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1.
Ann Intern Med ; 174(2): JC14, 2021 02.
Article in English | MEDLINE | ID: covidwho-1110692

ABSTRACT

SOURCE CITATION: Lynch JB, Davitkov P, Anderson DJ, et al. Infectious Diseases Society of America guidelines on infection prevention for health care personnel caring for patients with suspected or known COVID-19. Clin Infect Dis. 2020. [Epub ahead of print.] 32716496.


Subject(s)
/prevention & control , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Occupational Health , Personal Protective Equipment , Practice Guidelines as Topic , Humans , Societies, Medical , United States
2.
BMJ Open ; 11(2): e043837, 2021 02 22.
Article in English | MEDLINE | ID: covidwho-1096994

ABSTRACT

OBJECTIVES: Healthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty. SETTING: Our tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless. PARTICIPANTS: We recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone. RESULTS: Between 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment. CONCLUSION: A multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.


Subject(s)
Infectious Disease Transmission, Patient-to-Professional , Medical Staff, Hospital , Occupational Diseases , Adult , /prevention & control , /transmission , Developing Countries , Female , Hospitals, University/organization & administration , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Male , Medical Staff, Hospital/statistics & numerical data , Models, Organizational , Occupational Diseases/epidemiology , Occupational Diseases/prevention & control , Organizational Policy , Personal Protective Equipment , Prospective Studies , Risk Assessment , Tertiary Care Centers/organization & administration
4.
MMWR Morb Mortal Wkly Rep ; 70(7): 250-253, 2021 Feb 19.
Article in English | MEDLINE | ID: covidwho-1089244

ABSTRACT

Certain hazard controls, including physical barriers, cloth face masks, and other personal protective equipment (PPE), are recommended to reduce coronavirus 2019 (COVID-19) transmission in the workplace (1). Evaluation of occupational hazard control use for COVID-19 prevention can identify inadequately protected workers and opportunities to improve use. CDC's National Institute for Occupational Safety and Health used data from the June 2020 SummerStyles survey to characterize required and voluntary use of COVID-19-related occupational hazard controls among U.S. non-health care workers. A survey-weighted regression model was used to estimate the association between employer provision of hazard controls and voluntary use, and stratum-specific adjusted risk differences (aRDs) among workers reporting household incomes <250% and ≥250% of national poverty thresholds were estimated to assess effect modification by income. Approximately one half (45.6%; 95% confidence interval [CI] = 41.0%-50.3%) of non-health care workers reported use of hazard controls in the workplace, 55.5% (95% CI = 48.8%-62.2%) of whom reported employer requirements to use them. After adjustment for occupational group and proximity to others at work, voluntary use was approximately double, or 22.3 absolute percentage points higher, among workers who were provided hazard controls than among those who were not. This effect was more apparent among lower-income (aRD = 31.0%) than among higher-income workers (aRD = 16.3%). Employers can help protect workers from COVID-19 by requiring and encouraging use of occupational hazard controls and providing hazard controls to employees (1).


Subject(s)
/prevention & control , Mandatory Programs/statistics & numerical data , Occupational Diseases/prevention & control , Occupational Health/statistics & numerical data , Voluntary Programs/statistics & numerical data , Adolescent , Adult , Architectural Accessibility/statistics & numerical data , Female , Humans , Male , Masks/statistics & numerical data , Middle Aged , Personal Protective Equipment/statistics & numerical data , Surveys and Questionnaires , United States/epidemiology , Workplace/statistics & numerical data , Young Adult
5.
BMJ Case Rep ; 14(2)2021 Feb 17.
Article in English | MEDLINE | ID: covidwho-1088211

ABSTRACT

Placement of a double-lumen tube to achieve one lung ventilation is an aerosol-generating procedure. Performing it on a patient with COVID-19 will put healthcare workers at high risk of contracting the disease. We herein report a case of its use in a patient with traumatic diaphragmatic rupture, who was also suspected to have COVID-19. This article aims to highlight the issues, it presented and ways to address them as well as the perioperative impact of personal protective equipment.


Subject(s)
/prevention & control , Health Personnel/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , One-Lung Ventilation/standards , Personal Protective Equipment/standards , Accidents, Traffic , Adult , /transmission , Diaphragm/injuries , Diaphragm/surgery , Humans , Male , One-Lung Ventilation/instrumentation , Practice Guidelines as Topic , /etiology , Rupture/etiology , Rupture/therapy
7.
Isr Med Assoc J ; 23(2): 76-81, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1085727

ABSTRACT

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic presented a major medical management challenge to ophthalmology departments throughout Israel. OBJECTIVES: To examine the managerial challenges, actions taken, and insights of directors of ophthalmology departments in Israel during the COVID-19 pandemic. METHODS: We conducted a cross sectional survey of directors of ophthalmology departments during the COVID-19 pandemic while the Israeli population was quarantined. RESULTS: All 21 directors answered the survey. The majority of the COVID-19 admissions were located in the center of Israel (53%) and Jerusalem (30%). E-communication took a central role in coping with the pandemic with 80% of the directors satisfied with this form of communication; 75% reported a reduction in clinical and surgery volume of at least 25%, and 40% reported reallocations of manpower. Most of the medical staff used gloves, a face shield, disposable robe, and a mask with no uniformity across departments. Cross satisfaction was noted regarding a hospital's ability to equip the departments. Lack of preparation for post-pandemic era was reported by all directors, but one (95%). Directors sought guidelines and uniformity regarding outpatient referral to the hospital (p = 0.035). CONCLUSIONS: Guidelines via safe digital platforms aid in management decisions and uniformity across departments. Advanced preparation is needed to prevent adverse clinical outcomes and to maintain treatment continuum. Our results can be used to guide and help improve the preparedness of ophthalmology departments during COVID-19 and for future pandemics.


Subject(s)
Hospital Departments/organization & administration , Ophthalmology/organization & administration , Personal Protective Equipment/statistics & numerical data , Practice Guidelines as Topic , Adult , Communication , Cross-Sectional Studies , Disposable Equipment/statistics & numerical data , Gloves, Protective/statistics & numerical data , Hospital Departments/standards , Humans , Israel , Masks/statistics & numerical data , Middle Aged , Personal Protective Equipment/supply & distribution , Quarantine , Referral and Consultation , Surveys and Questionnaires
8.
BMJ Open Qual ; 10(1)2021 02.
Article in English | MEDLINE | ID: covidwho-1085260

ABSTRACT

The surge in clinical demand, shortage in personal protective equipment and high-exposure risk for healthcare workers during the COVID-19 pandemic has challenged hospital common practices and forced a reassessment of care delivery models. Code blue teams are highly specialised units that partake in life-saving situations that can jeopardise the safety of team members. There is a paucity of guidance in regards to proper infection control measures to protect the responders.This study describes a methodical approach to assessing vulnerabilities to transmission of SARS-CoV-2 within existing code blue practices, modalities to limit the number of code blue team responders and modifications to the protocol at a large community teaching hospital. The effort undertaken faced challenges due to the nature of the pandemic and the increased demand on healthcare workers. Quality improvement methods facilitated our protocol design and implementation. To this date, there has been no identified COVID-19 disease in any protected code blue (PCB) team members. We recommend that similar practices be considered and adopted widely and practised periodically.


Subject(s)
/prevention & control , Health Personnel/education , Hospital Rapid Response Team/standards , Infection Control/standards , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Adult , Female , Focus Groups , Health Personnel/standards , Hospitals, Teaching , Humans , Infection Control/methods , Male , Middle Aged , Personal Protective Equipment , Quality Improvement
9.
BMC Fam Pract ; 22(1): 36, 2021 02 14.
Article in English | MEDLINE | ID: covidwho-1081417

ABSTRACT

BACKGROUND: The COVID-19 pandemic has shaken the world in early 2020. In France, General Practitioners (GPs) were not involved in the care organization's decision-making process before and during the first wave of the COVID-19 pandemic. This omission could have generated stress for GPs. We aimed first to estimate the self-perception of stress as defined by the 10-item Perceived Stress Score (PSS-10), at the beginning of the pandemic in France, among GPs from the Auvergne-Rhône-Alpes, a french administrative area severely impacted by COVID-19. Second, we aimed to identify factors associated with a self-perceived stress (PSS-10 ≥ 27) among socio-demographic characteristics of GPs, their access to reliable information and to personal protective equipment during the pandemic, and their exposure to well established psychosocial risk at work. METHODS: We conducted an online cross-sectional survey between 8th April and 10th May 2020. The self-perception of stress was evaluated using the PSS-10, so to see the proportion of "not stressed" (≤20), "borderline" (21 ≤ PSS-10 ≤ 26), and "stressed" (≥27) GPs. The agreement to 31 positive assertions related to possible sources of stress identified by the scientific study committee was measured using a 10-point numeric scale. In complete cases, factors associated with stress (PSS-10 ≥ 27) were investigated using logistic regression, adjusted on gender, age and practice location. A supplementary analysis of the verbatims was made. RESULTS: Overall, 898 individual answers were collected, of which 879 were complete. A total of 437 GPs (49%) were stressed (PSS-10 ≥ 27), and 283 GPs (32%) had a very high level of stress (PSS-10 ≥ 30). Self-perceived stress was associated with multiple components, and involved classic psychosocial risk factors such as emotional requirements. However, in this context of health crisis, the primary source of stress was the diversity and quantity of information from diverse sources (614 GPs (69%, OR = 2.21, 95%CI [1.40-3.50], p < 0.001). Analysis of verbatims revealed that GPs felt isolated in a hospital-based model. CONCLUSION: The first wave of the pandemic was a source of stress for GPs. The diversity and quantity of information received from the health authorities were among the main sources of stress.


Subject(s)
Communicable Disease Control , General Practitioners , Occupational Exposure , Occupational Health/trends , Self Concept , Stress, Psychological , Adult , Attitude of Health Personnel , /prevention & control , Communicable Disease Control/instrumentation , Communicable Disease Control/organization & administration , Cross-Sectional Studies , Diagnostic Self Evaluation , Disease Transmission, Infectious/prevention & control , Female , France/epidemiology , General Practitioners/psychology , General Practitioners/statistics & numerical data , Humans , Male , Occupational Exposure/adverse effects , Occupational Exposure/prevention & control , Personal Protective Equipment/supply & distribution , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/etiology
10.
AAPS PharmSciTech ; 22(2): 72, 2021 Feb 11.
Article in English | MEDLINE | ID: covidwho-1081268

ABSTRACT

Since January 2020, the World Health Organization announces COVID-19 outbreak a case of public health emergency of international interest, and declaring it a pandemic on March. Due to the high transmission of this disease, rate precautions have been implemented, such as the use of masks by the population, personal protective equipment (PPE), and safety protocols, mainly to health workers. Thus, we performed a patent review to evaluate the current patents related to the protective mask. The review was carried out in the patent database in the period of May 2019 to May 2020. After the process of screening and eligibility, 563 patents were selected for our analysis according to the aim of the study which used masks such as a PPE against dust particles and pathogens, mostly when it is about airborne transmission, such as viruses and bacteria. Here, an overview of the main materials used in the mask manufacturing and their efficiency was described. The results of the review showed that most of the masks used cotton, nylon, silver fiber fabrics, among others as fabrics to develop the masks. It also makes an analysis of masks composed of nanotechnology which provide high filtration efficiency. Moreover, the review also brought possibilities of masking the population, which already have been done in countries such as China and Korea and ways of sterilization for reuse of PPE during COVID-19 outbreak. Thus, this review can further researchers in the developing of masks to decrease the spread of a pandemic disease. Graphical abstract.


Subject(s)
Masks , Pandemics , Patients , Personal Protective Equipment , Databases, Factual , Humans
11.
Int J Environ Res Public Health ; 18(4)2021 02 08.
Article in English | MEDLINE | ID: covidwho-1079658

ABSTRACT

BACKGROUND: During the SARS-CoV-2 pandemic, there was shortage of the standard respiratory protective equipment (RPE). The aim of this study was to develop a procedure to test the performance of alternative RPEs used in the care of COVID-19 patients. METHODS: A laboratory-based test was developed to compare RPEs by total inward leakage (TIL). We used a crossflow nebulizer to produce a jet spray of 1-100 µm water droplets with a fluorescent marker. The RPEs were placed on a dummy head and sprayed at distances of 30 and 60 cm. The outcome was determined as the recovery of the fluorescent marker on a membrane filter placed on the mouth of the dummy head. RESULTS: At 30 cm, a type IIR surgical mask gave a 17.7% lower TIL compared with an FFP2 respirator. At 60 cm, this difference was similar, with a 21.7% lower TIL for the surgical mask compared to the respirator. When adding a face shield, the TIL at 30 cm was further reduced by 9.5% for the respirator and 16.6% in the case of the surgical mask. CONCLUSIONS: A safe, fast and very sensitive test method was developed to assess the effectiveness of RPE by comparison under controlled conditions.


Subject(s)
/prevention & control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Masks/standards , Personal Protective Equipment/standards , Respiratory Protective Devices/standards , Aerosols/adverse effects , Humans , Occupational Exposure/prevention & control , Ventilators, Mechanical , Water
12.
J Orthop Surg (Hong Kong) ; 29(1): 2309499020988176, 2021.
Article in English | MEDLINE | ID: covidwho-1079201

ABSTRACT

PURPOSE: In this study we investigated on the personal protective equipment (PPE) usage, recycling, and disposal among spine surgeons in the Asia Pacific region. METHODS: A cross-sectional survey was carried out among spine surgeons in Asia Pacific. The questionnaires were focused on the usage, recycling and disposal of PPE. RESULTS: Two hundred and twenty-two surgeons from 19 countries participated in the survey. When we sub-analysed the differences between countries, the provision of adequate PPE by hospitals ranged from 37.5% to 100%. The usage of PPE was generally high. The most used PPE were surgical face masks (88.7%), followed by surgical caps (88.3%), gowns (85.6%), sterile gloves (83.3%) and face shields (82.0%). The least used PPE were powered air-purifying respirators (PAPR) (23.0%) and shoes/boots (45.0%). The commonly used PPE for surgeries involving COVID-19 positive patients were N95 masks (74.8%), sterile gloves (73.0%), gowns (72.1%), surgical caps (71.6%), face shields (64.4%), goggles (64.0%), shoe covers (58.6%), plastic aprons (45.9%), shoes/boots (45.9%), surgical face masks (36.5%) and PAPRs (21.2%). Most PPE were not recycled. Biohazard bins were the preferred method of disposal for all types of PPE items compared to general waste. CONCLUSIONS: The usage of PPE was generally high among most countries especially for surgeries involving COVID-19 positive patients except for Myanmar and Nepal. Overall, the most used PPE were surgical face masks. For surgeries involving COVID-19 positive patients, the most used PPE were N95 masks. Most PPE were not recycled. Biohazard bins were the preferred method of disposal for all types of PPE.


Subject(s)
/epidemiology , Disease Transmission, Infectious/prevention & control , Orthopedics , Personal Protective Equipment/statistics & numerical data , Societies, Medical , Spinal Diseases/surgery , Asia , Comorbidity , Cross-Sectional Studies , Humans , Pandemics , Spinal Diseases/epidemiology , Surveys and Questionnaires
13.
Cir Cir ; 89(1): 4-11, 2021.
Article in English | MEDLINE | ID: covidwho-1077009

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) outbreak have major implications in conventional surgical practice. As the number of patients with this diagnosis is rising, the infection risk for the surgical staff will be higher. Few publications have addressed the surgical management of patients diagnosed with COVID-19. Objective: To assess recommendations for care of patients and surgical team during the COVID-19 pandemic. Method: MEDLINE, Embase and the Cochrane Database of Systematic Reviews (April 2020) were searched the key words "COVID-19", "PROTOCOL" and "SURGERY". Relevant recommendations, guidelines and cases series were checked for the most accurate information for apply to our center. Results: We found 379 papers that included the key words. A total of 25 papers were included in the manuscript based in the pertinence of the recommendations. Three major topics were selected: perioperative, intraoperative and postoperative. Conclusion: As an attempt to regulate the surgical team approach, we present recommendations to preserve patients and surgical staff safety with high quality standards of care through reproducible strategies applicable in most hospital centers.


Subject(s)
/prevention & control , Cross Infection/prevention & control , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Pandemics , Aerosols , Air Pollution, Indoor , Appointments and Schedules , Disinfection/methods , Equipment Contamination/prevention & control , Humans , Mexico , Occupational Exposure , Operating Rooms , Patient Isolation , Perioperative Care , Personal Protective Equipment , Personnel, Hospital , Recovery Room , Sterilization/methods , Surgical Equipment
14.
Saudi Med J ; 42(2): 166-169, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1076930

ABSTRACT

OBJECTIVES: To avoid hospital spread of Coronavirus-2019 (COVID-19) and to analyze out of hospital outcomes after amputation. METHODS: Prospective analysis of data obtained from 60 diabetic patients in 2020 was performed at Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina. Personal protection equipment included double surgical mask, glasses, disposable surgical coats, and surgical masks for patients. Swabs were used to take samples from wounds. We randomly divided patients in 2 groups of 30 patients each. In pre-operative treatment, we used local anesthesia lidocaine hydrochloride 2% (Belupo, Koprivnica, Croatia) in group A and systemic analgesia intravenous tramadol chloride 100 mg intravenous (Krka, Novo Mesto, Slovenia) in group B. Wounds were surgically treated each day and heal spontaneously. Periodical control exams were performed. RESULTS: Wound healing did not present any statistically significant differences between groups (group A: 69±21.97 and B: 61±22.13 days, t=-1.22; p=0.11). No statistically significant differences (p<0.05) between groups A and B in wound healing regarding to gender or cigarette use was noted. CONCLUSION: No significant differences in amputation treatment between the 2 comparative groups were noted. No confirmed COVID-19 infections in medical staff who performed surgical interventions or in treated patients were detected.


Subject(s)
Amputation , Diabetic Foot/surgery , Infection Control/methods , Perioperative Care/methods , Bosnia and Herzegovina/epidemiology , /epidemiology , Diabetic Foot/complications , Female , Humans , Infection Control/instrumentation , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Male , Pandemics , Personal Protective Equipment , Prospective Studies , Treatment Outcome , Wound Healing
15.
Biomed Instrum Technol ; 54(6): 410-416, 2020 Nov 01.
Article in English | MEDLINE | ID: covidwho-1076411

ABSTRACT

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged healthcare providers in maintaining the supply of critical personal protective equipment, including single-use respirators and surgical masks. Single-use respirators and surgical masks can reduce risks from the inhalation of airborne particles and microbial contamination. The recent high-volume demand for single-use respirators and surgical masks has resulted in many healthcare facilities considering processing to address critical shortages. The dry heat process of 80°C (176°F) for two hours (120 min) has been confirmed to be an appropriate method for single-use respirator and surgical mask processing.


Subject(s)
/prevention & control , Decontamination/methods , Equipment Reuse , Hot Temperature , Masks , Humans , Pandemics , Personal Protective Equipment/supply & distribution
16.
PLoS One ; 16(2): e0245885, 2021.
Article in English | MEDLINE | ID: covidwho-1076261

ABSTRACT

BACKGROUND: During the catastrophic situation of the COVID-19 pandemic, the role of the health care workers (HCWs) is the most crucial, and their absenteeism, whether due to inability or unwillingness, becomes a major concern for the national health system. Hence, the present study aimed to determine the willingness and its associated factors to work during the COVID-19 pandemic among the physicians of Bangladesh. METHODS: This was a cross-sectional study conducted from April 21 to May 10, 2020, using an online survey among the Bangladeshi physicians living in the country. Both univariate and multivariable binary logistic regression models were used to determine the predictors of the willingness of the physicians to work during the COVID-19 pandemic. RESULTS: More than 69% physicians reported that they were willing to work during the COVID-19 pandemic, 8.9% reported that they were not willing, while 21.4% of participants were not sure about their willingness. Younger age, having experience of treating patients during previous pandemics, working in the emergency departments and high self-reported compliance to the recommended PPE were important predictors of being willing to work during COVID-19 pandemic. Concern for family and risk of transmitting the infection to family members were most commonly reported as major barriers of working during the pandemic (30%) followed by having comorbidities (25%), lack of adequate safety measures (25%), fear of being infected (12.2%), not involved in clinical practice (12.5%) etc. CONCLUSIONS: Though the majority of the physicians were willing to work during the COVID-19 pandemic, sufficient supply of PPE, support to maintain recommended quarantine and isolation policy after risky hospital duty along with adequate and effective training can increase their willingness to continue their sacred duty during this crucial pandemic.


Subject(s)
Pandemics , Physicians/psychology , Adult , Attitude of Health Personnel , Bangladesh/epidemiology , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Personal Protective Equipment , Risk , Surveys and Questionnaires , Work
17.
Ann R Coll Surg Engl ; 103(2): e44-e47, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1073076

ABSTRACT

Surgical tracheostomy is a high aerosol-generating procedure that is an essential aid to the recovery of patients who are critically ill with COVID-19 pneumonia. We present a single-centre case series of 16 patients with COVID-19 pneumonia who underwent tracheostomy. We recommend that the patient selection criteria for achieving a favourable outcome should be based on fraction of inspired oxygen together with prone-position ventilation. As with any challenging situation, the importance of effective communication is paramount. The critical modifications in the surgical steps are clearly explained. Timely tracheostomy also leads to an earlier freeing up of ventilator space during a period of a rapidly escalating pandemic. The outcomes in terms of swallow and speech function were also assessed. The study has also helped to remove the anxiety around open a tracheostomy in patients who are COVID-19 positive.


Subject(s)
/therapy , Tracheostomy/methods , Adult , Aged , Airway Extubation , /transmission , Female , Humans , Infection Control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Male , Middle Aged , Personal Protective Equipment , Respiration, Artificial , Treatment Outcome
18.
Ann R Coll Surg Engl ; 103(2): 88-95, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1073072

ABSTRACT

INTRODUCTION: COVID-19 remains a threat for a fear of a second pandemic. Emergency orthopaedic operations are still among the most commonly performed procedures with increased risk of transmission of SARS CoV-2 to the patients and the healthcare workers. The aim of this study was to present the evidence available into best practices limiting the spread of COVID-19 in healthcare setting during current and future pandemics. METHODS: A review of the literature was performed in multiple databases (PubMed, the Cochrane Library, Google Scholar, World Health Organization and Centers for Disease Control), using 'COVID-19' with other relevant keywords in different combinations. Owing to the limited and heterogenous evidence available, data were presented in a narrative manner. FINDINGS: From the evidence gathered it was noted that a multimodal approach to minimising pathogen transmission is required. This primarily comprises the wider engineering and administrative controls to reduce the concentration of the pathogen and to separate staff and patients from it. Theatre isolation and traffic control bundling, theatre flow and logistics, ventilation and waste management form a pivotal role in the environmental/engineering controls. Administrative measures include policies for both patients and staff. For patients, isolation and preoperative screening are of utmost value. For staff, testing for COVID-19, risk assessment, redeployment and provision of persona; protective equipment, together with the necessary training are important administrative controls. CONCLUSION: We believe these measures are likely to improve the sustainability of resources and can be carried to elective settings in order to return to some form of normality and help to mitigate the effects of future pandemics.


Subject(s)
/prevention & control , Housekeeping, Hospital , Infection Control/methods , Operating Rooms , Personal Protective Equipment , Ventilation , Waste Management , Workflow , Air Filters , Humans , Inservice Training , Personnel Staffing and Scheduling , Risk Assessment , State Medicine , United Kingdom
19.
J Hand Surg Asian Pac Vol ; 26(1): 127-129, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1072799

ABSTRACT

Coronavirus disease-19 has affected million of people worldwide, constituting the biggest social, economic, and health crisis since World War 2. During this pandemic, the hospitals have become hot zones for the treatment of patients. Therefore, it is important to take the appropriate protective measures and ensure the physician's health and, especially, those who work in the intensive care units and in operating rooms. In this letter, we are trying to make a discussion regarding the measures that should be considered by the healthcare workers who are facing this invisible enemy during their effort to provide their services in the surgery rooms.


Subject(s)
/prevention & control , Infection Control/methods , Air Filters , Disease Transmission, Infectious/prevention & control , Humans , Intubation, Intratracheal , Medical Waste Disposal , Pandemics , Personal Protective Equipment
20.
Curr Allergy Asthma Rep ; 21(2): 8, 2021 02 09.
Article in English | MEDLINE | ID: covidwho-1070935

ABSTRACT

PURPOSE OF REVIEW: The coronavirus disease 2019 (COVID-19) has challenged healthcare system capacities and safety for health care workers, reshaping doctor-patient interaction favoring e-Health or telemedicine. The pandemic situation may make difficult to prioritize patients with allergies diseases (AD), face-to-face evaluation, and moreover concern about the possible COVID-19 diagnosis, since COVID-19 shared many symptoms in common with AD. Being COVID-19 a novel disease, everyone is susceptible; there are some advances on vaccine and specific treatment. We evaluate existing literature on allergic diseases (AD): allergic rhinitis, asthma, food allergy, drug allergy, and skin allergy, and potential underlying mechanisms for any interrelationship between AD and COVID-19. RECENT FINDINGS: There is inconclusive and controversial evidence of the association between AD and the risk of adverse clinical outcomes of COVID-19. AD patients should minimize hospital and face-to-face visits, and those who have used biologics and allergen immunotherapy should continue the treatment. It is essential to wear personal protective equipment for the protection of health care workers. Social distancing, rational use of facemasks, eye protection, and hand disinfection for health care workers and patients deserve further attention and promotion. Teleconsultation during COVID-19 times for AD patients is very encouraging and telemedicine platform can provide a reliable service in patient care.


Subject(s)
Asthma/therapy , Food Hypersensitivity/therapy , Infection Control/methods , Rhinitis, Allergic/therapy , Telemedicine , Asthma/immunology , Biological Products , Dermatitis, Allergic Contact/immunology , Dermatitis, Allergic Contact/therapy , Dermatitis, Atopic/immunology , Dermatitis, Atopic/therapy , Desensitization, Immunologic , Disease Management , Disease Outbreaks , Drug Hypersensitivity/immunology , Drug Hypersensitivity/therapy , Food Hypersensitivity/immunology , Health Personnel , Humans , Pandemics/prevention & control , Personal Protective Equipment , Rhinitis, Allergic/immunology
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