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1.
Endocr Metab Immune Disord Drug Targets ; 21(10): 1775-1780, 2021.
Article in English | MEDLINE | ID: covidwho-1562450

ABSTRACT

In late 2019, SARS-COV-2 disease was firstly discovered in Wuhan, China and then it infected millions of people worldwide. Later, the World Health Organization (WHO) described COVID-19 as the first pandemic invading the world in the 21st century. The WHO has declared that the emerging infection will last long enough to force adjustments not only in people's lifestyles but also in the health care system. This amendment is expected to spread through many medical practices and specialties. A lot of diagnostic and therapeutic modalities have been proposed for COVID-19 management. The best strategy for the management of patients requires a multi-disciplinary team approach with correct decisions regarding the right timing of each modality of treatment. The participating multidisciplinary team for COVID-19 management includes six infectious diseases experts in Tanta University; one critical care management expert, an emergency medicine expert and two pharmacists in Tanta University. In this review, we reported our multi-disciplinary team experience with up to date literature guidance to propose a valid protocol for the management of COVID-19 patients in a limited resources setting.


Subject(s)
Academic Medical Centers/methods , COVID-19/prevention & control , Developing Countries , Disease Management , Health Resources , Patient Care Team , Academic Medical Centers/economics , COVID-19/economics , COVID-19/epidemiology , Developing Countries/economics , Egypt/epidemiology , Health Resources/economics , Humans , Patient Care Team/economics
6.
Glob Heart ; 16(1): 18, 2021 03 15.
Article in English | MEDLINE | ID: covidwho-1175699

ABSTRACT

The current pandemic of SARS-COV 2 infection (Covid-19) is challenging health systems and communities worldwide. At the individual level, the main biological system involved in Covid-19 is the respiratory system. Respiratory complications range from mild flu-like illness symptoms to a fatal respiratory distress syndrome or a severe and fulminant pneumonia. Critically, the presence of a pre-existing cardiovascular disease or its risk factors, such as hypertension or type II diabetes mellitus, increases the chance of having severe complications (including death) if infected by the virus. In addition, the infection can worsen an existing cardiovascular disease or precipitate new ones. This paper presents a contemporary review of cardiovascular complications of Covid-19. It also specifically examines the impact of the disease on those already vulnerable and on the poorly resourced health systems of Africa as well as the potential broader consequences on the socio-economic health of this region.


Subject(s)
COVID-19/physiopathology , Cardiovascular Diseases/physiopathology , Acute Coronary Syndrome/economics , Acute Coronary Syndrome/etiology , Acute Coronary Syndrome/physiopathology , Africa , Antimalarials/adverse effects , Arrhythmias, Cardiac/economics , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/physiopathology , COVID-19/complications , COVID-19/economics , Cardiovascular Diseases/economics , Cardiovascular Diseases/etiology , Chloroquine/adverse effects , Coronavirus Infections/complications , Coronavirus Infections/physiopathology , Delivery of Health Care/economics , Economic Factors , Economic Recession , Gross Domestic Product , Health Resources/economics , Health Resources/supply & distribution , Heart Failure/economics , Heart Failure/etiology , Heart Failure/physiopathology , Humans , Hydroxychloroquine/adverse effects , Inflammation , Myocardial Ischemia/economics , Myocardial Ischemia/etiology , Myocardial Ischemia/physiopathology , Myocarditis/economics , Myocarditis/etiology , Myocarditis/physiopathology , SARS-CoV-2 , Severe Acute Respiratory Syndrome/complications , Severe Acute Respiratory Syndrome/physiopathology , Socioeconomic Factors , Takotsubo Cardiomyopathy/economics , Takotsubo Cardiomyopathy/etiology , Takotsubo Cardiomyopathy/physiopathology
7.
Ciênc. Saúde Colet ; 26(3): 1001-1012, mar. 2021. tab, graf
Article in English, Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1138611

ABSTRACT

Resumo A resposta americana à pandemia envolve um proeminente volume de recursos federais, em especial destinados ao desenvolvimento e aquisição de produtos no uso interno, como diagnósticos ou vacinas. As justificativas para esse desembolso se baseiam em mecanismos de investimentos e aspectos históricos. Assim, a construção social do nacionalismo na formação na sociedade americana prejudica o acesso a tecnologias em saúde. A revisão desses aspectos demonstra como os Estados Unidos (EUA) garantiram compra de grande quantitativo de produtos em potencial, inclusive assegurando excessiva produção local. Essa política externa unilateral tem influenciado outros países ou blocos regionais e prejudicado a cooperação e a solidariedade global com impacto na saúde coletiva de diversas nações.


Abstract The American response to the pandemic involves a prominent volume of federal resources, especially for developing and acquiring products for internal use, such as diagnostics or vaccines. Investment mechanisms and historical aspects justify this expenditure. Thus, the social construction of nationalism in American society hinders access to health technologies. The review of such aspects shows how the United States (U.S.) secured a large number of potential products, ensuring excessive local production. This unilateral foreign policy has influenced other countries or regional blocs and undermined global cooperation and solidarity, affecting the collective health of several nations.


Subject(s)
Humans , Global Health , Coronavirus Infections/epidemiology , Pandemics , International Cooperation , Political Systems , United States/epidemiology , United States Dept. of Health and Human Services/economics , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Costs and Cost Analysis , Resource Allocation/economics , Resource Allocation/methods , Developing Countries , Diffusion of Innovation , Economics , Health Resources/economics , Health Resources/supply & distribution , Health Services Accessibility
12.
MMWR Morb Mortal Wkly Rep ; 69(50): 1917-1921, 2020 Dec 18.
Article in English | MEDLINE | ID: covidwho-1016446

ABSTRACT

As school districts across the United States consider how to safely operate during the 2020-21 academic year, CDC recommends mitigation strategies that schools can adopt to reduce the risk for transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1). To identify the resources and costs needed to implement school-based mitigation strategies and provide schools and jurisdictions with information to aid resource allocation, a microcosting methodology was employed to estimate costs in three categories: materials and consumables, additional custodial staff members, and potential additional transportation. National average estimates, using the national pre-kindergarten through grade 12 (preK-12) public enrollment of 50,685,567 students, range between a mean of $55 (materials and consumables only) to $442 (all three categories) per student. State-by-state estimates of additional funds needed as a percentage of fiscal year 2018 student expenditures (2) range from an additional 0.3% (materials and consumables only) to 7.1% (all three categories); however, only seven states had a maximum estimate above 4.2%. These estimates, although not exhaustive, highlight the level of resources needed to ensure that schools reopen and remain open in the safest possible manner and offer administrators at schools and school districts and other decision-makers the cost information necessary to budget and prioritize school resources during the COVID-19 pandemic.


Subject(s)
COVID-19/prevention & control , Health Resources/economics , Schools/economics , Adolescent , COVID-19/epidemiology , Centers for Disease Control and Prevention, U.S. , Child , Child, Preschool , Costs and Cost Analysis , Humans , Schools/statistics & numerical data , United States/epidemiology
13.
Med Leg J ; 89(1): 25-28, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-983824

ABSTRACT

The Covid-19 pandemic has created the opportunity for corruption to flourish in healthcare sectors around the world. Challenges include misuse and mismanagement of resources and corruption, which require scrutiny and attention. This article deals with such corruption during the pandemic, involving public procurement of goods and services for the treatment of diseases, falsification of public contracts and kickbacks, embezzlement of healthcare funds, opacity in governance, misuse of power, nepotism and favouritism in the management, petty corruption in the level of service, fraud and theft or embezzlement of medicines and medical devices.


Subject(s)
COVID-19/economics , Delivery of Health Care/economics , Delivery of Health Care/organization & administration , Fraud , Health Resources/economics , Theft , Government , Humans , Internationality , Public Sector , Social Responsibility
14.
J Surg Res ; 260: 56-63, 2021 04.
Article in English | MEDLINE | ID: covidwho-977146

ABSTRACT

BACKGROUND: As the COVID-19 pandemic continues, there is a question of whether hospitals have adequate resources to manage patients. We aim to investigate global hospital bed (HB), acute care bed (ACB), and intensive care unit (ICU) bed capacity and determine any correlation between these hospital resources and COVID-19 mortality. METHOD: Cross-sectional study utilizing data from the World Health Organization (WHO) and other official organizations regarding global HB, ACB, ICU bed capacity, and confirmed COVID-19 cases/mortality. Descriptive statistics and linear regression were performed. RESULTS: A total of 183 countries were included with a mean of 307.1 HBs, 413.9 ACBs, and 8.73 ICU beds/100,000 population. High-income regions had the highest mean number of ICU beds (12.79) and HBs (402.32) per 100,000 population whereas upper middle-income regions had the highest mean number of ACBs (424.75) per 100,000. A weakly positive significant association was discovered between the number of ICU beds/100,000 population and COVID-19 mortality. No significant associations exist between the number of HBs or ACBs per 100,000 population and COVID-19 mortality. CONCLUSIONS: Global COVID-19 mortality rates are likely affected by multiple factors, including hospital resources, personnel, and bed capacity. Higher income regions of the world have greater ICU, acute care, and hospital bed capacities. Mandatory reporting of ICU, acute care, and hospital bed capacity/occupancy and information relating to coronavirus should be implemented. Adopting a tiered critical care approach and targeting the expansion of space, staff, and supplies may serve to maximize the quality of care during resurgences and future disasters.


Subject(s)
COVID-19/therapy , Global Health/statistics & numerical data , Health Resources/statistics & numerical data , Hospital Bed Capacity/statistics & numerical data , Pandemics/prevention & control , COVID-19/mortality , Critical Care/economics , Critical Care/statistics & numerical data , Cross-Sectional Studies , Global Burden of Disease/statistics & numerical data , Global Health/economics , Health Resources/economics , Hospital Bed Capacity/economics , Humans , Intensive Care Units/statistics & numerical data , Pandemics/statistics & numerical data
15.
J Hosp Med ; 15(12): 709-715, 2020 12.
Article in English | MEDLINE | ID: covidwho-967311

ABSTRACT

BACKGROUND: Academic medical centers have expanded their inpatient medicine services with advanced practice clinicians (APCs) or nonteaching hospitalists in response to patient volumes, residency work hour restrictions, and recently, COVID-19. Reports of clinical outcomes, cost, and resource utilization differ among inpatient team structures. OBJECTIVE: Directly compare outcomes among resident, APC, and solo hospitalist inpatient general medicine teams. DESIGN: Retrospective cohort study using multivariable analysis adjusted for time of admission, interhospital transfer, and comorbidities that compares clinical outcomes, cost, and resource utilization. SUBJECTS: Patients 18 years or older discharged from an inpatient medicine service between July 2015 and July 2018 (N = 12,716). MAIN MEASURES: Length of stay (LOS), 30-day readmission, inpatient mortality, normalized total direct cost, discharge time, and consultation utilization. KEY RESULTS: Resident teams admitted fewer patients at night (32.0%; P < .001) than did APC (49.5%) and hospitalist (48.6%) teams. APCs received nearly 4% more outside transfer patients (P = .015). Hospitalists discharged patients 26 minutes earlier than did residents (mean hours after midnight [95% CI], 14.58 [14.44-14.72] vs 15.02 [14.97-15.08]). Adjusted consult utilization was 15% higher for APCs (adjusted mean consults per admission [95% CI], 1.00 [0.96-1.03]) and 8% higher for residents (0.93 [0.90-0.95]) than it was for hospitalists (0.85 [0.80-0.90]). No differences in LOS, readmission, mortality, or cost were observed between the teams. CONCLUSION: We observed similar costs, LOS, 30-day readmission, and mortality among hospitalist, APC, and resident teams. Our results suggest clinical outcomes are not significantly affected by team structure. The addition of APC or hospitalist teams represent safe and effective alternatives to traditional inpatient resident teams.


Subject(s)
Academic Medical Centers , Health Resources/economics , Hospitalists/economics , Internal Medicine , Internship and Residency , Patient Outcome Assessment , Female , Humans , Internal Medicine/economics , Internal Medicine/education , Length of Stay/statistics & numerical data , Male , Middle Aged , Patient Readmission , Quality of Health Care/statistics & numerical data , Retrospective Studies
16.
J Clin Gastroenterol ; 54(10): 833-840, 2020.
Article in English | MEDLINE | ID: covidwho-963399

ABSTRACT

Performance of endoscopic procedures is associated with a risk of infection from COVID-19. This risk can be reduced by the use of personal protective equipment (PPE). However, shortage of PPE has emerged as an important issue in managing the pandemic in both traditionally high and low-resource areas. A group of clinicians and researchers from thirteen countries representing low, middle, and high-income areas has developed recommendations for optimal utilization of PPE before, during, and after gastrointestinal endoscopy with particular reference to low-resource situations. We determined that there is limited flexibility with regard to the utilization of PPE between ideal and low-resource settings. Some compromises are possible, especially with regard to PPE use, during endoscopic procedures. We have, therefore, also stressed the need to prevent transmission of COVID-19 by measures other than PPE and to conserve PPE by reduction of patient volume, limiting procedures to urgent or emergent, and reducing the number of staff and trainees involved in procedures. This guidance aims to optimize utilization of PPE and protection of health care providers.


Subject(s)
Coronavirus Infections/prevention & control , Endoscopy, Gastrointestinal/economics , Health Resources/economics , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics/prevention & control , Personal Protective Equipment/standards , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , COVID-19 , Coronavirus Infections/epidemiology , Endoscopy, Gastrointestinal/statistics & numerical data , Female , Gastroenterology/standards , Global Health , Humans , Infection Control/organization & administration , Internationality , Male , Occupational Health/statistics & numerical data , Pandemics/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/epidemiology , Poverty , Societies, Medical
17.
Popul Health Manag ; 23(5): 361-367, 2020 10.
Article in English | MEDLINE | ID: covidwho-936312

ABSTRACT

Technology has played an important role in responding to the novel coronavirus (SARS-CoV-2) and subsequent COVID-19 pandemic. The virus's blend of lethality and transmissibility have challenged officials and exposed critical limitations of the traditional public health apparatus. However, throughout this pandemic, technology has answered the call for a new form of public health that illustrates opportunities for enhanced agility, scale, and responsiveness. The authors share the Microsoft perspective and illustrate how technology has helped transform the public health landscape with new and refined capabilities - the efficacy and impact of which will be determined by history. Technologies like chatbot and virtualized patient care offer a mechanism to triage and distribute care at scale. Artificial intelligence and high-performance computing have accelerated research into understanding the virus and developing targeted therapeutics to treat infection and prevent transmission. New mobile contact tracing protocols that preserve patient privacy and civil liberties were developed in response to public concerns, creating new opportunities for privacy-sensitive technologies that aid efforts to prevent and control outbreaks. While much progress is still needed, the COVID-19 pandemic has highlighted technology's importance to public health security and pandemic preparedness. Future multi-stakeholder collaborations, including those with technology organizations, are needed to facilitate progress in overcoming the current pandemic, setting the stage for improved pandemic preparedness in the future. As lessons are assessed from the current pandemic, public officials should consider technology's role and continue to seek opportunities to supplement and improve on traditional approaches.


Subject(s)
Biomedical Technology/methods , Coronavirus Infections/prevention & control , Infection Control/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Public Health/standards , Virtual Reality Exposure Therapy/methods , Biomedical Technology/statistics & numerical data , COVID-19 , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Female , Health Resources/economics , Humans , Male , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Population Health Management , Risk Assessment , Role , Software/statistics & numerical data , United States , Virtual Reality Exposure Therapy/statistics & numerical data
18.
Malar J ; 19(1): 411, 2020 Nov 16.
Article in English | MEDLINE | ID: covidwho-927504

ABSTRACT

The global COVID-19 pandemic has been affecting the maintenance of various disease control programmes, including malaria. In some malaria-endemic countries, funding and personnel reallocations were executed from malaria control programmes to support COVID-19 response efforts, resulting mainly in interruptions of disease control activities and reduced capabilities of health system. While it is principal to drive national budget rearrangements during the pandemic, the long-standing malaria control programmes should not be left behind in order to sustain the achievements from the previous years. With different levels of intensity, many countries have been struggling to improve the health system resilience and to mitigate the unavoidable stagnation of malaria control programmes. Current opinion emphasized the impacts of budget reprioritization on malaria-related resources during COVID-19 pandemic in malaria endemic countries in Africa and Southeast Asia, and feasible attempts that can be taken to lessen these impacts.


Subject(s)
Budgets/trends , Coronavirus Infections/economics , Endemic Diseases/economics , Health Resources/economics , Malaria/economics , Pandemics/economics , Pneumonia, Viral/economics , Africa , Asia, Southeastern , Budgets/statistics & numerical data , COVID-19 , Coronavirus Infections/prevention & control , Endemic Diseases/prevention & control , Health Resources/trends , Humans , Malaria/prevention & control , Mosquito Control/economics , Mosquito Control/trends , Pandemics/prevention & control , Pneumonia, Viral/prevention & control
19.
Geriatr Gerontol Int ; 20(12): 1112-1119, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-901048

ABSTRACT

Since the end of 2019, a life-threatening infectious disease (coronavirus disease 2019: COVID-19) has spread globally, and numerous victims have been reported. In particular, older persons tend to suffer more severely when infected with a novel coronavirus (SARS-CoV-2) and have higher case mortality rates; additionally, outbreaks frequently occur in hospitals and long-term care facilities where most of the residents are older persons. Unfortunately, it has been stated that the COVID-19 pandemic has caused a medical collapse in some countries, resulting in the depletion of medical resources, such as ventilators, and triage based on chronological age. Furthermore, as some COVID-19 cases show a rapid deterioration of clinical symptoms and accordingly, the medical and long-term care staff cannot always confirm the patient's values and wishes in time, we are very concerned as to whether older patients are receiving the medical and long-term care services that they wish for. It was once again recognized that it is vital to implement advance care planning as early as possible before suffering from COVID-19. To this end, in August 2020, the Japan Geriatrics Society announced ethical recommendations for medical and long-term care for older persons and emphasized the importance of conducting advance care planning at earlier stages. Geriatr Gerontol Int 2020; 20: 1112-1119.


Subject(s)
Advance Care Planning , COVID-19/therapy , Long-Term Care/ethics , Advance Care Planning/ethics , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/mortality , COVID-19/prevention & control , Consensus , Decision Making/ethics , Geriatrics/standards , Health Resources/economics , Humans , Japan , Pandemics/ethics , Triage/ethics
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