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2.
Natl Med J India ; 33(5): 298-301, 2020.
Article in English | MEDLINE | ID: covidwho-1289146

ABSTRACT

India has the largest global burden of new cases of tuberculosis (TB) and deaths due to TB. These occur predominantly in the poor who suffer catastrophic costs during diagnosis and treatment. The National Tuberculosis Elimination Programme has ambitious goals of 80% reduction of incidence of TB, 90% reduction in mortality due to TB by 2025 and 0% occurrence of catastrophic costs to households affected by TB by 2020. The Covid-19 pandemic and the resulting disruption to TB services are expected to worsen the situation. There are gaps in case finding at the peripheral level and access to care at the higher level for patients with TB. An estimated 32% patients with active TB do not access diagnostic services, while catastrophic costs associated with hospitalization are a barrier to access for seriously ill patients. Deaths due to TB in India occur largely at home and not in medical facilities, and are preventable with appropriate inpatient care. The Ayushman Bharat scheme with its Health and Wellness Centres (HWCs) and coverage for inpatient care under the Pradhan Mantri Jan Arogya Yojana (PM-JAY) can facilitate, the achievement of the goals of TB elimination. The HWCs provide an opportunity to close the case-finding gap as first point of contact by enabling sputum transport services to the designated microscopy centres. This will facilitate case detection, reduce diagnostic delays, and decrease community transmission and the incidence of TB. The benefit package of PM-JAY can cover patients with pulmonary TB, inpatient evaluation for other forms of TB, enhance the allocation for treatment and cover management of comorbid conditions such as severe undernutrition, anaemia, HIV and diabetes.


Subject(s)
COVID-19 , Communicable Disease Control/organization & administration , Early Diagnosis , Hospitalization , Patient Care Management , Tuberculosis , Universal Health Insurance , COVID-19/epidemiology , COVID-19/prevention & control , Health Expenditures , Health Services Accessibility/standards , Health Services Accessibility/statistics & numerical data , Health Services Needs and Demand , Humans , India/epidemiology , Mortality , Patient Care Management/methods , Patient Care Management/organization & administration , Patient Care Management/trends , Public Health/methods , Public Health/trends , Quality Improvement/organization & administration , SARS-CoV-2 , Time-to-Treatment , Tuberculosis/diagnosis , Tuberculosis/economics , Tuberculosis/mortality , Tuberculosis/therapy
4.
Can J Cardiol ; 37(8): 1260-1262, 2021 08.
Article in English | MEDLINE | ID: covidwho-1252584

ABSTRACT

It is now widely recognized that COVID-19 illness can be associated with significant intermediate and potentially longer-term physical limitations. The term, "long COVID-19" is used to define any patient with persistent symptoms after acute COVID-19 infection (ie, after 4 weeks). It is postulated that cardiac injury might be linked to symptoms that persist after resolution of acute infection, as part of this syndrome. The Canadian Cardiovascular Society Rapid Response Team has generated this document to provide guidance to health care providers on the optimal management of patients with suspected cardiac complications of long COVID-19.


Subject(s)
COVID-19/complications , Cardiology , Hypoxia/therapy , Myocarditis/therapy , Patient Care Management , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19/therapy , Canada , Cardiology/methods , Cardiology/trends , Humans , Hypoxia/etiology , Myocardial Ischemia/etiology , Myocardial Ischemia/physiopathology , Myocardial Ischemia/therapy , Myocarditis/etiology , Myocarditis/physiopathology , Myocarditis/virology , Patient Care Management/methods , Patient Care Management/organization & administration , Patient Care Team/organization & administration
7.
Soc Work Health Care ; 60(2): 197-207, 2021.
Article in English | MEDLINE | ID: covidwho-1152955

ABSTRACT

Covid-19 has profoundly impacted social work and has exposed the existing inequities in the health care system in the United States. Social workers play a critical role in the pandemic response for historically marginalized communities and for those who find themselves needing support for the first time. Innovative approaches to care management, including the Center for Health and Social Care Integration (CHaSCI) Bridge Model of transitional care provides a foundation from which social workers can rise to meet these new challenges.


Subject(s)
COVID-19/epidemiology , Delivery of Health Care/organization & administration , Multiple Chronic Conditions/epidemiology , Patient Care Management/organization & administration , Social Work/organization & administration , Aged , Aged, 80 and over , Humans , Interinstitutional Relations , Mental Health Services/organization & administration , Pandemics , Patient-Centered Care/organization & administration , SARS-CoV-2 , Self-Management , Telemedicine/organization & administration , United States/epidemiology
8.
Soc Work Health Care ; 60(2): 146-156, 2021.
Article in English | MEDLINE | ID: covidwho-1142546

ABSTRACT

Primary care systems are a mainstay for how many Americans seek health and behavioral health care. It is estimated that almost a quarter of behavioral health conditions are diagnosed and/or treated in primary care. Many clinics treat the whole person through integrated models of care such as the Primary Care Behavioral Health (PCBH) model. COVID-19 has disrupted integrated care delivery and traditional PCBH workflows requiring swift adaptations. This paper synthesizes how COVID-19 has impacted clinical services at one federally qualified health center and describes how care has continued despite the challenges experienced by frontline behavioral health providers.


Subject(s)
COVID-19/epidemiology , Mental Health Services/organization & administration , Patient Care Management/organization & administration , Primary Health Care/organization & administration , Safety-net Providers/organization & administration , Appointments and Schedules , Humans , Patient Care Team , Professional Role , SARS-CoV-2 , Self Care , Telemedicine/organization & administration , Workflow
9.
J Endocrinol Invest ; 44(7): 1353-1361, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1103596

ABSTRACT

As SARS-CoV-2 stunned and overtook everyone's lives, multiple daily briefings, protocols, policies and incident command committees were mobilized to provide frontline staff with the tools, supplies and infrastructure needed to address the COVID-19 pandemic. Medical resources were immediately shifted. In light of the necessity for self-isolation, telemedicine was expanded, although there has been concern than non-pandemic disorders were being ignored. Ambulatory care services such as bone densitometry and osteoporosis centered clinics came to a near halt. Progress with fracture prevention has been challenged. Despite the prolonged pandemic and the consequent sense of exhaustion, we must re-engage with chronic bone health concerns and fracture prevention. Creating triaging systems for bone mineral testing and in person visits, treating individuals designated as high risk of fracture using fracture risk assessment tools such as FRAX, maintaining telemedicine, leveraging other bone health care team members to monitor and care for osteoporotic patients, and re-engaging our primary care colleagues will remain paramount but challenging. The pandemic persists. Thus, we will summarize what we have learned about COVID-19 and bone health and provide a framework for osteoporosis diagnosis, treatment, and follow-up with the extended COVID-19 pandemic. The goal is to preserve bone health, with focused interventions to sustain osteoporosis screening and treatment initiation/maintenance rates.


Subject(s)
COVID-19 , Osteoporosis , Patient Care Management , Absorptiometry, Photon/methods , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Osteoporosis/epidemiology , Osteoporosis/therapy , Patient Care Management/methods , Patient Care Management/organization & administration , Patient Care Management/trends , Risk Assessment/methods , SARS-CoV-2 , Telemedicine
10.
J Intern Med ; 289(4): 450-462, 2021 04.
Article in English | MEDLINE | ID: covidwho-1102058

ABSTRACT

Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic affecting all levels of health systems. This includes the care of patients with noncommunicable diseases (NCDs) who bear a disproportionate burden of both COVID-19 itself and the public health measures enacted to combat it. In this review, we summarize major COVID-19-related considerations for NCD patients and their care providers, focusing on cardiovascular, pulmonary, renal, haematologic, oncologic, traumatic, obstetric/gynaecologic, operative, psychiatric, rheumatologic/immunologic, neurologic, gastrointestinal, ophthalmologic and endocrine disorders. Additionally, we offer a general framework for categorizing the pandemic's disruptions by disease-specific factors, direct health system factors and indirect health system factors. We also provide references to major NCD medical specialty professional society statements and guidelines on COVID-19. COVID-19 and its control policies have already resulted in major disruptions to the screening, treatment and surveillance of NCD patients. In addition, it differentially impacts those with pre-existing NCDs and may lead to de novo NCD sequelae. Likely, there will be long-term effects from this pandemic that will continue to affect practitioners and patients in this field for years to come.


Subject(s)
COVID-19 , Communicable Disease Control , Noncommunicable Diseases , Patient Care Management , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/therapy , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Humans , Noncommunicable Diseases/epidemiology , Noncommunicable Diseases/therapy , Organizational Innovation , Patient Care Management/organization & administration , Patient Care Management/trends , Public Health , SARS-CoV-2
12.
Lancet Gastroenterol Hepatol ; 6(3): 199-208, 2021 03.
Article in English | MEDLINE | ID: covidwho-1065697

ABSTRACT

BACKGROUND: There are concerns that the COVID-19 pandemic has had a negative effect on cancer care but there is little direct evidence to quantify any effect. This study aims to investigate the impact of the COVID-19 pandemic on the detection and management of colorectal cancer in England. METHODS: Data were extracted from four population-based datasets spanning NHS England (the National Cancer Cancer Waiting Time Monitoring, Monthly Diagnostic, Secondary Uses Service Admitted Patient Care and the National Radiotherapy datasets) for all referrals, colonoscopies, surgical procedures, and courses of rectal radiotherapy from Jan 1, 2019, to Oct 31, 2020, related to colorectal cancer in England. Differences in patterns of care were investigated between 2019 and 2020. Percentage reductions in monthly numbers and proportions were calculated. FINDINGS: As compared to the monthly average in 2019, in April, 2020, there was a 63% (95% CI 53-71) reduction (from 36 274 to 13 440) in the monthly number of 2-week referrals for suspected cancer and a 92% (95% CI 89-95) reduction in the number of colonoscopies (from 46 441 to 3484). Numbers had just recovered by October, 2020. This resulted in a 22% (95% CI 8-34) relative reduction in the number of cases referred for treatment (from a monthly average of 2781 in 2019 to 2158 referrals in April, 2020). By October, 2020, the monthly rate had returned to 2019 levels but did not exceed it, suggesting that, from April to October, 2020, over 3500 fewer people had been diagnosed and treated for colorectal cancer in England than would have been expected. There was also a 31% (95% CI 19-42) relative reduction in the numbers receiving surgery in April, 2020, and a lower proportion of laparoscopic and a greater proportion of stoma-forming procedures, relative to the monthly average in 2019. By October, 2020, laparoscopic surgery and stoma rates were similar to 2019 levels. For rectal cancer, there was a 44% (95% CI 17-76) relative increase in the use of neoadjuvant radiotherapy in April, 2020, relative to the monthly average in 2019, due to greater use of short-course regimens. Although in June, 2020, there was a drop in the use of short-course regimens, rates remained above 2019 levels until October, 2020. INTERPRETATION: The COVID-19 pandemic has led to a sustained reduction in the number of people referred, diagnosed, and treated for colorectal cancer. By October, 2020, achievement of care pathway targets had returned to 2019 levels, albeit with smaller volumes of patients and with modifications to usual practice. As pressure grows in the NHS due to the second wave of COVID-19, urgent action is needed to address the growing burden of undetected and untreated colorectal cancer in England. FUNDING: Cancer Research UK, the Medical Research Council, Public Health England, Health Data Research UK, NHS Digital, and the National Institute for Health Research Oxford Biomedical Research Centre.


Subject(s)
COVID-19 , Colonoscopy/statistics & numerical data , Colorectal Neoplasms , Colorectal Surgery/statistics & numerical data , Early Detection of Cancer , Patient Care Management , Radiotherapy/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms/therapy , Delivery of Health Care/trends , Early Detection of Cancer/methods , Early Detection of Cancer/statistics & numerical data , England/epidemiology , Female , Health Services Needs and Demand , Humans , Male , Middle Aged , Patient Care Management/methods , Patient Care Management/organization & administration , Patient Care Management/standards , Referral and Consultation/statistics & numerical data , SARS-CoV-2 , State Medicine
13.
Am J Obstet Gynecol MFM ; 2(3): 100154, 2020 08.
Article in English | MEDLINE | ID: covidwho-1064742

ABSTRACT

The novel coronavirus disease 2019 caused by the severe acute respiratory syndrome coronavirus 2 has become a pandemic. It has quickly swept across the globe, leaving many clinicians to care for infected patients with limited information about the disease and best practices for care. Our goal is to share our experiences of caring for pregnant and postpartum women with novel coronavirus disease 2019 in New York, which is the coronavirus disease 2019 epicenter in the United States, and review current guidelines. We offer a guide, focusing on inpatient management, including testing policies, admission criteria, medical management, care for the decompensating patient, and practical tips for inpatient antepartum service management.


Subject(s)
COVID-19 Testing , COVID-19 , Delivery, Obstetric , Postnatal Care , Pregnancy Complications, Infectious , Prenatal Care , Adult , COVID-19/blood , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , COVID-19 Testing/methods , Delivery, Obstetric/methods , Delivery, Obstetric/trends , Female , Humans , Infectious Disease Transmission, Vertical/prevention & control , New York , Obstetrics and Gynecology Department, Hospital/organization & administration , Obstetrics and Gynecology Department, Hospital/trends , Patient Care Management/methods , Patient Care Management/organization & administration , Patient Care Management/trends , Postnatal Care/methods , Postnatal Care/standards , Practice Guidelines as Topic , Pregnancy , Pregnancy Complications, Infectious/blood , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/therapy , Pregnancy Complications, Infectious/virology , Prenatal Care/methods , Prenatal Care/standards , SARS-CoV-2/isolation & purification
14.
Anesth Analg ; 131(1): 86-92, 2020 07.
Article in English | MEDLINE | ID: covidwho-980006

ABSTRACT

Coronavirus disease 2019 (COVID-19) is spreading rapidly around the world with devastating consequences on patients, health care workers, health systems, and economies. As it reaches low- and middle-income countries, its effects could be even more dire, because it will be difficult for them to respond aggressively to the pandemic. There is a great shortage of all health care providers, who will be at risk due to a lack of personal protection equipment. Social distancing will be almost impossible. The necessary resources to treat patients will be in short supply. The end result could be a catastrophic loss of life. A global effort will be required to support faltering economies and health care systems.


Subject(s)
Coronavirus Infections/economics , Developing Countries , Pandemics/economics , Pneumonia, Viral/economics , Poverty , COVID-19 , Coronavirus Infections/therapy , Humans , International Cooperation , Patient Care Management/economics , Patient Care Management/organization & administration , Personal Protective Equipment , Pneumonia, Viral/therapy
16.
Res Dev Disabil ; 108: 103816, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-939236

ABSTRACT

The COVID-19 pandemic imposed dramatic changes to everyone's daily routines, but especially to children with developmental disabilities. The Robert Hollman Foundation decided not to interrupt its service to all the visually impaired children and initiated a Distance Support Project. It was an online process covering all aspects of support for the children and involving audio-video calls, videos and tailored-made multisensory material created specifically for each child. A questionnaire, carried out after the 5-month project duration, was created to collect feedback from parents and professionals to understand the impact this project had on everyone involved. Overall both parents and professionals indicated high levels of satisfaction, but in a significant number of questions parents reported consistently higher levels of satisfaction (p-value <0.001). It was shown that parents felt reassured at this otherwise very difficult time because their children were able to continue their treatment, even if in a very different way. This fact encourages us to consider enriching our existing programmes of support and care, integrating this online approach when necessary. At the same time, it seems clear that the responses of the professionals indicate their belief that the benefits of the traditional ways of working remain of unquestionable importance for children with sight deprivation.


Subject(s)
COVID-19 , Internet-Based Intervention , Patient Care Management/organization & administration , Psychosocial Support Systems , Telemedicine/methods , Visually Impaired Persons , Audiovisual Aids/trends , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Child , Family Health/trends , Female , Humans , Male , Organizational Innovation , Parents/psychology , Patient Care Management/trends , SARS-CoV-2 , Visually Impaired Persons/psychology , Visually Impaired Persons/rehabilitation
17.
Nephrology (Carlton) ; 25(11): 822-828, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-913640

ABSTRACT

AIM: The COVID-19 pandemic poses unprecedented operational challenges to nephrology divisions in every country as they cope with COVID-19-related kidney disease in addition to regular patient care. Although general approaches have been proposed, there is a lack of practical guidance for nephrology division response in a hospital facing a surge of cases. Here, we describe the specific measures that our division has taken in the hope that our experience in Singapore may be helpful to others. METHODS: Descriptive narrative. RESULTS: A compilation of operational responses to the COVID-19 pandemic taken by a nephrology division at a Singapore university hospital. CONCLUSION: Nephrology operational readiness for COVID-19 requires a clinical mindset shift from usual standard of care to a crisis exigency model that targets best outcomes for available resources. Rapid multi-disciplinary efforts that evolve flexibly with the local dynamics of the outbreak are required.


Subject(s)
Civil Defense , Coronavirus Infections , Critical Pathways/trends , Group Practice , Kidney Diseases , Pandemics , Pneumonia, Viral , Renal Insufficiency, Chronic , Betacoronavirus , COVID-19 , Civil Defense/standards , Civil Defense/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Group Practice/organization & administration , Group Practice/trends , Hospitals, University , Humans , Interdisciplinary Communication , Kidney Diseases/diagnosis , Kidney Diseases/epidemiology , Kidney Diseases/virology , Nephrology/trends , Organizational Innovation , Patient Care Management/methods , Patient Care Management/organization & administration , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/therapy , SARS-CoV-2 , Singapore/epidemiology
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