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2.
Can J Cardiol ; 37(10): 1629-1634, 2021 10.
Article in English | MEDLINE | ID: covidwho-1406216

ABSTRACT

The mRNA vaccines against COVID-19 infection have been effective in reducing the number of symptomatic cases worldwide. With widespread uptake, case series of vaccine-related myocarditis/pericarditis have been reported, particularly in adolescents and young adults. Men tend to be affected with greater frequency, and symptom onset is usually within 1 week after vaccination. Clinical course appears to be mild in most cases. On the basis of the available evidence, we highlight a clinical framework to guide providers on how to assess, investigate, diagnose, and report suspected and confirmed cases. In any patient with highly suggestive symptoms temporally related to COVID-19 mRNA vaccination, standardized workup includes serum troponin measurement and polymerase chain reaction testing for COVID-19 infection, routine additional lab work, and a 12-lead electrocardiogram. Echocardiography is recommended as the imaging modality of choice for patients with unexplained troponin elevation and/or pathologic electrocardiogram changes. Cardiovascular specialist consultation and hospitalization should be considered on the basis of the results of standard investigations. Treatment is largely supportive, and myocarditis/pericarditis that is diagnosed according to defined clinical criteria should be reported to public health authorities in every jurisdiction. Finally, we recommend COVID-19 vaccination in all individuals in accordance with the Health Canada and National Advisory Committee on Immunization guidelines. In patients with suspected myocarditis/pericarditis after the first dose of an mRNA vaccine, deferral of a second dose is recommended until additional reports become available.


Subject(s)
COVID-19 Vaccines , COVID-19 , Myocarditis , Pericarditis , Risk Management , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing/methods , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Canada/epidemiology , Diagnosis, Differential , Disease Notification/methods , Female , Humans , Male , Myocarditis/diagnosis , Myocarditis/etiology , Myocarditis/microbiology , Pericarditis/diagnosis , Pericarditis/etiology , Pericarditis/microbiology , Risk Management/methods , Risk Management/organization & administration , SARS-CoV-2/isolation & purification , Sex Factors , Young Adult , /adverse effects
3.
Natl Med J India ; 34(1): 10-14, 2021.
Article in English | MEDLINE | ID: covidwho-1359327

ABSTRACT

Background: . Coronavirus disease 2019 (Covid-19) was first described in December 2019 and has evolved into an ongoing global pandemic. Cancer patients on chemotherapy are immunocompromised and are at the highest risk of Covid-19-related complications. We describe our experience with the management of haematology-oncology and stem cell transplant (SCT) patients receiving curative chemotherapy in a hospital with a high influx of Covid-19 patients. Methods: . We did a prospective observational study at a 99-bedded cancer centre of a tertiary care teaching hospital from April 2020 to September 2020. Preventive measures taken were categorized as follows: (i) staff: screening, mandatory use of personal protective equipment (PPE), risk stratification of potential exposure and testing and isolation as needed; (ii) patients: mandatory viral polymerase chain reaction testing, segregation of positive and untested patients and testing of family members; and (iii) environment: mandatory regular cleaning, visitor restriction, telemedicine services and reassignment of priority to clinic visits. Treatment of the underlying conditions was continued with added precautions. Results: . A total of 54 patients were included in the analysis, including 48 with haematological malignancies and 6 for stem cell therapy. Preventive measures were universally applied, and chemotherapy with a curative intent was initiated as per protocol. Three patients were detected to have Covid-19 infection before admission and one after the institution of chemotherapy. Nine patients died after the first cycle of chemotherapy, 2 due to severe Covid-19-related illness and 7 due to complications of chemotherapy or disease progression. Conclusions: . In the wake of the Covid-19 pandemic, treatment for haematological malignancies must continue while balancing the risk of Covid-19 infections. Our report emphasizes the effectiveness of measures such as hand hygiene, social isolation, patient segregation, use of masks and PPE and universal pre-treatment testing for Covid-19 in reducing the risk of infection in a high-risk clinical setting.


Subject(s)
COVID-19 , Hematologic Neoplasms , Infection Control , Risk Management , Stem Cell Transplantation , Telemedicine/organization & administration , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Testing/methods , Contact Tracing/methods , Female , Hematologic Neoplasms/epidemiology , Hematologic Neoplasms/therapy , Humans , Immunocompromised Host/immunology , India/epidemiology , Infection Control/instrumentation , Infection Control/methods , Infection Control/organization & administration , Male , Middle Aged , Prospective Studies , Risk Management/methods , Risk Management/organization & administration , SARS-CoV-2 , Stem Cell Transplantation/methods , Stem Cell Transplantation/statistics & numerical data
6.
Ann Glob Health ; 87(1): 23, 2021 02 25.
Article in English | MEDLINE | ID: covidwho-1119610

ABSTRACT

Introduction: Rwanda has made significant advancements in medical and economic development over the last 20 years and has emerged as a leader in healthcare in the East African region. The COVID-19 pandemic, which reached Rwanda in March 2020, presented new and unique challenges for infectious disease control. The objective of this paper is to characterize Rwanda's domestic response to the first year of the COVID-19 pandemic and highlight effective strategies so that other countries, including high and middle-income countries, can learn from its innovative initiatives. Methods: Government publications describing Rwanda's healthcare capacity were first consulted to obtain the country's baseline context. Next, official government and healthcare system communications, including case counts, prevention and screening protocols, treatment facility practices, and behavioral guidelines for the public, were read thoroughly to understand the course of the pandemic in Rwanda and the specific measures in the response. Results: As of 31 December 2020, Rwanda has recorded 8,383 cumulative COVID-19 cases, 6,542 recoveries, and 92 deaths since the first case on 14 March 2020. The Ministry of Health, Rwanda Biomedical Centre, and the Epidemic and Surveillance Response division have collaborated on preparative measures since the pandemic began in January 2020. The formation of a Joint Task Force in early March led to the Coronavirus National Preparedness and Response Plan, an extensive six-month plan that established a national incident management system and detailed four phases of a comprehensive national response. Notable strategies have included disseminating public information through drones, robots for screening and inpatient care, and official communications through social media platforms to combat misinformation and mobilize a cohesive response from the population. Conclusion: Rwanda's government and healthcare system has responded to the COVID-19 pandemic with innovative interventions to prevent and contain the virus. Importantly, the response has utilized adaptive and innovative technology and robust risk communication and community engagement to deliver an effective response to the COVID-19 pandemic.


Subject(s)
COVID-19 , Communicable Disease Control , Delivery of Health Care , Government Regulation , Risk Management , COVID-19/epidemiology , COVID-19/prevention & control , Change Management , Communicable Disease Control/legislation & jurisprudence , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Communication , Delivery of Health Care/organization & administration , Delivery of Health Care/trends , Disease Transmission, Infectious/prevention & control , Humans , Organizational Innovation , Risk Management/methods , Risk Management/organization & administration , Rwanda/epidemiology , SARS-CoV-2
7.
Adv Med Sci ; 66(1): 221-230, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1116131

ABSTRACT

Transnasal endoscopic skull base surgery (eSBS) has been adopted in recent years, in great part to replace the extended procedures required by external approaches. Though sometimes perceived as "minimally invasive", eSBS still necessitates extensive manipulations within the nose/paranasal sinuses. Furthermore, exposure of susceptible cerebral structures to light and heat emanated by the telescope should be considered to comprehensively evaluate the safety of the method. While the number of studies specifically targeting eSBS safety still remains scarce, the problem has recently expanded with the SARS-CoV-2 pandemic, which also has implications for the safety of the surgical personnel. It must be stressed that eSBS may directly expose the surgeon to potentially high volumes of virus-contaminated aerosol. Thus, the anxiety of both the patient and the surgeon must be taken into account. Consequently, safety requirements must follow the highest standards. This paper summarizes current knowledge on SARS-CoV-2 biology and the peculiarities of human immunology in respect of the host-virus relationship, taking into account the latest information concerning the SARS-CoV-2 worrisome affinity for the nervous system. Based on this information, a workflow proposal is offered for consideration. This could be useful not only for the duration of the pandemic, but also during the unpredictable timeline involving our coexistence with the virus. Recommendations include technical modifications to the operating theatre, personal protective equipment, standards of testing for SARS-CoV-2 infection, prophylactic pretreatment with interferon, anti-IL6 treatment and, last but not least, psychological support for the patient.


Subject(s)
COVID-19 , Natural Orifice Endoscopic Surgery , Neurosurgical Procedures , Occupational Exposure/prevention & control , Skull Base/surgery , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Infection Control/methods , Natural Orifice Endoscopic Surgery/adverse effects , Natural Orifice Endoscopic Surgery/methods , Neurosurgical Procedures/adverse effects , Neurosurgical Procedures/methods , Risk Management/organization & administration , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity
10.
Aust J Gen Pract ; 49(11): 745-751, 2020 11.
Article in English | MEDLINE | ID: covidwho-895902

ABSTRACT

METHOD: A national cross-sectional online survey of Australian general practitioners was conducted in April and May 2020, with 572 respondents. RESULTS: The COVID-19 pandemic in Australia has resulted in major changes to general practice business models. Most practices have experienced increased workload and reduced income. DISCUSSION: Australian general practices have undertaken major innovation and realignment to respond to staff safety and patient care challenges during the COVID-19 pandemic. Increased administration, reduced billable time, managing staffing and pivoting to telehealth service provision have negatively affected practice viability. Major sources of information for general practice are primary care-specific, but many practices turn to colleagues for support and resources.


Subject(s)
Communicable Disease Control/organization & administration , Coronavirus Infections , General Practice , Pandemics , Pneumonia, Viral , Risk Management , Attitude of Health Personnel , Australia/epidemiology , Betacoronavirus , COVID-19 , Civil Defense/standards , Civil Defense/statistics & numerical data , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Cross-Sectional Studies , General Practice/organization & administration , General Practice/trends , General Practitioners , Health Care Surveys , Humans , Mortality , Organizational Innovation , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Risk Management/organization & administration , Risk Management/trends , SARS-CoV-2 , Telemedicine/statistics & numerical data
11.
Dysphagia ; 36(4): 764-767, 2021 08.
Article in English | MEDLINE | ID: covidwho-893277

ABSTRACT

Since the World Health Organization declared the COVID-19 pandemic a Global Public Health Emergency, experts in swallowing are seeking guidance on service delivery and clinical procedures. The European Society for Swallowing Disorders provides considerations to support experts in swallowing disorders in clinical practice. During the COVID-19 pandemic, assessment and treatment of patients with oropharyngeal dysphagia should be provided, while at the same time balancing risk of oropharyngeal complications with that of infection of patients and healthcare professionals involved in their management. Elective, non-urgent assessment may be temporarily postponed and patients are triaged to decide whether dysphagia assessment is necessary; instrumental assessment of swallowing is performed only if processing of the instruments can be guaranteed and clinical assessment has not provided enough diagnostic information for treatment prescription. Assessment and management of oropharyngeal dysphagia is a high-risk situation as it must be considered an aerosol-generating procedure. Personal protective equipment (PPE) should be used. Telepractice is encouraged and compensatory treatments are recommended.


Subject(s)
COVID-19 , Deglutition Disorders , Infection Control , Practice Guidelines as Topic , Practice Patterns, Physicians'/organization & administration , Risk Management/organization & administration , COVID-19/epidemiology , COVID-19/prevention & control , Deglutition Disorders/diagnosis , Deglutition Disorders/epidemiology , Deglutition Disorders/therapy , Delivery of Health Care/standards , Delivery of Health Care/trends , Europe/epidemiology , Humans , Infection Control/instrumentation , Infection Control/methods , Infection Control/standards , Organizational Innovation , SARS-CoV-2 , Telemedicine/methods
12.
BMJ Open ; 10(9): e041370, 2020 09 28.
Article in English | MEDLINE | ID: covidwho-808664

ABSTRACT

OBJECTIVES: To use Population Health Management (PHM) methods to identify and characterise individuals at high-risk of severe COVID-19 for which shielding is required, for the purposes of managing ongoing health needs and mitigating potential shielding-induced harm. DESIGN: Individuals at 'high risk' of COVID-19 were identified using the published national 'Shielded Patient List' criteria. Individual-level information, including current chronic conditions, historical healthcare utilisation and demographic and socioeconomic status, was used for descriptive analyses of this group using PHM methods. Segmentation used k-prototypes cluster analysis. SETTING: A major healthcare system in the South West of England, for which linked primary, secondary, community and mental health data are available in a system-wide dataset. The study was performed at a time considered to be relatively early in the COVID-19 pandemic in the UK. PARTICIPANTS: 1 013 940 individuals from 78 contributing general practices. RESULTS: Compared with the groups considered at 'low' and 'moderate' risk (ie, eligible for the annual influenza vaccination), individuals at high risk were older (median age: 68 years (IQR: 55-77 years), cf 30 years (18-44 years) and 63 years (38-73 years), respectively), with more primary care/community contacts in the previous year (median contacts: 5 (2-10), cf 0 (0-2) and 2 (0-5)) and had a higher burden of comorbidity (median Charlson Score: 4 (3-6), cf 0 (0-0) and 2 (1-4)). Geospatial analyses revealed that 3.3% of rural and semi-rural residents were in the high-risk group compared with 2.91% of urban and inner-city residents (p<0.001). Segmentation uncovered six distinct clusters comprising the high-risk population, with key differentiation based on age and the presence of cancer, respiratory, and mental health conditions. CONCLUSIONS: PHM methods are useful in characterising the needs of individuals requiring shielding. Segmentation of the high-risk population identified groups with distinct characteristics that may benefit from a more tailored response from health and care providers and policy-makers.


Subject(s)
Coronavirus Infections , Health Information Systems/statistics & numerical data , Pandemics , Pneumonia, Viral , Population Health Management , Risk Assessment/methods , Risk Management , Aged , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Cross-Sectional Studies , Demography , England/epidemiology , Female , General Practice/statistics & numerical data , Humans , Male , Middle Aged , Needs Assessment , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Risk Factors , Risk Management/methods , Risk Management/organization & administration , SARS-CoV-2 , Severity of Illness Index
13.
Br J Hosp Med (Lond) ; 81(9): 1-9, 2020 Sep 02.
Article in English | MEDLINE | ID: covidwho-807015

ABSTRACT

Guidance regarding appropriate use of personal protective equipment in hospitals is in constant flux as research into SARS-COV-2 transmission continues to develop our understanding of the virus. The risk associated with procedures classed as 'aerosol generating' is under constant debate. Current guidance is largely based on pragmatic and cautious logic, as there is little scientific evidence of aerosolization and transmission of respiratory viruses associated with procedures. The physical properties of aerosol particles which may contain viable virus have implications for the safe use of personal protective equipment and infection control protocols. As elective work in the NHS is reinstated, it is important that the implications of the possibility of airborne transmission of the virus in hospitals are more widely understood. This will facilitate appropriate use of personal protective equipment and help direct further research into the true risks of aerosolization during these procedures to allow safe streamlining of services for staff and patients.


Subject(s)
Air Microbiology , Coronavirus Infections , Critical Care , Guideline Adherence/standards , Infection Control , Pandemics , Personal Protective Equipment , Pneumonia, Viral , Risk Management/organization & administration , Aerosols , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Critical Care/methods , Critical Care/trends , Disease Transmission, Infectious/prevention & control , Humans , Infection Control/instrumentation , Infection Control/methods , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , SARS-CoV-2 , United Kingdom/epidemiology
14.
Age Ageing ; 50(1): 49-54, 2021 01 08.
Article in English | MEDLINE | ID: covidwho-799418

ABSTRACT

BACKGROUND: SARS-CoV-2 has disproportionately affected nursing homes (NH). In Ireland, the first NH case COVID-19 occurred on 16 March 2020. A national point-prevalence testing programme of all NH residents and staff took place (18 April 2020 to 5 May 2020). AIMS: to examine characteristics of NHs across three Irish Community Health Organisations, proportions with COVID-19 outbreaks, staff and resident infection rates symptom profile and resident case fatality. METHODS: in total, 45 NHs surveyed, requesting details on occupancy, size, COVID-19 outbreak, outbreak timing, total symptomatic/asymptomatic cases and outcomes for residents from 29 February 2020 to 22 May 2020. RESULTS: surveys were returned from 62.2% (28/45) of NHs (2,043 residents, 2,303 beds). Three-quarters (21/28) had COVID-19 outbreaks (1,741 residents, 1,972 beds). Median time from first COVID-19 case in Ireland to first case in these NHs was 27.0 days. Resident incidence was 43.9% (764/1,741)-40.8% (710/1,741) laboratory confirmed, with 27.2% (193/710) asymptomatic and 3.1% (54/1,741) clinically suspected. Resident case fatality was 27.6% (211/764) for combined laboratory-confirmed/clinically suspected COVID-19. Similar proportions of residents in NHs with 'early-stage' (<28 days) versus 'later-stage' outbreaks developed COVID-19. Lower proportions of residents in 'early' outbreak NHs had recovered compared with those with 'late' outbreaks (37.4 versus 61.7%; χ2 = 56.9, P < 0.001). Of 395 NH staff across 12 sites with confirmed COVID-19, 24.7% (99/398) were asymptomatic. There was a significant correlation between the proportion of staff with symptomatic COVID-19 and resident numbers with confirmed/suspected COVID-19 (Spearman's rho = 0.81, P < 0.001). CONCLUSION: this study demonstrates the significant impact of COVID-19 on the NH sector. Systematic point-prevalence testing is necessary to reduce risk of transmission from asymptomatic carriers and manage outbreaks in this setting.


Subject(s)
Asymptomatic Infections/mortality , COVID-19 Testing/methods , COVID-19 , Carrier State/diagnosis , Homes for the Aged/statistics & numerical data , Nursing Homes/statistics & numerical data , Aged , COVID-19/diagnosis , COVID-19/mortality , Disease Transmission, Infectious/prevention & control , Female , Humans , Ireland/epidemiology , Male , Preventive Health Services/methods , Risk Management/methods , Risk Management/organization & administration , SARS-CoV-2/isolation & purification , Symptom Assessment/statistics & numerical data
15.
Acta Orthop ; 91(6): 633-638, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-735647

ABSTRACT

Background and purpose - The COVID-19 pandemic has been recognised as an unprecedented global health crisis. This study assesses the impact on a large acute paediatric hospital service in London, evaluating the trends in the acute paediatric orthopaedic trauma referral caseload and operative casemix before (2019) and during (2020) COVID-19 lockdown. Patients and methods - A longitudinal retrospective observational prevalence study of both acute paediatric orthopaedic trauma referrals and operative caseload was performed for the first 6 "golden weeks" of lockdown. These data were compared with the same period in 2019. Statistical analyses included median (± median absolute deviation), risk and odds ratios as well as Fisher's exact test to calculate the statistical significance, set at p ≤ 0.05. Results - Acute paediatric trauma referrals in 2020 were reduced by two-thirds compared with 2019 (n = 302 vs. 97) with a halving risk (RR 0.55) and odds ratios (OR 0.43) of sporting-related mechanism of injuries (p = 0.002). There was a greater use of outpatient telemedicine in the COVID-19 period with more Virtual Fracture Clinic use (OR 97, RR 84, p < 0.001), and fewer patients being seen for consultation and followed up face to face (OR 0.55, RR 0.05, p < 0.001). Interpretation - The impact of the COVID-19 pandemic has led to a decline in the number of acute paediatric trauma referrals, admissions, and operations during the COVID period. There has also been a significant change in the patient pathway with more being reviewed via the means of telemedicine to reduce the risk of COVID-19 transmission and exposure. More work is required to observe for similar trends nationwide and globally as the pandemic has permanently affected the entire healthcare infrastructure.


Subject(s)
Athletic Injuries , COVID-19 , Communicable Disease Control/methods , Hospitals, Pediatric , Telemedicine , Wounds and Injuries , Athletic Injuries/epidemiology , Athletic Injuries/therapy , COVID-19/epidemiology , COVID-19/prevention & control , Child , Delivery of Health Care/trends , Female , Hospitalization/statistics & numerical data , Hospitals, Pediatric/organization & administration , Hospitals, Pediatric/statistics & numerical data , Humans , London/epidemiology , Male , Risk Management/organization & administration , SARS-CoV-2 , Telemedicine/methods , Telemedicine/organization & administration , Telemedicine/statistics & numerical data , Workload/statistics & numerical data , Wounds and Injuries/epidemiology , Wounds and Injuries/therapy
16.
Infect Control Hosp Epidemiol ; 41(12): 1438-1440, 2020 12.
Article in English | MEDLINE | ID: covidwho-693323

ABSTRACT

Because severe acute respiratory coronavirus virus 2 (SARS-CoV-2) spreads easily and healthcare workers are at increased risk of both acquiring and transmitting infection, all healthcare facilities must rapidly and rigorously implement the full hierarchy of established infection controls: source control (removal or mitigation of infection sources), engineering and environmental controls, administrative controls, and personal protective equipment.


Subject(s)
COVID-19 , Health Personnel , Infection Control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Personal Protective Equipment/supply & distribution , Risk Management/organization & administration , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Health Facilities/standards , Health Facilities/trends , Health Facility Administration , Humans , Infection Control/methods , Infection Control/organization & administration , Occupational Health/standards , Occupational Health/trends , SARS-CoV-2
17.
Infect Control Hosp Epidemiol ; 42(1): 18-24, 2021 01.
Article in English | MEDLINE | ID: covidwho-690676

ABSTRACT

OBJECTIVES: We report our experience with an emergency room (ER) shutdown related to an accidental exposure to a patient with coronavirus disease 2019 (COVID-19) who had not been isolated. SETTING: A 635-bed, tertiary-care hospital in Daegu, South Korea. METHODS: To prevent nosocomial transmission of the disease, we subsequently isolated patients with suspected symptoms, relevant radiographic findings, or epidemiology. Severe acute respiratory coronavirus 2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction assays (RT-PCR) were performed for most patients requiring hospitalization. A universal mask policy and comprehensive use of personal protective equipment (PPE) were implemented. We analyzed effects of these interventions. RESULTS: From the pre-shutdown period (February 10-25, 2020) to the post-shutdown period (February 28 to March 16, 2020), the mean hourly turnaround time decreased from 23:31 ±6:43 hours to 9:27 ±3:41 hours (P < .001). As a result, the proportion of the patients tested increased from 5.8% (N=1,037) to 64.6% (N=690) (P < .001) and the average number of tests per day increased from 3.8±4.3 to 24.7±5.0 (P < .001). All 23 patients with COVID-19 in the post-shutdown period were isolated in the ER without any problematic accidental exposure or nosocomial transmission. After the shutdown, several metrics increased. The median duration of stay in the ER among hospitalized patients increased from 4:30 hours (interquartile range [IQR], 2:17-9:48) to 14:33 hours (IQR, 6:55-24:50) (P < .001). Rates of intensive care unit admissions increased from 1.4% to 2.9% (P = .023), and mortality increased from 0.9% to 3.0% (P = .001). CONCLUSIONS: Problematic accidental exposure and nosocomial transmission of COVID-19 can be successfully prevented through active isolation and surveillance policies and comprehensive PPE use despite longer ER stays and the presence of more severely ill patients during a severe COVID-19 outbreak.


Subject(s)
COVID-19 , Cross Infection , Emergency Service, Hospital , Hospitalization/statistics & numerical data , Patient Isolation , Risk Management , COVID-19/epidemiology , COVID-19/therapy , COVID-19/transmission , COVID-19 Nucleic Acid Testing/methods , Cross Infection/epidemiology , Cross Infection/prevention & control , Cross Infection/virology , Emergency Service, Hospital/organization & administration , Emergency Service, Hospital/statistics & numerical data , Female , Humans , Intensive Care Units/statistics & numerical data , Length of Stay/trends , Male , Middle Aged , Organizational Innovation , Patient Isolation/methods , Patient Isolation/organization & administration , Personal Protective Equipment/supply & distribution , Republic of Korea/epidemiology , Risk Management/methods , Risk Management/organization & administration , SARS-CoV-2/isolation & purification , Tertiary Care Centers
18.
J Health Commun ; 25(4): 301-302, 2020 04 02.
Article in English | MEDLINE | ID: covidwho-680298

ABSTRACT

As the world reacts with unprecedented efforts to contain the COVID-19 pandemic, the role of organizational leaders is to embark on a parallel track to keep mission-critical initiatives moving forward. One track includes preparing their organizations for the next "novel" virus. After all, organizations do not hire leaders to maintain the status quo; they are hired to drive the future. As much as death and taxes are inevitable, it is equally predictable that all organizations will sooner or later confront a black swan event. History teaches us that while the order of magnitude may vary, management crises are not entirely novel. This article explores a series of early risk mitigation strategies to prevent the next COVID-19 and prepare leadership to face this inevitable challenge.


Subject(s)
Leadership , Organizations/organization & administration , Pandemics/prevention & control , Risk Management/organization & administration , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Forecasting , Humans , Organizations/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control
20.
Actas Dermosifiliogr (Engl Ed) ; 111(8): 650-654, 2020 Oct.
Article in English, Spanish | MEDLINE | ID: covidwho-635588

ABSTRACT

As the COVID-19 pandemic gradually comes under control, the members of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) have drawn up a proposed list of the requirements, limitations, and conditioning factors affecting the resumption of work in contact dermatitis units. The assumption is that the severe acute respiratory syndrome coronavirus2 is still circulating and that occasional or seasonal outbreaks will occur. They recommend that the first step should be to assess how many patch tests each clinic can handle and review the waiting list to prioritize cases according to disease severity and urgency. Digital technologies can, where possible, be used to send and receive the documentation necessary for the patch test (information, instructions, informed consent, etc.). If the necessary infrastructure is available, patients can be offered the option of a remote initial consultation. Likewise, in selected cases, the patch test results can be read in a virtual visit using photographs taken by the patient or a video visit can be scheduled to allow the physician to evaluate the site of application remotely. These measures will reduce the number of face-to-face visits required, but will not affect the time spent on each case, which must be scheduled in the normal manner. All of these recommendations are suggestions and should be adapted to the needs and possibilities of each health centre.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Dermatology/organization & administration , Patch Tests/standards , Pneumonia, Viral/epidemiology , Telemedicine/organization & administration , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Dermatitis, Allergic Contact/diagnosis , Health Surveys/standards , Humans , Hypersensitivity/diagnosis , Office Visits , Pandemics/prevention & control , Patient Access to Records , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Risk Management/organization & administration , SARS-CoV-2 , Spain/epidemiology , Symptom Assessment/methods , Telepathology , Triage/organization & administration , Waiting Lists
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