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1.
Medicine (Baltimore) ; 100(41): e27418, 2021 Oct 15.
Article in English | MEDLINE | ID: covidwho-1501202

ABSTRACT

ABSTRACT: The occurrence of COVID-19 pandemic had a significant negative effect on health care systems over the last year. Health care providers were forced to focus mainly on COVID-19 patients, neglecting in many cases equally important diseases, both acute and chronic. Therefore, also screening and diagnostic strategies for HIV could have been significantly impaired.This retrospective, multicenter, observational study aimed at assessing the number and characteristics of new HIV/AIDS diagnoses during COVID-19 pandemic in Italy and compared characteristics of people living with HIV at diagnosis between pre- and post-COVID-19 era (2019 vs 2020).Our results showed a significant reduction of HIV diagnoses during pandemic. By contrast, people living with HIV during pandemic were older and were diagnosed in earlier stage of disease (considering CD4+ T cell count) compared to those who were diagnosed the year before. Moreover, there was a significant decrease of new HIV diagnoses among men who have sex with men, probably for the impact of social distancing and restriction applied by the Italian Government. Late presentation incidence, if numbers in 2020 were lower than those in 2019, is still an issue.Routinely performing HIV testing in patients with suspected SARS-CoV-2 infection is identifying and linking to care underdiagnosed people living with HIV earlier. Thus, combined tests (HIV and SARS-CoV-2) should be implemented in patients with SARS-CoV-2 symptoms overlapping HIV's ones. Lastly, our results lastly showed how urgent implementation of a national policy for HIV screening is necessary.


Subject(s)
Delivery of Health Care/organization & administration , HIV Infections/epidemiology , Mass Screening/statistics & numerical data , Adult , CD4 Lymphocyte Count/statistics & numerical data , COVID-19/epidemiology , Cross-Sectional Studies , Female , HIV Infections/diagnosis , Humans , Italy/epidemiology , Male , Mass Screening/organization & administration , Middle Aged , Pandemics , Retrospective Studies , Risk Factors , SARS-CoV-2
2.
Elife ; 92020 06 08.
Article in English | MEDLINE | ID: covidwho-1497819

ABSTRACT

SARS-CoV-2 presents an unprecedented international challenge, but it will not be the last such threat. Here, we argue that the world needs to be much better prepared to rapidly detect, define and defeat future pandemics. We propose that a Global Immunological Observatory and associated developments in systems immunology, therapeutics and vaccine design should be at the heart of this enterprise.


Subject(s)
Communicable Disease Control/organization & administration , Communicable Diseases, Emerging/prevention & control , Coronavirus Infections/epidemiology , Disaster Planning/organization & administration , Global Health , International Cooperation , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Population Surveillance , Animals , Anti-Infective Agents , COVID-19 , Climate Change , Cohort Studies , Communicable Disease Control/methods , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/immunology , Drug Development , Forecasting , Global Health/trends , Humans , Interdisciplinary Communication , Mass Screening/organization & administration , Models, Animal , Population Surveillance/methods , Serologic Tests , Vaccines , Weather , Zoonoses
3.
J Korean Med Sci ; 36(42): e295, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1497009

ABSTRACT

BACKGROUND: To minimize nosocomial infection against coronavirus disease 2019 (COVID-19), most hospitals conduct a prescreening process to evaluate the patient or guardian of any symptoms suggestive of COVID-19 or exposure to a COVID-19 patient at entrances of hospital buildings. In our hospital, we have implemented a two-level prescreening process in the outpatient clinic: an initial prescreening process at the entrance of the outpatient clinic (PPEO) and a second prescreening process is repeated in each department. If any symptoms or epidemiological history are identified at the second level, an emergency code is announced through the hospital's address system. The patient is then guided outside through a designated aisle. In this study, we analyze the cases missed in the PPEO that caused the emergency code to be applied. METHODS: All cases reported from March 2020 to April 2021 were analyzed retrospectively. We calculated the incidence of cases missed by the PPEO per 1,000 outpatients and compared the incidence between first-time hospital visitors and those visiting for the second time or more; morning and afternoon office hours; and days of the week. RESULTS: During the study period, the emergency code was applied to 449 cases missed by the PPEO. Among those cases, 20.7% were reported in otorhinolaryngology, followed by 11.6% in gastroenterology, 5.8% in urology, and 5.8% in dermatology. Fever was the most common symptom (59.9%), followed by cough (19.8%). The incidence of cases per 1,000 outpatients was significantly higher among first-time visitors than among those visiting for the second time or more (1.77 [confidence interval (CI), 1.44-2.10] vs. 0.59 [CI, 0.52-0.65], respectively) (P < 0.001). CONCLUSION: Fever was the most common symptom missed by the PPEO, and otorhinolaryngology and gastroenterology most frequently reported missed cases. Cases missed by the PPEO were more likely to occur among first-time visitors than returning visitors. The results obtained from this study can provide insights or recommendations to other healthcare facilities in operating prescreening processes during the COVID-19 pandemic.


Subject(s)
Ambulatory Care Facilities/statistics & numerical data , COVID-19/diagnosis , COVID-19/prevention & control , Cough/etiology , Fever/etiology , Mass Screening/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Ambulatory Care , COVID-19/epidemiology , Child , Female , Humans , Incidence , Infection Control , Male , Mass Screening/organization & administration , Middle Aged , Pandemics , Young Adult
4.
Work ; 66(4): 717-729, 2020.
Article in English | MEDLINE | ID: covidwho-1435948

ABSTRACT

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


Subject(s)
Betacoronavirus/pathogenicity , COVID-19/prevention & control , Coronavirus Infections/prevention & control , Infection Control/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Workplace/organization & administration , COVID-19/epidemiology , COVID-19/transmission , COVID-19 Testing , Clinical Laboratory Techniques/standards , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Decision Making, Organizational , Disinfection/organization & administration , Disinfection/standards , Guidelines as Topic , Hand Hygiene/organization & administration , Hand Hygiene/standards , Humans , Incidence , Infection Control/methods , Infection Control/organization & administration , Mass Screening/organization & administration , Mass Screening/standards , Physical Distancing , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , SARS-CoV-2 , Telecommunications/organization & administration , Telecommunications/standards , Workplace/standards
5.
Ann Biol Clin (Paris) ; 79(4): 325-330, 2021 Aug 01.
Article in English | MEDLINE | ID: covidwho-1412311

ABSTRACT

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


Subject(s)
COVID-19 Testing , COVID-19/diagnosis , Health Personnel , Asymptomatic Infections , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing/methods , COVID-19 Testing/standards , Cross Infection/prevention & control , France/epidemiology , Guideline Adherence/organization & administration , Guideline Adherence/standards , Guideline Adherence/statistics & numerical data , Health Personnel/statistics & numerical data , Hospitals, General , Humans , Implementation Science , Infection Control/methods , Infection Control/organization & administration , Infection Control/standards , Mass Screening/methods , Mass Screening/organization & administration , Mass Screening/standards , Occupational Health Services/organization & administration , Occupational Health Services/standards , Occupational Health Services/statistics & numerical data , Return to Work/statistics & numerical data , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification
9.
Ann Ig ; 33(5): 518-520, 2021.
Article in English | MEDLINE | ID: covidwho-1296186

ABSTRACT

Abstract: Out of 38,282 passengers entering Italy at a major seaport, submitted to SARS-CoV-2 rapid antigenic test, 272 (0.6%) resulted positive and 212 (93.4%) were confirmed positive by qRT-PCR, leaving a 0.6% of false positive. Those resident in the area under control of the same Local Health Authority of the seaport were immediately submitted to isolation and investigated for contact tracing, the others notified to their Local Health Authority which did the same in the following day. This procedure was made possible by a full-time dedication of the local healthcare workers who managed all the passengers disembarking around the clock along the months of the emergency.


Subject(s)
Antigens, Viral/blood , COVID-19 Testing , COVID-19/prevention & control , Mass Screening/organization & administration , SARS-CoV-2/isolation & purification , Travel , Adult , COVID-19/diagnosis , COVID-19 Nucleic Acid Testing , Contact Tracing , Female , Health Personnel , Humans , Italy , Male , Middle Aged , Nasopharynx/virology , Retrospective Studies , SARS-CoV-2/immunology , Ships , Socioeconomic Factors , Travel-Related Illness
10.
J Microbiol Immunol Infect ; 54(1): 85-88, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1272559

ABSTRACT

As the world witnessed the rapid spread of SARS-CoV-2, the World Health Organization has called for governing bodies worldwide to intensify case findings, contact tracing, monitoring, and quarantine or isolation of contacts with COVID-19. Drive-through (DT) screening is a form of case detection which has recently gain preference globally. Proper implementation of this system can help remediate the outbreak.


Subject(s)
COVID-19/diagnosis , COVID-19/prevention & control , Mass Screening/organization & administration , COVID-19/transmission , Contact Tracing , Disease Outbreaks/prevention & control , Epidemiological Monitoring , Humans , Mass Screening/methods , Medical Records Systems, Computerized , Public Health Surveillance , Quarantine , Research Report , SARS-CoV-2/isolation & purification , World Health Organization
11.
PLoS One ; 16(6): e0253327, 2021.
Article in English | MEDLINE | ID: covidwho-1269922

ABSTRACT

BACKGROUND: The National Health Service (NHS) abdominal aortic aneurysm (AAA) screening programme (NAAASP) in England screens 65-year-old men. The programme monitors those with an aneurysm, and early intervention for large aneurysms reduces ruptures and AAA-related mortality. AAA screening services have been disrupted following COVID-19 but it is not known how this may impact AAA-related mortality, or where efforts should be focussed as services resume. METHODS: We repurposed a previously validated discrete event simulation model to investigate the impact of COVID-19-related service disruption on key outcomes. This model was used to explore the impact of delayed invitation and reduced attendance in men invited to screening. Additionally, we investigated the impact of temporarily suspending scans, increasing the threshold for elective surgery to 7cm and increasing drop-out in the AAA cohort under surveillance, using data from NAAASP to inform the population. FINDINGS: Delaying invitation to primary screening up to two years had little impact on key outcomes whereas a 10% reduction in attendance could lead to a 2% lifetime increase in AAA-related deaths. In surveillance patients, a 1-year suspension of surveillance or increase in the elective threshold resulted in a 0.4% increase in excess AAA-related deaths (8% in those 5-5.4cm at the start). Longer suspensions or a doubling of drop-out from surveillance would have a pronounced impact on outcomes. INTERPRETATION: Efforts should be directed towards encouraging men to attend AAA screening service appointments post-COVID-19. Those with AAAs on surveillance should be prioritised as the screening programme resumes, as changes to these services beyond one year are likely to have a larger impact on surgical burden and AAA-related mortality.


Subject(s)
Aortic Aneurysm, Abdominal/diagnosis , Aortic Rupture/prevention & control , COVID-19/prevention & control , Mass Screening/statistics & numerical data , Models, Statistical , Age Factors , Aged , Aortic Aneurysm, Abdominal/complications , Aortic Aneurysm, Abdominal/mortality , Aortic Aneurysm, Abdominal/surgery , Aortic Rupture/etiology , Aortic Rupture/mortality , COVID-19/epidemiology , COVID-19/transmission , Communicable Disease Control/standards , Computer Simulation , Cost of Illness , Elective Surgical Procedures/standards , Elective Surgical Procedures/statistics & numerical data , England/epidemiology , Health Policy , Humans , Male , Mass Screening/organization & administration , Mass Screening/standards , Pandemics/prevention & control , Patient Acceptance of Health Care/statistics & numerical data , Risk Assessment/statistics & numerical data , Risk Factors , Severity of Illness Index , State Medicine/standards , State Medicine/statistics & numerical data , Time-to-Treatment , Ultrasonography/standards , Ultrasonography/statistics & numerical data
12.
JCO Glob Oncol ; 7: 416-424, 2021 03.
Article in English | MEDLINE | ID: covidwho-1239918

ABSTRACT

PURPOSE: The coronavirus-induced pandemic has put great pressure on health systems worldwide. Nonemergency health services, such as cancer screening, have been scaled down or withheld as a result of travel restrictions and resources being redirected to manage the pandemic. The present article discusses the challenges to cancer screening implementation in the pandemic environment, suggesting ways to optimize services for breast, cervical, and colorectal cancer screening. METHODS: The manuscript was drafted by a team of public health specialists with expertise in implementation and monitoring of cancer screening. A scoping review of literature revealed the lack of comprehensive guidance on continuation of cancer screening in the midst of waxing and waning of infection. The recommendations in the present article were based on the advisories issued by different health agencies and professional bodies and the authors' understanding of the best practices to maintain quality-assured cancer screening. RESULTS: A well-coordinated approach is required to ensure that essential health services such as cancer management are maintained and elective services are not threatened, especially because of resource constraints. In the context of cancer screening, a few changes in invitation strategies, screening and management protocols and program governance need to be considered to fit into the new normal situation. Restoring public trust in providing efficient and safe services should be one of the key mandates for screening program reorganization. This may be a good opportunity to introduce innovations (eg, telehealth) and consider de-implementing non-evidence-based practices. It is necessary to consider increased spending on primary health care and incorporating screening services in basic health package. CONCLUSION: The article provides guidance on reorganization of screening policies, governance, implementation, and program monitoring.


Subject(s)
COVID-19 , Mass Screening/organization & administration , Neoplasms/prevention & control , Breast Neoplasms/diagnosis , Breast Neoplasms/prevention & control , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/prevention & control , Delivery of Health Care , Early Detection of Cancer , Female , Health Policy , Humans , Mass Screening/methods , Neoplasms/diagnosis , Neoplasms/therapy , Pandemics , Practice Guidelines as Topic , Telemedicine , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control
13.
Bull World Health Organ ; 99(5): 374-380, 2021 May 01.
Article in English | MEDLINE | ID: covidwho-1218472

ABSTRACT

A surge in the number of international arrivals awaiting coronavirus disease 2019 (COVID-19) screening overwhelmed health-care workers and depleted medical resources in designated hospitals in Beijing, China in March 2020. The People's Government of Beijing Municipality therefore issued a policy which required the mandatory transfer of all asymptomatic passengers arriving from a foreign country to designated quarantine hotels, and the transfer of passengers with fever or respiratory symptoms to designated hospitals. Xiaotangshan Designated Hospital, a severe acute respiratory syndrome hospital in 2003, was rapidly renovated and put into operation with the main tasks of screening and isolating symptomatic international arrivals at Beijing Capital International Airport, providing basic medical care for mild to moderate COVID-19-positive cases, and rapidly referring severe to critical COVID-19-positive cases to higher-level hospitals. During the month-long period of its operation, 2171 passengers were screened and 53 were confirmed as having COVID-19 (six severe to critical). We describe how the use of Xiaotangshan Designated Hospital in this way enabled the efficient grouping and assessment of passengers arriving from a foreign country, the provision of optimal patient care without compromising public safety and the prioritization of critically ill patients requiring life-saving treatment. The designated hospital is a successful example of the World Health Organization's recommendation to renovate existing medical infrastructures to improve the COVID-19 response capacity. The flexible design of Xiaotangshan Designated Hospital means that it can be repurposed and reopened at any time to respond to the changing pandemic conditions.


Subject(s)
Airports , COVID-19/epidemiology , COVID-19/prevention & control , Hospitals, Special/organization & administration , Mass Screening/organization & administration , China/epidemiology , Humans , Internationality , Pandemics , SARS-CoV-2 , Severity of Illness Index
15.
Bull World Health Organ ; 99(4): 280-286, 2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-1167259

ABSTRACT

By 2040, deaths from chronic viral hepatitis worldwide are projected to exceed those from human immunodeficiency virus infection, tuberculosis and malaria combined. The burden of this disease is predominantly carried by low-resource countries in Africa and Asia. In resource-rich countries, the epidemiological spread of viral hepatitis is partially driven by migrant movements from areas of high endemicity. In the last decade, Member States of the European Union and the European Economic Area have experienced an unprecedented influx of migrants, which has resulted in the polarization of political views about migration. In addition, the coronavirus disease 2019 pandemic has worsened the economic and health conditions of migrants and contributed to hostility to ensuring their health rights. Moreover, the implementation of hostile laws in some host nations has increased the vulnerability of marginalized migrant subgroups, such as asylum seekers and undocumented individuals. These developments have complicated the historical challenge of identifying high-risk migrant groups for screening and treatment. However, if European countries can apply the simplified assessment tools and diagnostic tests for viral hepatitis that have been used for decentralized screening and monitoring in resource-poor countries, the uptake of care by migrants could be dramatically increased. Given the global calls for the elimination of viral hepatitis, European nations should recognize the importance of treating this vulnerable migrant population. Political and health strategies need to be adapted to meet this challenge and help eliminate viral hepatitis globally.


Subject(s)
Disease Eradication/organization & administration , Hepatitis, Viral, Human/ethnology , Hepatitis, Viral, Human/prevention & control , Mass Screening/organization & administration , Refugees , Transients and Migrants , COVID-19/epidemiology , Developing Countries , Europe/epidemiology , Humans , Politics , SARS-CoV-2
16.
Am J Nephrol ; 52(2): 161-172, 2021.
Article in English | MEDLINE | ID: covidwho-1150270

ABSTRACT

INTRODUCTION: Renal involvement in COVID-19 is less well characterized in settings with vigilant public health surveillance, including mass screening and early hospitalization. We assessed kidney complications among COVID-19 patients in Hong Kong, including the association with risk factors, length of hospitalization, critical presentation, and mortality. METHODS: Linked electronic records of all patients with confirmed COVID-19 from 5 major designated hospitals were extracted. Duplicated records due to interhospital transferal were removed. Primary outcome was the incidence of in-hospital acute kidney injury (AKI). Secondary outcomes were AKI-associated mortality, incident renal replacement therapy (RRT), intensive care admission, prolonged hospitalization and disease course (defined as >90th percentile of hospitalization duration [35 days] and duration from symptom onset to discharge [43 days], respectively), and change of estimated glomerular filtration rate (GFR). Patients were further stratified into being symptomatic or asymptomatic. RESULTS: Patients were characterized by young age (median: 38.4, IQR: 28.4-55.8 years) and short time (median: 5, IQR: 2-9 days) from symptom onset to admission. Among the 591 patients, 22 (3.72%) developed AKI and 4 (0.68%) required RRT. The median time from symptom onset to in-hospital AKI was 15 days. AKI increased the odds of prolonged hospitalization and disease course by 2.0- and 3.5-folds, respectively. Estimated GFR 24 weeks post-discharge reduced by 7.51 and 1.06 mL/min/1.73 m2 versus baseline (upon admission) in the AKI and non-AKI groups, respectively. The incidence of AKI was comparable between asymptomatic (4.8%, n = 3/62) and symptomatic (3.7%, n = 19/519) patients. CONCLUSION: The overall rate of AKI among COVID-19 patients in Hong Kong is low, which could be attributable to a vigilant screening program and early hospitalization. Among patients who developed in-hospital AKI, the duration of hospitalization is prolonged and kidney function impairment can persist for up to 6 months post-discharge. Mass surveillance for COVID-19 is warranted in identifying asymptomatic subjects for earlier AKI management.


Subject(s)
Acute Kidney Injury/epidemiology , COVID-19 Testing , COVID-19/diagnosis , Mass Screening/organization & administration , Renal Replacement Therapy/statistics & numerical data , Acute Kidney Injury/diagnosis , Acute Kidney Injury/immunology , Acute Kidney Injury/therapy , Adult , Age Factors , Aged , COVID-19/complications , COVID-19/immunology , COVID-19/virology , Critical Care/statistics & numerical data , Early Diagnosis , Female , Glomerular Filtration Rate/immunology , Hong Kong/epidemiology , Hospital Mortality , Humans , Incidence , Length of Stay , Male , Mass Screening/statistics & numerical data , Middle Aged , Patient Discharge , Retrospective Studies , Risk Factors , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification , Severity of Illness Index
19.
Indian J Tuberc ; 67(4S): S101-S106, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1124936

ABSTRACT

Case finding, an important parameter in fight against Tuberculosis (TB) has always remained a challenge despite advances in diagnostic modalities, access to health care and administrative commitment. We are still far from reaching the goals so set as per End TB Strategy and National Strategic Plan 2017-2025, and case finding is of paramount importance for achieving the said targets. This article, after identifying the obstacles faced in case finding, explores the various case finding strategies in the perspective of diagnostics, feasibility, resource utilization and current recommendations. Need for prioritization of case finding in different settings with involvement and active participation of one and all has been discussed. Role of health education in an individual, general public and health care worker in the context of case finding has been highlighted. Research areas to strengthen case finding have been enumerated. The review concludes by bringing out the need for heightened efforts for case finding in TB as the resources are significantly diverted as the world is facing the corona virus disease 2019 (COVID-19) pandemic.


Subject(s)
COVID-19/epidemiology , Mass Screening/organization & administration , Tuberculosis/diagnosis , Humans , SARS-CoV-2 , Strategic Planning , Tuberculosis/therapy
20.
Eval Health Prof ; 44(1): 98-101, 2021 03.
Article in English | MEDLINE | ID: covidwho-1102293

ABSTRACT

A single undiagnosed COVID-19 positive patient admitted in the green zone has the potential to infect many Health Care Workers (HCWs) and other patients at any given time with resultant spread of infection and reduction in the available workforce. Despite the existing triaging strategy at the Obstetric unit of a tertiary hospital in New Delhi, where all COVID-19 suspects obstetric patients were tested and admitted in orange zone and non-suspects in green zone, asymptomatic COVID-19 positive patients were found admitted in the green zone. This was the trigger to undertake a quality improvement (QI) initiative to prevent the admission of asymptomatic COVID-19 positive patients in green zones. The QI project aimed at reducing the admission of COVID-19 positive patients in the green zone of the unit from 20% to 10% in 4 weeks' time starting 13/6/2020 by means of dynamic triaging. A COVID-19 action team was made and after an initial analysis of the problem multiple Plan-Do-Study-Act (PDSA) cycles were run to test the change ideas. The main change ideas were revised testing strategies and creating gray Zones for patients awaiting COVID-19 test results. The admission of unsuspected COVID-19 positive cases in the green zone of the unit reduced from 20% to 0% during the stipulated period. There was a significant reduction in the number of HCWs, posted in the green zone, being quarantined or test positive for COVID-19 infection as well. The authors conclude that Quality Improvement methods have the potential to develop effective strategies to prevent spread of the deadly Corona virus.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/organization & administration , Obstetrics/organization & administration , Quality Improvement/organization & administration , Triage/organization & administration , COVID-19/diagnosis , Humans , India/epidemiology , Mass Screening/organization & administration , SARS-CoV-2 , Tertiary Care Centers/organization & administration
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