Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 15 de 15
Filter
1.
Indian J Ophthalmol ; 68(8): 1540-1544, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-680100

ABSTRACT

Purpose: To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute. Methods: Records of all the patients who presented from March 25th to May 3rd, 2020 were scanned to evaluate the details regarding the presenting complaints, diagnosis, advised treatment and surgical interventions. Results: The number of outpatient department visits, retinal laser procedures, intravitreal injections and cataract surgeries during this lockdown decreased by 96.5%, 96.5%, 98.7% and 99.7% respectively compared from the corresponding time last year. Around 38.8% patients could be triaged as non-emergency cases based on history alone while 59.5% patients could be triaged as non-emergency cases after examination. Only eighty-four patients opted for video-consultation from April 15th to May 3rd, 2020. Nine patients presented with perforated corneal ulcer, but could not undergo penetrating keratoplasty due to the lack to available donor corneal tissue. One of these patients had to undergo evisceration due to disease progression. Two patients with open globe injury presented late after trauma and had to undergo enucleation. Around 9% patients could not undergo the advised urgent procedure due to logistical issues related to the lockdown. Conclusion: A significant number of patients could not get adequate treatment during the lockdown period. Hospitals need to build capacity to cater to the expected patient surge post-COVID-19-era, especially those requiring immediate in-person attention. A large number of patients can be classified as non-emergency cases. These patients need to be encouraged to follow-up via video-consultation to carve adequate in-person time for the high-risk patients.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Eye Diseases/therapy , Ophthalmology/statistics & numerical data , Pandemics , Patient Care/statistics & numerical data , Pneumonia, Viral/epidemiology , Quarantine , Academies and Institutes/organization & administration , Academies and Institutes/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Emergency Medical Services/statistics & numerical data , Female , Hospitals, Special/organization & administration , Hospitals, Special/statistics & numerical data , Humans , India/epidemiology , Infant , Infant, Newborn , Male , Middle Aged , Ophthalmology/organization & administration , Retrospective Studies , Tertiary Care Centers/statistics & numerical data
2.
Ann Agric Environ Med ; 27(2): 201-206, 2020 Jun 19.
Article in English | MEDLINE | ID: covidwho-614681

ABSTRACT

INTRODUCTION: The article describes the process of converting a large multi-specialized hospital into one dedicated to COVID-19 patients, and present established standards of work organization in all the wards and training system of the medical and supporting staff. The several weeks pandemic of the COVID-19 disease has forced the healthcare systems of numerous countries to adjust their resources to the care of the growing number of COVID-19 patients. Managers were presented with the challenge of protecting the healthcare workers from transmission of the disease within medical institutions, and issues concerning the physical and psychological depletion of personnel. MATERIAL AND METHODS: Based on analyses of the structure and work processes in Central Clinical Hospital (CCH) reconstructive strategic plan was developed. It included: division of existing wards into observation and isolation wards; installing locks; weekly plan for supplying personal protection equipment (PPE); designating new access to the hospital and communication routes; training of medical and supporting staff. The plan was implemented from the first days of conversion of the hospital. RESULTS: The wards of the CCH were converted for observation and isolation, and each one was fitted with sanitary locks. There was a big improvement in the supply of PPE for the medical staff. Separation of the 'dirty' and 'clean' parts of the CCH were attained, and widespread intensive training not only protected personnel against infections, but also diminished unrest which was discernable at the beginning of conversion. CONCLUSIONS: The transformation efforts will ultimately be appraised at the end of the epidemic, but the data looks encouraging. Two weeks after conversion, the testing of hospital Staff was started and by the end of April, 459 tests were had been conducted, of which only 11 were positive.


Subject(s)
Betacoronavirus , Coronavirus Infections/therapy , Hospital Administration , Hospitals, Special/organization & administration , Infection Control/methods , Pneumonia, Viral/therapy , Health Personnel , Humans , Pandemics , Personal Protective Equipment , Poland
3.
Inflamm Bowel Dis ; 26(8): 1144-1148, 2020 07 17.
Article in English | MEDLINE | ID: covidwho-457571

ABSTRACT

BACKGROUND: After the first case of infection with the novel coronavirus, SARS-CoV-2, in China, an outbreak rapidly spread, finally evolving into a global pandemic. The new disease was named coronavirus disease 2019 (COVID-19) and by May 10, 2020, it has affected more than 4 million people worldwide and caused more than 270,000 deaths. METHODS: We describe the Greek experience regarding the response to COVID-19, with particular focus on 2 COVID-19 reference hospitals in the metropolitan area of Athens, the capital of Greece. RESULTS: The first case of SARS-CoV-2 infection in Greece was reported on February 26, 2020, and prompted a decisive response from the Greek government. The primary focus was containment of virus spread, considering shortage of ICU beds. A general lockdown was implemented early on, and the national Health Care System underwent massive re-structuring. Our 2 gastrointestinal (GI) centers, which provide care for more than 1500 inflammatory bowel disease (IBD) patients, are located in hospitals that were transformed to COVID-19 reference centers. To maintain sufficient care for our patients, while also contributing to the fight against COVID-19, we undertook specific measures. These included provision of telemedicine services, electronic prescriptions and home delivery of medications, isolation of infusion units and IBD clinics in COVID-free zones of the hospitals, in addition to limiting endoscopies to emergencies only. Such practices allowed us to avoid interruption of appropriate therapies for IBD patients. In fact, within the SECURE-IBD database, there have been only 4 Greek IBD patients, to date, who have been reported as positive for SARS-CoV-2. CONCLUSION: Timely application of preventive measures and strict compliance to guidelines limited the spread of COVID-19 in Greece and minimally impacted our IBD community, without interfering with therapeutic management.


Subject(s)
Communicable Disease Control/organization & administration , Communicable Diseases, Emerging/prevention & control , Coronavirus Infections/epidemiology , Delivery of Health Care/organization & administration , Outcome Assessment, Health Care , Pneumonia, Viral/epidemiology , Severe Acute Respiratory Syndrome/epidemiology , Adult , Civil Defense , Coronavirus Infections/prevention & control , Female , Greece , Hospitals, Special/organization & administration , Humans , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Risk Assessment , Severe Acute Respiratory Syndrome/prevention & control , Urban Population
6.
Stroke ; 51(7): 1991-1995, 2020 07.
Article in English | MEDLINE | ID: covidwho-343262

ABSTRACT

BACKGROUND AND PURPOSE: The purpose of the study is to analyze how the coronavirus disease 2019 (COVID-19) pandemic affected acute stroke care in a Comprehensive Stroke Center. METHODS: On February 28, 2020, contingency plans were implemented at Hospital Clinic of Barcelona to contain the COVID-19 pandemic. Among them, the decision to refrain from reallocating the Stroke Team and Stroke Unit to the care of patients with COVID-19. From March 1 to March 31, 2020, we measured the number of emergency calls to the Emergency Medical System in Catalonia (7.5 million inhabitants), and the Stroke Codes dispatched to Hospital Clinic of Barcelona. We recorded all stroke admissions, and the adequacy of acute care measures, including the number of thrombectomies, workflow metrics, angiographic results, and clinical outcomes. Data were compared with March 2019 using parametric or nonparametric methods as appropriate. RESULTS: At Hospital Clinic of Barcelona, 1232 patients with COVID-19 were admitted in March 2020, demanding 60% of the hospital bed capacity. Relative to March 2019, the Emergency Medical System had a 330% mean increment in the number of calls (158 005 versus 679 569), but fewer Stroke Code activations (517 versus 426). Stroke admissions (108 versus 83) and the number of thrombectomies (21 versus 16) declined at Hospital Clinic of Barcelona, particularly after lockdown of the population. Younger age was found in stroke admissions during the pandemic (median [interquartile range] 69 [64-73] versus 75 [73-80] years, P=0.009). In-hospital, there were no differences in workflow metrics, angiographic results, complications, or outcomes at discharge. CONCLUSIONS: The COVID-19 pandemic reduced by a quarter the stroke admissions and thrombectomies performed at a Comprehensive Stroke Center but did not affect the quality of care metrics. During the lockdown, there was an overload of emergency calls but fewer Stroke Code activations, particularly in elderly patients. Hospital contingency plans, patient transport systems, and population-targeted alerts must act concertedly to better protect the chain of stroke care in times of pandemic.


Subject(s)
Betacoronavirus , Coronavirus Infections , Hospitals, Special/organization & administration , Hospitals, Urban/organization & administration , Pandemics , Pneumonia, Viral , Stroke/therapy , Acute Disease , Age Distribution , Coronavirus Infections/epidemiology , Emergency Medical Services/statistics & numerical data , Emergency Service, Hospital , Hospital Bed Capacity/statistics & numerical data , Hospitals, Special/statistics & numerical data , Hospitals, Urban/standards , Humans , Intensive Care Units/statistics & numerical data , Neuroimaging/statistics & numerical data , Patient Acceptance of Health Care , Patient Admission/statistics & numerical data , Pneumonia, Viral/epidemiology , Procedures and Techniques Utilization/statistics & numerical data , Resource Allocation , Spain/epidemiology , Stroke/epidemiology , Stroke/surgery , Thrombectomy/statistics & numerical data , Treatment Outcome
8.
Knee Surg Sports Traumatol Arthrosc ; 28(6): 1683-1689, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-127452

ABSTRACT

PURPOSE: This article aims to share northern Italy's experience in hospital re-organization and management of clinical pathways for traumatic and orthopaedic patients in the early stages of the COVID-19 pandemic. METHODS: Authors collected regional recommendations to re-organize the healthcare system during the initial weeks of the COVID-19 pandemic in March, 2020. The specific protocols implemented in an orthopaedic hospital, selected as a regional hub for minor trauma, are analyzed and described in this article. RESULTS: Two referral centres were identified as the hubs for minor trauma to reduce the risk of overload in general hospitals. These two centres have specific features: an emergency room, specialized orthopaedic surgeons for joint diseases and trauma surgeons on-call 24/7. Patients with trauma without the need for a multi-disciplinary approach or needing non-deferrable elective orthopaedic surgery were moved to these hospitals. Authors report the internal protocols of one of these centres. All elective surgery was stopped, outpatient clinics limited to emergencies and specific pathways, ward and operating theatre dedicated to COVID-19-positive patients were implemented. An oropharyngeal swab was performed in the emergency room for all patients needing to be admitted, and patients were moved to a specific ward with single rooms to wait for the results. Specific courses were organized to demonstrate the correct use of personal protection equipment (PPE). CONCLUSION: The structure of the orthopaedic hubs, and the internal protocols proposed, could help to improve the quality of assistance for patients with musculoskeletal disorders and reduce the risk of overload in general hospitals during the COVID-19 pandemic.


Subject(s)
Betacoronavirus , Coronavirus Infections , Hospital Administration , Orthopedics , Pandemics , Pneumonia, Viral , Traumatology , Critical Pathways/organization & administration , Delivery of Health Care/organization & administration , Elective Surgical Procedures/trends , Hospital Administration/methods , Hospitals/standards , Hospitals, General/organization & administration , Hospitals, Special/organization & administration , Humans , Infection Control/methods , Italy , Musculoskeletal Diseases/therapy , Orthopedics/organization & administration , Orthopedics/standards , Quality of Health Care/organization & administration , Trauma Centers/organization & administration , Traumatology/organization & administration , Traumatology/standards , Wounds and Injuries/therapy
10.
Head Neck ; 42(6): 1153-1158, 2020 06.
Article in English | MEDLINE | ID: covidwho-48032

ABSTRACT

Since December 2019, a number of patients with novel coronavirus pneumonia (NCP) have been identified in Wuhan, Hubei Province, China. NCP has rapidly spread to other provinces and cities in China and other countries in the world. Due to the rapid increase in reported cases in China and around the world, on January 30, 2020, the World Health Organization (WHO) Emergency Committee announced that NCP is a Public Health Emergency of International Concern (PHEIC). However, there are relatively few suggestions and measures for tumor patients, especially patients with head and neck tumors. This article summarizes the prevention and control of disease in our medical institution to provide a reference for front-line head and neck surgeons.


Subject(s)
Cancer Care Facilities/organization & administration , Communicable Diseases/transmission , Coronavirus Infections/epidemiology , Delivery of Health Care/organization & administration , Head and Neck Neoplasms/therapy , Pneumonia, Viral/epidemiology , Betacoronavirus , China , Communicable Disease Control/organization & administration , Coronavirus Infections/prevention & control , Emergencies/epidemiology , Emergency Service, Hospital/organization & administration , Female , Head and Neck Neoplasms/diagnosis , Head and Neck Neoplasms/epidemiology , Hospitals, Special/organization & administration , Humans , Male , Pandemics/prevention & control , Patient Safety , Pneumonia, Viral/prevention & control , Triage
11.
J Am Pharm Assoc (2003) ; 60(3): 431-438.e1, 2020.
Article in English | MEDLINE | ID: covidwho-47500

ABSTRACT

OBJECTIVES: To describe the pharmacy administration and pharmaceutical care in a module hospital during the coronavirus disease 2019 (COVID-19) epidemic and provide reference for domestic and foreign pharmacists participating in the epidemic prevention and control. SETTING: The study was performed in a Jianghan module hospital constructed at the Wuhan Convention and Exhibition Center in Wuhan, China. This is 1 of the first 3 module hospitals. PRACTICE DESCRIPTION: One thousand eight hundred forty-eight patients were admitted to the Jianghan module hospital, and 1327 cases (71.81% of the total number) were cured and discharged. Pharmacists have successfully completed the tasks of purchase, storage, and free distribution of drugs worth ¥1.03 million (approximately $146,000), reviewed about 20,000 electronic orders, provided one-on-one online medication consultation for 484 patients, and held 5 lectures on rational drug use knowledge, which could help reduce irrational drug use and minimize the risk involved. PRACTICE INNOVATION: The new COVID-19 "module" pharmaceutical care model is equipped with new features such as pharmacy emergency command group, organizational structure for pharmacy administration, electronic control of drug prescription, and "zero contact" pharmaceutical care relying on the new media platform "WeChat." This platform provides relevant pharmaceutical care for patients, such as ensuring drug supply, setting up critical care drug trolleys, designing specific drug packaging bags, creating a module radio station to broadcast rational drug use information to the patients, and other aspects. EVALUATION: With the continuous improvement of the module hospital and the progress in in-depth knowledge about COVID-19, some aspects such as patient admission criteria and variety of drugs need to be adjusted depending on the actual situation. RESULTS: The pharmacists provided pharmaceutical care for 1848 patients with mild COVID-19 disease. They not only ensured the timely supply of the drugs but also reduced the incidence of drug-induced risks through medication review and guidance, thereby improving patient compliance and helping the patients rebuild their confidence in overcoming the disease. CONCLUSION: The new COVID-19 module pharmaceutical care model has played an important role in overcoming the epidemic situation of COVID-19 in China and thus can be implemented on a broader scale.


Subject(s)
Coronavirus Infections/drug therapy , Hospitals, Special/organization & administration , Pharmacists/organization & administration , Pharmacy Service, Hospital/organization & administration , Pneumonia, Viral/drug therapy , Adolescent , Adult , Aged , China/epidemiology , Coronavirus Infections/epidemiology , Hospitalization , Humans , Male , Middle Aged , Pandemics , Pharmacy Administration , Pneumonia, Viral/epidemiology , Professional Role , Young Adult
12.
Int J Gynaecol Obstet ; 149(3): 377-378, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-47393

ABSTRACT

From February 24, 2020, a COVID-19 obstetric task force was structured to deliver management recommendations for obstetric care. From March 1, 2020, six COVID-19 hubs and their spokes were designated. An interim analysis of cases occurring in or transferred to these hubs was performed on March 20, 2020 and recommendations were released on March 24, 2020. The vision of this strict organization was to centralize patients in high-risk maternity centers in order to concentrate human resources and personal protective equipment (PPE), dedicate protected areas of these major hospitals, and centralize clinical multidisciplinary experience with this disease. All maternity hospitals were informed to provide a protected labor and delivery room for nontransferable patients in advanced labor. A pre-triage based on temperature and 14 other items was developed in order to screen suspected patients in all hospitals to be tested with nasopharyngeal swabs. Obstetric outpatient facilities were instructed to maintain scheduled pregnancy screening as per Italian guidelines, and to provide pre-triage screening and surgical masks for personnel and patients for pre-triage-negative patients. Forty-two cases were recorded in the first 20 days of hub and spoke organization. The clinical presentation was interstitial pneumonia in 20 women. Of these, seven required respiratory support and eventually recovered. Two premature labors occurred.


Subject(s)
Ambulatory Care Facilities/standards , Coronavirus Infections , Health Care Rationing , Hospitals, Maternity/standards , Obstetrics/standards , Pandemics , Patient Care/standards , Pneumonia, Viral , Ambulatory Care Facilities/organization & administration , Female , Health Care Rationing/organization & administration , Health Care Rationing/standards , Hospitals, Maternity/organization & administration , Hospitals, Special/organization & administration , Hospitals, Special/standards , Humans , Italy , Personal Protective Equipment/supply & distribution , Pregnancy
13.
Lancet ; 395(10232): 1305-1314, 2020 04 18.
Article in English | MEDLINE | ID: covidwho-27038

ABSTRACT

Fangcang shelter hospitals are a novel public health concept. They were implemented for the first time in China in February, 2020, to tackle the coronavirus disease 2019 (COVID-19) outbreak. The Fangcang shelter hospitals in China were large-scale, temporary hospitals, rapidly built by converting existing public venues, such as stadiums and exhibition centres, into health-care facilities. They served to isolate patients with mild to moderate COVID-19 from their families and communities, while providing medical care, disease monitoring, food, shelter, and social activities. We document the development of Fangcang shelter hospitals during the COVID-19 outbreak in China and explain their three key characteristics (rapid construction, massive scale, and low cost) and five essential functions (isolation, triage, basic medical care, frequent monitoring and rapid referral, and essential living and social engagement). Fangcang shelter hospitals could be powerful components of national responses to the COVID-19 pandemic, as well as future epidemics and public health emergencies.


Subject(s)
Coronavirus Infections , Emergencies , Facility Design and Construction , Hospitals, Special , Mobile Health Units , Pandemics , Pneumonia, Viral , Betacoronavirus , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Cost Control , Disease Outbreaks , Hospitals, Special/organization & administration , Hospitals, Special/statistics & numerical data , Humans , Infection Control , Mobile Health Units/organization & administration , Mobile Health Units/statistics & numerical data , Patient Isolation , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy
SELECTION OF CITATIONS
SEARCH DETAIL