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1.
Medwave ; 20(5)26-06-2020.
Article in English, Spanish | LILACS (Americas) | ID: covidwho-651724

ABSTRACT

Introducción La enfermedad por coronavirus-19 (COVID-19) es un problema mundial de salud pública debido a su morbimortalidad, especialmente en grupos de riesgo. El entorno odontológico tiene un alto riesgo de transmisión viral, por ello el objetivo de este estudio fue identificar recomendaciones para la atención odontológica durante esta pandemia. Métodos Se realizó una búsqueda de evidencia científica publicada desde 2002 hasta el 23 de marzo de 2020 en bases de datos electrónicas (MEDLINE/PubMed, EMBASE, Cochrane y Epistemonikos) y en las páginas electrónicas de la Asociación Dental Americana, de Centers for Disease Control and Prevention Oral Health, del Ministerio de Salud de Chile y de sociedades científicas. Resultados Se incluyeron nueve artículos publicados, en los cuales se recomienda el uso irrestricto de elementos de protección personal, preferir técnicas radiográficas extraorales, uso de enjuagues bucales con peróxido de hidrógeno al 1% o povidona yodada al 0,2%, técnica a cuatro manos con aspiración constante y uso de suturas reabsorbibles. Además, existe consenso respecto a que durante los periodos de transmisión comunitaria se deben posponer los tratamientos odontológicos no urgentes. Conclusiones Debido al alto riesgo de infección cruzada que presentan los equipos odontológicos, deben implementarse recomendaciones basadas en la mejor evidencia disponible, con el fin de preservar la salud de los miembros del equipo y de la población a su cuidado.


Introduction COVID-19 is a world public health problem due to its morbidity and mortality, especially in at-risk groups. The dental environment has a high risk of viral transmission; accordingly, this study aimed to identify recommendations based on the best available evidence for dental care during this pandemic. Methods We performed a search for scientific evidence published since 2002 to March 23th 2020 in electronic databases (MEDLINE/PubMed, EMBASE, Cochrane, and Epistemonikos) and the web pages of the American Dental Association, Centers for Disease Control and Prevention Oral Health, the Ministry of Health in Chile and scientific societies. Results We included nine published studies. The recommendations were the following: unrestricted use of personal protection elements, use of extraoral radiographic techniques, use of mouth rinses with 1% hydrogen peroxide or 0.2% iodine povidone, a four-hand technique with ongoing aspiration and the use of absorbable sutures. Furthermore, there is a consensus that non-urgent treatments should be postponed during periods of community transmission. Conclusions Dental practitioners are exposed to a high risk of cross-infection, meaning they must implement recommendations based on the best available evidence to preserve the health of team members and the population they are caring for.


Subject(s)
Humans , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Dental Care/standards , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Pandemics/prevention & control , Practice Guidelines as Topic
2.
J Am Med Inform Assoc ; 27(9): 1450-1455, 2020 07 01.
Article in English | MEDLINE | ID: covidwho-766656

ABSTRACT

The screening of healthcare workers for COVID-19 (coronavirus disease 2019) symptoms and exposures prior to every clinical shift is important for preventing nosocomial spread of infection but creates a major logistical challenge. To make the screening process simple and efficient, University of California, San Francisco Health designed and implemented a digital chatbot-based workflow. Within 1 week of forming a team, we conducted a product development sprint and deployed the digital screening process. In the first 2 months of use, over 270 000 digital screens have been conducted. This process has reduced wait times for employees entering our hospitals during shift changes, allowed for physical distancing at hospital entrances, prevented higher-risk individuals from coming to work, and provided our healthcare leaders with robust, real-time data for make staffing decisions.


Subject(s)
Betacoronavirus , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Health Personnel , Mobile Applications , Pneumonia, Viral/diagnosis , Coronavirus Infections/transmission , Hospitals, University , Humans , Infection Control/methods , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Occupational Health , Organizational Case Studies , Pandemics/prevention & control , Pneumonia, Viral/transmission , San Francisco
3.
Am J Gastroenterol ; 115(10): 1575-1583, 2020 10.
Article in English | MEDLINE | ID: covidwho-737627

ABSTRACT

The American Neurogastroenterology and Motility Society Task Force recommends that gastrointestinal motility procedures should be performed in motility laboratories adhering to the strict recommendations and personal protective equipment (PPE) measures to protect patients, ancillary staff, and motility allied health professionals. When available and within constraints of institutional guidelines, it is preferable for patients scheduled for motility procedures to complete a coronavirus disease 2019 (COVID-19) test within 48 hours before their procedure, similar to the recommendations before endoscopy made by gastroenterology societies. COVID-19 test results must be documented before performing procedures. If procedures are to be performed without a COVID-19 test, full PPE use is recommended, along with all social distancing and infection control measures. Because patients with suspected motility disorders may require multiple procedures, sequential scheduling of procedures should be considered to minimize need for repeat COVID-19 testing. The strategies for and timing of procedure(s) should be adapted, taking into consideration local institutional standards, with the provision for screening without testing in low prevalence areas. If tested positive for COVID-19, subsequent negative testing may be required before scheduling a motility procedure (timing is variable). Specific recommendations for each motility procedure including triaging, indications, PPE use, and alternatives to motility procedures are detailed in the document. These recommendations may evolve as understanding of virus transmission and prevalence of COVID-19 infection in the community changes over the upcoming months.


Subject(s)
Coronavirus Infections/prevention & control , Gastroenterology/standards , Gastrointestinal Diseases/diagnosis , Infection Control/standards , Laboratories/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Advisory Committees/standards , Betacoronavirus/pathogenicity , Clinical Laboratory Techniques/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Gastroenterology/methods , Gastrointestinal Diseases/physiopathology , Gastrointestinal Motility/physiology , Humans , Infection Control/instrumentation , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Patient Selection , Personal Protective Equipment/standards , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Prevalence , Societies, Medical/standards , Triage/standards , United States/epidemiology
5.
Am J Gastroenterol ; 115(10): 1719-1721, 2020 10.
Article in English | MEDLINE | ID: covidwho-732651

ABSTRACT

INTRODUCTION: The risk of coronavirus disease-19 infection for healthcare professionals and patients in hospitals remains unclear. METHODS: We investigated whether precautions adopted in our inflammatory bowel disease (IBD) unit have minimized the risks of infection for all patients accessing our facilities in a 1-month period by assessing the rate of coronavirus disease-19 infection in the follow-up period. RESULTS: Three hundred-twenty patients with IBD were included. None were infected from severe acute respiratory syndrome-coronavirus 2 in the follow-up period. None of the IBD team members were infected. DISCUSSION: Neither pharmacological immunosuppression nor access to the hospital seem to be risk factors for infection in patients with IBD.


Subject(s)
Coronavirus Infections/prevention & control , Hospital Units/statistics & numerical data , Immunosuppressive Agents/adverse effects , Infection Control/statistics & numerical data , Inflammatory Bowel Diseases/immunology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Adolescent , Adult , Aged , Aged, 80 and over , Betacoronavirus/immunology , Clinical Laboratory Techniques/statistics & numerical data , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Follow-Up Studies , Health Services Accessibility/statistics & numerical data , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Infectious Disease Transmission, Professional-to-Patient/statistics & numerical data , Inflammatory Bowel Diseases/drug therapy , Italy/epidemiology , Middle Aged , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Risk Factors , Young Adult
6.
MMWR Morb Mortal Wkly Rep ; 69(32): 1095-1099, 2020 Aug 11.
Article in English | MEDLINE | ID: covidwho-705516

ABSTRACT

Undetected infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) contributes to transmission in nursing homes, settings where large outbreaks with high resident mortality have occurred (1,2). Facility-wide testing of residents and health care personnel (HCP) can identify asymptomatic and presymptomatic infections and facilitate infection prevention and control interventions (3-5). Seven state or local health departments conducted initial facility-wide testing of residents and staff members in 288 nursing homes during March 24-June 14, 2020. Two of the seven health departments conducted testing in 195 nursing homes as part of facility-wide testing all nursing homes in their state, which were in low-incidence areas (i.e., the median preceding 14-day cumulative incidence in the surrounding county for each jurisdiction was 19 and 38 cases per 100,000 persons); 125 of the 195 nursing homes had not reported any COVID-19 cases before the testing. Ninety-five of 22,977 (0.4%) persons tested in 29 (23%) of these 125 facilities had positive SARS-CoV-2 test results. The other five health departments targeted facility-wide testing to 93 nursing homes, where 13,443 persons were tested, and 1,619 (12%) had positive SARS-CoV-2 test results. In regression analyses among 88 of these nursing homes with a documented case before facility-wide testing occurred, each additional day between identification of the first case and completion of facility-wide testing was associated with identification of 1.3 additional cases. Among 62 facilities that could differentiate results by resident and HCP status, an estimated 1.3 HCP cases were identified for every three resident cases. Performing facility-wide testing immediately after identification of a case commonly identifies additional unrecognized cases and, therefore, might maximize the benefits of infection prevention and control interventions. In contrast, facility-wide testing in low-incidence areas without a case has a lower proportion of test positivity; strategies are needed to further optimize testing in these settings.


Subject(s)
Clinical Laboratory Techniques , Coronavirus Infections/prevention & control , Nursing Homes , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Aged , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Health Personnel , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , United States/epidemiology
7.
8.
JCO Glob Oncol ; 6: 1248-1257, 2020 08.
Article in English | MEDLINE | ID: covidwho-696845

ABSTRACT

PURPOSE: To understand readiness measures taken by oncologists to protect patients and health care workers from the novel coronavirus (COVID-19) and how their clinical decision making was influenced by the pandemic. METHODS: An online survey was conducted between March 24 and April 29, 2020. RESULTS: A total of 343 oncologists from 28 countries participated. The median age was 43 years (range, 29-68 years), and the majority were male (62%). At the time of the survey, nearly all participants self-reported an outbreak in their country (99.7%). Personal protective equipment was available to all participants, of which surgical mask was the most common (n = 308; 90%). Telemedicine, in the form of phone or video encounters, was common and implemented by 80% (n = 273). Testing patients with cancer for COVID-19 via reverse transcriptase polymerase chain reaction before systemic treatment was not routinely implemented: 58% reported no routine testing, 39% performed testing in selected patients, and 3% performed systematic testing in all patients. The most significant factors influencing an oncologist's decision making regarding choice of systemic therapy included patient age and comorbidities (81% and 92%, respectively). Although hormonal treatments and tyrosine kinase inhibitors were considered to be relatively safe, cytotoxic chemotherapy and immune therapies were perceived as being less safe or unsafe by participants. The vast majority of participants stated that during the pandemic they would use less chemotherapy, immune checkpoint inhibitors, and steroids. Although treatment in neoadjuvant, adjuvant, and first-line metastatic disease was less affected, most of the participants stated that they would be more hesitant to recommend second- or third-line therapies in metastatic disease. CONCLUSION: Decision making by oncologists has been significantly influenced by the ongoing COVID-19 pandemic.


Subject(s)
Betacoronavirus/pathogenicity , Clinical Decision-Making , Coronavirus Infections/prevention & control , Infection Control/statistics & numerical data , Neoplasms/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Adult , Aged , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Female , Humans , Infection Control/methods , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Medical Oncology/methods , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Middle Aged , Neoplasms/diagnosis , Oncologists/statistics & numerical data , Personal Protective Equipment/standards , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Practice Patterns, Physicians'/standards , Practice Patterns, Physicians'/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data , Telemedicine/statistics & numerical data
10.
Nefrologia ; 40(4): 395-402, 2020.
Article in English, Spanish | MEDLINE | ID: covidwho-675850

ABSTRACT

The COVID-19 epidemic represents a special risk for kidney patients due to their comorbidities and advanced age, and the need for hemodialysis treatment in group rooms. It also represents a risk for professionals responsible for their attention. This manuscript contains a proposal for action to prevent infection of professionals in the Nephrology Services, one of the most valuable assets at the present time.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Health Personnel , Nephrology , Occupational Diseases/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Renal Dialysis , Coronavirus Infections/transmission , Cross Infection/prevention & control , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Occupational Exposure , Occupational Stress/prevention & control , Personal Protective Equipment , Pneumonia, Viral/transmission , Social Isolation
11.
Cancer Cell ; 38(2): 161-163, 2020 08 10.
Article in English | MEDLINE | ID: covidwho-670131

ABSTRACT

Two recent Lancet and Lancet Oncology papers report that cancer patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have higher mortality rates. Common independent factors associated with increased risk of death were older age, history of smoking status, number of comorbidities, more advanced performance status, and active cancer.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/mortality , Infection Control/standards , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Neoplasms/mortality , Pneumonia, Viral/mortality , Age Factors , Aged , Betacoronavirus/immunology , Coronavirus Infections/immunology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Humans , Neoplasms/immunology , Neoplasms/therapy , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Risk Assessment , Risk Factors
12.
J Thorac Cardiovasc Surg ; 160(2): 447-451, 2020 08.
Article in English | MEDLINE | ID: covidwho-661781

ABSTRACT

The COVID-19 pandemic necessitates aggressive infection mitigation strategies to reduce the risk to patients and healthcare providers. This document is intended to provide a framework for the adult cardiac surgeon to consider in this rapidly changing environment. Preoperative, intraoperative, and postoperative detailed protective measures are outlined. These are guidance recommendations during a pandemic surge to be used for all patients while local COVID-19 disease burden remains elevated.


Subject(s)
Betacoronavirus/pathogenicity , Cardiac Surgical Procedures/standards , Coronavirus Infections/prevention & control , Cross Infection/prevention & control , Heart Diseases/surgery , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Operating Rooms/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Recovery Room/standards , Cardiac Surgical Procedures/adverse effects , Consensus , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Cross Infection/epidemiology , Cross Infection/transmission , Cross Infection/virology , Heart Diseases/epidemiology , Humans , Occupational Health/standards , Patient Safety/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Risk Assessment , Risk Factors , Virulence
13.
Gastroenterol Hepatol ; 43(6): 332-347, 2020.
Article in English, Spanish | MEDLINE | ID: covidwho-658769

ABSTRACT

The set of measures proposed by SEPD, AEEH, GETECCU and AEG are aimed to help departments in their resumption of usual activity. We have prepared a number of practical recommendations regarding patient management and the stepwise resumption of healthcare activity. These recommendations are based on the sparse, changing evidence available, and will be updated in the future according to daily needs and the availability of expendable materials to suit them; in each department they will be implemented depending upon the cumulative incidence of SARS-CoV-2 infection in each region, and the burden the pandemic has represented for each hospital. The general objectives of these recommendations include: (a)To protect our patients against the risks of infection with SARS-CoV-2 and to provide them with high-quality care. (b)To protect all healthcare professionals against the risks of infection with SARS-CoV-2. (c)To resume normal functioning of our departments in a setting of ongoing risk for infection with SARS-CoV-2.


Subject(s)
Coronavirus Infections/prevention & control , Gastroenterology/organization & administration , Hospital Departments/organization & administration , Infection Control/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Appointments and Schedules , Clinical Laboratory Techniques , Clinical Trials as Topic , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/transmission , Cross Infection/prevention & control , Diagnostic Techniques, Digestive System/instrumentation , Digestive System Diseases/complications , Digestive System Diseases/diagnosis , Digestive System Diseases/therapy , Disinfection , Drug Interactions , Equipment Contamination/prevention & control , Home Care Services/organization & administration , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Liver Transplantation , Mass Screening/organization & administration , Occupational Diseases/prevention & control , Pneumonia, Viral/drug therapy , Pneumonia, Viral/transmission , Protective Devices , Symptom Assessment , Telemedicine/organization & administration , Universal Precautions
14.
Surgery ; 168(4): 572-577, 2020 10.
Article in English | MEDLINE | ID: covidwho-645321

ABSTRACT

BACKGROUND: Resumption of elective surgery during the current coronavirus disease 2019 pandemic crisis has been debated widely and largely discouraged. The aim of this prospective cohort study was to assess the feasibility of resuming elective operations during the current and possible future peaks of this coronavirus disease 2019 pandemic. METHODS: We collected data during the peak of the current pandemic in the United Kingdom on adult patients who underwent elective surgery in a "COVID-19-free" hospital from April 8 to May 29, 2020. The study included patients from various surgical specialties. Nonelective and pediatric cases were excluded. The primary outcome was 30-day mortality postoperatively. Secondary outcomes were the rate of coronavirus disease 2019 infections, new onset of pulmonary symptoms after hospitalization, and requirement for admission to the intensive care unit. RESULTS: A total of 309 consecutive adult patients were included in this study. No patients died nor required intensive care unit admission. Operations graded "Intermediate" were the most performed procedure representing 91% of the total number. One patient was diagnosed with a coronavirus disease 2019 infection after being transferred to the nearest local emergency hospital for management of postoperative pain secondary to common bile duct stone and was successfully treated conservatively on the ward. No patient developed pulmonary complications. Three patients were admitted for greater than 23 hours. Twenty-seven patients (8.7%) developed complications. Complications graded as 2 and 3 according to the Clavien-Dindo classification occurred in 14 and 2 patients, respectively. CONCLUSION: This prospective study shows that, despite the severity and high transmissibility of novel coronavirus 2 disease, COVID-19-free hospitals can represent a safe setting to resume many types of elective surgery during the peak of a pandemic.


Subject(s)
Coronavirus Infections/prevention & control , Elective Surgical Procedures/standards , Infection Control/standards , Pandemics/prevention & control , Patient Admission/standards , Pneumonia, Viral/prevention & control , Postoperative Complications/epidemiology , Adult , Aged , Betacoronavirus/isolation & purification , Clinical Laboratory Techniques/standards , Clinical Laboratory Techniques/statistics & numerical data , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Elective Surgical Procedures/adverse effects , Feasibility Studies , Female , Hospital Mortality , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Patient Admission/statistics & numerical data , Patient Selection , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Postoperative Complications/etiology , Prospective Studies , Treatment Outcome , United Kingdom/epidemiology
15.
United European Gastroenterol J ; 8(7): 798-803, 2020 08.
Article in English | MEDLINE | ID: covidwho-630426

ABSTRACT

Since December 2019, a novel coronavirus disease, COVID-19, has occurred in China and has spread around the world rapidly. As an acute respiratory infectious disease, COVID-19 has been included in type B infectious diseases and managed according to the standard of type A infectious disease in China. Given the high risk of COVID-19 infection during endoscopic procedures via an airborne route, the Chinese Society of Digestive Endoscopy issued a series of recommendations to guide the endoscopy works in China during the pandemic. To the best of our knowledge, no new infectious case of COVID-19 resulting from endoscopic procedures has been reported in China to date. Here, these recommendations are integrated to provide guidance about the prevention of COVID-19 for endoscopists. The recommendations include advice about postponing non-urgent endoscopies, excluding the possibility of COVID-19 in patients undergoing endoscopy, protection of medical staff from coronavirus infection, and cleaning of endoscopy centres.


Subject(s)
Coronavirus Infections/prevention & control , Endoscopy, Gastrointestinal/standards , Infection Control/organization & administration , Pandemics/prevention & control , Personal Protective Equipment/standards , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Betacoronavirus/isolation & purification , Betacoronavirus/pathogenicity , China/epidemiology , Clinical Laboratory Techniques/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Endoscopy, Gastrointestinal/instrumentation , Equipment Contamination/prevention & control , Gastroenterology/methods , Gastroenterology/standards , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/therapy , Health Personnel/standards , Humans , Infection Control/instrumentation , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Operating Rooms/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Preoperative Care/standards , Societies, Medical/standards
16.
Nefrologia ; 40(4): 395-402, 2020.
Article in English, Spanish | MEDLINE | ID: covidwho-627210

ABSTRACT

The COVID-19 epidemic represents a special risk for kidney patients due to their comorbidities and advanced age, and the need for hemodialysis treatment in group rooms. It also represents a risk for professionals responsible for their attention. This manuscript contains a proposal for action to prevent infection of professionals in the Nephrology Services, one of the most valuable assets at the present time.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Health Personnel , Nephrology , Occupational Diseases/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Renal Dialysis , Coronavirus Infections/transmission , Cross Infection/prevention & control , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Occupational Exposure , Occupational Stress/prevention & control , Personal Protective Equipment , Pneumonia, Viral/transmission , Social Isolation
18.
Eur J Cancer ; 135: 159-169, 2020 08.
Article in English | MEDLINE | ID: covidwho-614144

ABSTRACT

BACKGROUND: On February 23rd, the 1st case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was diagnosed at the University Hospital Trust of Verona, Italy. On March 13th, the Oncology Section was converted into a 22-inpatient bed coronavirus disease (COVID) Unit, and we reshaped our organisation to face the SARS-CoV-2 epidemic, while maintaining oncological activities. METHODS: We tracked down (i) volumes of oncological activities (January 1st - March 31st, 2020 versus the same period of 2019), (ii) patients' and caregivers' perception and (iii) SARS-CoV-2 infection rate in oncology health professionals and SARS-CoV-2 infection-related hospital admissions of "active"' oncological patients. RESULTS: As compared with the same trimester in 2019, the overall reduction in total numbers of inpatient admissions, chemotherapy administrations and specialist visits in January-March 2020 was 8%, 6% and 3%, respectively; based on the weekly average of daily accesses, reduction in some of the oncological activities became statistically significant from week 11. The overall acceptance of adopted measures, as measured by targeted questionnaires administered to a sample of 241 outpatients, was high (>70%). Overall, 8 of 85 oncology health professionals tested positive for SARS-CoV-2 infection (all but one employed in the COVID Unit, no hospital admissions and no treatment required); among 471 patients admitted for SARS-CoV-2 infection, 7 had an "active"' oncological disease (2 died of infection-related complications). CONCLUSIONS: A slight, but statistically significant reduction in oncology activity was registered during the SARS-CoV-2 epidemic peak in Verona, Italy. Organisational and protective measures adopted appear to have contributed to keep infections in both oncological patients and health professionals to a minimum.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/prevention & control , Infection Control/organization & administration , Medical Oncology/organization & administration , Neoplasms/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Clinical Laboratory Techniques/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Female , Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Humans , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Italy/epidemiology , Male , Mass Screening/standards , Medical Oncology/methods , Neoplasms/psychology , Patient Admission/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Psychosocial Support Systems , Retrospective Studies , Risk Factors
19.
Am J Otolaryngol ; 41(5): 102618, 2020.
Article in English | MEDLINE | ID: covidwho-612482

ABSTRACT

SARS CoV 2 is very much homologous in structure to SARS CoV. Review of literature suggests the in-vitro virucidal action of povidone iodine in SARS CoV and MERS. The oropharynx and nasopharynx are target sites of SARS CoV 2. A significant proportion of COVID 19 sufferers are asymptomatic, but shedding these viral particles, PVP-I has been shown to be a safe therapy when used as a mouthwash or taken nasally or used during ophthalmic surgeries. AIMS: MATERIALS AND METHODS: 0.5% PVP-I solution is prepared from commercially available 10% PVP-I solution. Patients were instructed to put 0.5% PVP-I drops in nose and rinse mouth with gargle prior examinations for 30 s. For endoscopic procedure (nasal and throat) nasal douching and gargling to be started one day prior. Douching and rinsing to be repeated just before procedures. Nasal packing with 0.5% PVP-I along with 4% xylocaine/adrenaline solution, tolerability and any allergic reaction noted. RESULTS: The patient and health care workers tolerated the 0.5%. No allergy was noted. CONCLUSION: We propose the use of 0.5% PVP-I in healthcare workers and their patients to minimise the risk of spread of the disease in addition to the recommended PPE.


Subject(s)
Anti-Infective Agents, Local/administration & dosage , Betacoronavirus , Coronavirus Infections/prevention & control , Otolaryngology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Povidone-Iodine/administration & dosage , Administration, Intranasal , Adolescent , Adult , Ambulatory Care , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Female , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Middle Aged , Mouthwashes , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Young Adult
20.
Emerg Med Australas ; 32(5): 823-829, 2020 10.
Article in English | MEDLINE | ID: covidwho-612375

ABSTRACT

OBJECTIVE: Concerns have been raised by healthcare organisations in New Zealand that routine mask use by healthcare workers (HCW) may increase the risk of transmission of SARS-CoV-2 through increased face touching. Routine mask use by frontline HCW was not recommended when seeing 'low risk' patients. The aim of this review was to determine the carriage of respiratory viruses on facemasks used by HCW. METHODS: A systematic review was conducted with structured searches of medical and allied health databases. Two authors independently screened articles for inclusion, with substantial agreement (k = 0.66, 95% CI 0.54-0.79). Studies that at least one author recommended for full text review were reviewed in full for inclusion. Two authors independently extracted data from included studies including the setting, method of analysis and results. There was exact agreement on the proportion of virus detected on masks. RESULTS: We retrieved 1233 titles, 47 underwent full text review and five studies reported in four articles were included. The studies were limited by small numbers and failure to test all eligible masks in some studies. The proportion in each study ranged from 0 (95% CI 0-10) to 25% (95% CI 8-54). No study reported clinical respiratory illness as a result of virus on the masks. CONCLUSIONS: Although limited, current evidence suggests that viral carriage on the outer surface of surgical masks worn by HCW treating patients with clinical respiratory illness is low and there was not strong evidence to support the assumption that mask use may increase the risk of viral transmission.


Subject(s)
Coronavirus Infections/epidemiology , Health Personnel/statistics & numerical data , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Masks/virology , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Coronavirus Infections/prevention & control , Female , Humans , Incidence , Infectious Disease Transmission, Professional-to-Patient/statistics & numerical data , Male , New Zealand , Pandemics/prevention & control , Patient Safety , Pneumonia, Viral/prevention & control , Risk Assessment
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