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3.
J Prev Med Public Health ; 54(5): 360-369, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1471032

ABSTRACT

OBJECTIVES: The purpose of this study was to investigate public preferences regarding allocation principles for scarce medical resources in the coronavirus disease 2019 (COVID-19) pandemic, particularly in comparison with the recommendations of ethicists. METHODS: An online survey was conducted with a nationally representative sample of 1509 adults residing in Korea, from November 2 to 5, 2020. The degree of agreement with resource allocation principles in the context of the medical resource constraints precipitated by the COVID-19 pandemic was examined. The results were then compared with ethicists' recommendations. We also examined whether the perceived severity of COVID-19 explained differences in individual preferences, and by doing so, whether perceived severity helps explain discrepancies between public preferences and ethicists' recommendations. RESULTS: Overall, the public of Korea agreed strongly with the principles of "save the most lives," "Koreans first," and "sickest first," but less with "random selection," in contrast to the recommendations of ethicists. "Save the most lives" was given the highest priority by both the public and ethicists. Higher perceived severity of the pandemic was associated with a greater likelihood of agreeing with allocation principles based on utilitarianism, as well as those promoting and rewarding social usefulness, in line with the opinions of expert ethicists. CONCLUSIONS: The general public of Korea preferred rationing scarce medical resources in the COVID-19 pandemic predominantly based on utilitarianism, identity and prioritarianism, rather than egalitarianism. Further research is needed to explore the reasons for discrepancies between public preferences and ethicists' recommendations.


Subject(s)
COVID-19 , Health Resources/supply & distribution , Pandemics , Public Opinion , Adult , Aged , Ethicists , Female , Health Care Rationing/ethics , Health Resources/ethics , Humans , Male , Middle Aged , Republic of Korea , Surveys and Questionnaires , Young Adult
4.
Br J Surg ; 108(10): 1162-1180, 2021 10 23.
Article in English | MEDLINE | ID: covidwho-1462296

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues' experiences and published evidence. METHODS: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. RESULTS: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. CONCLUSION: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era.


Subject(s)
COVID-19/prevention & control , Perioperative Care/trends , Practice Patterns, Physicians'/trends , Surgical Procedures, Operative/trends , Adult , Biomedical Research/organization & administration , COVID-19/diagnosis , COVID-19/economics , COVID-19/epidemiology , Education, Medical, Graduate/methods , Education, Medical, Graduate/trends , Female , Global Health , Health Resources/supply & distribution , Health Services Accessibility/trends , Humans , Infection Control/economics , Infection Control/methods , Infection Control/standards , International Cooperation , Male , Middle Aged , Pandemics , Perioperative Care/education , Perioperative Care/methods , Perioperative Care/standards , Practice Patterns, Physicians'/standards , Surgeons/education , Surgeons/psychology , Surgeons/trends , Surgical Procedures, Operative/education , Surgical Procedures, Operative/methods , Surgical Procedures, Operative/standards
5.
Global Health ; 17(1): 111, 2021 09 19.
Article in English | MEDLINE | ID: covidwho-1430460

ABSTRACT

Ten years of the Syrian war had a devastating effect on Syrian lives, including millions of refugees and displaced people, enormous destruction in the infrastructure, and the worst economic crisis Syria has ever faced. The health sector was hit hard by this war, up to 50% of the health facilities have been destroyed and up to 70% of the healthcare providers fled the country seeking safety, which increased the workload and mental pressure for the remaining medical staff. Five databases were searched and 438 articles were included according to the inclusion criteria, the articles were divided into categories according to the topic of the article.Through this review, the current health status of the Syrian population living inside Syria, whether under governmental or opposition control, was reviewed, and also, the health status of the Syrian refugees was examined according to each host country. Public health indicators were used to summarize and categorize the information. This research reviewed mental health, children and maternal health, oral health, non-communicable diseases, infectious diseases, occupational health, and the effect of the COVID - 19 pandemic on the Syrian healthcare system. The results of the review are irritating, as still after ten years of war and millions of refugees there is an enormous need for healthcare services, and international organization has failed to respond to those needs. The review ended with the current and future challenges facing the healthcare system, and suggestions about rebuilding the healthcare system.Through this review, the major consequences of the Syrian war on the health of the Syrian population have been reviewed and highlighted. Considerable challenges will face the future of health in Syria which require the collaboration of the health authorities to respond to the growing needs of the Syrian population. This article draws an overview about how the Syrian war affected health sector for Syrian population inside and outside Syria after ten years of war which makes it an important reference for future researchers to get the main highlight of the health sector during the Syrian crisis.


Subject(s)
Public Health/standards , Refugees/statistics & numerical data , Warfare/statistics & numerical data , Altruism , Developing Countries/statistics & numerical data , Health Resources/supply & distribution , Health Resources/trends , Health Services Accessibility/standards , Humans , Public Health/statistics & numerical data , Public Health/trends , Syria
7.
Diagn Microbiol Infect Dis ; 101(2): 115469, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1385401

ABSTRACT

Alternatives to nasopharyngeal sampling are needed to increase capacity for SARS-CoV-2 testing. Among 275 participants, we piloted the collection of nasal mid-turbinate swabs amenable to self-testing, including polyester flocked swabs as well as 3D-printed plastic lattice swabs, placed into viral transport media or an RNA stabilization agent. Flocked nasal swabs identified 104/121 individuals who were PCR-positive for SARS-CoV-2 by nasopharyngeal sampling (sensitivity 87%, 95% CI 79-92%), missing those with low viral load (<106 viral copies/mL). 3D-printed nasal swabs showed similar sensitivity. When nasal swabs were placed directly into RNA preservative, the mean 1.4 log decrease in viral copies/uL compared to nasopharyngeal samples was reduced to <1 log, even when samples were left at room temperature for up to 7 days. We also evaluated pooling strategies that involved pooling specimens in the lab versus pooling swabs at the point of collection, finding both successfully detected samples with >105 viral copies/mL.


Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19/diagnosis , SARS-CoV-2/isolation & purification , Health Resources/supply & distribution , Humans , Limit of Detection , Nasopharynx/virology , RNA, Viral/genetics , SARS-CoV-2/genetics , Self-Testing , Specimen Handling/instrumentation , Specimen Handling/methods , Turbinates/virology , Viral Load
10.
Bull Cancer ; 108(9): 787-797, 2021 Sep.
Article in French | MEDLINE | ID: covidwho-1336273

ABSTRACT

The Curie Institute exclusively cares for cancer patients, who were considered particularly "vulnerable" from the start of the SARS-CoV 2 pandemic. This pandemic, which took the medical world by surprise, suddenly required the Institute's hospital to undergo rapid and multimodal restructuring, while having an impact on everyone to varying degrees. We will examine here how this hospital has coped, with the concern for a new benefit-risk balance, in times of greater medical uncertainty and scarcity of certain resources, for these "vulnerable" patients but also for their relatives and staff. We will highlight by theme the positive aspects and difficulties encountered, and then what could be useful for other hospitals as the pandemic is ongoing.


Subject(s)
COVID-19/epidemiology , Cancer Care Facilities/organization & administration , Pandemics , SARS-CoV-2 , Delivery of Health Care/organization & administration , Ethics, Medical , Family , Guidelines as Topic , Health Resources/supply & distribution , Humans , Personnel Administration, Hospital , Pilot Projects , Psychotherapy/organization & administration , Remote Consultation , Research/organization & administration , Risk Assessment/methods , Teleworking , Videoconferencing/organization & administration
11.
Int J Health Plann Manage ; 36(S1): 182-189, 2021 May.
Article in English | MEDLINE | ID: covidwho-1318705

ABSTRACT

Being a small island and low-middle income country (LMIC) heavily dependent on global markets for sustaining its basic needs and health system, Maldives faced specific challenges during the COVID-19 pandemic. This was reinforced through tensions between the heavily centralized healthcare delivery and a partially decentralized public health system. Using the pillars of pandemic response proposed by the World Health Organisation, this article explores the planning assumptions, resource estimations and strategies adopted to equip the health system with resources for the pandemic response. The resource need estimates based on projections for COVID-19 identified a shortfall of medical professionals to care for patients while maintaining 55% of the workforce for regular healthcare across the atolls. The findings show that while the policy of lockdown bought time to increase hospital beds and devices, the country was unable to increase the healthcare workforce. Furthermore, as the lockdown eased, the exponential increase of cases took Maldives to the global one per capita incidence. Despite this, with cautious planning and use of resources, the country has so far managed to maintain low mortality from COVID-19. The lessons from this experience are paramount in future pandemic response planning, not only for Maldives, but other small island LMICs.


Subject(s)
COVID-19 , Delivery of Health Care/organization & administration , Health Resources/organization & administration , Health Resources/supply & distribution , Humans , Indian Ocean Islands , Pandemics , SARS-CoV-2
12.
Int J Health Plann Manage ; 36(S1): 42-57, 2021 May.
Article in English | MEDLINE | ID: covidwho-1318700

ABSTRACT

Public health emergencies are a test of resilience for health systems, which depend on health workforces that are well managed and cared for. The COVID-19 pandemic exposed the weakness of many health systems in preparing their health workforces. The crisis also exacerbated the unequal conditions between different professions, an issue that is still understudied in the workforce literature. This paper analyzes the consequences of the COVID-19 pandemic for different health professionals, considering the ways in which Brazil's the health system does or does not protect them. We also analyse the role of pre-existing inequalities between different professions and social groups within the workforce in shaping their different experiences of the pandemic. We present data comparing the perceptions of different health professionals facing the pandemic in Brazil: physicians, nurses, and community health workers. Data were collected in an online survey in Brazil with 1630 health care workers between June 15th and July 1st. Findings suggest that none of the professions felt well prepared to work under emergencies. However, differences relating to professional background were exacerbated during the pandemic, creating unequal conditions for different health workers. These inequalities may pose new challenges for the post-pandemic scenario.


Subject(s)
COVID-19 , Health Personnel/psychology , Health Resources/supply & distribution , Workplace , Brazil , COVID-19/transmission , Delivery of Health Care , Health Knowledge, Attitudes, Practice , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics , Public Health , SARS-CoV-2 , Surveys and Questionnaires
13.
Ann Ig ; 33(5): 521-523, 2021.
Article in English | MEDLINE | ID: covidwho-1296187

ABSTRACT

Abstract: The differences of the epidemiology (incidence, case-to-death rate, mortality, etc) of COVID-19 between USA and Italy are analyzed taking into account the social, economic and sanitary characteristics of the two countries, both severely hit be the pandemic; and the causes of the so many different behaviors of the disease in each of them are discussed and explained.


Subject(s)
COVID-19/mortality , Pandemics/statistics & numerical data , SARS-CoV-2 , COVID-19/prevention & control , COVID-19/therapy , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Comorbidity , Europe/epidemiology , Health Policy , Health Resources/supply & distribution , Humans , Immunization, Passive , Italy/epidemiology , Social Determinants of Health , United States/epidemiology
15.
Int J Infect Dis ; 106: 79-82, 2021 May.
Article in English | MEDLINE | ID: covidwho-1279593

ABSTRACT

The first case of COVID-19 in Yemen was confirmed on 10 April 2020. Having faced with a six-year long conflict that has destroyed half of its healthcare facilities and displaced millions, predictions of infections and mortality in Yemen suggested a looming healthcare catastrophe. Difficulty in implementing coordinated lockdowns and preventive measures due to the daily labor working nature of the majority of the population, provided the perfect breeding ground for the SARS-CoV-2 virus. However, official figures of infections and mortality are very low and there have not been confirmed reports of excess mortality. This could indicate that Yemen is silently marching towards forced herd immunity. Seroprevalence studies will provide useful insight into the COVID-19 transmission trajectory in Yemen, which can serve as a guide in planning vaccine distribution strategies and allocating the limited funds wisely.


Subject(s)
COVID-19/epidemiology , COVID-19/mortality , Health Resources/supply & distribution , Immunity, Herd , Armed Conflicts , COVID-19/immunology , Communicable Disease Control/methods , Humans , SARS-CoV-2/immunology , Yemen/epidemiology
18.
Gastroenterol Hepatol ; 43(8): 472-480, 2020 Oct.
Article in English, Spanish | MEDLINE | ID: covidwho-1235898

ABSTRACT

The SARS-CoV-2 pandemic has proven to be a serious challenge for the Spanish healthcare system. The impact of the virus on the liver is not well known, but in patients with chronic liver disease, mostly in advanced stages, it can critically compromise survival and trigger decompensation. Treatment in this subpopulation is complex due to the potential hepatotoxicity of some of the medicinal products used. Moreover, the pandemic has also negatively impacted patients with liver disease who have not contracted COVID-19, since the reallocation of human and material resources to the care of patients with the virus has resulted in a decrease in the treatment, diagnosis and follow-up of patients with liver disease, which will surely have negative consequences in the near future. Efficient reorganization of hepatology units is a priority to minimise the impact of the pandemic on a population as vulnerable as liver disease patients.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Liver Diseases/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Adenosine Monophosphate/adverse effects , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , Age Factors , Alanine/adverse effects , Alanine/analogs & derivatives , Alanine/therapeutic use , Antiviral Agents/adverse effects , Antiviral Agents/therapeutic use , Bile Ducts/virology , COVID-19 , Chemical and Drug Induced Liver Injury/etiology , Chronic Disease , Comorbidity , Coronavirus Infections/drug therapy , Disease Susceptibility , Gastroenterology/organization & administration , Health Resources/supply & distribution , Hepatitis, Chronic/drug therapy , Hepatitis, Chronic/epidemiology , Humans , Immunosuppressive Agents/adverse effects , Liver/drug effects , Liver/pathology , Liver/virology , Liver Function Tests , Liver Transplantation , Obesity/epidemiology , Resource Allocation , Risk Factors , SARS-CoV-2
20.
Infect Control Hosp Epidemiol ; 42(5): 600-603, 2021 05.
Article in English | MEDLINE | ID: covidwho-1233672

ABSTRACT

We performed a cross-sectional survey of infection preventionists in 60 US community hospitals between April 22 and May 8, 2020. Several differences in hospital preparedness for SARS-CoV-2 emerged with respect to personal protective equipment conservation strategies, protocols related to testing, universal masking, and restarting elective procedures.


Subject(s)
COVID-19/prevention & control , Health Resources/supply & distribution , Hospitals, Community/statistics & numerical data , Infection Control/statistics & numerical data , Cross-Sectional Studies , Health Care Surveys , Humans , Infection Control/instrumentation , Infection Control/methods , Personal Protective Equipment/supply & distribution , SARS-CoV-2
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