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1.
Nat Hum Behav ; 5(10): 1273-1281, 2021 10.
Article in English | MEDLINE | ID: covidwho-1440475

ABSTRACT

The COVID-19 pandemic has forced teachers and parents to quickly adapt to a new educational context: distance learning. Teachers developed online academic material while parents taught the exercises and lessons provided by teachers to their children at home. Considering that the use of digital tools in education has dramatically increased during this crisis, and it is set to continue, there is a pressing need to understand the impact of distance learning. Taking a multidisciplinary view, we argue that by making the learning process rely more than ever on families, rather than on teachers, and by getting students to work predominantly via digital resources, school closures exacerbate social class academic disparities. To address this burning issue, we propose an agenda for future research and outline recommendations to help parents, teachers and policymakers to limit the impact of the lockdown on social-class-based academic inequality.


Subject(s)
COVID-19 , Communicable Disease Control/methods , Education, Distance/methods , Needs Assessment/organization & administration , Social Class , Socioeconomic Factors , COVID-19/economics , COVID-19/epidemiology , COVID-19/prevention & control , Family Characteristics , Humans , SARS-CoV-2
2.
Health Secur ; 19(S1): S41-S49, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1219235

ABSTRACT

Vulnerable refugee communities are disproportionately affected by the ongoing COVID-19 pandemic; existing longstanding health inequity in these communities is exacerbated by ineffective risk communication practices about COVID-19. Culturally and linguistically appropriate health communication following health literacy guidelines is needed to dispel cultural myths, social stigma, misinformation, and disinformation. For refugee communities, the physical, mental, and social-related consequences of displacement further complicate understanding of risk communication practices grounded in a Western cultural ethos. We present a case study of Clarkston, Georgia, the "most diverse square mile in America," where half the population is foreign born and majority refugee. Supporting marginalized communities in times of risk will require a multipronged, systemic approach to health communication including: (1) creating a task force of local leaders and community members to deal with emergent issues; (2) expanding English-language education and support for refugees; (3) including refugee perspectives on risk, health, and wellness into risk communication messaging; (4) improving cultural competence and health literacy training for community leaders and healthcare providers; and (5) supporting community health workers. Finally, better prepared public health programs, including partnerships with trusted community organizations and leadership, can ensure that appropriate and supportive risk communication and health education and promotion are in place long before the next emergency.


Subject(s)
COVID-19/therapy , Community Health Workers/organization & administration , Culturally Competent Care/organization & administration , Health Promotion/organization & administration , Health Status Indicators , Refugees/statistics & numerical data , COVID-19/epidemiology , Georgia , Humans , Needs Assessment/organization & administration
4.
Clin Otolaryngol ; 46(4): 689-691, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1191425

ABSTRACT

Remote communication in ENT has been expanding, spurred by the COVID-19 pandemic. Conferences and teaching have moved online, enabling easier participation and reducing financial and environmental costs. Online multi-disciplinary meetings have recently been instigated in Africa to discuss management of cases in head and neck cancer, or cochlear implantation, expanding access and enhancing patient care. Remote patient consultation has also seen an explosion, but existing literature suggests some caution, particularly because many patients in ENT need an examination to enable definitive diagnosis. Ongoing experience will help us to better understand how remote communication will fit into our future working lives, and also where face-to-face interaction may still be preferable.


Subject(s)
COVID-19/epidemiology , Delivery of Health Care/methods , Education, Medical/methods , Needs Assessment/organization & administration , Otolaryngology/methods , Pandemics , Remote Consultation/methods , Humans , Learning , SARS-CoV-2 , South Africa/epidemiology
5.
Telemed J E Health ; 27(1): 102-106, 2021 01.
Article in English | MEDLINE | ID: covidwho-1066235

ABSTRACT

Purpose: The vulnerability of postacute and long-term care (PA/LTC) facility residents to COVID-19 has manifested across the world with increasing facility outbreaks associated with high hospitalization and mortality rates. Systematic protocols to guide telehealth-centered interventions in response to COVID-19 outbreaks have yet to be delineated. This article is intended to inform PA/LTC facilities and neighboring health care partners how to collaboratively utilize telehealth-centered strategies to improve outcomes in facility outbreaks. Methods: The University of Virginia rapidly developed a multidisciplinary telehealth-centered COVID-19 facility outbreak strategy in response to a LTC facility outbreak in which 41 (out of 48) facility residents and 7 staff members tested positive. This strategy focused on supporting the facility team remotely using rapidly deployed technologic solutions. Goals included (1) early identification of patients who need their care escalated, (2) monitoring and treating patients deemed safe to remain in the facility, (3) care coordination to facilitate bidirectional transfers between the skilled nursing facility (SNF) and hospital, and (4) daily facility needs assessment related to technology, infection control, and staff well-being. To achieve these goals, a standardized approach centered on daily multidisciplinary virtual rounds and telemedicine consultation was provided. Results: Over a month since the outbreak began, 18 out of 48 (38%) facility residents required hospitalization and 6 (12.5%) died. Eleven facility residents have since returned back to the SNF after recovering from their hospitalization. No staff required hospitalization. Conclusions: Interventions that reduce hospitalizations and mortality are a critical need during the COVID-19 pandemic. The mortality and hospitalization rates seen in this PA/LTC facility outbreak are significantly lower than has been documented in other facility outbreaks. Our multidisciplinary approach centered on telemedicine should be considered as other PA/LTC facilities partner with neighboring health care systems in responding to COVID-19 outbreaks. We have begun replicating these services to additional PA/LTC facilities facing COVID-19 outbreaks.


Subject(s)
COVID-19/epidemiology , Remote Consultation/organization & administration , Residential Facilities/organization & administration , Subacute Care/organization & administration , Continuity of Patient Care , Humans , Infection Control/organization & administration , Needs Assessment/organization & administration , Pandemics , SARS-CoV-2 , Time Factors
6.
Anesth Analg ; 131(2): 351-364, 2020 08.
Article in English | MEDLINE | ID: covidwho-980720

ABSTRACT

Health care systems are belligerently responding to the new coronavirus disease 2019 (COVID-19). The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a specific condition, whose distinctive features are severe hypoxemia associated with (>50% of cases) normal respiratory system compliance. When a patient requires intubation and invasive ventilation, the outcome is poor, and the length of stay in the intensive care unit (ICU) is usually 2 or 3 weeks. In this article, the authors review several technological devices, which could support health care providers at the bedside to optimize the care for COVID-19 patients who are sedated, paralyzed, and ventilated. Particular attention is provided to the use of videolaryngoscopes (VL) because these can assist anesthetists to perform a successful intubation outside the ICU while protecting health care providers from this viral infection. Authors will also review processed electroencephalographic (EEG) monitors which are used to better titrate sedation and the train-of-four monitors which are utilized to better administer neuromuscular blocking agents in the view of sparing limited pharmacological resources. COVID-19 can rapidly exhaust human and technological resources too within the ICU. This review features a series of technological advancements that can significantly improve the care of patients requiring isolation. The working conditions in isolation could cause gaps or barriers in communication, fatigue, and poor documentation of provided care. The available technology has several advantages including (a) facilitating appropriate paperless documentation and communication between all health care givers working in isolation rooms or large isolation areas; (b) testing patients and staff at the bedside using smart point-of-care diagnostics (SPOCD) to confirm COVID-19 infection; (c) allowing diagnostics and treatment at the bedside through point-of-care ultrasound (POCUS) and thromboelastography (TEG); (d) adapting the use of anesthetic machines and the use of volatile anesthetics. Implementing technologies for safeguarding health care providers as well as monitoring the limited pharmacological resources are paramount. Only by leveraging new technologies, it will be possible to sustain and support health care systems during the expected long course of this pandemic.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/therapy , Critical Care/organization & administration , Delivery of Health Care, Integrated/organization & administration , Health Resources/organization & administration , Health Services Accessibility/organization & administration , Infection Control/organization & administration , Pneumonia, Viral/therapy , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Coronavirus Infections/transmission , Coronavirus Infections/virology , Health Services Needs and Demand/organization & administration , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Needs Assessment/organization & administration , Occupational Exposure/adverse effects , Occupational Exposure/prevention & control , Occupational Health , Pandemics , Patient Care Team/organization & administration , Pneumonia, Viral/diagnosis , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Point-of-Care Systems/organization & administration , Point-of-Care Testing/organization & administration , Risk Factors , SARS-CoV-2 , Severity of Illness Index
8.
Australas Psychiatry ; 29(2): 189-193, 2021 04.
Article in English | MEDLINE | ID: covidwho-969644

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 and the consequent public health and social distancing measures significantly impacted on service continuity for mental health patients. This article reports on contingency planning initiative in the Australian public sector. METHODS: Ninety-word care synopses were developed for each patient. These formed the basis for guided conversations between case managers and consultant psychiatrists to ensure safe service provision and retain a person-centred focus amidst the threat of major staffing shortfalls. RESULTS: This process identified vulnerable patient groups with specific communication needs and those most at risk through service contraction. The challenges and opportunities for promoting safety and self-management through proactive telehealth came up repeatedly. The guided conversations also raised awareness of the shared experience between patients and professionals of coronavirus disease 2019. CONCLUSION: There is a parallel pandemic of anxiety which creates a unique opportunity to connect at a human level.


Subject(s)
COVID-19/psychology , Mental Disorders/therapy , Mental Health Services , Patient Care Planning , Patient-Centered Care/methods , Telemedicine/methods , Australia , COVID-19/prevention & control , Humans , Interprofessional Relations , Mental Disorders/psychology , Mental Health Services/organization & administration , Needs Assessment/organization & administration , Patient Care Planning/organization & administration , Patient Safety , Patient-Centered Care/organization & administration , Professional-Patient Relations , Self-Management/methods , Self-Management/psychology , Telemedicine/organization & administration , Triage/methods , Triage/organization & administration
9.
J Stroke Cerebrovasc Dis ; 30(2): 105479, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-933306

ABSTRACT

INTRODUCTION: Acute stroke and acute myocardial infarction (AMI) treatments are time sensitive. Early data revealed a decrease in presentation and an increase in pre-hospital delay for acute stroke and AMI during the coronavirus disease 2019 (COVID-19) pandemic. Thus, we set out to understand community members' perception of seeking acute stroke and AMI care during the COVID-19 pandemic to inform strategies to increase cardiovascular disease preparedness during the pandemic. METHODS: Given the urgency of the clinical and public health situation, through a community-based participatory research partnership, we utilized a rapid assessment approach. We developed an interview guide and data collection form guided by the Theory of Planned Behavior (TPB). Semi-structured interviews were recorded and conducted via phone and data was collected on structured collection forms and real time transcription. Direct content analysis was conducted guided by the TPB model and responses for AMI and stroke were compared. RESULTS: We performed 15 semi-structured interviews. Eighty percent of participants were Black Americans; median age was 50; 73% were women. Participants reported concerns about coronavirus transmission in the ambulance and at the hospital, hospital capacity and ability to triage, and quality of care. Change in employment and childcare also impacted participants reported control over seeking emergent cardiovascular care. Based on these findings, our community and academic team co-created online materials to address the community-identified barriers, which has reached over 8,600 users and engaged almost 600 users. CONCLUSIONS: We found that community members' attitudes and perceived behavioral control to seek emergent cardiovascular care were impacted by the COVID-19 pandemic. Community-informed, health behavior theory-based public health messaging that address these constructs may decrease prehospital delay.


Subject(s)
COVID-19 , Community Health Services/organization & administration , Emergency Service, Hospital/organization & administration , Health Promotion/organization & administration , Myocardial Infarction/therapy , Patient Acceptance of Health Care , Stroke/therapy , Community-Based Participatory Research , Female , Health Knowledge, Attitudes, Practice , Health Services Needs and Demand/organization & administration , Humans , Male , Middle Aged , Myocardial Infarction/diagnosis , Needs Assessment/organization & administration , Quality Indicators, Health Care/organization & administration , Stroke/diagnosis , Triage/organization & administration
10.
J Transl Med ; 18(1): 390, 2020 10 15.
Article in English | MEDLINE | ID: covidwho-863645

ABSTRACT

While the COVID-19 pandemic has spurred intense research and collaborative discovery worldwide, the development of a safe, effective, and targeted antiviral from the ground up is time intensive. Therefore, most antiviral discovery efforts are focused on the re-purposing of clinical stage or approved drugs. While emerging data on drugs undergoing COVID-19 repurpose are intriguing, there is an undeniable need to develop broad-spectrum antivirals to prevent future viral pandemics of unknown origin. The ideal drug to curtail rapid viral spread would be a broad-acting agent with activity against a wide range of viruses. Such a drug would work by modulating host-proteins that are often shared by multiple virus families thereby enabling preemptive drug development and therefore rapid deployment at the onset of an outbreak. Targeting host-pathways and cellular proteins that are hijacked by viruses can potentially offer broad-spectrum targets for the development of future antiviral drugs. Such host-directed antivirals are also likely to offer a higher barrier to the development and selection of drug resistant mutations. Given that most approved antivirals do not target host-proteins, we reinforce the need for the development of such antivirals that can be used in pre- and post-exposure populations.


Subject(s)
Antiviral Agents , Betacoronavirus/drug effects , Coronavirus Infections/drug therapy , Drug Discovery , Health Services Needs and Demand , Host-Pathogen Interactions/drug effects , Pneumonia, Viral/drug therapy , Anti-Inflammatory Agents/pharmacology , Anti-Inflammatory Agents/therapeutic use , Antiviral Agents/classification , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , Betacoronavirus/genetics , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Drug Delivery Systems/methods , Drug Delivery Systems/standards , Drug Discovery/organization & administration , Drug Discovery/standards , Drug Discovery/trends , Global Health , Health Services Needs and Demand/organization & administration , Health Services Needs and Demand/standards , Health Services Needs and Demand/trends , Humans , Mutagenesis/drug effects , Needs Assessment/organization & administration , Needs Assessment/standards , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2 , Virus Internalization/drug effects
11.
Med Intensiva (Engl Ed) ; 44(6): 363-370, 2020.
Article in English, Spanish | MEDLINE | ID: covidwho-706806

ABSTRACT

In January 2020, the Chinese authorities identified a new virus of the Coronaviridae family as the cause of several cases of pneumonia of unknown aetiology. The outbreak was initially confined to Wuhan City, but then spread outside Chinese borders. On 31 January 2020, the first case was declared in Spain. On 11 March 2020, The World Health Organization (WHO) declared the coronavirus outbreak a pandemic. On 16 March 2020, there were 139 countries affected. In this situation, the Scientific Societies SEMICYUC and SEEIUC have decided to draw up this Contingency Plan to guide the response of the Intensive Care Services. The objectives of this plan are to estimate the magnitude of the problem and identify the necessary human and material resources. This is to provide the Spanish Intensive Medicine Services with a tool to programme optimal response strategies.


Subject(s)
Betacoronavirus , Coronavirus Infections/therapy , Critical Care/organization & administration , Needs Assessment/organization & administration , Pneumonia, Viral/therapy , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Critical Care/standards , Cross Infection/prevention & control , Health Resources/organization & administration , Humans , Information Dissemination/methods , Intensive Care Units/organization & administration , Needs Assessment/statistics & numerical data , Pandemics/prevention & control , Patient Admission/standards , Personal Protective Equipment/standards , Personnel Staffing and Scheduling , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Resource Allocation/methods , Resource Allocation/organization & administration , SARS-CoV-2 , Software , Spain/epidemiology , Staff Development/organization & administration
14.
J Stroke Cerebrovasc Dis ; 29(8): 104927, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-350500

ABSTRACT

BACKGROUND AND PURPOSE: The COVID-19 pandemic has required the adaptation of hyperacute stroke care (including stroke code pathways) and hospital stroke management. There remains a need to provide rapid and comprehensive assessment to acute stroke patients while reducing the risk of COVID-19 exposure, protecting healthcare providers, and preserving personal protective equipment (PPE) supplies. While the COVID infection is typically not a primary cerebrovascular condition, the downstream effects of this pandemic force adjustments to stroke care pathways to maintain optimal stroke patient outcomes. METHODS: The University of California San Diego (UCSD) Health System encompasses two academic, Comprehensive Stroke Centers (CSCs). The UCSD Stroke Center reviewed the national COVID-19 crisis and implications on stroke care. All current resources for stroke care were identified and adapted to include COVID-19 screening. The adjusted model focused on comprehensive and rapid acute stroke treatment, reduction of exposure to the healthcare team, and preservation of PPE. AIMS: The adjusted pathways implement telestroke assessments as a specific option for all inpatient and outpatient encounters and accounts for when telemedicine systems are not available or functional. COVID screening is done on all stroke patients. We outline a model of hyperacute stroke evaluation in an adapted stroke code protocol and novel methods of stroke patient management. CONCLUSIONS: The overall goal of the model is to preserve patient access and outcomes while decreasing potential COVID-19 exposure to patients and healthcare providers. This model also serves to reduce the use of vital PPE. It is critical that stroke providers share best practices via academic and vetted social media platforms for rapid dissemination of tools and care models during the COVID-19 crisis.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/therapy , Delivery of Health Care, Integrated/organization & administration , Health Services Needs and Demand/organization & administration , Needs Assessment/organization & administration , Neurology/organization & administration , Pneumonia, Viral/therapy , Stroke/therapy , Academic Medical Centers , COVID-19 , California , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Critical Pathways/organization & administration , Host-Pathogen Interactions , Humans , Infection Control/organization & administration , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Models, Organizational , Occupational Exposure/adverse effects , Occupational Exposure/prevention & control , Occupational Health , Pandemics , Patient Safety , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Risk Assessment , Risk Factors , SARS-CoV-2 , Stroke/diagnosis , Stroke/epidemiology , Time Factors
15.
AAPS PharmSciTech ; 21(5): 153, 2020 May 24.
Article in English | MEDLINE | ID: covidwho-343702

ABSTRACT

The supply of affordable, high-quality pharmaceuticals to US patients has been on a critical path for decades. In and beyond the COVID-19 pandemic, this critical path has become tortuous. To regain reliability, reshoring of the pharmaceutical supply chain to the USA is now a vital national security need. Reshoring the pharmaceutical supply with old know-how and outdated technologies that cause inherent unpredictability and adverse environmental impact will neither provide the security we seek nor will it be competitive and affordable. The challenge at hand is complex akin to redesigning systems, including corporate and public research and development, manufacturing, regulatory, and education ones. The US academic community must be engaged in progressing solutions needed to counter emergencies in the COVID-19 pandemic and in building new methods to reshore the pharmaceutical supply chain beyond the pandemic.


Subject(s)
Antiviral Agents/supply & distribution , Betacoronavirus/drug effects , Civil Defense/organization & administration , Coronavirus Infections/therapy , Health Services Needs and Demand/organization & administration , Needs Assessment/organization & administration , Pandemics , Pneumonia, Viral/therapy , Viral Vaccines/supply & distribution , Antiviral Agents/economics , Betacoronavirus/pathogenicity , COVID-19 , COVID-19 Vaccines , Civil Defense/economics , Coronavirus Infections/drug therapy , Coronavirus Infections/economics , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/virology , Drug Costs , Health Services Needs and Demand/economics , Humans , Needs Assessment/economics , Pandemics/economics , Pneumonia, Viral/economics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2 , United States , Viral Vaccines/economics
16.
J Stroke Cerebrovasc Dis ; 29(8): 104980, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-343178

ABSTRACT

BACKGROUND: The COVID-19 pandemic has presented unprecedented challenges to healthcare organizations worldwide. A steadily rising number of patients requiring intensive care, a large proportion from racial and ethnic minorities, demands creative solutions to provide high-quality care while ensuring healthcare worker safety in the face of limited resources. Boston Medical Center has been particularly affected due to the underserved patient population we care for and the increased risk of ischemic stroke in patients with COVID-19 infection. METHODS: We present protocol modifications developed to manage patients with acute ischemic stroke in a safe and effective manner while prioritizing judicious use of personal protective equipment and intensive care unit resources. CONCLUSION: We feel this information will benefit other organizations facing similar obstacles in caring for the most vulnerable patient populations during this ongoing public health crisis.


Subject(s)
Betacoronavirus/pathogenicity , Brain Ischemia/virology , Coronavirus Infections/therapy , Endovascular Procedures , Health Services Needs and Demand/organization & administration , Needs Assessment/organization & administration , Pneumonia, Viral/therapy , Radiography, Interventional , Stroke/therapy , Thrombolytic Therapy , Boston , Brain Ischemia/diagnosis , Brain Ischemia/epidemiology , COVID-19 , Clinical Decision-Making , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Critical Pathways/organization & administration , Endovascular Procedures/adverse effects , Host Microbial Interactions , Humans , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Radiography, Interventional/adverse effects , Risk Assessment , Risk Factors , SARS-CoV-2 , Stroke/diagnosis , Stroke/epidemiology , Thrombolytic Therapy/adverse effects , Treatment Outcome , Triage/organization & administration
17.
J Med Ethics ; 46(7): 436-440, 2020 07.
Article in English | MEDLINE | ID: covidwho-271465

ABSTRACT

As the COVID-19 pandemic impacts on health service delivery, health providers are modifying care pathways and staffing models in ways that require health professionals to be reallocated to work in critical care settings. Many of the roles that staff are being allocated to in the intensive care unit and emergency department pose additional risks to themselves, and new policies for staff reallocation are causing distress and uncertainty to the professionals concerned. In this paper, we analyse a range of ethical issues associated with changes to staff allocation processes in the face of COVID-19. In line with a dominant view in the medical ethics literature, we claim, first, that no individual health professional has a specific, positive obligation to treat a patient when doing so places that professional at risk of harm, and so there is a clear ethical tension in any reallocation process in this context. Next, we argue that the changing asymmetries of health needs in hospitals means that careful consideration needs to be given to a stepwise process for deallocating staff from their usual duties. We conclude by considering how a justifiable process of reallocating professionals to high-risk clinical roles should be configured once those who are 'fit for reallocation' have been identified. We claim that this process needs to attend to three questions that we consider in detail: (1) how the choice to make reallocation decisions is made, (2) what justifiable models for reallocation might look like and (3) what is owed to those who are reallocated.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Health Care Rationing/ethics , Health Personnel/ethics , Health Personnel/organization & administration , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Betacoronavirus , COVID-19 , Health Care Rationing/organization & administration , Humans , Needs Assessment/ethics , Needs Assessment/organization & administration , Pandemics , Personnel Staffing and Scheduling/ethics , Personnel Staffing and Scheduling/organization & administration , Professional Role , Risk Factors , SARS-CoV-2 , Volunteers
18.
Andrology ; 9(1): 10-18, 2021 01.
Article in English | MEDLINE | ID: covidwho-155103

ABSTRACT

The prolonged lockdown of health facilities providing non-urgent gamete cryopreservation-as currently recommended by many reproductive medicine entities and regulatory authorities due to the SARS-CoV-2 pandemic will be detrimental for subgroups of male infertility patients. We believe the existing recommendations should be promptly modified and propose that the same permissive approach for sperm banking granted for men with cancer is expanded to other groups of vulnerable patients. These groups include infertility patients (eg, azoospermic and cryptozoospermic) undergoing medical or surgical treatment to improve sperm quantity and quality, as well as males of reproductive age affected by inflammatory and systemic auto-immune diseases who are about to start treatment with gonadotoxic drugs or who are under remission. In both scenarios, the "fertility window" may be transitory; postponing diagnostic semen analysis and sperm banking in these men could compromise the prospects of biological parenthood. Moreover, we provide recommendations on how to continue the provision of andrological services in a considered manner and a safe environment. Our opinion is timely and relevant given the fact that fertility services are currently rated as of low priority in most countries.


Subject(s)
Andrology/organization & administration , COVID-19 , Health Services Accessibility/organization & administration , Health Services Needs and Demand/organization & administration , Infertility, Male/therapy , Needs Assessment/organization & administration , Humans , Infertility, Male/diagnosis , Infertility, Male/physiopathology , Male
20.
J Thorac Cardiovasc Surg ; 160(2): 601-605, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-46092

ABSTRACT

The extraordinary demands of managing the COVID-19 pandemic has disrupted the world's ability to care for patients with thoracic malignancies. As a hospital's COVID-19 population increases and hospital resources are depleted, the ability to provide surgical care is progressively restricted, forcing surgeons to prioritize among their cancer populations. Representatives from multiple cancer, surgical, and research organizations have come together to provide a guide for triaging patients with thoracic malignancies as the impact of COVID-19 evolves as each hospital.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/therapy , Delivery of Health Care, Integrated/organization & administration , Pneumonia, Viral/therapy , Thoracic Neoplasms/surgery , Thoracic Surgical Procedures , Triage/organization & administration , COVID-19 , Clinical Decision-Making , Consensus , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , Health Services Needs and Demand/organization & administration , Host Microbial Interactions , Humans , Needs Assessment/organization & administration , Occupational Health , Pandemics , Patient Safety , Patient Selection , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Risk Assessment , Risk Factors , SARS-CoV-2 , Thoracic Neoplasms/epidemiology , Thoracic Surgical Procedures/adverse effects , Time-to-Treatment
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