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1.
Int J Prison Health ; ahead-of-print(ahead-of-print)2021 03 01.
Article in English | MEDLINE | ID: covidwho-1501265

ABSTRACT

PURPOSE: New South Wales (NSW) correctional system houses 30% of prisoners in Australia and at this time has only had a single documented case of COVID-19 amongst its prisoner population. The coordinated response by Justice Health and Forensic Mental Health Network (The Network) undertaken with the support of NSW Ministry of Health, in partnership with Corrective Services NSW (CSNSW), Youth Justice and private jails has ensured that the NSW correctional system has remained otherwise COVID-free. DESIGN/METHODOLOGY/APPROACH: A research study of how a range of partners which support the operations of NSW Correctional System developed an effective approach for the prevention a COVID-19 epidemic amongst its inmates. FINDINGS: Establishment of effective partnerships, early coordination of representatives from all aspects of the NSW correctional system, limited access to the correctional environment, reduced prison population and strict isolation of all new receptions have all contributed to maintaining this COVID-free status despite other NSW settings with similar risk profiles, such as aged care facilities and cruise ship arrivals, experiencing serious outbreaks. RESEARCH LIMITATIONS/IMPLICATIONS: Although Australia/New Zealand context of suppressed community infection rates for COVID-19 (which are approaching elimination in some jurisdictions) is in contrast to the situation in other parts of the world, the principles described in this paper will be useful to most other correctional systems. PRACTICAL IMPLICATIONS: Modelling was used to underline our approach and reinforced the veracity of following this approach. ORIGINALITY/VALUE: The Network and CSNSW has been able to mount an effective, integrated response to the COVID-19 pandemic, which has been sustainable through the first peak of COVID-19 cases. This case study catalogues the process of developing this response and details each intervention implemented with inventive use of tables to demonstrate the impact of the range of interventions used.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Infection Control/organization & administration , Prisons/organization & administration , Adult , Female , Humans , Male , New South Wales/epidemiology , Organizational Case Studies , Pandemics , SARS-CoV-2
4.
ASAIO J ; 67(9): 973-981, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1494076

ABSTRACT

Coronavirus disease 2019 (COVID-19) radically modified the organization of healthcare systems with shutdown of routine activities and outpatient clinics. Herein, we report our institutional experience with a Telemonitoring and Care Program (TC-Program) to monitor and support left ventricular assist device (LVAD) patients during COVID-19 outbreak. This single-arm cohort study analyzed 156 patients who entered the TC-Program at our institution between April and August 2020. The TC-Program was based on routine phone calls to patients and a 24/7 emergency line. In November 2020, patients were asked for feedback on the TC-Program and checked for survival, transplant, or explant. The primary endpoint was the rate of TC-Program-driven interventions. Patients (males: 82.8%) were 61 years old (interquartile range [IQR]: 53.0-67.5) and on LVAD support for 1,266 days (IQR: 475-2,211). Patients were included in the TC-Program for a median time of 99 days (min:15, max:120) and received a median number of six phone calls (min:1, max:14). Twenty-three patients (14.7%) were referred for clinical evaluation after phone contact. Two patients (1.27%) were diagnosed with COVID-19: one of them died after intensive care, and one remained paucisymptomatic and recovered. Three patients asked to exit the program considering it not useful while the others gave high rates in terms of usefulness (median: 9, IQR: 8-10), information (median: 9, IQR: 8-10), good medical care (median: 9, IQR: 8-10), and psychologic support (median: 8, IQR: 7-10). A TC-Program based on the four ICSA principles (Inform, Care, Support, and Adapt) is feasible in LVAD patients and can be rapidly implemented during the COVID-19 pandemic.


Subject(s)
COVID-19/prevention & control , Heart Failure/therapy , Heart-Assist Devices/statistics & numerical data , Infection Control/organization & administration , Telemedicine , COVID-19/epidemiology , Cohort Studies , Disease Outbreaks , Female , Heart Failure/epidemiology , Heart-Assist Devices/adverse effects , Humans , Male , Middle Aged , Pandemics/prevention & control , SARS-CoV-2
5.
Am J Nurs ; 121(11): 53-58, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1475854

ABSTRACT

ABSTRACT: Most existing biocontainment units (BCUs) in U.S. hospitals are designed to care for a limited number of patients infected with epidemiologically significant pathogens. The COVID-19 pandemic presented substantial challenges to hospital preparedness and operations because of its high incidence rate and the high risk of transmission to staff members. This article describes a novel practice innovation: a hospital-wide deployment of nurses on a trained BCU team to support hospital staff in safely caring for patients with COVID-19. Their responsibilities included assisting in the development of guidelines and providing training on safety protocols and the appropriate use of personal protective equipment. The authors show how this deployment contributed significantly to staff education and support during the pandemic.


Subject(s)
COVID-19/prevention & control , Infection Control/organization & administration , Nursing Staff, Hospital/organization & administration , COVID-19/transmission , Clinical Protocols , Containment of Biohazards , Humans
7.
Int J Prison Health ; ahead-of-print(ahead-of-print)2021 05 06.
Article in English | MEDLINE | ID: covidwho-1467474

ABSTRACT

PURPOSE: In this paper, the authors present insights and findings drawn from the authors' experiences of containing a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in a large prison in northern Italy.Within penitentiaries, close-quarter living is ripe terrain for outbreaks of disease among detainees and staff. If left unchecked, these outbreaks can easily spill over the prison walls to threaten the general public. Moreover, these risks are heightened by preexisting environmental conditions, especially overcrowding. It is thus paramount to establish effective protocols for prevention, early detection and outbreak management. The purpose of this article is to document a strategy that been at least partially successful in reducing the damage that could potentially be caused by a sustained SARS-CoV-2 outbreak within a correctional facility. DESIGN/METHODOLOGY/APPROACH: The authors conducted a retrospective analysis on patients' and health-care workers' medical records to obtain demographic and clinical information. Descriptive data analysis was then carried out. FINDINGS: In total, the authors tested 453 people with oropharyngeal swabs from March 15, 2020, to June 30, 2020. Of these people, 58 were positive and 395 were negative, with a prevalence of 12.8%.Of the 453 patients, 60 were health workers: 24 tested positive for SARS-CoV2 ribonucleic acid (RNA); 18 developed symptoms; and three needed hospitalization.Among patients in detention, 34 resulted positive for SARS-CoV-2 RNA. Two were hospitalized and later died. Both had severe preexisting conditions; they were aged 76 and 59 years old, respectively. ORIGINALITY/VALUE: In this study, the authors describe the design and effective implementation of prevention and containment measures against SARS-CoV-2 within the walls of a correctional facility. The authors describe how they rapidly created clean confinement sections to isolate cases in an environment designed for security at the expense of virus containment and how educational efforts have played a vital role in their strategy.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Infection Control/organization & administration , Prisons/organization & administration , Adult , Aged , COVID-19/mortality , COVID-19/physiopathology , Female , Health Personnel/statistics & numerical data , Humans , Italy/epidemiology , Male , Middle Aged , Prisoners/statistics & numerical data , Real-Time Polymerase Chain Reaction , Retrospective Studies , SARS-CoV-2 , Socioeconomic Factors
12.
Cancer Control ; 28: 10732748211045275, 2021.
Article in English | MEDLINE | ID: covidwho-1463162

ABSTRACT

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has overwhelmed the capacity of healthcare systems worldwide. Cancer patients, in particular, are vulnerable and oncology departments drastically needed to modify their care systems and established new priorities. We evaluated the impact of SARS-CoV-2 on the activity of a single cancer center. METHODS: We performed a retrospective analysis of (i) volumes of oncological activities (2020 vs 2019), (ii) patients' perception rate of the preventive measures, (iii) patients' SARS-CoV-2 infections, clinical signs thereof, and (iv) new diagnoses made during the SARS-CoV-2 pandemic. RESULTS: As compared with a similar time frame in 2019, the overall activity in total numbers of outpatient chemotherapy administrations and specialist visits was not statistically different (P = .961 and P = .252), while inpatient admissions decreased for both medical oncology and thoracic oncology (18% (P = .0018) and 44% (P < .0001), respectively). Cancer diagnosis plummeted (-34%), but no stage shift could be demonstrated.Acceptance and adoption of hygienic measures was high, as measured by a targeted questionnaire (>85%). However, only 46.2% of responding patients regarded telemedicine, although widely deployed, as an efficient surrogate to a consultation.Thirty-three patients developed SARS-CoV-2, 27 were hospitalized, and 11 died within this time frame. These infected patients were younger, current smokers, and suffered more comorbidities. CONCLUSIONS: This retrospective cohort analysis adds to the evidence that continuation of active cancer therapy and specialist visits is feasible and safe with the implementation of telemedicine. These data further confirm the impact of SARS-CoV-2 on cancer care management, cancer diagnosis, and impact of infection on cancer patients.


Subject(s)
COVID-19/epidemiology , Cancer Care Facilities/organization & administration , Cancer Care Facilities/statistics & numerical data , Neoplasms/epidemiology , Neoplasms/therapy , Age Factors , Comorbidity , Cyclopentanes , Humans , Infection Control/organization & administration , Neoplasms/diagnosis , Neoplasms/mortality , Organosilicon Compounds , Pandemics , Perception , Retrospective Studies , SARS-CoV-2
15.
Ind Health ; 59(5): 318-324, 2021 Oct 05.
Article in English | MEDLINE | ID: covidwho-1448676

ABSTRACT

COVID-19 is around the world. We attempt to apply three-step method in ISO/IEC Guide 51: 2014 to COVID-19 infection control in the workplace. The results show that the COVID-19 infection control measures include the eradication of the virus, the destruction of infectivity, the detoxification and weakening and the elimination of opportunities for infection as "Inherently Safe Design Measures", the avoidance of contact as "Safeguarding and Complementary Protective Measures" and the reduction of contact and the avoidance of seriousness as "Information for Use". Among these specific measures, the New Normal, especially in the manufacturing industries, would be "telecommuting" and "unmanned workplaces", which are part of the elimination of opportunities for infection, and "changes in flow lines" and "changes in airflow", which are part of the avoidance of contact. Where "telecommuting" and "unmanned workplaces" are feasible, they should be implemented as much as possible, and where they are not, attempts should be made to minimize human-to-human contact by "changes in flow lines". In addition, in the area of "changes in airflow", there are high expectations for future research on how to establish a ventilation design for COVID-19, in which but also the source would be workers themselves, not only combustible gases and toxic gases.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Infection Control/organization & administration , Occupational Health/standards , Workplace/organization & administration , Global Health , Humans , Infection Control/standards , Manufacturing and Industrial Facilities/standards , SARS-CoV-2 , Teleworking , Ventilation/standards , Workplace/standards
16.
Eur J Med Res ; 26(1): 112, 2021 Sep 23.
Article in English | MEDLINE | ID: covidwho-1438306

ABSTRACT

BACKGROUND: Patients with coronavirus disease 2019 (COVID-19) who undergo surgery have impaired postoperative outcomes and increased mortality. Consequently, elective and semi-urgent operations on the increasing number of patients severely affected by COVID-19 have been indefinitely postponed.in many countries with unclear implications on disease progression and overall survival. The purpose of this study was to evaluate whether the establishment of a standardized screening program for acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is sufficient to ensure high-quality medical and surgical treatment of COVID-19 and non-COVID-19 patients while minimizing in-hospital SARS-CoV-2 transmission. METHODS: The screening program comprised polymerase chain reaction (PCR) testing of nasopharyngeal swabs and a standardized questionnaire about potential symptoms for SARS-CoV-2 infection. All elective and emergency patients admitted to the surgical department of a tertiary-care hospital center in Lower Franconia, Germany, between March and May 2020 were included and their characteristics were recorded. RESULTS: Out of the study population (n = 657), 509 patients (77.5%) had at least one risk factor for a potentially severe course of COVID-19 and 164 patients (25%) were active smokers. The average 7-day incidence in Lower Franconia was 24.0/100,000 during the observation period. Preoperative PCR testing revealed four asymptomatic positive patients out of the 657 tested patients. No postoperative SARS-CoV-2 infection or transmission could be detected. CONCLUSION: The implementation of a standardized preoperative screening program to both COVID-19 and non-COVID-19 patients can ensure high-quality surgical care while minimizing infection risk for healthcare workers and potential in-hospital transmission.


Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19 , Elective Surgical Procedures , Infection Control/methods , Vascular Surgical Procedures , Adult , Aged , Elective Surgical Procedures/statistics & numerical data , Female , Germany/epidemiology , Humans , Infection Control/organization & administration , Male , Middle Aged , Nasopharynx/virology , Preoperative Care , Retrospective Studies , Tertiary Care Centers , Vascular Surgical Procedures/statistics & numerical data
17.
Work ; 66(4): 717-729, 2020.
Article in English | MEDLINE | ID: covidwho-1435948

ABSTRACT

BACKGROUND: COVID-19 is a highly contagious acute respiratory syndrome and has been declared a pandemic in more than 209 countries worldwide. At the time of writing, no preventive vaccine has been developed and tested in the community. This study was conducted to review studies aimed at preventing the spread of the coronavirus worldwide. METHODS: This study was a review of the evidence-based literature and was conducted by searching databases, including Google Scholar, PubMed, and ScienceDirect, until April 2020. The search was performed based on keywords including "coronavirus", "COVID-19", and "prevention". The list of references in the final studies has also been re-reviewed to find articles that might not have been obtained through the search. The guidelines published by trustworthy organizations such as the World Health Organization and Center for Disease Control have been used in this study. CONCLUSION: So far, no vaccine or definitive treatment for COVID-19 has been invented, and the disease has become a pandemic. Therefore, observation of hand hygiene, disinfection of high-touch surfaces, observation of social distance, and lack of presence in public places are recommended as preventive measures. Moreover, to control the situation and to reduce the incidence of the virus, some of the measures taken by the decision-making bodies and the guidelines of the deterrent institutions to strengthen telecommuting of employees and reduce the presence of people in the community and prevent unnecessary activities, are very important.


Subject(s)
Betacoronavirus/pathogenicity , COVID-19/prevention & control , Coronavirus Infections/prevention & control , Infection Control/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Workplace/organization & administration , COVID-19/epidemiology , COVID-19/transmission , COVID-19 Testing , Clinical Laboratory Techniques/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Decision Making, Organizational , Disinfection/organization & administration , Disinfection/standards , Guidelines as Topic , Hand Hygiene/organization & administration , Hand Hygiene/standards , Humans , Incidence , Infection Control/methods , Infection Control/organization & administration , Mass Screening/organization & administration , Mass Screening/standards , Physical Distancing , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , SARS-CoV-2 , Telecommunications/organization & administration , Telecommunications/standards , Workplace/standards
18.
Ann Biol Clin (Paris) ; 79(4): 325-330, 2021 Aug 01.
Article in English | MEDLINE | ID: covidwho-1412311

ABSTRACT

Health care workers (HCWs) are at major risk to be infected by SARS-CoV-2 and transmit the virus to the patients. Furthermore, travels are a major factor in the diffusion of the virus. We report our experience regarding the screening of asymptomatic HCWs returning from holidays, following the issue of a national guideline on 08/20/2020. The organization of the occupational health department and the clinical laboratory was adapted in order to start the screening on August, 24, 2020. All HCWs tested for SARS-CoV-2 the week before and 4 weeks after the implementation of the screening were included. The mean number of tests was analyzed per working day and working week. Overall, 502 (31.4%) HCWs were tested for SARS-CoV-2 during the study period. The mean number of HCWs tested per working day was 27.1. HCWs accounted for 36.9% (n = 167) and 11.2% (n = 84) of the tests performed in the 1st and the 4th week following the implementation of the guidelines. The number of tests performed each week in HCWs increased by at least 20-fold after the implementation of the guidelines. No asymptomatic HCW was tested positive. Screening of asymptomatic HCWs was poorly effective in the context of low circulation of the virus. We suggest giving priority to infection prevention and control measures and screening of symptomatic subjects and asymptomatic contacts.


Subject(s)
COVID-19 Testing , COVID-19/diagnosis , Health Personnel , Asymptomatic Infections , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing/methods , COVID-19 Testing/standards , Cross Infection/prevention & control , France/epidemiology , Guideline Adherence/organization & administration , Guideline Adherence/standards , Guideline Adherence/statistics & numerical data , Health Personnel/statistics & numerical data , Hospitals, General , Humans , Implementation Science , Infection Control/methods , Infection Control/organization & administration , Infection Control/standards , Mass Screening/methods , Mass Screening/organization & administration , Mass Screening/standards , Occupational Health Services/organization & administration , Occupational Health Services/standards , Occupational Health Services/statistics & numerical data , Return to Work/statistics & numerical data , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification
19.
Medicine (Baltimore) ; 100(25): e26433, 2021 Jun 25.
Article in English | MEDLINE | ID: covidwho-1410303

ABSTRACT

ABSTRACT: The subclinical severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rate in hospitals during the pandemic remains unclear. To evaluate the effectiveness of our hospital's current nosocomial infection control measures, we conducted a serological survey of anti-SARS-CoV-2 antibodies (immunoglobulin [Ig] G) among the staff of our hospital, which is treating coronavirus disease 2019 (COVID-19) patients.The study design was cross-sectional. We measured anti-SARS-CoV-2 IgG in the participants using a laboratory-based quantitative test (Abbott immunoassay), which has a sensitivity and specificity of 100% and 99.6%, respectively. To investigate the factors associated with seropositivity, we also obtained some information from the participants with an anonymous questionnaire. We invited 1133 staff members in our hospital, and 925 (82%) participated. The mean age of the participants was 40.0 ±â€Š11.8 years, and most were women (80.0%). According to job title, there were 149 medical doctors or dentists (16.0%), 489 nurses (52.9%), 140 medical technologists (14.2%), 49 healthcare providers (5.3%), and 98 administrative staff (10.5%). The overall prevalence of seropositivity for anti-SARS-CoV-2 IgG was 0.43% (4/925), which was similar to the control seroprevalence of 0.54% (16/2970) in the general population in Osaka during the same period according to a government survey conducted with the same assay. Seropositive rates did not significantly differ according to job title, exposure to suspected or confirmed COVID-19 patients, or any other investigated factors.The subclinical SARS-CoV-2 infection rate in our hospital was not higher than that in the general population under our nosocomial infection control measures.


Subject(s)
Antibodies, Viral/blood , Asymptomatic Infections/epidemiology , COVID-19/epidemiology , Health Personnel/statistics & numerical data , Seroepidemiologic Studies , Adult , COVID-19/blood , COVID-19/immunology , COVID-19/transmission , Cross-Sectional Studies , Female , Hospitals, Urban/organization & administration , Hospitals, Urban/standards , Hospitals, Urban/statistics & numerical data , Humans , Immunoglobulin G/blood , Infection Control/organization & administration , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Japan/epidemiology , Male , Middle Aged , Pandemics/statistics & numerical data , Prevalence , Risk Factors , SARS-CoV-2/immunology , Surveys and Questionnaires/statistics & numerical data
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