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1.
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
2.
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
3.
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
4.
Health Sociol Rev ; 29(2): 158-167, 2020 07.
Article in English | MEDLINE | ID: covidwho-1066140

ABSTRACT

Shortages of personal protective equipment (PPE) and medical devices needed during the COVID-19 pandemic were widely reported in early 2020. In response, civic DIY volunteers explored how they could produce the required equipment. Members of communities such as hacker- and makerspaces employed their skills and tools to manufacture, for example, face shields and masks. The article discusses these civic innovation practices and their broader social implications by relating them to critical making theory. Methodologically, it is based on a digital ethnography approach, focusing on hacker and maker communities in the UK. Communities' DIY initiatives display characteristics of critical making and 'craftivism', as they assessed and counteracted politicised healthcare supply shortages. It is argued that their manufacturing activities during the COVID pandemic relate to UK austerity politics' effects on healthcare and government failure to ensure medical crisis supplies. Facilitated by open source design, communities' innovation enabled healthcare emergency equipment. At the same time, their DIY manufacturing raises practical as well as ethical issues concerning, among other things, efficacy and safety of use.


Subject(s)
/prevention & control , Masks/supply & distribution , Personal Protective Equipment/supply & distribution , Protective Devices , Equipment Design , Humans , Masks/standards , Personal Protective Equipment/standards , Private Sector
5.
Bull World Health Organ ; 99(2): 85-91, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1063301

ABSTRACT

Objective: To investigate community and health-care workers' perspectives on the coronavirus disease 2019 (COVID-19) pandemic and on early pandemic responses during the first 2 weeks of national lockdown in Zimbabwe. Methods: Rapid qualitative research was carried out between March and April 2020 via phone interviews with one representative from each of four community-based organizations and 16 health-care workers involved in a trial of community-based services for young people. In addition, information on COVID-19 was collected from social media platforms, news outlets and government announcements. Data were analysed thematically. Findings: Four themes emerged: (i) individuals were overloaded with information but lacked trusted sources, which resulted in widespread fear and unanswered questions; (ii) communities had limited ability to comply with prevention measures, such as social distancing, because access to long-term food supplies and water at home was limited and because income had to be earned daily; (iii) health-care workers perceived themselves to be vulnerable and undervalued because of a shortage of personal protective equipment and inadequate pay; and (iv) other health conditions were sidelined because resources were redirected, with potentially wide-reaching implications. Conclusion: It is important that prevention measures against COVID-19 are appropriate for the local context. In Zimbabwe, communities require support with basic needs and access to reliable information to enable them to follow prevention measures. In addition, health-care workers urgently need personal protective equipment and adequate salaries. Essential health-care services and medications for conditions other than COVID-19 must also continue to be provided to help reduce excess mortality and morbidity.


Subject(s)
/prevention & control , Communicable Disease Control/methods , Community Health Services/organization & administration , Health Personnel , Access to Information , Humans , Pandemics , Personal Protective Equipment/supply & distribution , Qualitative Research , Salaries and Fringe Benefits , Zimbabwe
6.
PLoS One ; 16(2): e0246110, 2021.
Article in English | MEDLINE | ID: covidwho-1060289

ABSTRACT

Since the outbreak of the COVID-19 pandemic, many healthcare facilities have suffered from shortages in medical resources, particularly in Personal Protective Equipment (PPE). In this paper, we propose a game-theoretic approach to schedule PPE orders among healthcare facilities. In this PPE game, each independent healthcare facility optimises its own storage utilisation in order to keep its PPE cost at a minimum. Such a model can reduce peak demand considerably when applied to a variable PPE consumption profile. Experiments conducted for NHS England regions using actual data confirm that the challenge of securing PPE supply during disasters such as COVID-19 can be eased if proper stock management procedures are adopted. These procedures can include early stockpiling, increasing storage capacities and implementing measures that can prolong the time period between successive infection waves, such as social distancing measures. Simulation results suggest that the provision of PPE dedicated storage space can be a viable solution to avoid straining PPE supply chains in case a second wave of COVID-19 infections occurs.


Subject(s)
/epidemiology , Disease Outbreaks , Game Theory , Personal Protective Equipment/supply & distribution , Computer Simulation , Geography , Humans
7.
BMJ Open ; 11(1): e042591, 2021 01 28.
Article in English | MEDLINE | ID: covidwho-1054682

ABSTRACT

OBJECTIVES: To measure work-related burnout in all groups of health service staff during the COVID-19 pandemic and to identify factors associated with work-related burnout. DESIGN: Cross-sectional staff survey. SETTING: All staff grades and types across primary and secondary care in a single National Health Service organisation. PARTICIPANTS: 257 staff members completed the survey, 251 had a work-related burnout score and 239 records were used in the regression analysis. PRIMARY AND SECONDARY OUTCOME MEASURES: (1) Work-related burnout as measured by the Copenhagen Burnout Inventory; (2) factors associated with work-related burnout identified through a multiple linear regression model; and (3) factors associated with work-related burnout identified through thematic analysis of free text responses. RESULTS: After adjusting for other covariates (including age, sex, job, being able to take breaks and COVID-19 knowledge), we observed meaningful changes in work-related burnout associated with having different COVID-19 roles (p=0.03), differences in the ability to rest and recover during breaks (p<0.01) and having personal protective equipment concerns (p=0.04). Thematic analysis of the free text comments also linked burnout to changes in workload and responsibility and to a lack of control through redeployment and working patterns. Reduction in non-COVID-19 services has resulted in some members of staff feeling underutilised, with feelings of inequality in workload. CONCLUSIONS: Our analyses support anecdotal reports of staff struggling with the additional pressures brought on by COVID-19. All three of the factors we found to be associated with work-related burnout are modifiable and hence their effects can be mitigated. When we next find ourselves in extraordinary times the ordinary considerations of rest and protection and monitoring of the impact of new roles will be more important than ever.


Subject(s)
Burnout, Professional/epidemiology , Health Personnel/psychology , Professional Role/psychology , Workload/psychology , Adolescent , Adult , Cross-Sectional Studies , Female , Health Workforce/organization & administration , Humans , Male , Middle Aged , Personal Protective Equipment/supply & distribution , Psychiatric Status Rating Scales , Rest/psychology , State Medicine , United Kingdom/epidemiology , Young Adult
8.
BMJ Glob Health ; 6(1)2021 01.
Article in English | MEDLINE | ID: covidwho-1054671

ABSTRACT

BACKGROUND: Despite the widespread implementation of personal protective equipment (PPE) in the COVID-19 pandemic, there are surprisingly few studies of its impact. To assess the risk, severity and duration of COVID-19 in relation to access to PPE in at-risk healthcare workers (HCWs). METHODS: From 17 July to 25 September 2020, at-risk physicians and nurses registered as a provider in the Survey Healthcare Globus network in six countries (the UK, Germany, France, Italy, Spain and USA) were identified based on adult medical specialties with frequent and close contact with patients with COVID-19. Exposed HCWs completed a detailed questionnaire including demographics, medical, social and lifestyle factors. COVID-19 cases were defined as COVID-19 symptoms (fever, cough, fatigue, loss of taste or smell) and asymptomatic COVID-19 test positive cases. RESULTS: Among 2884 exposed HCWs (94% medical doctors and 6% nurses or physician assistants), there were 514 reports of COVID-19 illness and 54 asymptomatic COVID-19 test positive cases. COVID-19 risk was significantly associated with close contact with COVID-19 cases both inside and outside the workplace, number of work shifts and hours worked per week. Limited access to PPE compared with access to a fresh mask, gown and gloves and face shield with each patient encounter was associated with a 2.2-fold to 22-fold increased risk of reporting COVID-19 symptoms (p<0.0001), a pattern consistent across all six countries. Further, limited access to PPE was associated with symptom duration greater than 2 weeks and the presence of moderate to severe symptoms such as difficulty breathing, abnormal chest X-ray, low oxygen saturations, respiratory distress and acute lung injury. CONCLUSION: In six countries, less access to PPE was strongly associated with both increased risk of reporting COVID-19 illness as well as more prolonged and severe disease course in frontline HCWs.


Subject(s)
/physiopathology , Health Personnel , Occupational Exposure/prevention & control , Personal Protective Equipment/supply & distribution , Adult , Case-Control Studies , Europe , Female , Humans , Male , Middle Aged , Pandemics , Severity of Illness Index , Surveys and Questionnaires , United States
9.
Med J Malaysia ; 76(1): 98-100, 2021 01.
Article in English | MEDLINE | ID: covidwho-1052661

ABSTRACT

Around June 2020, many institutions restarted full operating schedules to clear the backlog of postponed surgeries because of the first wave in the COVID-19 pandemic. In an online survey distributed among anaesthestists in Asian countries at that time, most of them described their safety concerns and recommendations related to the supply of personal protective equipment and its usage. The second concern was related to pre-operative screening for all elective surgical cases and its related issues. The new norm in practice was found to be non-standardized and involved untested devices or workflow that have since been phased out with growing evidence. Subsequent months after reinstating full elective surgeries tested the ability of many hospitals in handling the workload of non-COVID surgical cases together with rising COVID-19 positive cases in the second and third waves when stay-at-home orders eased.


Subject(s)
Anesthetists , /prevention & control , Occupational Exposure/prevention & control , Occupational Health , Personal Protective Equipment/supply & distribution , Elective Surgical Procedures , Humans , Preoperative Period , Surveys and Questionnaires , Workflow
10.
Enferm Clin ; 31 Suppl 1: S73-S77, 2021 Feb.
Article in English, Spanish | MEDLINE | ID: covidwho-1046465

ABSTRACT

The main element of personal protective equipment against the SARS-CoV-2 pandemic are masks, which protect against droplets and aerosols that can remain suspended in the air. The objective of this study is to summarize the existing evidence on the filtration of different materials for the manufacture of masks. A scoping review or exploratory review has been carried out in the PubMEd and Scopus databases, using the terms "respirator", "mask", "facemask", "material", and "tissue", combined with Boolean operators. The results show some of the materials used for the manufacture of masks, both surgical masks and medium-high filtration masks, as well as materials used for the manufacture of household masks. As a conclusion, it is necessary to know the characteristics of the different materials as well as their properties to guarantee an adequate use according to the specific needs in each context, being fundamental the application of particle filtration systems as well as support materials that comply with current recommendations.


Subject(s)
/prevention & control , Masks/standards , /epidemiology , Cellulose/standards , Equipment Design/methods , Filtration/instrumentation , Filtration/standards , Health Personnel , Humans , Masks/supply & distribution , Pandemics , Personal Protective Equipment/supply & distribution , Polypropylenes/standards , Static Electricity , Textiles/standards
11.
Front Public Health ; 8: 577021, 2020.
Article in English | MEDLINE | ID: covidwho-1045488

ABSTRACT

Turkey's response experience thus far with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic affords the globe and the region a unique opportunity for and distinctive insights into combating this novel virus. The country's pandemic response, having one of the lowest case fatality ratio (2.8%; 52.5 infections/million population), particularly among the elderly (the high-risk group), rising to the occasion to shoulder its long-standing role in global solidarity and humanitarian support by providing personal protective equipment (globally scarce) to many countries in their desperate time of fight against the pandemic while also meeting its own critical domestic needs, stands out. This paper aims to highlight key decisions, actions, and partnerships behind Turkey's successful fight against the SARS-CoV-2 pandemic that have enabled the country to turn the corner, as well as the components of its success story.


Subject(s)
/prevention & control , Health Policy , Health Services Accessibility/organization & administration , Personal Protective Equipment/supply & distribution , Universal Health Care , Delivery of Health Care/organization & administration , Humans , Turkey
12.
BMC Public Health ; 21(1): 199, 2021 01 22.
Article in English | MEDLINE | ID: covidwho-1043226

ABSTRACT

BACKGROUND: Novel coronavirus is a global pandemic and killed many individuals, including health care professionals. It caused stress on the health care system of all countries. Presently, studies are emerging regarding the COVID-19 pandemic in different aspects. However, a few have explored barriers that affecting the practice of preventive measures for the COVID-19. As such, the study aimed to fill these research gaps in the study setting. METHODS: A semi-structured interview guide was used to conduct this phenomenological study among 16 key informants. Key informants were recruited by the purposive sampling method. To analyze that data, thematic content analysis was employed by using an inductive approach in NVivo 12 Pro software. RESULTS: In this study, six main themes were identified with the sub-themes. Overview of COVID-19 pandemic (with the six sub-themes), consequences (with the two sub-themes), perceived practice (with four sub-themes), perceived barriers (with four sub-themes), newfangled activities (with three sub-themes), and suggestion for improvement (with seven sub-themes) were the major themes. The participants perceived the influence of shortage of personal protective equipment and solutions for hand hygiene, negligence and ignorance, inadequate infrastructure, lack of training, and lack of attention and recognition for the staff on the practice of preventive measures. CONCLUSIONS: This study showed a gap in preventive measure practices for the COVID-19 in the health care system. Community influences, health care provider related barriers, institutional barriers, and lack of communication and support affect the practice. Hence, attention should give to fulfill the necessary supplies in the health facilities, improve the infrastructures, and equip health professionals by providing capacity-building activities. Besides, health care workers must recognize, and attention is needed.


Subject(s)
Attitude of Health Personnel , Health Personnel/psychology , Pandemics/prevention & control , Public Health Administration , Adult , Ethiopia/epidemiology , Female , Hand Hygiene , Health Personnel/statistics & numerical data , Humans , Male , Personal Protective Equipment/supply & distribution , Qualitative Research
13.
Sci Rep ; 11(1): 2051, 2021 01 21.
Article in English | MEDLINE | ID: covidwho-1041626

ABSTRACT

The COVID-19 pandemic has led to widespread shortages of personal protective equipment (PPE) for healthcare workers, including of N95 masks (filtering facepiece respirators; FFRs). These masks are intended for single use but their sterilization and subsequent reuse has the potential to substantially mitigate shortages. Here we investigate PPE sterilization using ionized hydrogen peroxide (iHP), generated by SteraMist equipment (TOMI; Frederick, MD), in a sealed environment chamber. The efficacy of sterilization by iHP was assessed using bacterial spores in biological indicator assemblies. After one or more iHP treatments, five models of N95 masks from three manufacturers were assessed for retention of function based on their ability to form an airtight seal (measured using a quantitative fit test) and filter aerosolized particles. Filtration testing was performed at a university lab and at a National Institute for Occupational Safety and Health (NIOSH) pre-certification laboratory. The data demonstrate that N95 masks sterilized using SteraMist iHP technology retain filtration efficiency up to ten cycles, the maximum number tested to date. A typical iHP environment chamber with a volume of ~ 80 m3 can treat ~ 7000 masks and other items (e.g. other PPE, iPADs), making this an effective approach for a busy medical center.


Subject(s)
Hydrogen Peroxide/pharmacology , Personal Protective Equipment/virology , Sterilization/methods , /epidemiology , Equipment Reuse/statistics & numerical data , Humans , Pandemics/prevention & control , Personal Protective Equipment/supply & distribution , Respiratory Protective Devices , United States/epidemiology
14.
Healthc Q ; 23(4): 12-16, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1040178

ABSTRACT

Canada's COVID-19 response has been described as slow, with reactive decision making that has left the most vulnerable populations at risk of infection and death from the virus. Yet, within and across the provincial health systems, the supply chain processes and data infrastructure needed to generate the relevant data for, and evidence of, the spread of COVID-19 and the health system's capacity to respond to the pandemic are non-existent in Canada. Emerging evidence from a national research study highlights the significance of supply chain data infrastructure and processes that offer transparent, real-time data to inform decisions that support a coordinated, evidence-informed pandemic strategy that is proactive and capable of protecting the health of every Canadian.


Subject(s)
/epidemiology , Equipment and Supplies/supply & distribution , Aged , /therapy , Canada/epidemiology , Delivery of Health Care/statistics & numerical data , Health Workforce/statistics & numerical data , Humans , Personal Protective Equipment/supply & distribution
15.
BMJ Open ; 11(1): e046199, 2021 01 20.
Article in English | MEDLINE | ID: covidwho-1039890

ABSTRACT

OBJECTIVES: To report frontline healthcare workers' (HCWs) experiences with personal protective equipment (PPE) during the COVID-19 pandemic in the UK. To understand HCWs' fears and concerns surrounding PPE, their experiences following its guidance and how these affected their perceived ability to deliver care during the COVID-19 pandemic. DESIGN: A rapid qualitative appraisal study combining three sources of data: semistructured in-depth telephone interviews with frontline HCWs (n=46), media reports (n=39 newspaper articles and 145 000 social media posts) and government PPE policies (n=25). PARTICIPANTS: Interview participants were HCWs purposively sampled from critical care, emergency and respiratory departments as well as redeployed HCWs from primary, secondary and tertiary care centres across the UK. RESULTS: A major concern was running out of PPE, putting HCWs and patients at risk of infection. Following national level guidance was often not feasible when there were shortages, leading to reuse and improvisation of PPE. Frequently changing guidelines generated confusion and distrust. PPE was reserved for high-risk secondary care settings and this translated into HCWs outside these settings feeling inadequately protected. Participants were concerned about differential access to adequate PPE, particularly for women and Black, Asian and Minority Ethnic HCWs. Participants continued delivering care despite the physical discomfort, practical problems and communication barriers associated with PPE use. CONCLUSION: This study found that frontline HCWs persisted in caring for their patients despite multiple challenges including inappropriate provision of PPE, inadequate training and inconsistent guidance. In order to effectively care for patients during the COVID-19 pandemic, frontline HCWs need appropriate provision of PPE, training in its use as well as comprehensive and consistent guidance. These needs must be addressed in order to protect the health and well-being of the most valuable healthcare resource in the COVID-19 pandemic: our HCWs.


Subject(s)
/prevention & control , Health Personnel/psychology , Infection Control/organization & administration , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Personal Protective Equipment/supply & distribution , Female , Guidelines as Topic , Health Personnel/education , Humans , Interviews as Topic , Male , Qualitative Research , Tertiary Care Centers , United Kingdom
16.
Ann Glob Health ; 87(1): 5, 2021 01 05.
Article in English | MEDLINE | ID: covidwho-1038733

ABSTRACT

COVID-19 is now impacting every country in Africa and healthcare workers (HCWs) across the continent remain susceptible to professional burnout. We designed a 43-question survey addressing multiple aspects of the COVID-19 pandemic. The survey was anonymous, distributed via email and phone messaging to 13 countries in Africa. We obtained 489 analyzable responses. 49% off HCWs reported a decrease in income, with the majority experiencing between 1-25% salary reduction. Sixty-six percent reported some access to personal protective equipment (PPE), 20% had no access to PPE and only 14% reported proper access. Strikingly, the percentage reporting never feeling depressed changed from 61% before the pandemic to 31% during the pandemic, with an increase in daily depression from 2% to 20%. We found no association between depression and change in income, household size, availability of PPE or lockdown. Safety concerns related to stigma from being HCWs affected 56% of respondents.


Subject(s)
Burnout, Professional/epidemiology , Depression/epidemiology , Health Personnel/psychology , Safety , Adult , Africa/epidemiology , Female , Humans , Income/statistics & numerical data , Male , Personal Protective Equipment/supply & distribution , Risk Factors , Social Stigma , Surveys and Questionnaires , Workload/psychology
17.
Curr Opin Anaesthesiol ; 34(1): 54-61, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1028307

ABSTRACT

PURPOSE OF REVIEW: The COVID-19 pandemic has driven transformation in every aspect of the healthcare delivery system. The unpredictable onset and magnitude of COVID-19 infections resulted in wide gaps in preparedness for healthcare systems. The development of protocols to address both scarcity of resources and staff protection continues to be essential for risk mitigation. RECENT FINDINGS: The northeast region of the United States had a rapid early surge of COVID-19 infections leading to the exhaustion of critical care capacity. In addition, northeastern hospitals experienced decrease in elective surgical interventions, including organ transplantation. Limited availability of COVID-19 testing and personal protective equipment further fueled the pandemic. This commentary highlights a comprehensive innovative approach to addressing the operating room and hospital demands, as well as the shortages in resources and staffing during the pandemic. SUMMARY: The VCU Department of Anesthesiology operated at 40% of its regular operating room volume throughout the COVID-19 pandemic because of the increased demand from emergency cases. The delay in the peak surge allowed Virginia Commonwealth University, Department of Anesthesiology to develop a comprehensive infrastructure resulting in resulting is maximal workforce risk mitigation.


Subject(s)
Anesthesia Department, Hospital/organization & administration , /prevention & control , /statistics & numerical data , Hospitals, University/organization & administration , Humans , Occupational Exposure/prevention & control , Pandemics , Personal Protective Equipment/supply & distribution , United States
19.
Ann Fam Med ; 19(1): 55-62, 2021.
Article in English | MEDLINE | ID: covidwho-1024391

ABSTRACT

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has led at times to a scarcity of personal protective equipment, including medical masks, for health care clinicians, especially in primary care settings. The objective of this review was to summarize current evidence regarding the use of cloth masks to prevent respiratory viral infections, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), among health care clinicians. METHODS: We searched 5 databases, the Centers for Disease Control and Prevention website, and the reference lists of identified articles on April 3, 2020. All identified publications were independently screened by 2 reviewers. Two authors independently extracted data and graded the studies. Randomized control trials (RCTs) were graded using the Consolidated Standards of Reporting Trials (CONSORT) checklist, and observational and nonhuman subject studies were graded using 11 domains common across frequently used critical appraisal tools. All discrepancies were resolved by consensus. RESULTS: Our search identified 136 original publications. Nine studies met inclusion criteria. We performed a qualitative synthesis of the data from these studies. Four nonrandomized trials, 3 laboratory studies, 1 single-case experiment, and 1 RCT were identified. The laboratory studies found that cloth materials provided measurable levels of particle filtration but were less efficacious at blocking biologic material than medical masks. The RCT found that cloth masks were associated with significantly more viral infections than medical masks. CONCLUSIONS: The current literature suggests that cloth materials are somewhat efficacious in filtering particulate matter and aerosols but provide a worse fit and inferior protection compared to medical masks in clinical environments. The quality and quantity of literature addressing this question are lacking. Cloth masks lack evidence for adequate protection of health care clinicians against respiratory viral infections.


Subject(s)
/prevention & control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Masks/standards , Textiles , Equipment Design , Humans , Masks/supply & distribution , Materials Testing , Personal Protective Equipment/supply & distribution , United States
20.
J Occup Environ Med ; 62(11): 892-897, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-1024148

ABSTRACT

OBJECTIVE: To determine the association between access to adequate personal protective equipment (PPE) and mental health outcomes among a sample of U.S. nurses. METHODS: An online questionnaire was administered in May 2020 to Michigan nurses via three statewide nursing organizations (n = 695 respondents). Multivariable logistic regression analysis was used to identify factors associated with mental health symptoms. RESULTS: Nurses lacking access to adequate PPE (24.9%, n = 163) were more likely to report symptoms of depression (OR 1.96, 95% CI 1.31, 2.94; P = 0.001), anxiety (OR 1.64, 95% CI 1.12, 2.40; P = 0.01) and post-traumatic stress disorder (OR 1.83, 95% CI 1.22, 2.74; P = 0.003). CONCLUSIONS: Healthcare organizations should be aware of the magnitude of mental health problems among nurses and vigilant in providing them with adequate PPE as the pandemic continues.


Subject(s)
Anxiety/epidemiology , Betacoronavirus , Coronavirus Infections/prevention & control , Depression/epidemiology , Nursing Staff/psychology , Pandemics/prevention & control , Personal Protective Equipment/supply & distribution , Pneumonia, Viral/prevention & control , Adult , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Cross-Sectional Studies , Female , Humans , Logistic Models , Male , Michigan , Middle Aged , Odds Ratio , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Stress Disorders, Post-Traumatic/epidemiology , Surveys and Questionnaires , Symptom Assessment
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