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1.
JCO Glob Oncol ; 6: 1428-1438, 2020 09.
Article in English | MEDLINE | ID: covidwho-844422

ABSTRACT

PURPOSE: The COVID-19 pandemic affected health care systems globally and resulted in the interruption of usual care in many health care facilities, exposing vulnerable patients with cancer to significant risks. Our study aimed to evaluate the impact of this pandemic on cancer care worldwide. METHODS: We conducted a cross-sectional study using a validated web-based questionnaire of 51 items. The questionnaire obtained information on the capacity and services offered at these centers, magnitude of disruption of care, reasons for disruption, challenges faced, interventions implemented, and the estimation of patient harm during the pandemic. RESULTS: A total of 356 centers from 54 countries across six continents participated between April 21 and May 8, 2020. These centers serve 716,979 new patients with cancer a year. Most of them (88.2%) reported facing challenges in delivering care during the pandemic. Although 55.34% reduced services as part of a preemptive strategy, other common reasons included an overwhelmed system (19.94%), lack of personal protective equipment (19.10%), staff shortage (17.98%), and restricted access to medications (9.83%). Missing at least one cycle of therapy by > 10% of patients was reported in 46.31% of the centers. Participants reported patient exposure to harm from interruption of cancer-specific care (36.52%) and noncancer-related care (39.04%), with some centers estimating that up to 80% of their patients were exposed to harm. CONCLUSION: The detrimental impact of the COVID-19 pandemic on cancer care is widespread, with varying magnitude among centers worldwide. Additional research to assess this impact at the patient level is required.


Subject(s)
Cancer Care Facilities/statistics & numerical data , Coronavirus Infections/prevention & control , Health Services Accessibility/statistics & numerical data , Medical Oncology/statistics & numerical data , Neoplasms/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus/pathogenicity , Cancer Care Facilities/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Cross-Sectional Studies , Global Burden of Disease , Health Services Accessibility/standards , Humans , Infection Control/standards , International Cooperation , Medical Oncology/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Surveys and Questionnaires/statistics & numerical data
2.
AJR Am J Roentgenol ; 214(6): 1206-1210, 2020 06.
Article in English | MEDLINE | ID: covidwho-823643

ABSTRACT

OBJECTIVE. This article shares the ground operational perspective of how a tertiary hospital radiology department in Singapore is responding to the coronavirus disease (COVID-19) epidemic. This same department was also deeply impacted by the severe acute respiratory syndrome (SARS) outbreak in 2003. CONCLUSION. Though similar to SARS, the COVID-19 outbreak has several differences. We share how lessons from 2003 are applied and modified in our ongoing operational response to this evolving novel pathogen.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Epidemics , Infection Control/standards , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Radiology Department, Hospital/organization & administration , Radiology Department, Hospital/standards , Severe Acute Respiratory Syndrome/epidemiology , Severe Acute Respiratory Syndrome/prevention & control , Humans , Singapore/epidemiology
4.
JCO Glob Oncol ; 6: 1494-1509, 2020 10.
Article in English | MEDLINE | ID: covidwho-814637

ABSTRACT

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has had a global impact, and Singapore has seen 33,000 confirmed cases. Patients with cancer, their caregivers, and health care workers (HCWs) need to balance the challenges associated with COVID-19 while ensuring that cancer care is not compromised. This study aimed to evaluate the psychological effect of COVID-19 on these groups and the prevalence of burnout among HCWs. METHODS: A cross-sectional survey of patients, caregivers, and HCWs at the National Cancer Centre Singapore was performed over 17 days during the lockdown. The Generalized Anxiety Disorder-7 and Maslach Burnout Inventory were used to assess for anxiety and burnout, respectively. Self-reported fears related to COVID-19 were collected. RESULTS: A total of 624 patients, 408 caregivers, and 421 HCWs participated in the study, with a response rate of 84%, 88%, and 92% respectively. Sixty-six percent of patients, 72.8% of caregivers, and 41.6% of HCWs reported a high level of fear from COVID-19. The top concern of patients was the wide community spread of COVID-19. Caregivers were primarily worried about patients dying alone. HCWs were most worried about the relatively mild symptoms of COVID-19. The prevalence of anxiety was 19.1%, 22.5%, and 14.0% for patients, caregivers, and HCWs, respectively. Patients who were nongraduates and married, and caregivers who were married were more anxious. The prevalence of burnout in HCWs was 43.5%, with more anxious and fearful HCWs reporting higher burnout rates. CONCLUSION: Fears and anxiety related to COVID-19 are high. Burnout among HCWs is similar to rates reported prepandemic. An individualized approach to target the specific fears of each group will be crucial to maintain the well-being of these vulnerable groups and prevent burnout of HCWs.


Subject(s)
Anxiety/epidemiology , Burnout, Professional/epidemiology , Caregivers/psychology , Coronavirus Infections/psychology , Neoplasms/psychology , Pneumonia, Viral/psychology , Adult , Aged , Anxiety/diagnosis , Anxiety/psychology , Betacoronavirus/pathogenicity , Burnout, Professional/diagnosis , Burnout, Professional/psychology , Cancer Care Facilities/organization & administration , Cancer Care Facilities/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Cross-Sectional Studies , Fear/psychology , Female , Health Personnel/psychology , Health Services Accessibility/organization & administration , Health Services Accessibility/standards , Humans , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Medical Oncology/organization & administration , Medical Oncology/standards , Middle Aged , Neoplasms/therapy , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Prevalence , Singapore/epidemiology , Workload/psychology
6.
Can J Surg ; 63(5): E393-E394, 2020.
Article in English | MEDLINE | ID: covidwho-812955

ABSTRACT

SUMMARY: The impact of waiting for surgery on the mental health of patients usually receives little attention. Because of the coronavirus disease 2019 (COVID-19) pandemic, the waits for elective surgery have been lengthening, potentially inducing or exacerbating mental health burdens. Provinces' health systems need to provide better support to assess not only patients' physical health, but also their mental health, and provide them with timely access to care based on need. A stepped care approach is needed to mitigate negative mental health effects associated with prolonged waits for elective operations. To provide the best care possible, we need to recognize and address both the physical and mental health problems of our waiting patients.


Subject(s)
Coronavirus Infections/prevention & control , Elective Surgical Procedures/psychology , Infection Control/standards , Mental Health , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Preoperative Care/methods , Betacoronavirus/pathogenicity , Canada/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Elective Surgical Procedures/standards , Health Services Accessibility/standards , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Time Factors , Time-to-Treatment , Waiting Lists
7.
Can J Surg ; 63(5): E418-E421, 2020.
Article in English | MEDLINE | ID: covidwho-811328

ABSTRACT

SUMMARY: The Canadian Network for International Surgery (CNIS) hosted a workshop in May of 2020 with a goal of critically evaluating Trauma Team Training courses. The workshop was held virtually because of the coronavirus disease 2019 (COVID-19) pandemic. Twenty-three participants attended from 8 countries: Canada, Guyana, Kenya, Nigeria, Switzerland, Tanzania, Uganda and the United States. More participants were able to attend the virtual meeting than the traditional in-person meetings. Web-based videoconference software was used, participants presented prerecorded PowerPoint videos, and questions were raised using a written chat. The review proved successful, with discussions and recommendations for improvements surrounding course quality, lecture content, skills sessions, curriculum variations and clinical practical scenarios. The CNIS's successful experience conducting an online curriculum review involving international participants may prove useful to others proceeding with collaborative projects during the COVID-19 pandemic.


Subject(s)
Congresses as Topic/organization & administration , Coronavirus Infections/prevention & control , Curriculum , General Surgery/education , International Cooperation , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus/pathogenicity , Canada/epidemiology , Congresses as Topic/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , General Surgery/methods , Guyana/epidemiology , Humans , Infection Control/organization & administration , Infection Control/standards , Kenya/epidemiology , Nigeria/epidemiology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Switzerland/epidemiology , Tanzania/epidemiology , Uganda/epidemiology , United States/epidemiology , Videoconferencing/organization & administration , Videoconferencing/standards , Wounds and Injuries/surgery
9.
J Cancer Res Ther ; 16(5): 974-978, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-809555

ABSTRACT

The pandemic of coronavirus disease 2019 (COVID-19) has become a major public health threat to the whole world. Although the control of COVID-19 has been in the forefront of interventional practice, most interventional radiologists (IRs) are not equipped adequately to cope with such a crisis. In this review, we share our experience from Chinese IRs' perspective, report on the acute measures instituted within interventional radiology (IR) units, and give recommendations to the prevention and control of COVID-19.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/prevention & control , Infection Control/standards , Pandemics/prevention & control , Personal Protective Equipment/standards , Pneumonia, Viral/prevention & control , Practice Patterns, Physicians'/standards , Radiology, Interventional/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Radiology, Interventional/instrumentation
10.
BMJ Open ; 10(9): e042045, 2020 09 28.
Article in English | MEDLINE | ID: covidwho-807320

ABSTRACT

BACKGROUND: In a previous randomised controlled trial (RCT) in hospital healthcare workers (HCWs), cloth masks resulted in a higher risk of respiratory infections compared with medical masks. This was the only published RCT of cloth masks at the time of the COVID-19 pandemic. OBJECTIVE: To do a post hoc analysis of unpublished data on mask washing and mask contamination from the original RCT to further understand poor performance of the two-layered cotton cloth mask used by HCWs in that RCT. SETTING: 14 secondary-level/tertiary-level hospitals in Hanoi, Vietnam. PARTICIPANTS: A subgroup of 607 HCWs aged ≥18 years working full time in selected high-risk wards, who used a two-layered cloth mask and were part of a randomised controlled clinical trial comparing medical masks and cloth masks. INTERVENTION: Washing method for cloth masks (self-washing or hospital laundry). A substudy of contamination of a sample of 15 cloth and medical masks was also conducted. OUTCOME MEASURE: Infection rate over 4 weeks of follow up and viral contamination of masks tested by multiplex PCR. RESULTS: Viral contamination with rhinovirus was identified on both used medical and cloth masks. Most HCW (77% of daily washing) self-washed their masks by hand. The risk of infection was more than double among HCW self-washing their masks compared with the hospital laundry (HR 2.04 (95% CI 1.03 to 4.00); p=0.04). There was no significant difference in infection between HCW who wore cloth masks washed in the hospital laundry compared with medical masks (p=0.5). CONCLUSIONS: Using self-reported method of washing, we showed double the risk of infection with seasonal respiratory viruses if masks were self-washed by hand by HCWs. The majority of HCWs in the study reported hand-washing their mask themselves. This could explain the poor performance of two layered cloth masks, if the self-washing was inadequate. Cloth masks washed in the hospital laundry were as protective as medical masks. Both cloth and medical masks were contaminated, but only cloth masks were reused in the study, reiterating the importance of daily washing of reusable cloth masks using proper method. A well-washed cloth mask can be as protective as a medical mask. TRIAL RESGISTRATION NUMBER: ACTRN12610000887077.


Subject(s)
Coronavirus Infections , Disinfection , Equipment Contamination , Infection Control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Masks , Pandemics , Personnel, Hospital/statistics & numerical data , Pneumonia, Viral , Adult , Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Disinfection/methods , Disinfection/standards , Disinfection/statistics & numerical data , Equipment Contamination/prevention & control , Equipment Contamination/statistics & numerical data , Female , Humans , Infection Control/instrumentation , Infection Control/methods , Infection Control/standards , Male , Masks/classification , Masks/standards , Masks/supply & distribution , Occupational Exposure/analysis , Occupational Exposure/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Vietnam/epidemiology
11.
JCO Glob Oncol ; 6: 1455-1460, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-809157

ABSTRACT

The core pillars of multimodal care of patients with cancer are surgical, radiation, and medical oncology. The global pandemic of coronavirus disease 2019 (COVID-19) has suddenly resurrected a new pillar in oncology care: teleoncology. With oncologists reaching out to patients through telemedicine, it is possible to evaluate and fulfill patients' needs; triage patients for elective procedures; screen them for influenza-like illness; provide them with guidance for hospital visits, if needed; and bridge oral medications and treatments when a hospital visit is not desirable because of any high risk-benefit ratio. Teleoncology can bring great reassurance to patients at times when reaching an oncology center is challenging, and more so in resource-constrained countries. Evidence-based treatment protocols, dispensable by teleoncology, already exist for many sites of cancer and they can provide a bridge to treatment when patients are unable to reach cancer centers for their standard treatment. The young pillar of teleoncology is going to remain much longer than COVID-19.


Subject(s)
Coronavirus Infections/prevention & control , Infection Control/organization & administration , Medical Oncology/organization & administration , Neoplasms/diagnosis , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Telemedicine/organization & administration , Betacoronavirus/pathogenicity , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Evidence-Based Medicine/methods , Evidence-Based Medicine/organization & administration , Evidence-Based Medicine/standards , Evidence-Based Medicine/trends , Humans , Infection Control/methods , Infection Control/standards , Medical Oncology/methods , Medical Oncology/standards , Medical Oncology/trends , Neoplasms/therapy , Patient Selection , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Telemedicine/standards , Telemedicine/trends , Triage/methods , Triage/organization & administration , Triage/standards
12.
JCO Glob Oncol ; 6: 1461-1471, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-807637

ABSTRACT

PURPOSE: In response to the COVID-19 pandemic, the ASCO launched a Global Webinar Series to address various aspects of cancer care during the pandemic. Here we present the lessons learned and recommendations that have emerged from these webinars. METHODS: Fifteen international health care experts from different global regions and oncology disciplines participated in one of the six 1-hour webinars to discuss the latest data, share their experiences, and provide recommendations to manage cancer care during the COVID-19 pandemic. These sessions include didactic presentations followed by a moderated discussion and questions from the audience. All recommendations have been transcribed, categorized, and reviewed by the experts, who have also approved the consensus recommendations. RESULTS: The summary recommendations are divided into different categories, including risk minimization; care prioritization of patients; health care team management; virtual care; management of patients with cancer undergoing surgical, radiation, and systemic therapy; clinical research; and recovery plans. The recommendations emphasize the protection of patients and health care teams from infections, delivery of timely and appropriate care, reduction of harm from the interruption of care, and preparation to handle a surge of new COVID-19 cases, complications, or comorbidities thereof. CONCLUSION: The recommendations from the ASCO Global Webinar Series may guide practicing oncologists to manage their patients during the ongoing pandemic and help organizations recover from the crisis. Implementation of these recommendations may improve understanding of how COVID-19 has affected cancer care and increase readiness to manage the current and any future outbreaks effectively.


Subject(s)
Coronavirus Infections/prevention & control , Global Health , Medical Oncology/standards , Neoplasms/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Betacoronavirus/pathogenicity , Consensus , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Coronavirus Infections/transmission , Health Services Accessibility/organization & administration , Health Services Accessibility/standards , Health Services Accessibility/trends , Humans , Infection Control/organization & administration , Infection Control/standards , Medical Oncology/organization & administration , Medical Oncology/trends , Neoplasms/diagnosis , Neoplasms/immunology , Oncologists/organization & administration , Oncologists/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Pneumonia, Viral/transmission , Telemedicine/organization & administration , Telemedicine/standards , Telemedicine/trends
13.
BMJ Open Qual ; 9(3)2020 09.
Article in English | MEDLINE | ID: covidwho-795584

ABSTRACT

INTRODUCTION: Effective implementation of standard precautions specific to COVID-19 is a challenge for hospitals within the existing constraints of time and resources. AIM: To rapidly design and operationalise personal protective equipment (PPE) donning and doffing areas required for a COVID-19 care facility. METHODS: Literature review was done to identify all issues pertaining to donning and doffing in terms of Donabedian's structure, process and outcome. Training on donning and doffing was given to hospital staff. Donning and doffing mock drills were held. 5S was used as a tool to set up donning and doffing areas. Instances of donning and doffing were observed for protocol deviations and errors. Plan-do-study-act cycles were conducted every alternate day for 4 weeks. The initiative was reported using Standards for QUality Improvement Reporting Excellence (SQUIRE) guidelines. RESULTS: Best practices in donning and doffing were described. Our study recommends a minimum area of 16 m2 each for donning and doffing rooms. Verbally assisted doffing was found most useful than visual prompts. DISCUSSION: Challenges included sustaining the structure and process of donning and doffing, varied supplies of PPE which altered sequencing of donning and/or doffing, and training non-healthcare workers such as plumbers, electricians and drivers who were required during emergencies in the facility. CONCLUSION: Our study used evidence-based literature and quality improvement (QI) tools to design and operationalise donning and doffing areas with focus on people, task and environment. Our QI will enable healthcare facilities to rapidly prototype donning and doffing areas in a systematic way.


Subject(s)
Coronavirus Infections/prevention & control , Health Personnel/organization & administration , Infection Control/standards , Occupational Health/standards , Pandemics/prevention & control , Personal Protective Equipment/standards , Pneumonia, Viral/prevention & control , Adult , Betacoronavirus , Coronavirus Infections/transmission , Female , Health Personnel/standards , Health Plan Implementation , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Male , Middle Aged , Pneumonia, Viral/transmission , Protective Clothing/standards , Quality Improvement , Respiratory Protective Devices/standards , Young Adult
14.
J Nepal Health Res Counc ; 18(2): 293-300, 2020 Sep 08.
Article in English | MEDLINE | ID: covidwho-793220

ABSTRACT

BACKGROUND: The emergence of SARS-CoV 2 pandemic is the greatest public health concern of the century. Healthcare workers are the front liners of pandemic management. Their knowledge, attitudes and practices can influence the outcome of pandemic. The study aims to determine the knowledge, attitude and practices among healthcare workers. METHODS: Knowledge, attitude and practice related questionnaire based online survey through Google forms was conducted from Healthcare workers, following ethical approval from NHRC (ERB protocol registration number: 297/2020 P). Online forms were disseminated via Facebook, Instagram, Whatsapp, Viber and personal messaging. Responses containing anonymized data was collected analyzed in using SPSS-version 26, (Year: 2019). The results were interpreted in terms of percentage response, knowledge score, and practice and discussed on the possible solutions in improving the infection prevention and control practice. RESULTS: 473 HCWs responded to the questionnaire, out of which 426 responses met inclusion criteria which is 90% of the total responses. The mean score for knowledge was 3.20 + 1.15 out of maximum seven; with 45.7% correct answers. 70.4 % (300) participants felt that Nepal will be unable to contain the pandemic, 64 % of the total employed participants felt that there was inadequate institutional preparedness to protect HCWs from exposure. 91% participants reported practicing hand hygiene after every patient encounter; whereas 31.7% (77) and 22.1% (59) participants did not know how to check sealing of the N95 masks and use personal protective equipment's respectively. CONCLUSIONS: The survey findings showed deficiencies in knowledge and appropriate practice among the HCWs, in prevention of SARS-CoV-2 transmission. Attitudes towards COVID19 were a mix of both positive and negative viewpoints. Even in health care workers with access to internet, there is significant gap in universal infection prevention and control practices required for self-protection and limiting untoward transmission.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Health Knowledge, Attitudes, Practice , Health Personnel , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Adult , Betacoronavirus , Female , Humans , Infection Control/standards , Male , Nepal/epidemiology , Personal Protective Equipment , Surveys and Questionnaires
16.
Arch Pathol Lab Med ; 144(9): 1048-1056, 2020 09 01.
Article in English | MEDLINE | ID: covidwho-771248

ABSTRACT

CONTEXT.­: The novel coronavirus disease 2019 (COVID-19) pandemic is significantly changing methodologic approaches in all branches of the health system. From a forensic point of view, this event is partly changing the manner in which forensic pathologists and all those who work in autopsy services operate, but above all, it is changing the patterns established for years by which cadavers are analyzed postmortem. OBJECTIVE.­: To present a review of the literature and a proposal for COVID-19 autopsy protocols. To contain the infection risk, a revision of all the protocols that until now have been applied to the examination of bodies that require autopsy services is required. DATA SOURCES.­: Currently, the diagnosis and postmortem analysis of positive or suspected COVID-19 cases plays a crucial role in scientific research. A review of the main recommendations proposed by international scientific societies regarding the risk of infection during autopsy was carried out. Scientific papers currently available via the PubMed NCBI search engine on COVID-19 postmortem diagnosis were also examined. CONCLUSIONS.­: Throughout the history of medicine, autopsy has been fundamental to the understanding of multiple pathogenic processes that are investigated postmortem. The purpose of the study is to propose an operating protocol that can be useful for all clinical and forensic autopsies, with particular reference to the correct methods to be applied to the examination of positive or suspected COVID-19 cases, regarding both the autopsy procedure and the collection and analysis of biological samples.


Subject(s)
Autopsy/methods , Betacoronavirus , Coronavirus Infections/prevention & control , Infection Control/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Autopsy/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/pathology , Coronavirus Infections/transmission , Humans , Infection Control/standards , Pneumonia, Viral/diagnosis , Pneumonia, Viral/pathology , Pneumonia, Viral/transmission , Risk Assessment , Specimen Handling/methods , Specimen Handling/standards
17.
J Hosp Infect ; 106(2): 264-270, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-765088

ABSTRACT

The World Health Organization (WHO) hand-rub formulations have been in use around the world for at least the past 10 years. The advent of coronavirus disease 2019 (COVID-19) has further enhanced their use. We reviewed published efficacy data for the original and modified formulations. Only efficacy data according to the European Norms (EN) were found. The bactericidal efficacy of the original formulations was, under practical conditions, partly insufficient (EN 1500, only effective in 60 s; EN 12791, efficacy too low in 5 min). The first modification with higher alcohol concentrations improves their efficacy as hygienic hand rub (effective in 30 s). The second (0.725% glycerol) and third (0.5% glycerol) modification improves their efficacy for surgical hand preparation (effective in 5 and 3 min). The original and second modified formulations were tested and demonstrate activity against enveloped viruses including severe acute resiratory syndrome coronavirus 2 (SARS-CoV-2) in 30 s. The ethanol-based formulation is also active against some non-enveloped test viruses in 60 s (suspension tests, EN 14476). In-vivo data on the formulations would provide a more reliable result on the virucidal efficacy on contaminated hands but are currently not available. Nevertheless, the most recent modifications should be adopted for use in healthcare.


Subject(s)
2-Propanol/standards , Anti-Infective Agents, Local/standards , Coronavirus Infections/prevention & control , Disinfectants/standards , Guidelines as Topic , Hand Disinfection/standards , Infection Control/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus , Humans , World Health Organization
20.
Eur Spine J ; 29(10): 2409-2412, 2020 10.
Article in English | MEDLINE | ID: covidwho-617333

ABSTRACT

INTRODUCTION: At the time of writing, we are all coping with the global COVID-19 pandemic. Amongst other things, this has had a significant impact on postponing virtually all routine clinic visits and elective surgeries. Concurrently, the Magnetic Expansion Control (MAGEC) rod has been issued with a number of field safety notices and UK regulator medical device alerts. METHODS: This document serves to provide an overview of the current situation regarding the use of MAGEC rods, primarily in the UK, and the impact that the pandemic has had on the management of patients with these rods. RESULTS AND CONCLUSION: The care of each patient must of course be determined on an individual basis; however, the experience of the authors is that a short delay in scheduled distractions and clinic visits will not adversely impact patient treatment. The authors caution against a gap in distractions of longer than 6 months and emphasise the importance of continued remote patient monitoring to identify those who may need to be seen more urgently.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Magnets , Osteogenesis, Distraction/methods , Pandemics/prevention & control , Patient Safety , Pneumonia, Viral/prevention & control , Prostheses and Implants , Scoliosis/surgery , Child , Health Care Rationing/methods , Health Care Rationing/standards , Humans , Infection Control/methods , Infection Control/standards , Osteogenesis, Distraction/instrumentation , Osteogenesis, Distraction/standards , Patient Safety/standards , Practice Guidelines as Topic , Telemedicine/methods , Telemedicine/standards , Time Factors , United Kingdom
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