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1.
Arch Argent Pediatr ; 119(2): 76-82, 2021 04.
Article in English, Spanish | MEDLINE | ID: covidwho-1183983

ABSTRACT

INTRODUCTION: The objective of this study was to analyze available resources, guidelines in use, and preparedness to care for newborn infants at maternity centers in Argentina during the COVID-19 pandemic. METHOD: Cross-sectional study based on a survey administered to medical and nursing staff. In May 2020, Argentine facilities with more than 500 annual births were contacted; 58 % of these were from the public sector. RESULTS: In total, 104/147 facilities answered (71 %). All had guidelines for care during the pandemic, and 93 % indicated they had been trained on how to use them. A companion was not allowed during childbirth in 26 % of private facilities and in 60 % of public ones (p < 0.01). Deferred cord clamping was recommended in 87 %; rooming-in with asymptomatic newborns was promoted in 62 %; breastfeeding using protective measures was recommended in 70 %; and breast milk using a bottle, in 23 %. In 94 %, family visiting in the Neonatology Unit was restricted. Difficulties included the unavailability of individual rooms for symptomatic newborn infants and a potential shortage of health care staff and personal protective equipment. CONCLUSIONS: All facilities are aware of the national guidelines to fight the pandemic. Most have the resources to comply with the recommended protective measures. There is uncertainty as to whether personal protective equipment, staff, and physical space available at the different facilities would be enough if cases increased significantly.


Subject(s)
/prevention & control , Health Resources/supply & distribution , Infant Care/organization & administration , Infection Control/organization & administration , Maternal Health Services/organization & administration , Argentina/epidemiology , Cross-Sectional Studies , Female , Health Care Surveys , Health Policy , Humans , Infant Care/statistics & numerical data , Infant, Newborn , Infection Control/instrumentation , Infection Control/methods , Infection Control/statistics & numerical data , Male , Maternal Health Services/statistics & numerical data , Pandemics , Personal Protective Equipment/supply & distribution , Practice Guidelines as Topic , Pregnancy
2.
J Glob Health ; 10(2): 020507, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1154782

ABSTRACT

Background: In a surgical setting, COVID-19 patients may trigger in-hospital outbreaks and have worse postoperative outcomes. Despite these risks, there have been no consistent statements on surgical guidelines regarding the perioperative screening or management of COVID-19 patients, and we do not have objective global data that describe the current conditions surrounding this issue. This study aimed to clarify the current global surgical practice including COVID-19 screening, preventive measures and in-hospital infection under the COVID-19 pandemic, and to clarify the international gaps on infection control policies among countries worldwide. Methods: During April 2-8, 2020, a cross-sectional online survey on surgical practice was distributed to surgeons worldwide through international surgical societies, social media and personal contacts. Main outcome and measures included preventive measures and screening policies of COVID-19 in surgical practice and centers' experiences of in-hospital COVID-19 infection. Data were analyzed by country's cumulative deaths number by April 8, 2020 (high risk, >5000; intermediate risk, 100-5000; low risk, <100). Results: A total of 936 centers in 71 countries responded to the survey (high risk, 330 centers; intermediate risk, 242 centers; low risk, 364 centers). In the majority (71.9%) of the centers, local guidelines recommended preoperative testing based on symptoms or suspicious radiologic findings. Universal testing for every surgical patient was recommended in only 18.4% of the centers. In-hospital COVID-19 infection was reported from 31.5% of the centers, with higher rates in higher risk countries (high risk, 53.6%; intermediate risk, 26.4%; low risk, 14.8%; P < 0.001). Of the 295 centers that experienced in-hospital COVID-19 infection, 122 (41.4%) failed to trace it and 58 (19.7%) reported the infection originating from asymptomatic patients/staff members. Higher risk countries adopted more preventive measures including universal testing, routine testing of hospital staff and use of dedicated personal protective equipment in operation theatres, but there were remarkable discrepancies across the countries. Conclusions: This large international survey captured the global surgical practice under the COVID-19 pandemic and highlighted the insufficient preoperative screening of COVID-19 in the current surgical practice. More intensive screening programs will be necessary particularly in severely affected countries/institutions. Study registration: Registered in ClinicalTrials.gov: NCT04344197.


Subject(s)
Coronavirus Infections/prevention & control , Cross Infection/prevention & control , Infection Control/statistics & numerical data , Mass Screening/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Patterns, Physicians'/statistics & numerical data , Surgical Procedures, Operative/standards , Betacoronavirus , Coronavirus Infections/transmission , Cross Infection/virology , Cross-Sectional Studies , Hospitals/standards , Hospitals/statistics & numerical data , Humans , Infection Control/standards , Mass Screening/standards , Pneumonia, Viral/transmission , Policy , Practice Patterns, Physicians'/standards , Surgical Procedures, Operative/adverse effects , Surveys and Questionnaires
4.
Medicine (Baltimore) ; 100(5): e24409, 2021 Feb 05.
Article in English | MEDLINE | ID: covidwho-1125185

ABSTRACT

ABSTRACT: Infection with the SARS-CoV-2 virus seems to contribute significantly to increased postoperative complications and mortality after emergency surgical procedures. Additionally, the fear of COVID-19 contagion delays the consultation of patients, resulting in the deterioration of their acute diseases by the time of consultation. In the specific case of urgent digestive surgery patients, both factors significantly worsen the postoperative course and prognosis. Main working hypothesis: infection by COVID-19 increases postoperative 30-day-mortality for any cause in patients submitted to emergency/urgent general or gastrointestinal surgery. Likewise, hospital collapse during the first wave of the COVID-19 pandemic increased 30-day-mortality for any cause. Hence, the main objective of this study is to estimate the cumulative incidence of mortality at 30-days-after-surgery. Secondary objectives are: to estimate the cumulative incidence of postoperative complications and to develop a specific postoperative risk propensity model for COVID-19-infected patients.A multicenter, observational retrospective cohort study (COVID-CIR-study) will be carried out in consecutive patients operated on for urgent digestive pathology. Two cohorts will be defined: the "pandemic" cohort, which will include all patients (classified as COVID-19-positive or -negative) operated on for emergency digestive pathology during the months of March to June 2020; and the "control" cohort, which will include all patients operated on for emergency digestive pathology during the months of March to June 2019. Information will be gathered on demographic characteristics, clinical and analytical parameters, scores on the usual prognostic scales for quality management in a General Surgery service (POSSUM, P-POSSUM and LUCENTUM scores), prognostic factors applicable to all patients, specific prognostic factors for patients infected with SARS-CoV-2, postoperative morbidity and mortality (at 30 and 90 postoperative days). The main objective is to estimate the cumulative incidence of mortality at 30 days after surgery. As secondary objectives, to estimate the cumulative incidence of postoperative complications and to develop a specific postoperative risk propensity model for SARS-CoV-2 infected patients.The protocol (version1.0, April 20th 2020) was approved by the local Institutional Review Board (Ethic-and-Clinical-Investigation-Committee, code PR169/20, date 05/05/20). The study findings will be submitted to peer-reviewed journals and presented at relevant national and international scientific meetings.ClinicalTrials.gov Identifier: NCT04479150 (July 21, 2020).


Subject(s)
Digestive System Diseases , Digestive System Surgical Procedures , Emergency Treatment , Infection Control , Postoperative Complications , Time-to-Treatment , Adult , /prevention & control , Digestive System Diseases/diagnosis , Digestive System Diseases/epidemiology , Digestive System Diseases/mortality , Digestive System Diseases/surgery , Digestive System Surgical Procedures/adverse effects , Digestive System Surgical Procedures/methods , Digestive System Surgical Procedures/mortality , Emergencies/epidemiology , Emergency Treatment/adverse effects , Emergency Treatment/methods , Emergency Treatment/mortality , Female , Humans , Incidence , Infection Control/methods , Infection Control/statistics & numerical data , Male , Mortality , Multicenter Studies as Topic , Observational Studies as Topic , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Research Design , Risk Assessment/methods
5.
AANA J ; 89(1): 71-75, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1049350

ABSTRACT

The ongoing coronavirus disease 2019 (COVID-19) pandemic has created many changes and difficulties in healthcare, and the anesthesia specialty is no exception. Both the increased need for personal protective equipment (PPE) and the potential for infection and contamination through respiratory droplets have been sources of much concern. Policies and protocols have been adapted worldwide to help neutralize infection risk and exposure. Transmission of the virus to healthcare workers has been a major concern, and the risk of infection is exceptionally high for Certified Registered Nurse Anesthetists (CRNAs) because of their close contact with infected patients. CRNAs are in a unique position to help decrease exposure for themselves and other members of the healthcare team by taking extra precautions during airway manipulation. A great deal of focus has been placed on reducing risks during intubation, but reports describing methods of reducing contamination and exposure to respiratory droplets during emergence and extubation are scarce. The authors have reviewed techniques to reduce coughing, thereby decreasing the potential of virus exposure through contact with large respiratory droplets and aerosolized particles that may remain suspended in air.


Subject(s)
/prevention & control , Health Personnel/psychology , Infection Control/methods , Infection Control/standards , Operating Rooms/standards , Pandemics/prevention & control , Personal Protective Equipment/standards , Attitude of Health Personnel , Guidelines as Topic , Humans , Infection Control/statistics & numerical data , Personal Protective Equipment/statistics & numerical data
6.
Emerg Infect Dis ; 27(2): 669-672, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1048942

ABSTRACT

Despite mitigation efforts, 2 coronavirus disease outbreaks were identified among office workers in Washington, DC. Moderate adherence to workplace mitigation efforts was reported in a serologic survey; activities outside of the workplace were associated with infection. Adherence to safety measures are critical for returning to work during the pandemic.


Subject(s)
/statistics & numerical data , Disease Outbreaks/prevention & control , Infection Control/statistics & numerical data , Workplace/statistics & numerical data , Adult , Antibodies, Viral/blood , /diagnosis , District of Columbia/epidemiology , Female , Health Plan Implementation , Humans , Infection Control/methods , Male , Middle Aged , Seroepidemiologic Studies
7.
Am J Infect Control ; 49(3): 281-285, 2021 03.
Article in English | MEDLINE | ID: covidwho-1014299

ABSTRACT

BACKGROUND: The proportion of positive patients admitted to acute-care hospitals for reasons other than coronavirus disease-19 (COVID-19) is unknown. These patients potentially put other patients and healthcare workers at risk of infection. OBJECTIVE: The objective of this study was to define the proportion of asymptomatic patients admitted with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Secondary objectives were to define the positivity rate, reasons for admission, and the geographic distribution in the region. METHODS: Universal surveillance testing for SARS-CoV-2 was performed on patients admitted to this hospital over a 12-week period from April 9, 2020 to July 1, 2020. Positive patients were categorized as either symptomatic or asymptomatic as defined by the 11 criteria per the Centers for Disease Control and Prevention. The positivity rate, proportion with and without symptoms, reasons for admission, and geographic distribution in the region were recorded. RESULTS: The positivity rate ranged from 0.8% to 6.2%. The proportion of asymptomatic patients with SARS-CoV-2 was 37%. Asymptomatic patients primarily presented to the hospital because of either trauma or labor. Some clusters in the region were identified of both symptomatic and asymptomatic patients. CONCLUSIONS: The proportion of asymptomatic patients admitted with SARS-CoV-2 was significant. Identifying and isolating asymptomatic patients likely prevented exposure and development of hospital-acquired COVID-19 cases among healthcare workers and other patients, supporting the universal surveillance of all admitted patients.


Subject(s)
Asymptomatic Infections/epidemiology , Patient Admission/statistics & numerical data , Population Surveillance/methods , Adult , Cross Infection/prevention & control , Cross Infection/virology , Female , Humans , Infection Control/methods , Infection Control/statistics & numerical data , Kentucky/epidemiology , Male , Middle Aged
8.
Front Public Health ; 8: 590275, 2020.
Article in English | MEDLINE | ID: covidwho-983747

ABSTRACT

The COVID-19 pandemic has laid bare the inadequacy of the U.S. healthcare system to deliver timely and resilient care. According to the American Hospital Association, the pandemic has created a $202 billion loss across the healthcare industry, forcing health care systems to lay off workers and making hospitals scramble to minimize supply chain costs. However, as the demand for personal protective equipment (PPE) grows, hospitals have sacrificed sustainable solutions for disposable options that, although convenient, will exacerbate supply strains, financial burden, and waste. We advocate for reusable gowns as a means to lower health care costs, address climate change, and improve resilience while preserving the safety of health care workers. Reusable gowns' polyester material provides comparable capacity to reduce microbial cross-transmission and liquid penetration. In addition, previous hospitals have reported a 50% cost reduction in gown expenditures after adopting reusable gowns; given the current 2000% price increase in isolation gowns during COVID-19, reusable gown use will build both healthcare resilience and security from price fluctuations. Finally, with the United States' medical waste stream worsening, reusable isolation gowns show promising reductions in energy and water use, solid waste, and carbon footprint. The gowns are shown to withstand laundering 75-100 times in contrast to the single-use disposable gown. The circumstances of the pandemic forewarn the need to shift our single-use PPE practices to standardized reusable applications. Ultimately, sustainable forms of protective equipment can help us prepare for future crises that challenge the resilience of the healthcare system.


Subject(s)
/prevention & control , Disposable Equipment/economics , Equipment Reuse/economics , Health Personnel/statistics & numerical data , Infection Control/economics , Pandemics/prevention & control , Protective Clothing/economics , Adult , Disposable Equipment/statistics & numerical data , Equipment Reuse/statistics & numerical data , Female , Humans , Infection Control/statistics & numerical data , Male , Middle Aged , Occupational Exposure/economics , Occupational Exposure/statistics & numerical data , Pandemics/statistics & numerical data , Protective Clothing/statistics & numerical data , United States
9.
Sci Rep ; 10(1): 18422, 2020 10 28.
Article in English | MEDLINE | ID: covidwho-894412

ABSTRACT

We use an individual based model and national level epidemic simulations to estimate the medical costs of keeping the US economy open during COVID-19 pandemic under different counterfactual scenarios. We model an unmitigated scenario and 12 mitigation scenarios which differ in compliance behavior to social distancing strategies and in the duration of the stay-home order. Under each scenario we estimate the number of people who are likely to get infected and require medical attention, hospitalization, and ventilators. Given the per capita medical cost for each of these health states, we compute the total medical costs for each scenario and show the tradeoffs between deaths, costs, infections, compliance and the duration of stay-home order. We also consider the hospital bed capacity of each Hospital Referral Region (HRR) in the US to estimate the deficit in beds each HRR will likely encounter given the demand for hospital beds. We consider a case where HRRs share hospital beds among the neighboring HRRs during a surge in demand beyond the available beds and the impact it has in controlling additional deaths.


Subject(s)
Coronavirus Infections/economics , Health Care Costs/statistics & numerical data , Pandemics/economics , Pneumonia, Viral/economics , Capacity Building/economics , Capacity Building/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Health Facilities/economics , Health Facilities/statistics & numerical data , Humans , Infection Control/economics , Infection Control/statistics & numerical data , Models, Statistical , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , United States
11.
Infect Control Hosp Epidemiol ; 41(9): 1003-1010, 2020 09.
Article in English | MEDLINE | ID: covidwho-862242

ABSTRACT

BACKGROUND: SARS-CoV-2 has been implicated in the largest recorded coronavirus outbreak to date. Initially, most COVID-19 cases were in China, but the virus has spread to more than 184 countries worldwide, and the United States currently has more cases than any other country. OBJECTIVE: With person-to-person spread expanding in the United States, we describe hospital preparedness for managing suspected and confirmed COVID-19 patients. DESIGN: Cross-sectional survey focused on various elements of respiratory disease preparedness. SETTING: Critical access hospitals (CAHs) and acute-care hospitals (ACHs) in Idaho. METHODS: The electronic survey was sent to infection preventionists (IPs) and nurse administrators in 44 hospitals in Idaho. RESULTS: Overall, 32 (73%) hospitals responded to the survey. Participating facilities reported their preparedness with respect to existing, formalized structures for managing infectious disease incidents-specifically COVID-19-as well as availability of resources, such as isolation rooms and personal protective equipment, for safely managing suspected and confirmed COVID-19 cases. CONCLUSIONS: Hospitals covered by the survey had varying levels of preparedness for managing COVID-19 cases, with differences across the various categories of interest in this study. Although the study reveals strengths, including in application of emergency management and infection control frameworks, it also suggests that other areas, such as consistent implementation of federal guidelines and requirements for infection prevention, are potential areas for strengthening preparedness for SARS-CoV-2 and other respiratory pathogens with pandemic potential.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Health Resources/supply & distribution , Hospitals/statistics & numerical data , Infection Control/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Cross-Sectional Studies , Health Care Surveys , Humans , Idaho , Infection Control/instrumentation , Infection Control/methods , Personal Protective Equipment/supply & distribution , Quarantine/methods , Quarantine/statistics & numerical data
13.
Arch Pediatr ; 27(8): 423-427, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-785151

ABSTRACT

BACKGROUND: The outbreak of COVID-19 has imposed many challenges on health systems. The purpose of this study was to describe the impact of the COVID-19 pandemic on the clinical activity of pediatricians. METHODS: We conducted a cross-sectional and descriptive online survey among pediatricians practicing in Cameroon. Data were collected through an anonymous pre-tested Google Form®. RESULTS: Among the 118 pediatricians eligible for the survey, 101 responded (85.6%), of whom 61.2% were women. The pediatric outpatient consultations dropped significantly from 60.4% of pediatricians seeing more than 30 patients per week before the pandemic to 9.9% during the pandemic (P<0.000). According to the occupancy rate of hospitalisation beds, 45.5% of pediatricians reported having 76-100% of pediatric hospitalisation beds occupied per week before the pandemic but no pediatrician reported a similar rate during the pandemic (P<0.000). There was a significant increase in the use of telehealth, ranging from no pediatrician using telehealth "very frequently" before the pandemic to 23.8% using it during the pandemic (P<0.000). Most of the pediatricians had at their disposal surgical masks (96%), care gloves (80.2%), hydroalcoholic gel (99.0%), and soap and water (86.1%). For the management of children, 90.1% and 71.3% of pediatricians experienced difficulties accessing COVID-19 PCR and chloroquine, respectively, and 74.3% declared difficulties for proper isolation of patients. More than half (65.3%) of the pediatricians interviewed were "very afraid" or "extremely afraid" of being infected with SARS-Cov-2, respectively 45.5% and 19.8%. The most frequent reasons included fear of infecting their relatives (85.1%) and of developing a severe form of the disease (43.6%). The reluctance to consult health services expressed by the parents was due to: fear of being infected when leaving their home and especially in the health facility (96%), strict compliance with confinement (30.7%), and financial difficulties of families (13.9%). CONCLUSION: This work highlights the impact of the coronavirus pandemic on the clinical activity of Cameroonian pediatricians. Since the beginning of the pandemic, there has been a significant drop in the use of health facilities, which probably has a negative impact on children's overall level of health. Although the preventive measures explain this drop in attendance at health facilities, the parents' fear of being infected when leaving the house was the predominant reason likely to explain this drop in attendance at health facilities. This could constitute an axis for developing messages to parents to encourage a gradual return to child health services.


Subject(s)
Attitude of Health Personnel , Coronavirus Infections , Pandemics , Pediatricians/psychology , Pediatrics/trends , Pneumonia, Viral , Practice Patterns, Physicians'/trends , Adult , Cameroon , Child , Coronavirus Infections/diagnosis , Coronavirus Infections/psychology , Coronavirus Infections/therapy , Coronavirus Infections/transmission , Cross-Sectional Studies , Female , Health Care Surveys , Health Services Accessibility/trends , Humans , Infection Control/methods , Infection Control/statistics & numerical data , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Male , Middle Aged , Pneumonia, Viral/diagnosis , Pneumonia, Viral/psychology , Pneumonia, Viral/therapy , Pneumonia, Viral/transmission , Professional-Family Relations , Telemedicine
14.
J Psychiatr Res ; 131: 244-254, 2020 12.
Article in English | MEDLINE | ID: covidwho-779326

ABSTRACT

BACKGROUND: COVID-19 has affected social interaction and healthcare worldwide. METHODS: We examined changes in presentations and referrals to the primary provider of mental health and community health services in Cambridgeshire and Peterborough, UK (population ~0·86 million), plus service activity and deaths. We conducted interrupted time series analyses with respect to the time of UK "lockdown", which was shortly before the peak of COVID-19 infections in this area. We examined changes in standardized mortality ratio for those with and without severe mental illness (SMI). RESULTS: Referrals and presentations to nearly all mental and physical health services dropped at lockdown, with evidence for changes in both supply (service provision) and demand (help-seeking). This was followed by an increase in demand for some services. This pattern was seen for all major forms of presentation to liaison psychiatry services, except for eating disorders, for which there was no evidence of change. Inpatient numbers fell, but new detentions under the Mental Health Act were unchanged. Many services shifted from face-to-face to remote contacts. Excess mortality was primarily in the over-70s. There was a much greater increase in mortality for patients with SMI, which was not explained by ethnicity. CONCLUSIONS: COVID-19 has been associated with a system-wide drop in the use of mental health services, with some subsequent return in activity. "Supply" changes may have reduced access to mental health services for some. "Demand" changes may reflect a genuine reduction of need or a lack of help-seeking with pent-up demand. There has been a disproportionate increase in death among those with SMI during the pandemic.


Subject(s)
Community Health Services/statistics & numerical data , Coronavirus Infections , Health Services Accessibility/statistics & numerical data , Mental Disorders/mortality , Pandemics , Patient Acceptance of Health Care/statistics & numerical data , Pneumonia, Viral , Referral and Consultation/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Community Mental Health Services/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Female , Humans , Infection Control/statistics & numerical data , Male , Middle Aged , Mortality , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , United Kingdom/epidemiology , Young Adult
15.
Cancer Rep (Hoboken) ; 3(5): e1280, 2020 10.
Article in English | MEDLINE | ID: covidwho-774546

ABSTRACT

BACKGROUND: Health care services across the globe are undergoing a major transformation to combat the coronavirus disease 2019 (COVID-19) pandemic. Regardless of the strength of health care infrastructure across different economies, all countries are diverting their resources toward care for COVID-19 patients. AIM: The aim of this survey was to evaluate the pattern of care of gynaecologic cancers in a developing country during the COVID-19 pandemic. METHODS: An anonymous survey consisting of 20 questions intended for the gynaecologic cancer care providers with emphasis on their current practice and approach to their patients was distributed online via social media from April 30 to May 31, 2020. Basic descriptive statistics were applied. RESULTS: Among a total of 61 respondents, 63.9% were gynaecologic oncologists, 18.0% were radiation oncologists and 18.0% were medical oncologists. Majority, that is, 95.1% health care professionals felt that COVID-19 pandemic has had a significant change on their practice pattern and 56.2% practitioners had stopped registering new cases of cancer. In 75.4% centers surgery was being done for gynaecologic cancer cases and among them 60.8% were doing surgery only for cases requiring immediate intervention. Among the centers providing chemotherapy, 39.1% had switched to oral drugs. Among the centers providing radiation, 40.9% were providing radiation to cases based on their type and urgency and 9.0% had implemented hypofractionation. In early stage low risk cases, majority, that is, 34.0% centers were managing as before. In early stage high-risk cases, 32.6% centers were managing as before. In advanced stage endometrial cancer cases, 28.8% had postponed any treatment and 28.8% administered chemotherapy. In early stage, epithelial ovarian cancer 65.9% centers were performing complete staging of the disease. In advanced stage epithelial ovarian cancer, 65.9% centers preferred biopsy followed by neoadjuvant chemotherapy and 11.3% centers performed primary debulking surgery. In cases of interval debulking surgery, 73.3% centers deferred surgery till all six cycles of chemotherapy was completed. In cases of recurrent ovarian cancer amenable for secondary debulking surgery, 38.6% preferred chemotherapy. In early stage cervical cancer, surgical treatment was provided in 46.5% centers. In locally advanced cervical cancer, chemoradiation was given in 65.9% centers. In cases of metastatic cervical cancer, 46.6% centers were performing palliative radiation. CONCLUSION: COVID-19 has affected the treatment of gynecologic cancers patients and health care professionals are trying to mitigate the damage by incorporating new elements which are suited to the current scenario.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Genital Neoplasms, Female/therapy , Infection Control/statistics & numerical data , Pneumonia, Viral/complications , Practice Patterns, Physicians'/statistics & numerical data , Social Media/statistics & numerical data , Telemedicine , Combined Modality Therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Disease Management , Female , Genital Neoplasms, Female/virology , Humans , India/epidemiology , Infection Control/methods , Infection Control/standards , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Surveys and Questionnaires
16.
J Pediatr Orthop ; 40(10): e990-e993, 2020.
Article in English | MEDLINE | ID: covidwho-766811

ABSTRACT

BACKGROUND: The COVID-19 pandemic has substantially altered the typical process around performing surgery to ensure protection of health care workers, patients, and their families. One safety precaution has been the implementation of universal preoperative screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study examines the results of universal screening on children undergoing orthopaedic surgery. METHODS: This is a retrospective cohort study evaluating the incidence and symptomatology of COVID-19 in all patients presenting for orthopaedic surgery at 3 pediatric tertiary care children's hospitals during the COVID-19 pandemic (March to June 2020). All patients underwent universal screening with a nasopharyngeal swab to detect presence of SARS-CoV-2. Bivariate and multivariate logistic regression analysis was performed to identify risk factors for positive COVID-19 screening. RESULTS: In total, 1198 patients underwent preoperative screening across all 3 institutions and 7 (0.58%) had detection of SARS-CoV-2. The majority of patients (1/7, 86%) were asymptomatic. Patients that tested positive were significantly more likely to be Hispanic (P=0.046) and had greater number of medical comorbidities (P=0.013), as scored on the American Society of Anesthesiologists (ASA) physical status score. A known COVID-19 positive contact was found to be a significant risk factor in the multivariate analysis (P=0.004). CONCLUSIONS: Early results of universal preoperative screening for COVID-19 demonstrates a low incidence and high rate of asymptomatic patients. Health care professionals, especially those at higher risk for the virus, should be aware of the challenges related to screening based solely on symptoms or travel history and consider universal screening for patients undergoing elective surgery. LEVEL OF EVIDENCE: Level II.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections , Diagnostic Screening Programs , Infection Control , Orthopedic Procedures/methods , Pandemics , Pneumonia, Viral , Preoperative Care/methods , Child , Clinical Laboratory Techniques/methods , Contact Tracing , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Ethnic Groups , Female , Humans , Incidence , Infection Control/methods , Infection Control/statistics & numerical data , Male , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Retrospective Studies , United States
17.
Work ; 66(4): 767-775, 2020.
Article in English | MEDLINE | ID: covidwho-760847

ABSTRACT

BACKGROUND: Prevention is the best way to manage a pandemic like COVID-19. The World Health Organization has issued public advice to create awareness by providing people knowledge to prevent/protect them from COVID-19. Hence, the present study was planned to assess knowledge of prevention and its practical use amongst samples from the Saudi Arabian population. It can be used to bring awareness among the masses not only in expanding their knowledge about COVID-19 but also on how to enforce a practicing behavior in relation to the prevention of COVID-19. The study is among the pioneer studies on the issue related to knowledge and practice of the prevention of COVID-19 among Saudis and foreign nationals residing in Saudi Arabia. OBJECTIVE: The prime objective of this study is to examine the existence of knowledge among the Saudi and non-Saudi nationals about COVID-19 and its impact on their behavior to practice the protocols to prevent the disastrous infection of COVID-19. This study has also examined how the residents in Saudi Arabia react to the methods and protection measures adopted by the government for their dominions to eradicate the spread of COVID-19. METHODS: The study used a survey-based methodology and data was collected from Saudi nationals as well as expatriates living and working in five different regions of Saudi Arabia. Non-probability snowball sampling was used to reach and select the population of the current study. A self-designed, structured, and validated questionnaire was electronically distributed among the respondents. SPSS version 21 was used to analyze the data of the current study. RESULTS: Out of the 443 respondents, 356 respondents (84%) knew they had to wash their hands for 20 seconds and did this as well, 303 respondents (75%) knew that sneezing or coughing into the arm/elbow can prevent the spread of COVID-19 and were doing this as well, 357 respondents (82%) knew that COVID-19 can be transferred by shaking hands and avoided this, 333 respondents (79%) knew that they had to maintain a safe distance of at least one meter and kept this distance, 315 respondents (76%) knew that touching one's face can transfer the virus and avoid this, and 414 respondents (95%) knew that staying at home can decrease the chances of getting infected. The relationship between different regions and most of the knowledge-based and practice-based questions was significant (p < 0.05). CONCLUSION: Results reveal that there is a significant relationship between knowledge and practice, but the strength of association is weak. It was found that knowledge and practice of COVID-19 was followed differently in the five regions of Saudi Arabia and the level of education of the respondents influenced their choice of practice to protect themselves from the effects of COVID-19. The study has contributed in the body of literature by examining the inter-relationship between knowledge and practice and their use in prevention of COVID-19 among the Saudi population.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/prevention & control , Health Knowledge, Attitudes, Practice , Infection Control/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Adolescent , Adult , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Cross-Sectional Studies , Educational Status , Female , Hand Hygiene/standards , Hand Hygiene/statistics & numerical data , Humans , Infection Control/statistics & numerical data , Male , Middle Aged , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Saudi Arabia/epidemiology , Surveys and Questionnaires/statistics & numerical data , Young Adult
18.
J Med Internet Res ; 22(9): e22457, 2020 09 29.
Article in English | MEDLINE | ID: covidwho-760807

ABSTRACT

BACKGROUND: Maintaining compliance with personal preventive measures is important to achieve a balance of COVID-19 pandemic control and work resumption. OBJECTIVE: The aim of this study was to investigate self-reported compliance with four personal measures to prevent COVID-19 among a sample of factory workers in Shenzhen, China, at the beginning of work resumption in China following the COVID-19 outbreak. These preventive measures included consistent wearing of face masks in public spaces (the workplace and other public settings); sanitizing hands using soap, liquid soap, or alcohol-based hand sanitizer after returning from public spaces or touching public installations and equipment; avoiding social and meal gatherings; and avoiding crowded places. METHODS: The participants were adult factory workers who had resumed work in Shenzhen, China. A stratified two-stage cluster sampling design was used. We randomly selected 14 factories that had resumed work. All full-time employees aged ≥18 years who had resumed work in these factories were invited to complete a web-based survey. Out of 4158 workers who had resumed work in these factories, 3035 (73.0%) completed the web-based survey from March 1 to 14, 2020. Multilevel logistic regression models were fitted. RESULTS: Among the 3035 participants, 2938 (96.8%) and 2996 (98.7%) reported always wearing a face mask in the workplace and in other public settings, respectively, in the past month. However, frequencies of self-reported sanitizing hands (2152/3035, 70.9%), avoiding social and meal gatherings (2225/3035, 73.3%), and avoiding crowded places (1997/3035, 65.8%) were relatively low. At the individual level, knowledge about COVID-19 (adjusted odds ratios [AORs] from 1.16, CI 1.10-1.24, to 1.29, CI 1.21-1.37), perceived risk (AORs from 0.58, CI 0.50-0.68, to 0.85, CI 0.72-0.99) and severity (AOR 1.05, CI 1.01-1.09, and AOR 1.07, CI 1.03-1.11) of COVID-19, perceived effectiveness of preventive measures by the individual (AORs from 1.05, CI 1.00-1.10, to 1.09, CI 1.04-1.13), organization (AOR 1.30, CI 1.20-1.41), and government (AORs from 1.14, CI 1.04-1.25, to 1.21, CI 1.02-1.42), perceived preparedness for a potential outbreak after work resumption (AORs from 1.10, CI 1.00-1.21, to 1.50, CI 1.36-1.64), and depressive symptoms (AORs from 0.93, CI 0.91-0.94, to 0.96, CI 0.92-0.99) were associated with self-reported compliance with at least one personal preventive measure. At the interpersonal level, exposure to COVID-19-specific information through official media channels (AOR 1.08, CI 1.04-1.11) and face-to-face communication (AOR 0.90, CI 0.83-0.98) were associated with self-reported sanitizing of hands. The number of preventive measures implemented in the workplace was positively associated with self-reported compliance with all four preventive measures (AORs from 1.30, CI 1.08-1.57, to 1.63, CI 1.45-1.84). CONCLUSIONS: Measures are needed to strengthen hand hygiene and physical distancing among factory workers to reduce transmission following work resumption. Future programs in workplaces should address these factors at multiple levels.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Employment/statistics & numerical data , Health Surveys , Infection Control/statistics & numerical data , Occupational Health/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Self Report , Workplace , Adult , Betacoronavirus , China/epidemiology , Coronavirus Infections/transmission , Cross-Sectional Studies , Disease Outbreaks , Female , Humans , Infection Control/methods , Male , Occupational Health/standards , Odds Ratio , Pneumonia, Viral/transmission , Young Adult
19.
Math Biosci Eng ; 17(4): 4165-4183, 2020 06 15.
Article in English | MEDLINE | ID: covidwho-750588

ABSTRACT

In this paper we develop a compartmental epidemic model to study the transmission dynamics of the COVID-19 epidemic outbreak, with Mexico as a practical example. In particular, we evaluate the theoretical impact of plausible control interventions such as home quarantine, social distancing, cautious behavior and other self-imposed measures. We also investigate the impact of environmental cleaning and disinfection, and government-imposed isolation of infected individuals. We use a Bayesian approach and officially published data to estimate some of the model parameters, including the basic reproduction number. Our findings suggest that social distancing and quarantine are the winning strategies to reduce the impact of the outbreak. Environmental cleaning can also be relevant, but its cost and effort required to bring the maximum of the outbreak under control indicate that its cost-efficacy is low.


Subject(s)
Betacoronavirus , Coronavirus Infections/transmission , Models, Biological , Pandemics , Pneumonia, Viral/transmission , Basic Reproduction Number/statistics & numerical data , Bayes Theorem , Computer Simulation , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disinfection/statistics & numerical data , Epidemics/prevention & control , Epidemics/statistics & numerical data , Humans , Infection Control/methods , Infection Control/statistics & numerical data , Mathematical Concepts , Mexico/epidemiology , Pandemics/prevention & control , Pandemics/statistics & numerical data , Patient Isolation/statistics & numerical data , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Quarantine/statistics & numerical data
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