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1.
J Oral Maxillofac Surg ; 80(10): 1575-1576, 2022 10.
Article in English | MEDLINE | ID: covidwho-2041963
2.
Br Dent J ; 233(4): 266-270, 2022 08.
Article in English | MEDLINE | ID: covidwho-2016665

ABSTRACT

The acute management of a facial swelling is a core competency for the dental practitioner. Onward referral to secondary care for acutely unwell patients requires timely decisions, with the referrer's initial assessment often critical in later management. Oral and maxillofacial triage is essential to ensure appropriate care is provided in the appropriate environment. Acute swelling and haemorrhage referrals to secondary care are not a common, everyday occurrence in general dental practice; however, the ability to provide a sufficient and safe handover will improve patient outcomes and ensure timely transfer to appropriate care providers. This article aims to provide the dental practitioner with insight into the oral and maxillofacial assessment of acute facial swellings and dental haemorrhage. The reader should be able to make an appropriate clinical assessment and communicate an effective referral to oral and maxillofacial care.


Subject(s)
Dentists , Surgery, Oral , General Practice, Dental , Humans , Professional Role , Referral and Consultation
3.
BMC Oral Health ; 22(1): 83, 2022 03 21.
Article in English | MEDLINE | ID: covidwho-1759736

ABSTRACT

BACKGROUND: Following Covid-19, many departments have incorporated teledentistry into practice. As new consultation methods are introduced, it's imperative that patients have as similar an experience with virtual consultations to ensure informed decision-making. This project evaluated patients' perceptions of video consultations and determined if patients seen virtually received the same standard of information by auditing compliance with sending patient information leaflets (PILs) following video consultation. METHOD: The department's PILs were used to create an inclusion list for patients requiring a PIL. A retrospective audit assessed the notes of 100 video consultations for records of if PILs were sent and by what method. The department's PILs were digitalised and a clinical mailbox introduced enabling clinicians to email patients a PIL hyperlink. The audit was repeated for 88 video consultations. Patient and staff feedback was gathered via online surveys. RESULTS: Initially, 51% of cases met the criteria requiring a PIL and 16% of patients were sent PILs. Following mailbox introduction, 53% of cases met the criteria and 94% were sent PILs, 100% via email. Patient and staff feedback was positive regarding video consultations and digital PILS. Technical difficulties were reported in 44% of cases. CONCLUSIONS: Patients perceive virtual consultations to be a positive change and the introduction of a mailbox enhances video consultations in an efficient and cost-effective manner. Patient information can be standardised, via digital PILs, regardless of consultation type. As departments implement post-pandemic changes, utilisation of a mailbox can provide multiple improvements to care.


Subject(s)
COVID-19 , Oral Surgical Procedures , Surgery, Oral , Humans , Referral and Consultation , Retrospective Studies
4.
J Craniomaxillofac Surg ; 50(4): 380-387, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1720277

ABSTRACT

The aim of this study was to evaluate the current state of training of German interns in oral and maxillofacial surgery (OMFS) under the influence of the COVID-19 pandemic in 2021. A previously tested questionnaire consisting of 53 questions was sent to interns in German OMFS (non-) university hospitals and private practices as an online survey. The questionnaire was adapted to current topics, such as the ongoing COVID-19 pandemic, aspects concerning nighttime and weekend services, overtime hours, surgical logbooks, benefits of academic degrees and support for scientific activities, part-time employment, parental leave and childcare. Next, results of questions from before the COVID-19 pandemic were re-evaluated. The COVID-19 pandemic influenced the clinical work (71.83%) and the current state of training (68.64%) in OMFS of most participants. Nighttime and weekend services are possible for employees in possession of only one degree (87.93% with a medical degree) in most hospitals. Not having one or both doctorate degrees was considered to be a disadvantage by 54.95%. In all, 42.11% of the participants attested to a positive influence of research on their training situation, and 50% reported financial or non-financial research support from the employer. Part-time employment was possible for 78.81% of the participants. The course of training was interrupted more often for women due to parental or maternity leave (10.53% of men and 30.95% of women). A total of 40.71% of the participants reported that childcare was available at the hospital, theoretically. The state of OMFS training in Germany can be referred to as positive. Current and future challenges are diverse, including aspects originating from the ongoing COVID-19 pandemic, gender aspects, reconciliation of family and work, and flexible working hours. Addressing these topics will ensure OMFS training at the highest surgical level and further increase interns' satisfaction, preserving the specialty's popularity and reception.


Subject(s)
COVID-19 , Surgery, Oral , COVID-19/epidemiology , Female , Germany , Humans , Male , Pandemics , Pregnancy , Surveys and Questionnaires
5.
Head Face Med ; 17(1): 51, 2021 Dec 18.
Article in English | MEDLINE | ID: covidwho-1582046

ABSTRACT

BACKGROUND: The pandemic has challenged educational institutions to catalyze digitalization and rapidly develop online teaching formats. The aim of the study was to evaluate the teaching offered for oral and maxillofacial surgery at our university during the pandemic and to investigate the students' perceptions of the current situation. METHODS: A 38-item questionnaire with five sections (demographic information, lectures, internships, e-learning, and pandemic-related solutions/effects) was created online. Most questions were answered on a 10-point Likert scale, with 1 indicating "fully agree/positive" and 10 indicating "totally disagree/negative." The remaining questions were either answered with yes/no, percent value, or open-ended text responses. All 3rd-5th year dental students were invited to voluntarily participate and were sent a link by email in a general mail shot. RESULTS: A total of 63.7% of the participants had no prior experience with online courses before the pandemic. The students stated that the change from face-to-face to online teaching worked very well in the last two semesters (mean = 2.73, standard deviation = 2.05). Overall, the pandemic had a rather positive influence on the acquisition of theoretical skills and a negative influence on the acquisition of practical skills (p < 0.0001). The evaluation showed that, compared to other dental clinics at our university, the department for oral and maxillofacial surgery was well prepared for the pandemic. CONCLUSION: Digitalization of oral and maxillofacial surgery teaching in dental education is possible but depends on the institution's preparatory work and technological possibilities. The students declared a high acceptance of digital learning formats and indicated an increased motivation to learn due to e-learning. The pandemic's influence on the students' education was rated ambivalent.


Subject(s)
COVID-19 , Surgery, Oral , Cross-Sectional Studies , Humans , Pandemics , SARS-CoV-2
6.
J Oral Maxillofac Surg ; 79(12): 2482-2486, 2021 12.
Article in English | MEDLINE | ID: covidwho-1545199

ABSTRACT

PURPOSE: Attempts to mitigate the coronavirus disease of 2019 (COVID) have disrupted the delivery of non-pandemic care. The purpose of this study was to evaluate the effects of the COVID pandemic on surgical volume and variety at an academic oral and maxillofacial surgery program. MATERIALS AND METHODS: A retrospective cohort study was conducted using the surgical logs of the University of Pennsylvania, Department of Oral and Maxillofacial Surgery from January 2012 through January 2021. Each record identified patient demographics and case classifications. The study predictor was timing of care, which was divided into pre-pandemic, peak pandemic, or post-peak pandemic. The primary study outcomes were the monthly procedure count and the procedure categories. The secondary dependent variables were patient age and race. Multivariate and univariate analyses of variance were used to determine whether pandemic effects existed within outcome groups. RESULTS: The final sample included 64,709 surgical procedures. Before, during, and after the pandemic peak, there were means of 691.0, 209.0, and 789.4 procedures per time period, respectively (P < .01). There was significantly more infection (baseline 2.2%, peak 6.0%, post-peak 2.0%, P < .01) and trauma (baseline 5.3%, peak 26.7%, post-peak 3.9%, P < .01) cases during the pandemic peak. The mean percentage of pediatric patients increased during the peak and post-peak periods (baseline 2.4%, peak 12.9%, post-peak 10.2%, P < .01). No differences were observed among the mean percentage of White (P = .12), Black (P = .21), and Hispanic (P = .25) patients treated. CONCLUSIONS: Along with a predictable decline in surgical numbers, a greater proportion of infection and trauma procedures were performed at the pandemic's peak. Despite these changes, surgery volume normalized and case variety returned to pre-pandemic levels in the post-peak period. Our study suggests that the addition of COVID restrictions did not change the case volume or variety in the months' after the initial crisis.


Subject(s)
COVID-19 , Surgery, Oral , Child , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
7.
Br J Oral Maxillofac Surg ; 60(1): 14-19, 2022 01.
Article in English | MEDLINE | ID: covidwho-1540400

ABSTRACT

Mean retirement age for UK doctors is 59.6 years, giving the average OMFS consultant approximately 20 years of practice. Current pension tax regulations, new consultant posts typically restricted to a maximum of 10 sessions (40 hours), increasing proportions of consultants working less than full time (LTFT), all combined with the backlog of elective care created by COVID-19 will create a significant gap between workforce capacity and clinical demand. The age of current OMFS consultants was estimated using the date of their primary medical/dental qualification. Changes in job plans were estimated using data from the BAOMS Workforce Census and from recently advertised posts. Reports of unfilled posts were collated by OMFS Regional Specialty Professional Advisors (RSPAs). First degree dates were identified for 476 OMFS substantive consultant posts. Estimated current average age of OMFS consultants was 52.7 years (minimum 35.9, maximum 72.1), 75th centile age 59.0 and 23% of the current consultant workforce above the average retirement age for doctors. The 10 sessions of new OMFS consultants posts is significantly less than existing consultants' average of 12.1 sessions (48.4 hours). Unfilled consultant posts in Great Britain are 13% of the total compared to 20% in Northern Ireland and Ireland. Many (23%) of the OMFS consultant workforce are above average retirement age. Forty-hour contracts; new consultants working LTFT; and early loss of senior colleagues because of pension pressure will reduce NHS' capacity to treat OMFS disorders and injuries. This paper suggests increasing consultant posts, increasing trainee numbers, and actively retaining senior surgeons to maintain capacity.


Subject(s)
COVID-19 , Surgeons , Surgery, Oral , Consultants , Demography , Humans , Middle Aged , Pensions , SARS-CoV-2 , Surveys and Questionnaires , United Kingdom , Workforce
8.
J Oral Maxillofac Surg ; 79(8): 1599-1601, 2021 08.
Article in English | MEDLINE | ID: covidwho-1517359
9.
J Oral Maxillofac Surg ; 80(3): 525-529, 2022 03.
Article in English | MEDLINE | ID: covidwho-1446890

ABSTRACT

PURPOSE: The SARS-CoV-2 global pandemic has resulted in widespread changes to healthcare practices across the United States. The purpose of this study is to examine the incidence of COVID-19 patients in the oral-maxillofacial surgery setting in order to help guide perioperative protocols during the pandemic. METHODS: In this retrospective cohort study, predictor variables (presence of preoperative symptoms on presentation, patient age, patient gender, patient race, hospital location, and presence of statewide stay-at-home orders) were examined with outcome variables (SARS-CoV-2 test results) over 10 months between March 2020 and December 2020 for patients undergoing surgical procedures in the operating room by the following Oral-Maxillofacial Surgery Departments: - Louisiana State University Health Sciences Center (Baton Rouge, LA) - University of Illinois at Chicago (Chicago, IL) - University of Texas Health Science Center at Houston (Houston, TX) Data analysis included Fisher exact tests to compare categorical variables across COVID test groups and Wilcoxon rank sum tests to compare continuous covariates. Two-sample tests of proportions were used to compare observed COVID-19 positivity rates to other study results. RESULTS: Out of 684 patients in 3 institutions, 17 patients (2.5%, 95% CI = 1.5 to 4.0%) tested positive for COVID-19 over a 10 month interval (March 1, 2020- December 31, 2020). The majority of patients that tested positive were asymptomatic in the preoperative setting (P-value = .09). They were significantly more likely to be African-American (P-value = .015) and less likely to have a stay-at-home order present at the time of surgery (P-value = .033). Age, gender, and hospital location did not play a statistically significant role. CONCLUSION: Our results demonstrate a 2.5% incidence of COVID-19 infection in the total population of patients undergoing scheduled oral-maxillofacial surgeries in 3 major healthcare systems across the United States. This data may help inform perioperative protocols and infection control measures during the COVID-19 pandemic.


Subject(s)
COVID-19 , Surgery, Oral , COVID-19/epidemiology , Humans , Incidence , Infant , Pandemics , Retrospective Studies , SARS-CoV-2 , United States/epidemiology
10.
Eur Arch Otorhinolaryngol ; 279(3): 1615-1620, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1446159

ABSTRACT

OBJECTIVES: The study purpose was to evaluate the effects of the COVID-19 pandemic on the rate and disease profile of orofacial and respiratory infections in oral and maxillofacial surgery (OMFS) and ear, nose, and throat (ENT) emergency units. MATERIALS AND METHODS: Records of patients with orofacial or respiratory infection, or infectious symptoms, diagnosed in the OMFS or ENT Emergency Departments of the Helsinki University Hospital, Helsinki, Finland between 1st March and 30th October 2020 and the corresponding periods in 2018 and 2019 were reviewed. The main outcome variable was the occurrence of studied infections during the evaluated periods. Other study variables were age, gender, residence area, speciality, specific cause for the emergency department visit and admission to ward. RESULTS: There was a significant 37% decrease in the number of infection patients in 2020 compared to the years 2019 and 2018 (1894 vs. 2929 and 3077, respectively, p < .001). A mean decrease of 51% (from 1319 and 1249 patients in 2018 and 2019, respectively, to 592 patients in 2020) was seen in the "Other ENT respiratory infection" category. ENT patients were 51% less likely to be admitted to the ward in 2020 compared to 2019 and 2018 (p = .013). CONCLUSION: A significant decrease was observed in the volume of emergency department visits for orofacial and respiratory infections during the COVID-19-pandemic in 2020 compared to the non-COVID periods. CLINICAL RELEVANCE: It seems that social distancing, facial mask wearing, and other infection prevention precautions have changed the accustomed patient profile in orofacial and respiratory infections.


Subject(s)
COVID-19 , Respiratory Tract Infections , Surgery, Oral , COVID-19/epidemiology , Emergency Service, Hospital , Humans , Pandemics/prevention & control , Pharynx , Retrospective Studies , SARS-CoV-2
11.
Br J Oral Maxillofac Surg ; 60(1): 20-22, 2022 01.
Article in English | MEDLINE | ID: covidwho-1415231

ABSTRACT

For oral and maxillofacial surgery (OMFS) senior house officers (SHOs) with no formal medical training, the first exposure to emergency scenarios will be the first time they have to manage them, usually alone. Simulation-based education (SBE) has been demonstrated to increase experience and confidence when used in medical education, so an OMFS SBE course was created to facilitate this. The course was centred on scenarios that necessitate a rapid response, including sepsis, retrobulbar haemorrhage, and carotid artery blowout. A questionnaire with a 10-point numerical score was given to assess the change in confidence when managing these scenarios. Learner numbers were limited due to the COVID-19 pandemic, but all 10 completed both questionnaires. There was an even distribution between first and second-year SHOs. Two had received simulation training before, but it was very limited. In all stations every learner felt an increase in confidence, on average by 45% (range 38%-56%, p<0.05) on the 10-point scale. Positive feedback was also given by them all. SBE has been shown to be an invaluable method of training for clinical scenarios and needs to become common in OMFS. The course is to be expanded post COVID-19 to become available nationally.


Subject(s)
COVID-19 , Surgery, Oral , Emergencies , Humans , Pandemics , SARS-CoV-2 , Surgery, Oral/education , Surveys and Questionnaires
12.
J Oral Maxillofac Surg ; 80(2): 386-391, 2022 02.
Article in English | MEDLINE | ID: covidwho-1370611

ABSTRACT

PURPOSE: With the outbreak of COVID-19, residency programs for the 2020 to 2021 OMS interview cycle were forced to quickly adapt to a new method of assessing candidates-virtual interviewing-for the first time. The purpose of this study is to describe applicants' perspectives regarding the advantages and disadvantages of the virtual interview process through an online descriptive survey. METHODS: This cross-sectional study utilizes a descriptive survey sent to the 2020 to 2021 interview cycle applicants of the University of Illinois at Chicago Oral and Maxillofacial Surgery (UIC OMS) residency program. The survey consisted of questions employing both scaled and open-ended designs. The questions were fabricated to extrapolate applicants' perceived advantages and disadvantages of virtual interviewing compared to their expectations of in-person interviewing by focusing on interactions, number of interviews received/attended, and overall applicant satisfaction. Descriptive statistics were computed for each variable for data analysis. RESULTS: In the 2020 to 2021 UIC OMS residency cycle, there were 288 applications. A total of 102 surveys were collected (response rate = 35.4%). Respondents attended more interviews during the virtual format due to accessibility (64.7%), and cost savings (63.7%). 42.2% of applicants felt they did not present themselves as well during the virtual interview as they would have in person and 46.1% felt they did not have a good understanding of the culture of the program after the interview. 49.0% of all participants do not feel that virtual interviews should continue in the future. CONCLUSIONS: Virtual formats would allow access to a greater number of interviews; however, they lack the ability to promote effective interaction between applicants, residents, and faculty members. The results of the study show that although applicants agreed that interviews were more accessible this year, they felt that the "personal" interaction was lacking and they could not present themselves effectively with the virtual format. Ultimately, almost half (49%) of the respondents do not wish for virtual interviews to continue in the future.


Subject(s)
COVID-19 , Internship and Residency , Surgery, Oral , Cross-Sectional Studies , Humans , SARS-CoV-2
13.
Oral Maxillofac Surg Clin North Am ; 33(4): 475-480, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1356182

ABSTRACT

The COVID-19 pandemic altered all facets of society on a fundamental level, impacting work, mental health, and family life. Female surgeons experienced gender inequity and bias before COVID; therefore, women in oral and maxillofacial surgery (OMS) were affected disproportionately by the repercussions of the pandemic. Well-established inequalities are intensified during times of crisis. This article enlightens readers regarding the preexisting inequalities in the OMS specialty, how the COVID-19 pandemic exacerbated these ubiquitous issues, and how the specialty should accommodate these inequities moving forward.


Subject(s)
COVID-19 , Surgery, Oral , Female , Humans , Oral and Maxillofacial Surgeons , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
16.
Br J Oral Maxillofac Surg ; 60(1): 3-10, 2022 01.
Article in English | MEDLINE | ID: covidwho-1316400

ABSTRACT

COVID-19 has resulted in an expansion of webinar-based teaching globally. Socially distanced e-learning is the new normal. The delivery of regional OMFS teaching programmes in the UK and the Republic of Ireland, for Specialty Trainees (ST's) under the Joint Committee on Surgical Training (JCST) and Intercollegiate Surgical Curriculum Programme (ISCP) umbrellas is variable. We recognised the need to provide additional teaching to supplement this teaching, at a time of crisis in our countries and healthcare systems, which had jointly led to a significant impact on the progression of training. The membership category of Specialty Trainees within the national specialty association-the British Association of Oral and Maxillofacial Surgeons (BAOMS) is Fellows in Training abbreviated to FiT. We designed an OMFS FiT (Fellows in Training) webinar series based on the current Oral and Maxillofacial Surgery (OMFS) curriculum. Senior trainers delivered weekly national web-based teaching using learning theories of education. Thirteen webinars were conducted between the 14th of May and the 4th of August 2020. Webinars were attended by 40-75 ST's with 98 percent of trainees rating the webinars as 'excellent' or 'very good', and 99% found the content 'extremely useful' or 'very useful'. We discuss the learning theories used for this teaching which include - Bloom's taxonomy, Bruner's spiral model, Vygotsky's zone of proximal development, the flipped classroom model, and Knowles' andragogy model. This pilot national teaching programme has been extremely well received by OMFS trainees and is here to stay!


Subject(s)
COVID-19 , Surgery, Oral , Educational Status , Humans , Oral and Maxillofacial Surgeons , SARS-CoV-2 , Surgery, Oral/education , Surveys and Questionnaires , United Kingdom
18.
J Craniofac Surg ; 32(3): e305-e308, 2021 May 01.
Article in English | MEDLINE | ID: covidwho-1307609

ABSTRACT

INTRODUCTION: The COVID-19 pandemic affects basic health care in maxillofacial surgery (MFS) due to the shift in resources and the change in patient disorders treated during the pandemic. This paper aims to elucidate the medical and financial consequences driven by the measures for COVID-19 treatment in a tertiary care centre. MATERIAL AND METHODS: To evaluate the impact of pandemic measures on daily routines of MFS, the surgical schedule during the first 2 weeks after the onset of the curfew (March 2020), and to compare it with the schedule of the same period of time 1 year earlier. Furthermore, postponed surgeries as well as cancelled follow-ups are listed. The loss of earning was calculated as well as the number and kind of postponed procedures. RESULTS: The number of surgeries decreased by 45% (n = 163 in 2019 vs n = 89 in 2020), and the duration of the surgeries decreased from 94.2 minutes to 62.1 minutes. No elective surgeries, such as implantology, aesthetic surgery, or orthognathic surgery, took place. Furthermore, also trauma cases decreased from 9 to 3 cases. Considering all variables, the financial loss can be calculated as approximately 100,256.50 Euros per week. CONCLUSION: The impact of COVID-19 on MFS is certainly of medical and economic importance and is related to the duration of the pandemic.


Subject(s)
COVID-19 , Surgery, Oral , COVID-19/drug therapy , Humans , Pandemics , SARS-CoV-2
19.
J Craniofac Surg ; 32(3): 1002-1005, 2021 May 01.
Article in English | MEDLINE | ID: covidwho-1307608

ABSTRACT

ABSTRACT: The pandemic status of the Novel Coronavirus 2019 has affected many countries around the world, due to the high virulence of the SARS-CoV-2, the recommended protocol to prevent infection is social isolation. The purpose of this study was to compare the number of patients admitted and their epidemiological data on a Level 1 Trauma Hospital after the declaration of the pandemic status and the first week of mandatory lockdown, with the same period of time in the last year. This was a retrospective study of medical records from the patients admitted in the Oral and Maxillofacial Surgery of the João XXIII Hospital, between the March 24 and March 31 of 2020 and the same period of the last year. There was a 52.27% decrease in the total number of patients and 76.34% decrease in the total consultations of the service of oral and maxillofacial surgery during the lockdown. All the groups presented a decrease in significance with motor vehicle accidents events, the group 11 to 20 years old presented an increase on the correlation with violence (P = 0.019) and falls (P = 0.002). When comparing both sex with the etiologies, the male one presented an increase in the correlation with violence and falls. The female sex presented correlations only with the minor causes. No valid significance was observed when comparing females with violence events. The lockdown is an effective way to reduce the transmission of the COVID-19, the hospital usage and occupation.


Subject(s)
COVID-19 , Surgery, Oral , Adolescent , Adult , Child , Communicable Disease Control , Female , Hospitals , Humans , Male , Pandemics , Retrospective Studies , SARS-CoV-2 , Young Adult
20.
Evid Based Dent ; 22(2): 74-75, 2021 01.
Article in English | MEDLINE | ID: covidwho-1281702

ABSTRACT

Design Cross-sectional study/special report.Study population This paper presents the early experience of the oral and maxillofacial surgery department at Hadassah University Medical Centre in Jerusalem during the first wave of the COVID-19 pandemic in 2020. The study involved both medical staff and patients.Data analysis A retrospective analysis of an eight-week period (February-April 2020) collated 1,471 patient records and examined diagnoses, procedures performed and COVID-19 status of patients and staff. Any attempts made to access routine dental care before presentation in secondary care were recorded.Results In the study period, one member of staff was confirmed as COVID-19-positive. Sixty-three patients had formal COVID-19 tests; all were negative. Forty-three patients were admitted for drainage of odontogenic fascial space infections; 53% reported delayed or failed attempts to access dental care before their infection. Additionally, the authors describe a screening process, personal protective equipment (PPE) allocation and staff/patient testing protocols employed in their surgical unit throughout this period.Conclusions The authors suggest a series of triage and screening measures to limit the risk of unknowingly exposing clinical staff to the COVID-19 virus and offer advice on safely delaying non-emergency treatment where necessary. Recommendations for use of PPE for aerosol and non-aerosol generating procedures are made, but it is important to recognise that the efficacy of these measures cannot be determined by the methodology employed. This paper demonstrates an early example of complications developing from absent or delayed routine dental services resulting from lockdowns. This 'excess morbidity' is likely to have an impact on healthcare services as the pandemic recovery unfolds and services begin to return to normal.


Subject(s)
COVID-19 , Oral Surgical Procedures , Surgery, Oral , Communicable Disease Control , Cross-Sectional Studies , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
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