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1.
J Healthc Manag ; 66(4): 304-322, 2021.
Article in English | MEDLINE | ID: covidwho-1475893

ABSTRACT

EXECUTIVE SUMMARY: While the COVID-19 pandemic has added stressors to the lives of healthcare workers, it is unclear which factors represent the most useful targets for interventions to mitigate employee distress across the entire healthcare team. A survey was distributed to employees of a large healthcare system in the Southeastern United States, and 1,130 respondents participated. The survey measured overall distress using the 9-item Well-Being Index (WBI), work-related factors, moral distress, resilience, and organizational-level factors. Respondents were also asked to identify major work, clinical, and nonwork stressors. Multivariate regression was used to evaluate associations between employee characteristics and WBI distress score. Overall, 82% of employees reported high distress (WBI ≥ 2), with nurses, clinical support staff, and advanced practice providers reporting the highest average scores. Factors associated with higher distress included increased job demands or responsibilities, heavy workload or long hours, higher frequency of moral distress, and loneliness or social isolation. Factors associated with lower distress were perceived organizational support, work control, perceived fairness of salary cuts, and resilience. Most factors significantly associated with distress-heavy workloads and long hours, increased job demands, and moral distress, in particular-were work-related, indicating that efforts can be made to mitigate them. Resilience explained a small portion of the variance in distress relative to other work-related factors. Ensuring appropriate staffing levels may represent the single largest opportunity to significantly move the needle on distress. However, the financial impact of the COVID-19 pandemic on the healthcare system may represent a barrier to addressing these stressors.


Subject(s)
COVID-19 , Health Personnel/psychology , Job Satisfaction , Occupational Stress , Patient Care Team , Stress, Psychological , Workload/psychology , Adult , Female , Health Personnel/statistics & numerical data , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Surveys and Questionnaires , Workload/statistics & numerical data
3.
Int J Circumpolar Health ; 80(1): 1959700, 2021 12.
Article in English | MEDLINE | ID: covidwho-1352067

ABSTRACT

The aim of this study is to identify how managers of micro-sized enterprises experience the impact of the Covid-19 pandemic on their business operations, work-life balance and well-being. Further, the study aims to make comparisons between managers of micro-sized businesses and managers of small-sized businesses. This mixed-method study is based on qualitative interviews with ten managers of micro-sized enterprises and a questionnaire answered by 95 managers of micro-sized and small-sized enterprises in regions in the north of Sweden. Managers of micro-sized enterprises reported significantly worse scores for mental well-being, job satisfaction and life satisfaction in comparison with managers of small-sized enterprises. Three themes emerged from the qualitative analysis: Changed leadership role, Impact on private life and Impact on well-being. In the interviews, the managers of micro-sized enterprises reported that the pandemic had increased their workload and forced them to mobilise strategies for enterprise survival. This study indicates that managers of micro-sized enterprises had changed their leadership role and increased their workload and number of work tasks, including supporting the employees, developing strategies for business survival and applying for governmental support. However, the managers demonstrated creativity in finding new solutions for their enterprises.


Subject(s)
Administrative Personnel/psychology , COVID-19/prevention & control , Entrepreneurship/statistics & numerical data , Small Business/organization & administration , Work-Life Balance , Workload/statistics & numerical data , COVID-19/epidemiology , Humans , Occupational Health/statistics & numerical data , Occupational Health Services/organization & administration , Sweden
5.
Br J Nurs ; 30(14): 840-844, 2021 Jul 22.
Article in English | MEDLINE | ID: covidwho-1319860

ABSTRACT

BACKGROUND: Inflammatory bowel disease (IBD) is a chronic relapsing and remitting condition. The COVID-19 pandemic has severely disrupted provision of medical care across the world. IBD clinical nurse specialists (CNSs) played a pivotal role in the care of children with IBD during the pandemic national lockdown and in the recovery phase. This article aims to look at the impact of COVID-19 on the paediatric IBD service in one children's hospital and the effect on the IBD CNSs' workload. METHOD: A retrospective review of clinical notes and the service's IBD database from January 2019 to September 2020. RESULTS: There was a significant increase in the number of email and telephone contacts to the IBD CNS team during lockdown. There was an increase in virtual clinics, and an increase in new IBD patients coming to the service, but a reduction in the number of face-to-face consultant clinics. CONCLUSION: COVID-19 has disrupted medical services to children with IBD and led to a reduction in face-to-face activities but has also led to a significant increase in virtual activities. CNSs have taken up a wider role to cover patient care during a time of both medical and nursing redeployment.


Subject(s)
COVID-19 , Inflammatory Bowel Diseases , Nurse Clinicians , Nurse's Role , Child , Hospitals, Pediatric , Humans , Inflammatory Bowel Diseases/nursing , Retrospective Studies , United Kingdom/epidemiology , Workload/statistics & numerical data
6.
Ann Glob Health ; 87(1): 51, 2021 06 24.
Article in English | MEDLINE | ID: covidwho-1296121

ABSTRACT

Background: Nurses working in treating patients with COVID-19 are exposed to various stressors, such as fear of COVID-19, stress, and high workload, leading to burnout. Objectives: This study aimed to identify the level of burnout and its predictors in nurses working in hospitals for COVID-19 patients. Methods: Participants in this study were nurses working in 11 hospitals for COVID-19 patients in the Fars province of Iran. The Maslach burnout and the UK Health and Safety stress questionnaires were used to assess burnout and stress, respectively. Analysis, using multiple regression in the SPSS21 software, aimed to identify the factors affecting burnout. Findings: The mean level of burnout in the nurses at the COVID-19 hospitals was 57 out of 120, and burnout was affected by workload (ß = 0.69, p < 0.001), job stress (ß = 0.25, p < 0.001) and inadequate hospital resources for the prevention of COVID-19 (ß = -0.16, p < 0.001). These three variables explained 87% of the variance in burnout. Conclusions: The burnout of nurses directly exposed to COVID-19 patients is more than nurses in other wards, and workload is the most significant cause of burnout in them. Therefore, necessary measures such as hiring more nurses, reducing working hours and increasing rest periods are necessary to reduce workload. In addition, the job stress of these nurses should be managed and controlled, and the hospital resources needed to prevent this disease should be provided.


Subject(s)
Burnout, Professional , COVID-19 , Nurses , Occupational Stress , Work Schedule Tolerance/psychology , Workload , Adult , Burnout, Professional/epidemiology , Burnout, Professional/prevention & control , Burnout, Professional/psychology , COVID-19/epidemiology , COVID-19/nursing , COVID-19/psychology , Fear/psychology , Female , Health Services Needs and Demand , Humans , Infection Control/methods , Iran/epidemiology , Male , Nurses/psychology , Nurses/supply & distribution , Occupational Stress/complications , Occupational Stress/prevention & control , SARS-CoV-2 , Workload/psychology , Workload/standards , Workload/statistics & numerical data
8.
BMC Pregnancy Childbirth ; 21(1): 416, 2021 Jun 04.
Article in English | MEDLINE | ID: covidwho-1259189

ABSTRACT

BACKGROUND: On the 27th of March 2020 the Zimbabwean government declared the Covid-19 pandemic a 'national disaster'. Travel restrictions and emergency regulations have had significant impacts on maternity services, including resource stock-outs, and closure of antenatal clinics during the lockdown period. Estimates of the indirect impact of Covid-19 on maternal and perinatal mortality was expected it to be considerable, but little data was yet available. This study aimed to examine the impact of Covid-19 and lockdown control measures on non-Covid outcomes in a government tertiary level maternity unit in Bulawayo, Zimbabwe, by comparing maternal and perinatal morbidity and mortality before, and after the lockdown was implemented. METHODS: This was a retrospective, observational study, using a cross-sectional design to compare routine monthly maternal and perinatal statistics three months before and after Covid-19 emergency measures were implemented at Mpilo Central Hospital. RESULTS: Between January-March and April-June 2020, the mean monthly deliveries reduced from 747.3 (SD ± 61.3) in the first quarter of 2020 to 681.0 (SD ± 17.6) during lockdown, but this was not statistically significant, p = 0.20. The Caesarean section rates fell from a mean of 29.8% (SD ± 1.7) versus 28.0% (SD ± 1.7), which was also not statistically significant, p = 0.18. During lockdown, the percentage of women delivering at Mpilo Central Hospital who were booked at the hospital fell from a mean of 41.6% (SD ± 1.1) to 35.8% (SD ± 4.3) which was statistically significant, p = 0.03. There was no significant change, however, in maternal mortality or severe maternal morbidity (such as post-partum haemorrhage (PPH), uterine rupture, and severe preeclampsia/eclampsia), stillbirth rate or special care baby unit admission. There was an increase in the mean total number of early neonatal deaths (ENND) (mean 18.7 (SD ± 2.9) versus 24.0 (SD ± 4.6), but this was not statistically significant, p = 0.32. CONCLUSIONS: Overall, maternity services at Mpilo showed resilience during the lockdown period, with no significant change in maternal and perinatal adverse outcomes, with the same number of man-hours worked before and during the lockdown Maternal and perinatal outcomes should continue to be monitored to assess the impact of Covid-19 and the lockdown measures as the pandemic in Zimbabwe unfolds. Further studies would be beneficial to explore women's experiences and understand how bookings and deliveries at local clinics changed during this time.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control , Maternal Health Services/statistics & numerical data , Tertiary Care Centers/statistics & numerical data , Cross-Sectional Studies , Female , Humans , Maternal Health Services/trends , Maternal Mortality , Morbidity , Perinatal Mortality , Pregnancy , Pregnancy Outcome , Retrospective Studies , SARS-CoV-2 , Tertiary Care Centers/trends , Workload/statistics & numerical data , Zimbabwe/epidemiology
9.
Diagn Microbiol Infect Dis ; 101(2): 115426, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1230428

ABSTRACT

OBJECTIVES: To quantify the workload and cost overload that the COVID-19 pandemic has meant for a Clinical Microbiology laboratory in a real-life scenario. METHODS: We compared the number of samples received, their distribution, the human resources, and the budget of a Microbiology laboratory in the COVID pandemic (March-December 2020) with the same months of the previous year. RESULTS: the total number of samples processed in the Clinical Microbiology laboratory in March to December 2020 increased 96.70% with respect to 2019 (from 246,060 to 483,993 samples), reflecting an increment of 127.50% when expressed as samples/1000 admissions (from 6057 to 13,780). The increase in workload was mainly at the expense of the virology (+2058%) and serology (+86%) areas. Despite additional personnel hiring, the samples processed per technician increased 12.5%. The extra cost attributed to Microbiology amounts to 6,616,511 euros (114.8%). CONCLUSIONS: This is the first study to provide quantitative figures about workload and cost increase caused by the COVID-19 in a Microbiology laboratory.


Subject(s)
COVID-19/epidemiology , Laboratories, Hospital/statistics & numerical data , COVID-19/diagnosis , COVID-19/economics , COVID-19 Testing/economics , COVID-19 Testing/statistics & numerical data , Clinical Laboratory Services/economics , Clinical Laboratory Services/statistics & numerical data , Costs and Cost Analysis , Hospitalization/statistics & numerical data , Humans , Laboratories, Hospital/economics , Medical Laboratory Personnel/economics , Medical Laboratory Personnel/statistics & numerical data , SARS-CoV-2/isolation & purification , Spain/epidemiology , Tertiary Care Centers , Workload/statistics & numerical data
10.
Lab Med ; 52(4): e115-e124, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1214641

ABSTRACT

OBJECTIVE: To explore the experiences of medical laboratory professionals (MLPs) and their perceptions of the needs of clinical laboratories in response to COVID-19. METHODS: We surveyed laboratory professionals working in United States clinical laboratories during the initial months of the pandemic. RESULTS: Overall clinical laboratory testing and overtime work for laboratorians decreased during the first months of the pandemic. Laboratory professionals reported better or unchanged job satisfaction, feelings toward their work, and morale in their workplace, which were related to healthcare facility and laboratory leadership response. They reported receiving in-kind gifts, but no hazard pay, for their essential work. Important supply needs included reagents and personal protective equipment (PPE). CONCLUSION: The response by healthcare facilities and laboratory leadership can influence MLPs job satisfaction, feelings toward their work, and laboratory morale during a pandemic. Current COVID-19 laboratory testing management, in the absence of sufficient reagents and supplies, cannot fully address the needs of clinical laboratories.


Subject(s)
COVID-19 , Laboratories , Medical Laboratory Personnel/statistics & numerical data , Occupational Health , Adult , Aged , Cross-Sectional Studies , Female , Humans , Job Satisfaction , Laboratories/organization & administration , Laboratories/statistics & numerical data , Laboratories/supply & distribution , Male , Middle Aged , Personal Protective Equipment/supply & distribution , SARS-CoV-2 , Surveys and Questionnaires , United States , Workload/statistics & numerical data , Young Adult
11.
J Nurs Scholarsh ; 53(3): 333-342, 2021 05.
Article in English | MEDLINE | ID: covidwho-1159166

ABSTRACT

PURPOSE: To explore how big data can be used to identify the contribution or influence of six specific workload variables: patient count, medication count, task count call lights, patient sepsis score, and hours worked on the occurrence of a near miss (NM) by individual nurses. DESIGN: A correlational and cross-section research design was used to collect over 82,000 useable data points of historical workload data from the three unique systems on a medical-surgical unit in a midsized hospital in the southeast United States over a 60-day period. Data were collected prior to the start of the Covid-19 pandemic in the United States. METHODS: Combined data were analyzed using JMP Pro version 12. Mean responses from two groups were compared using a t-test and those from more than two groups using analysis of variance. Logistic regression was used to determine the significance of impact each workload variable had on individual nurses' ability to administer medications successfully as measured by occurrence of NMs. FINDINGS: The mean outcome of each of the six workload factors measured differed significantly (p < .0001) among nurses. The mean outcome for all workload factors except the hours worked was found to be significantly higher (p < .0001) for those who committed an NM compared to those who did not. At least one workload variable was observed to be significantly associated (p < .05) with the occurrence or nonoccurrence of NMs in 82.6% of the nurses in the study. CONCLUSIONS: For the majority of the nurses in our study, the occurrence of an NM was significantly impacted by at least one workload variable. Because the specific variables that impact performance are different for each individual nurse, decreasing only one variable, such as patient load, will not adequately address the risk for NMs. Other variables not studied here, such as education and experience, might be associated with the occurrence of NMs. CLINICAL RELEVANCE: In the majority of nurses, different workload variables increase their risk for an NM, suggesting that interventions addressing medication errors should be implemented based on the individual's risk profile.


Subject(s)
Big Data , Near Miss, Healthcare/statistics & numerical data , Nursing Staff, Hospital , Workload/statistics & numerical data , Humans , Risk Factors , Southeastern United States
12.
Anxiety Stress Coping ; 34(5): 530-544, 2021 09.
Article in English | MEDLINE | ID: covidwho-1152995

ABSTRACT

BACKGROUND: After the worldwide outbreak of COVID-19 in 2020, many employees transitioned from in-office work to telework to slow down the spread of the virus. Building on the Job Demands-Resources model, we examined day-level relationships between job demands, home demands and emotional exhaustion during telework. Moreover, we tested if leisure crafting (i.e., the proactive pursuit and enactment of leisure activities targeted at goal setting, socializing, growth and development) is negatively related to emotional exhaustion. We expected that proactive personality would be positively related to leisure crafting. Finally, emotional exhaustion was predicted to relate negatively to job performance. METHODS: We tested our assumptions using a daily diary study on seven consecutive days with 178 employees (964 observations in total). RESULTS: Multilevel path analysis supports the assumptions that daily job demands as well as daily home demands during telework are positively related to emotional exhaustion. As predicted, we found leisure crafting to be negatively related to emotional exhaustion, and proactive personality to be positively related to leisure crafting. Finally, emotional exhaustion was negatively related to job performance. CONCLUSIONS: Overall, our study supports a health-promoting role of leisure crafting above the unfavorable relationships between job demands and home demands with emotional exhaustion.


Subject(s)
Burnout, Professional/psychology , COVID-19/epidemiology , Leisure Activities , Teleworking , Adult , Burnout, Professional/etiology , Burnout, Professional/prevention & control , COVID-19/prevention & control , COVID-19/psychology , Female , Germany/epidemiology , Humans , Leisure Activities/psychology , Male , Rumination, Cognitive , Surveys and Questionnaires , Work Performance , Work-Life Balance , Workload/psychology , Workload/statistics & numerical data
13.
Acta Orthop ; 91(5): 556-561, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1153041

ABSTRACT

Background and purpose - The COVID-19 pandemic has been recognized as an unprecedented global health crisis. This is the first observational study to evaluate its impact on the orthopedic workload in a London level 1 trauma center (i.e., a major trauma center [MTC]) before (2019) and during (2020) the "golden month" post-COVID-19 lockdown.Patients and methods - We performed a longitudinal observational prevalence study of both acute orthopedic trauma referrals, operative and anesthetic casemix for the first "golden" month from March 17, 2020. We compared the data 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 trauma referrals in the post-COVID period were almost halved compared with 2019, with similar distribution between pediatric and adult patients, requiring a significant 19% more admissions (RR 1.3, OR 2.6, p = 0.003). Hip fractures and polytrauma cases accounted for an additional 11% of the modal number of injuries in 2020, but with 19% reduction in isolated limb injuries that were modal in 2019. Total operative cases fell by a third during the COVID-19 outbreak. There was a decrease of 14% (RR 0.85, OR 0.20, p = 0.006) in aerosol-generating anesthetic techniques used.Interpretation - The impact of the COVID-19 pandemic has led to a decline in the number of acute trauma referrals, admissions (but increased risk and odds ratio), operations, and aerosolizing anesthetic procedures since implementing social distancing and lockdown measures during the "golden month."


Subject(s)
COVID-19 , Musculoskeletal System/injuries , Workload/statistics & numerical data , Adolescent , Adult , Aged , COVID-19/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , London , Longitudinal Studies , Male , Middle Aged , Referral and Consultation/statistics & numerical data , Trauma Centers/statistics & numerical data , Wounds and Injuries/epidemiology , Wounds and Injuries/surgery , Young Adult
14.
J Psychosoc Oncol ; 39(3): 461-468, 2021.
Article in English | MEDLINE | ID: covidwho-1124595

ABSTRACT

The extent to which oncology social workers (OSWs) are available and adapting to disruptions in service delivery throughout the COVID-19 pandemic is unknown.Objectives: The purpose of this report is to outline the initial impact of COVID-19 on oncology social work practice during the first six months of the pandemic.Methods: As part of a nationwide investigation of workforce conditions for OSWs, three professional organizations surveyed their members to assess the effects of COVID-19 on changes to work hours, employment status, work setting, pay, and mode for patient contact (e.g., telephone or videoconference).Findings: Among 939 OSWs, 20% reported a reduction in work hours, and two-thirds indicated a temporary shift in work to home, with most patient contact occurring primarily via telephone or videoconference.Implications: Results speak to the essential nature of oncology social work and the need for evidence to inform OSW training and advocacy efforts for however long the pandemic continues.


Subject(s)
COVID-19 , Health Personnel/statistics & numerical data , Neoplasms/rehabilitation , Professional Practice/statistics & numerical data , Social Work/statistics & numerical data , Social Workers/statistics & numerical data , Telemedicine/statistics & numerical data , Workload/statistics & numerical data , Adult , Humans , Psycho-Oncology , Telecommunications , Telephone
15.
Radiol Med ; 126(5): 717-721, 2021 May.
Article in English | MEDLINE | ID: covidwho-1107863

ABSTRACT

BACKGROUND AND PURPOSE: COVID-19 constitutes a worldwide threat, prompting Italian Government to implement specific measures on March 8, 2020, to protect patients and health workers from disease transmission. The impact of preventive measures on daily activity of a radiotherapy facility may hamper the ability to fulfill normal workload burden. Thus, we assessed the number of delivered treatments in a specific observation period after the adoption of preventive measures (since March 11 to April 24, 2020) and compared it with the corresponding period of the year 2019. MATERIALS AND METHODS: Overall number of delivered fractions was related to actual time of platform daily activity and reported as a ratio between number of delivered fractions and activity hours (Fr/Hrs). Fr/Hrs were calculated and compared for two different periods of time, March 11-April 24, 2019 (Fr/Hrs1), and March 11-April 24, 2020 (Fr/Hrs2). RESULTS: Fr/Hrs1 and Fr/Hrs2 were 2.66 and 2.54 for year 2019 and 2020, respectively, for a Fr/Hrsratio of 1.07 (95% CI 1.03-1.12, p = 0.0005). Fr/Hrs1 was significantly higher than Fr/Hrs2 for SliR and PreciseR, with Fr/Hrsratio of 1.92 (95% CI 1.66-2.23, p < 0.0001) and 1.11 (95% CI 1.03-1.2, p = 0.003), respectively. No significant difference was reported for SynergyR and CyberknifeR with Fr/Hrsratio of 0.99 (95% CI 0.91-1.08, p = 0.8) and 0.9 (95% CI 0.77-1.06, p = 0.2), respectively. Fr/Hrs1 was significantly lower than Fr/Hrs2 for TomotherapyR, with Fr/Hrsratio of 0.88 (95% CI 0.8-0.96, p = 0.007). CONCLUSION: Preventive measures did not influence workload burden performed. Automation in treatment delivery seems to compensate effectively for health workers number reduction.


Subject(s)
COVID-19 , Health Facilities/statistics & numerical data , Radiotherapy/statistics & numerical data , Workload/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Italy/epidemiology
17.
Infect Dis Health ; 26(1): 3-10, 2021 02.
Article in English | MEDLINE | ID: covidwho-1065108

ABSTRACT

BACKGROUND: Doctors commonly continue to work when they are unwell. This norm is increasingly problematic during the COVID-19 (SARS-CoV-2) pandemic when effective infection control measures are of paramount importance. This study investigates the barriers existing before COVID-19 that prevent junior doctors with an acute respiratory illness working in Canberra, Australia, from taking sick leave, and offers suggestions about how to make sick leave more accessible for junior doctors. METHODS: Anonymous online survey study. RESULTS: 192 junior doctors were invited to participate in the study. Fifty-four responded, and only those who had worked whilst unwell with an acute respiratory illness were included, providing a total number of fifty responses. Of these, 72% believed they were infectious at the time they worked whilst unwell. 86% of respondents did not feel supported by the workplace to take sick leave when they were unwell, and 96% identified concerns about burdening colleagues with extra workload and lack of available cover as the main deterrents to accessing sick leave. CONCLUSION: Junior doctors at our health service, pre-COVID-19, do not widely feel empowered to take sick leave when they have an acute respiratory illness. Junior doctors are primarily concerned about burdening their colleagues with extra workloads in an environment where they perceive there to be a lack of available cover. Having more available cover, leadership from seniors, and clearer guidelines around the impact of sick leave on registration may contribute to a culture where junior doctors feel supported to access sick leave.


Subject(s)
Attitude of Health Personnel , Medical Staff, Hospital/statistics & numerical data , Physicians/statistics & numerical data , Sick Leave/statistics & numerical data , Workload/psychology , Australia , COVID-19 , Humans , Infection Control , Respiratory Tract Infections/physiopathology , Surveys and Questionnaires , Workload/standards , Workload/statistics & numerical data
18.
mSphere ; 6(1)2021 01 13.
Article in English | MEDLINE | ID: covidwho-1066824

ABSTRACT

Information on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread in Africa is limited by insufficient diagnostic capacity. Here, we assessed the coronavirus disease (COVID-19)-related diagnostic workload during the onset of the pandemic in the central laboratory of Benin, Western Africa; characterized 12 SARS-CoV-2 genomes from returning travelers; and validated the Da An RT-PCR-based diagnostic kit that is widely used across Africa. We found a 15-fold increase in the monthly laboratory workload due to COVID-19, dealt with at the cost of routine activities. Genomic surveillance showed near-simultaneous introduction of distinct SARS-CoV-2 lineages termed A.4 and B.1, including the D614G spike protein variant potentially associated with higher transmissibility from travelers from six different European and African countries during March-April 2020. We decoded the target regions within the ORF1ab and N genes of the Da An dual-target kit by MinION-based amplicon sequencing. Despite relatively high similarity between SARS-CoV-2 and endemic human coronaviruses (HCoVs) within the ORF1ab target domain, no cross-detection of high-titered cell culture supernatants of HCoVs was observed, suggesting high analytical specificity. The Da An kit was highly sensitive, detecting 3.2 to 9.0 copies of target-specific in vitro transcripts/reaction. Although discrepant test results were observed in low-titered clinical samples, clinical sensitivity of the Da An kit was at least comparable to that of commercial kits from affluent settings. In sum, virologic diagnostics are achievable in a resource-limited setting, but unprecedented pressure resulting from COVID-19-related diagnostics requires rapid and sustainable support of national and supranational stakeholders addressing limited laboratory capacity.IMPORTANCE Months after the start of the COVID-19 pandemic, case numbers from Africa are surprisingly low, potentially because the number of SARS-CoV-2 tests performed in Africa is lower than in other regions. Here, we show an overload of COVID-19-related diagnostics in the central laboratory of Benin, Western Africa, with a stagnating average number of positive samples irrespective of daily sample counts. SARS-CoV-2 genomic surveillance confirmed a high genomic diversity in Benin introduced by travelers returning from Europe and other African countries, including early circulation of the D614G spike mutation associated with potentially higher transmissibility. We validated a widely used RT-PCR kit donated by the Chinese Jack Ma Foundation and confirmed high analytical specificity and clinical sensitivity equivalent to tests used in affluent settings. Our assessment shows that although achievable in an African setting, the burden from COVID-19-related diagnostics on national reference laboratories is very high.


Subject(s)
COVID-19 Nucleic Acid Testing , COVID-19/diagnosis , SARS-CoV-2/isolation & purification , Adult , Benin/epidemiology , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , COVID-19 Nucleic Acid Testing/methods , COVID-19 Nucleic Acid Testing/statistics & numerical data , Developing Countries , Female , Genome, Viral , Health Resources/supply & distribution , Health Services Accessibility/statistics & numerical data , Humans , Male , Middle Aged , SARS-CoV-2/genetics , Sensitivity and Specificity , Travel-Related Illness , Workload/statistics & numerical data
19.
J Am Coll Radiol ; 17(11): 1453-1459, 2020 11.
Article in English | MEDLINE | ID: covidwho-1065250

ABSTRACT

PURPOSE: The operational and financial impact of the widespread coronavirus disease 2019 (COVID-19) curtailment of imaging services on radiology practices is unknown. We aimed to characterize recent COVID-19-related community practice noninvasive diagnostic imaging professional work declines. METHODS: Using imaging metadata from nine community radiology practices across the United States between January 2019 and May 2020, we mapped work relative value unit (wRVU)-weighted stand-alone noninvasive diagnostic imaging service codes to both modality and body region. Weekly 2020 versus 2019 wRVU changes were analyzed by modality, body region, and site of service. Practice share χ2 testing was performed. RESULTS: Aggregate weekly wRVUs ranged from a high of 120,450 (February 2020) to a low of 55,188 (April 2020). During that -52% wRVU nadir, outpatient declines were greatest (-66%). All practices followed similar aggregate trends in the distribution of wRVUs between each 2020 versus 2019 week (P = .96-.98). As a percentage of total all-practice wRVUs, declines in CT (20,046 of 63,992; 31%) and radiography and fluoroscopy (19,196; 30%) were greatest. By body region, declines in abdomen and pelvis (16,203; 25%) and breast (12,032; 19%) imaging were greatest. Mammography (-17%) and abdominal and pelvic CT (-14%) accounted for the largest shares of total all-practice wRVU reductions. Across modality-region groups, declines were far greatest for mammography (-92%). CONCLUSIONS: Substantial COVID-19-related diagnostic imaging work declines were similar across community practices and disproportionately impacted mammography. Decline patterns could facilitate pandemic second wave planning. Overall implications for practice workflows, practice finances, patient access, and payment policy are manifold.


Subject(s)
COVID-19/epidemiology , Diagnostic Imaging/statistics & numerical data , Workload/statistics & numerical data , Diagnostic Imaging/economics , Humans , Pandemics , Relative Value Scales , SARS-CoV-2 , United States/epidemiology , Workload/economics
20.
Acta Biomed ; 91(4): e2020166, 2020 11 10.
Article in English | MEDLINE | ID: covidwho-1059640

ABSTRACT

BACKGROUND: On March 9th, 2020, the Italian government decided to go into lockdown due to the COVID-19 pandemic, which led to changes in the workflow of radiological examinations. AIMS: Aim of the study is to illustrate how the workload and outcome of radiological exams changed in a community hospital during the pandemic. METHODS AND MATERIAL: The exams performed in the radiology department from March 9th to March 29th, 2020 were retrospectively reviewed and compared to the exams conducted during the same time-period in 2019. Only exams coming from the emergency department (ED) were included. Two radiologists defined the cases as positive or negative findings, based on independent blind readings of the imaging studies. Categorical measurements are presented as frequency and percentages, and p-values are calculated using the Chi-squared test. RESULTS AND CONCLUSIONS: There was a significant reduction in the amount of exams performed in 2020: there were 143 (93|65% male, 60.7±21.5 years) patients who underwent radiological examinations from the ED vs. 485 (255|53% male, 51.2±24.8 years) in 2019. Furthermore, the total number of ED exams dropped from 699 (2019) to 215 (2020). However, the percentage of patients with a positive result was significantly higher in 2020 (69|48%) compared to 2019 (151|31%) (p<.001). The reduction of emergency radiological examinations might be a result of the movement restrictions enforced during the lockdown, and possible fear of the hospital as a contagious place. This translated to a relative increase of positive cases as only patients with very serious conditions were accessing the ED.


Subject(s)
COVID-19 , Quarantine , Radiography/statistics & numerical data , Workload/statistics & numerical data , Adult , Aged , Aged, 80 and over , Emergency Service, Hospital/statistics & numerical data , Female , Hospitals, Community , Humans , Italy , Male , Middle Aged , Radiology Department, Hospital/statistics & numerical data , Retrospective Studies
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