , Women's Health/trends
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