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1.
J Med Ethics ; 48(7): 430-433, 2022 07.
Article in English | MEDLINE | ID: covidwho-1909808

ABSTRACT

Physicians expressing opinions on medical matters that run contrary to the consensus of experts pose a challenge to licensing bodies and regulatory authorities. While the right to express contrarian views feeds a robust marketplace of ideas that is essential for scientific progress, physicians advocating ineffective or dangerous cures, or actively opposing public health measures, pose a grave threat to societal welfare. Increasingly, a distinction has been made between professional speech that occurs during the physician-patient encounter and public speech that transpires beyond the clinical setting, with physicians being afforded wide latitude to voice empirically false claims outside the context of patient care. This paper argues that such a bifurcated model does not sufficiently address the challenges of an age when mass communications and social media allow dissenting physicians to offer misleading medical advice to the general public on a mass scale. Instead, a three-tiered model that distinguishes between citizen speech, physician speech and clinical speech would best serve authorities when regulating physician expression.


Subject(s)
Ducks , Physicians , Animals , Communication , Freedom , Humans , Physician-Patient Relations
2.
J Healthc Leadersh ; 12: 85-94, 2020.
Article in English | MEDLINE | ID: covidwho-1793328

ABSTRACT

PURPOSE: The aim of the study is to evaluate the prevalence and extent of burnout among physicians and investigate the factors related with burnout and the influence of the fight against coronavirus (COVID-19) on the burnout syndrome. METHODS: A cross-sectional survey design was adopted and conducted on 200 actively working physicians in Izmir/Turkey. Personal Information Form and Maslach Burnout Inventory were used in the survey. RESULTS: The findings showed that the emotional exhaustion level of the physicians was medium, the levels of depersonalization and personal accomplishment were low, and the level of total burnout was low. It was observed that the burnout levels of males and females, and married and single physicians were similar. The emotional exhaustion level of 18-23-year-old physicians was lower than the rest of the physicians. Physicians' level of satisfaction with their income is not effective on burnout. The burnout level of physicians who did not choose their profession willingly was determined to be higher than the burnout level of the physicians who chose their profession willingly. One important finding showed that the burnout level of physicians who actively involved in the fight against COVID-19 was lower than the burnout level of the physicians who did not actively involve in the fight against COVID-19. CONCLUSION: Although the impact of some demographic variables, such as gender, marital status and satisfaction of income on burnout, was similar among the groups, total burnout level was lower in physicians who actively fought with the virus. This result may suggest that those physicians who were actively involved in the fight against COVID-19 had a high sense of meaningfulness of work which will result in high satisfaction with the work itself and, thus, creating less burnout. Also, they had a stronger feeling of personal accomplishment as they faced the immediate outcomes of their care for people infected by COVID-19.

3.
Int J Environ Res Public Health ; 17(9)2020 05 02.
Article in English | MEDLINE | ID: covidwho-1725600

ABSTRACT

The number of COVID-19 (Coronavirus Disease of 2019) cases in Jordan is rising rapidly. A serious threat to the healthcare system appears on the horizon. Our study aims to evaluate preparedness of Jordanian frontline doctors to the worsening scenario. It has a questionnaire-based cross-sectional structure. The questionnaire was designed to evaluate preparedness according to knowledge about virus transmission and protective measures, adherence to protection guidelines, and psychological impacts affecting doctors. Institutional factors affecting doctors' readiness like adopting approach protocols and making protection equipment available were investigated; 308 doctors from different healthcare facilities participated (response rate: 53.9%). Approximately 25% of doctors (n = 77) previously took care of COVID-19 patients, and 173 (56.2%) have institutional COVID-19 approach protocols. Only 57 doctors (18.5%) reported all PPE (Personal Protective Equipment) available. The self-reported score of preparedness to deal with COVID-19 patients was 4.9 ± 2.4. Doctors having institutional protocols for dealing with COVID-19 cases and those with sustained availability of PPE reported higher scores of preparedness (5.5 ± 2.3 and 6.2 ± 2.1 with p < 0.001, respectively). Correlations with knowledge score, adherence to PPE score, and psychological impacts were investigated. The study revealed multiple challenges and insufficiencies that can affect frontline doctors' preparedness. Policy makers are urged to take these findings into consideration and to act promptly.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Disease Outbreaks , Health Knowledge, Attitudes, Practice , Physicians/psychology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Adult , COVID-19 , Cross-Sectional Studies , Female , Health Facilities , Humans , Jordan/epidemiology , Male , Pandemics , Personal Protective Equipment/supply & distribution , Physicians/statistics & numerical data , Surveys and Questionnaires
4.
Clin Infect Dis ; 73(1): e199-e205, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1290577

ABSTRACT

BACKGROUND: We evaluated the risk of death for health-care workers (HCW) with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Mexico City during the coronavirus disease 2019 (COVID-19) pandemic, and describe the associated factors in hospitalized HCW, compared with non-HCW. METHODS: We analyzed data from laboratory-confirmed SARS-CoV-2 cases registered from 27 February-31 August 2020 in Mexico City's public database. Individuals were classified as non-HCW or HCW (subcategorized as physicians, nurses, and other HCW). In hospitalized individuals, a multivariate logistic regression model was used to analyze the potential factors associated with death and compare mortality risks among groups. RESULTS: A total of 125 665 patients were included. Of these, 13.1% were HCW (28% physicians, 38% nurses, and 34% other HCW). Compared with non-HCW, HCW were more frequently female, were younger, and had fewer comorbidities. Overall, 25 771 (20.5%) were treated as inpatients and 11 182 (8.9%) deaths were reported. Deaths in the total population (9.9% vs 1.9%, respectively; P < .001) and in hospitalized patients (39.6% vs 19.3%, respectively; P < .001) were significantly higher in non-HCW than in HCW. In hospitalized patients, using a multivariate model, the risk of death was lower in HCW in general (odds ratio [OR], 0.53) than in non-HCW, and the risks were also lower by specific occupation (OR for physicians, 0.60; OR for nurses, 0.29; OR for other HCW 0.61). CONCLUSIONS: HCW represent an important proportion of individuals with SARS-CoV-2 infection in Mexico City. While the mortality risk is lower in HCW compared to non-HCW, a high mortality rate in hospitalized patients was observed in this study. Among HCW, nurses had a lower risk of death compared to physicians and other HCW.


Subject(s)
COVID-19 , SARS-CoV-2 , Female , Health Personnel , Humans , Mexico , Pandemics
5.
Disaster Med Public Health Prep ; : 1-5, 2021 Mar 25.
Article in English | MEDLINE | ID: covidwho-1270638

ABSTRACT

OBJECTIVE: The aim of this study was to assess the stigma associated with coronavirus disease - 2019 (COVID-19) among health care workers (HCWs) in Indonesia during the early phase of the pandemic. METHODS: A cross-sectional study was conducted in 12 hospitals across the country in March, 2020. A logistic regression was employed to assess the association between stigma and explanatory variables. RESULTS: In total, 288 HCWs were surveyed, of which 93.4% had never experienced any outbreaks. Approximately 21.9% of the respondents had stigma associated with COVID-19. HCWs who were doctors, had not participated in trainings related to COVID-19, worked in the capital of the province, worked at private hospitals, or worked at a hospital with COVID-19 triage protocols were likely to have no stigma associated with COVID-19. CONCLUSIONS: The stigma associated with COVID-19 is relatively high among HCWs in the early phase of the COVID-19 pandemic in Indonesia. Adequate dissemination of knowledge and adequate protection are necessary to reduce stigma among HCWs.

6.
J Dr Nurs Pract ; 2021 Jun 09.
Article in English | MEDLINE | ID: covidwho-1264240

ABSTRACT

BACKGROUND: Severe acute respiratory infection Coronavirus 2 (SARS-CoV-2) infection has spread all over the world since December 2019. Treatment of the syndrome represents an important challenge for all physicians. Spread prevention relies on a correct diagnosis which is performed with nasopharyngeal swabs. OBJECTIVE: To describe the proper execution of the swab with a few simple steps. METHODS: Figures and video recording. RESULTS: A few simple steps are presented within this paper in order to perform easily nasopharyngeal swab for SARS-Cov-2 diagnosis and for other possible infectious diseases of the airways tract. CONCLUSIONS AND IMPLICATION FOR NURSING: Nasopharyngeal swab may be performed in an easier way than usually thought. This method may also be used for any other microorganism detection. By following simple steps, a correct diagnosis can easily be obtained.

7.
J Am Board Fam Med ; 34(3): 522-530, 2021.
Article in English | MEDLINE | ID: covidwho-1259318

ABSTRACT

INTRODUCTION: COVID-19 has spread rapidly, with vast global implications. This study assessed how family physicians in Kansas were responding to COVID-19 and the effects of the pandemic on their well-being. METHODS: The authors conducted a cross-sectional survey of 113 family physicians in Kansas between May 22, 2020 and June 25, 2020. The study participants completed an anonymous, 36-item survey assessing their concerns about being exposed to COVID-19 and levels of personal depression, anxiety, stress, and burnout in addition to demographic information. RESULTS: There was a 45.6% response rate, with 50.4% (n = 57) of the respondents reporting manifestations of burnout. The physicians who personally treated any presumptive or confirmed COVID-19 patient, compared with those who did not, were more likely to report at least 1 manifestation of burnout, experience emotional exhaustion, and feel a higher level of personal stress. CONCLUSION: Our findings demonstrate that the COVID-19 pandemic may be taking an emotional toll on family physicians in Kansas. This study provides a baseline from which to continue further monitoring of outcomes. Data can help drive initiatives at local, state, and national levels to help diminish the negative impact of the COVID-19 pandemic on physicians.


Subject(s)
Anxiety , Burnout, Professional , COVID-19/psychology , Depression/epidemiology , Physicians, Family/psychology , Anxiety/epidemiology , Burnout, Professional/epidemiology , Cross-Sectional Studies , Humans , Kansas/epidemiology , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
8.
JMIR Med Inform ; 9(6): e28497, 2021 Jun 03.
Article in English | MEDLINE | ID: covidwho-1256269

ABSTRACT

BACKGROUND: The COVID-19 pandemic spread worldwide in 2020. Notably, in the countries dealing with massive casualties, clinicians have worked in new conditions characterized by a heavy workload and a high risk of being infected. The issue of clinician burnout during the pandemic has attracted considerable attention in health care research. Electronic health records (EHRs) provide health care workers with several features to meet a health system's clinical needs. OBJECTIVE: We aim to examine how the use of EHR features affects the burnout of clinicians working in hospitals that have special wards for confirmed COVID-19 cases. METHODS: Using an online survey, we collected data from 368 physicians, physician assistants, and nurses working in six hospitals that have implemented EHRs in the city of Tehran in Iran. We used logistic regression to assess the association between burnout and awareness of EHR features, EHR system usability, concerns about COVID-19, technology solutions, hospital technology interventions, hospital preparedness, and professional efficacy adjusted for demographic and practice characteristics. RESULTS: The primary outcome of our study was self-reported burnout during the COVID-19 pandemic. Of the 368 respondents, 36% (n=134) reported having at least one symptom of burnout. Participants indicated that the leading cause of EHR-related stress is inadequate training for using technology (n=159, 43%), followed by having less face-to-face time with patients (n=140, 38%). Positive perceptions about the EHR's ease of use were associated with lower odds of burnout symptoms. More interventions, such as clear communication of regulations; transparency in policies, expectations, and goals regarding the use of technology in the clinical workflow; and hospital preparedness to cope with the challenges of the pandemic, were associated with lower odds of burnout. CONCLUSIONS: The use of EHR applications, hospital pandemic preparation programs, and transparent technology-related policies and procedures throughout the epidemic can be substantial mitigators of technology-based stress and clinician burnout. Hospitals will then be better positioned to devise or modify technology-related policies and procedures to support physicians' and nurses' well-being during the COVID-19 pandemic. Training programs, transparency in communications of regulations, and developing a clear channel for informing clinicians of changes in policies may help reduce burnout symptoms among physicians and nurses during a pandemic. Providing easily accessible mentorship through teleconsultation and 24-hour available information technology support may also help to mitigate the odds of burnout.

9.
Cureus ; 13(5): e15050, 2021 May 16.
Article in English | MEDLINE | ID: covidwho-1257012

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has caused a major global healthcare crisis, and the fields of science and medicine have been engaged in a massive effort to control and prevent the resultant deaths and morbidity. Researchers and pharmaceutical companies have developed in record time vaccines against COVID-19 that are intended to be safe and effective; however, the short validation time has been a challenge for doctors and epidemiologists, especially in light of the increase in reports emerging from various parts of the world about the adverse effects of the new vaccines. Portugal's national regulatory authority, the National Authority of Medicines and Health Products (INFARMED), has recently granted approval for Pfizer-BioNTech (Pfizer Inc., New York, NY; BioNTech SE, Mainz, Germany) and Moderna (Moderna, Inc, Cambridge, MA) COVID-19 vaccines, and they are being rolled out to be administered among the general population. In light of this, it is important for breast surgeons, family doctors, hematologists, and radiologists to consider the effects of recent COVID-19 vaccination history as a possible cause in the differential diagnosis for patients with unilateral cervical adenopathy. The objective of this report is to present a case that involves an adverse reaction involving acute-onset cervical lymphadenopathy in a female patient that coincided with her vaccination against COVID-19, even though cervical lymphadenopathy had not been previously reported as a potential side effect of the COVID-19 vaccination. We discuss the case of a Portuguese physician with a family history of breast cancer, who developed right cervical lymphadenopathy after receiving the first dose of the COVID-19 vaccine. Lymph node growth and ultrasound changes observed in the patient over the weeks, and a lack of information on the COVID-19 vaccine's adverse effects, prompted an in-depth study to understand its etiology.

10.
Expert Rev Vaccines ; 20(7): 881-889, 2021 07.
Article in English | MEDLINE | ID: covidwho-1254220

ABSTRACT

BACKGROUND: Understanding healthcare workers (HCWs) willingness to receive a future vaccination against coronavirus disease 2019 (COVID-19) may be useful. METHODS: Cross-sectional study, conducted in Italy from September 14th to November 30th, 2020, among 811 HCWs who undergo a voluntary antibody-testing for anti-SARS-CoV-2. RESULTS: The perceived risk level of developing COVID-19, measured on a Likert-type scale ranging from 1 to 10, was 6.6 and it was higher among females, older HCWs, and in those who agreed that COVID-19 is a severe disease. Married/cohabitant, not physicians, and those who needed additional information regarding the vaccination against COVID-19 were more likely to be concerned that COVID-19 vaccination might not be safe. Males, physicians, those who did not have had any symptom compatible with COVID-19, those who agreed that COVID-19 is a severe disease, those who perceived to be at higher risk of developing COVID-19, those who were not concerned about the vaccine's safety, and those who had received information regarding the COVID-19 vaccination from scientific journals expressed willingness to receive vaccination against COVID-19. CONCLUSIONS: Communication and education targeted to groups with lowest willingness are needed to raise awareness regarding the safety and benefits of the vaccination and to improve vaccine uptake.


Subject(s)
Attitude of Health Personnel , COVID-19 Vaccines/administration & dosage , COVID-19/psychology , Health Personnel/psychology , Surveys and Questionnaires , Vaccination/psychology , Adult , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Female , Humans , Italy/epidemiology , Male , Middle Aged , Patient Acceptance of Health Care/psychology , Pilot Projects
11.
Hosp Top ; : 1-12, 2021 May 24.
Article in English | MEDLINE | ID: covidwho-1240818

ABSTRACT

This study described how COVID-19 impacted employment, telehealth usage, and interprofessional collaboration. A cross-sectional survey was deployed in June 2020 to healthcare professionals in Florida. Job status was uniquely separated by profession, with more nurses and medical doctors reported having no effect, and more mental health counselors transitioned to telehealth. Over a third of rehabilitation providers reported being furloughed. Over forty percent of providers had no training in telehealth, yet 33.1% reported an increase in usage. Interprofessional interactions are lower across professions during the pandemic, compared with before. This study shows the need for additional training on telehealth and interprofessional collaboration.

12.
Int J Environ Res Public Health ; 18(10)2021 05 18.
Article in English | MEDLINE | ID: covidwho-1234732

ABSTRACT

BACKGROUND: burnout syndrome is a serious and growing problem among medical staff. Its adverse outcomes not only affect health-care providers' health, but also extend to their patients, resulting in bad-quality care. The COVID-19 pandemic puts frontline health-care providers at greater risk of psychological stress and burnout syndrome. OBJECTIVES: this study aimed to identify the levels of burnout among health-care professionals currently working at Assiut University hospitals during the COVID-19 pandemic. METHODS: the current study adopted an online cross-sectional design using the SurveyMonkey® website for data collection. A total of 201 physicians were included and the Maslach Burnout Inventory (MBI) scale was used to assess the three burnout syndrome dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. RESULTS: about one-third, two-thirds, and one-quarter of the respondents had high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Younger, resident, and single physicians reported higher burnout scores. The personal accomplishment score was significantly higher among males. Those working more than eight hours/day and dealing with COVID-19 patients had significantly higher scores. CONCLUSION: during the COVID-19 pandemic, a high prevalence of burnout was recorded among physicians. Age, job title, working duration, and working hours/day were significant predictors for burnout syndrome subscale results. Preventive and interventive programs should be applied in health-care organizations during pandemics.


Subject(s)
Burnout, Professional , COVID-19 , Burnout, Professional/epidemiology , Burnout, Psychological/epidemiology , Cross-Sectional Studies , Hospitals, University , Humans , Male , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
14.
J Community Health ; 46(6): 1161-1169, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1230268

ABSTRACT

The Covid-19 pandemic has exposed the difficulty of the US public health system to respond effectively to vulnerable subpopulations, causing disproportionate rates of morbidity and mortality. New York Haredi-Orthodox Jewish communities represent a group that have been heavily impacted by Covid-19. Little research has examined their experience or perceptions toward Covid-19 and vaccines. We conducted a cross-sectional, observational study to explore the experience of Covid-19 among Haredim. Paper surveys were self-administered between December 2020 and January 2021 in Haredi neighborhood pediatricians' offices in Brooklyn, New York. Of 102 respondents, 43% reported either a positive SARS-CoV-2 viral or antibody test. Participants trusted their physicians, Orthodox medical organizations, and rabbinic leaders for medical information. Knowledge of Covid-19 transmission and risk was good (69% answered ≥ 4/6 questions correctly). Only 12% of respondents would accept a Covid-19 vaccine, 41% were undecided and 47% were strongly hesitant. Independent predictors of strong vaccine hesitancy included believing natural infection to be better than vaccination for developing immunity (adjusted odds ratio [aOR] 4.28; 95% confidence interval [CI] 1.23-14.86), agreement that prior infection provides a path toward resuming communal life (aOR 4.10; 95% CI 1.22-13.77), and pandemic-related loss of trust in physicians (aOR 5.01; 95% CI 1.05-23.96). The primary disseminators of health information for self-protective religious communities should be stakeholders who understand these groups' unique health needs. In communities with significant Covid-19 experience, vaccination messaging may need to be tailored toward protecting infection-naïve individuals and boosting natural immunity against emerging variants.


Subject(s)
COVID-19 , Vaccines , Attitude , COVID-19 Vaccines , Cross-Sectional Studies , Humans , Jews , New York , Pandemics , SARS-CoV-2 , Vaccination
15.
BMJ Open ; 11(5): e050380, 2021 05 10.
Article in English | MEDLINE | ID: covidwho-1223611

ABSTRACT

OBJECTIVE: To determine the prevalence of physician burnout during the pandemic and differences by gender, ethnicity or sexual orientation. DESIGN, SETTING AND PARTICIPANTS: We conducted a cross-sectional survey (August-October in 2020) of internal medicine physicians at two academic hospitals in Vancouver, Canada. PRIMARY AND SECONDARY OUTCOMES: Physician burnout and its components, emotional exhaustion, depersonalisation and personal accomplishment were measured using the Maslach Burnout Inventory. RESULTS: The response rate was 38% (n=302/803 respondents, 49% women,). The prevalence of burnout was 68% (emotional exhaustion 63%, depersonalisation 39%) and feeling low personal accomplishment 22%. In addition, 21% reported that they were considering quitting the profession or had quit a position. Women were more likely to report emotional exhaustion (OR 2.00, 95% CI: 1.07 to 3.73, p=0.03) and feeling low personal accomplishment (OR 2.26, 95% CI: 1.09 to 4.70, p=0.03) than men. Visible ethnic minority physicians were more likely to report feeling lower personal accomplishment than white physicians (OR 1.81, 95% CI: 1.28 to 2.55, p=0.001). There was no difference in emotional exhaustion or depersonalisation by ethnicity or sexual orientation. Physicians who reported that COVID-19 affected their burnout were more likely to report any burnout (OR: 3.74, 95% CI: 1.99 to 7.01, p<0.001) and consideration of quitting or quit (OR: 3.20, 95% CI: 1.34 to 7.66, p=0.009). CONCLUSION: Burnout affects 2 out of 3 internal medicine physicians during the pandemic. Women, ethnic minority physicians and those who feel that COVID-19 affects burnout were more likely to report components of burnout. Further understanding of factors driving feelings of low personal accomplishment in women and ethnic minority physicians is needed.


Subject(s)
Burnout, Professional , COVID-19 , Physicians , Burnout, Professional/epidemiology , Burnout, Psychological , Canada/epidemiology , Cross-Sectional Studies , Female , Humans , Job Satisfaction , Male , Minority Groups , Pandemics , SARS-CoV-2 , Sexual Behavior , Surveys and Questionnaires
16.
Int J Clin Pract ; 75(8): e14319, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1223493

ABSTRACT

BACKGROUND: The impact of lockdown measures can be widespread, affecting both clinical and psychosocial aspects of health. This study aims to assess changes in health services access, self-care, behavioural, and psychological impact of COVID-19 and partial lockdown amongst diabetes patients in Singapore. METHODS: We conducted a cross-sectional online survey amongst people with diabetes with the Diabetes Health Profile-18 (DHP-18). Hierarchical regression analyses were performed for each DHP-18 subscale (Psychological Distress, Disinhibited Eating and Barriers to Activity) as dependent variables in separate models. RESULTS: Among 301 respondents, 45.2% were women, 67.1% of Chinese ethnicity, 24.2% were aged 40 to 49 years, 68.4% have Type 2 diabetes and 42.2% on oral medications alone. During the pandemic and the lockdown, nearly all respondents were able to receive care safely from the clinics they attend (94%) and obtain their medications and diabetes equipment and supplies (97%) when needed. Respondents reported less frequent engagement in physical activity (38%), checking of blood pressure (29%) and blood glucose (22%). Previous diagnosis of mental health conditions (ß = 9.33, P = .043), Type 1 diabetes (ß = 12.92, P = .023), number of diabetes-related comorbidities (ß = 3.16, P = .007) and Indian ethnicity (ß = 6.65, P = .034) were associated with higher psychological distress. Comorbidities were associated with higher disinhibited eating (ß = 2.49, P = .014) while ability to reach their doctor despite not going to the clinic is negatively associated with psychological distress (ß = -9.50 P = .002) and barriers to activity (ß = -7.53, P = .007). CONCLUSION: Health services access were minimally affected, but COVID-19 and lockdown had mixed impacts on self-care and management behaviours. Greater clinical care and attention should be provided to people with diabetes with multiple comorbidities and previous mental health disorders during the pandemic and lockdown.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Self-Management , Communicable Disease Control , Cross-Sectional Studies , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/therapy , Female , Health Services Accessibility , Humans , SARS-CoV-2 , Singapore
17.
Health Sci Rep ; 4(2): e278, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1222625

ABSTRACT

OBJECTIVES: To investigate how personal protective equipment (PPE) guidance altered the facial hair of hospital doctors and explore the wider impact and implications of these changes. METHODS: A single site uncontrolled before-after survey study examining change in facial hairstyles, and wider implications on doctor's cultural, religious, and personal wellbeing. Outcome measures included change in facial hair between January and April 2020 and whether these changes adhered to guidance set by Public Health England. Participants were also asked about the wider impact of these changes which were thematically analyzed using an inductive approach. RESULTS: Of those who completed the survey, 257 participants met the inclusion criteria. 68% (n = 67) of doctors who could grow facial hair changed their facial hairstyle during the COVID-19 pandemic and 96% (n = 64) reported that the change was in response to PPE guidance. The odds of having a facial hairstyle that complied with PPE guidance before the pandemic was 0.32, which rose to 2.77 after guidance was released, giving an odds ratio of 8.54 (95% CI 4.49-16.23, P < .001). When compared to those who sported a shaven face prepandemic, the odds ratio of a change in style for those with prepandemic full beards was 37.92 (95% CI 7.45-192.8, P < .001), for goatees was 7.22 (95% CI 1.076-48.47, P = .04), for moustaches was 4.33 (95% CI 0.207-90.85, P = .345), and for stubble was 9.06 (95% CI 2.133-38.49, P = .003). Qualitative analysis revealed multiple themes, including skin irritation, loss of identity, and a significant impact on participants required to maintain a beard due to religious or cultural reasons. CONCLUSIONS: Facial hairstyles have changed significantly at our hospital during the COVID-19 pandemic. Facial hair can impact upon doctors' cultural, religious, and personal wellbeing and these factors need to be considered with policy and provision of PPE.

18.
Orphanet J Rare Dis ; 16(1): 204, 2021 05 06.
Article in English | MEDLINE | ID: covidwho-1219017

ABSTRACT

BACKGROUND: The global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causing the ongoing coronavirus disease 2019 (COVID-19) pandemic has raised serious concern for patients with chronic disease. A correlation has been identified between the severity of COVID-19 and a patient's preexisting comorbidities. Although COVID-19 primarily involves the respiratory system, dysfunction in multiple organ systems is common, particularly in the cardiovascular, gastrointestinal, immune, renal, and nervous systems. Patients with amyloid transthyretin (ATTR) amyloidosis represent a population particularly vulnerable to COVID-19 morbidity due to the multisystem nature of ATTR amyloidosis. MAIN BODY: ATTR amyloidosis is a clinically heterogeneous progressive disease, resulting from the accumulation of amyloid fibrils in various organs and tissues. Amyloid deposition causes multisystem clinical manifestations, including cardiomyopathy and polyneuropathy, along with gastrointestinal symptoms and renal dysfunction. Given the potential for exacerbation of organ dysfunction, physicians note possible unique challenges in the management of patients with ATTR amyloidosis who develop multiorgan complications from COVID-19. While the interplay between COVID-19 and ATTR amyloidosis is still being evaluated, physicians should consider that the heightened susceptibility of patients with ATTR amyloidosis to multiorgan complications might increase their risk for poor outcomes with COVID-19. CONCLUSION: Patients with ATTR amyloidosis are suspected to have a higher risk of morbidity and mortality due to age and underlying ATTR amyloidosis-related organ dysfunction. While further research is needed to characterize this risk and management implications, ATTR amyloidosis patients might require specialized management if they develop COVID-19. The risks of delaying diagnosis or interrupting treatment for patients with ATTR amyloidosis should be balanced with the risk of exposure in the health care setting. Both physicians and patients must adapt to a new construct for care during and possibly after the pandemic to ensure optimal health for patients with ATTR amyloidosis, minimizing treatment interruptions.


Subject(s)
Amyloid Neuropathies, Familial , COVID-19 , Amyloid , Humans , Pandemics , Prealbumin , SARS-CoV-2
19.
Obes Res Clin Pract ; 15(3): 281-284, 2021.
Article in English | MEDLINE | ID: covidwho-1209648

ABSTRACT

In our paper we aimed to increase the awareness among physicians, concerning coronavirus disease 2019 (COVID-19) severity, especially in patients with specific underlying comorbidities. Obesity is the second most common condition in hospitalized COVID-19 patients. Furthermore it has a major role in the development of obstructive sleep apnoea (OSA), which is highly involved in a severe COVID-19 development and its serious outcomes. Even though obese OSA patients had an increased pulmonary embolism (PE) risk, there is no enough evidence to support the interaction between obesity and OSA regarding PE development in the setting of COVID-19. Our patient is a 45-year-old obese male with COVID-19, who was admitted to the intensive care unit (ICU) with acute respiratory failure requiring high-flow nasal oxygenation. Clinical, laboratory and diagnostic findings pointed on severe COVID-19 form, complicated with PE. After recovery, the diagnosis of OSA was established. With this case, we wanted to alert the physicians on comorbidities, such as obesity and OSA, while those conditions, to some extent, may contribute to worse COVID-19 clinical presentation.


Subject(s)
COVID-19 , Hospitalization , Intensive Care Units , Obesity/complications , Severity of Illness Index , Sleep Apnea, Obstructive/complications , COVID-19/therapy , Comorbidity , Humans , Male , Middle Aged , Respiratory Insufficiency , Risk Factors , SARS-CoV-2
20.
BMC Public Health ; 21(1): 833, 2021 04 30.
Article in English | MEDLINE | ID: covidwho-1209120

ABSTRACT

BACKGROUND: The novel coronavirus disease-2019 (COVID-19) has seriously affected the lives of millions of people across the world. It has also heavily burdened healthcare professionals and the virus poses serious risks for their personal and professional lives. Therefore, the present study examined the associations between fear of COVID-19 and workplace phobia among doctors in Pakistan during the COVID-19 pandemic. METHODS: An online survey was conducted among 421 doctors in Pakistan between April 10 and May 25, 2020. The Workplace Phobia Scale (WPS) and the Fear of COVID-19 Scale (FCV-19S) were the main psychometric instruments used in this study. RESULTS: There was a significant positive relationship between fear of COVID-19 and workplace panic anxiety and workplace avoidance behavior. Significantly higher fear of COVID-19 was found among (i) females compared to males, (ii) doctors with 5 years or less of work experience compared to those with more than 5 years, and (iii) postgraduate trainees compared with other ranks. Two groups (doctors who were above 30 years old and postgraduate trainees) were found to have higher levels of workplace phobia compared to their counterparts. Doctors with severe levels of fear of COVID-19 had significantly higher levels of workplace panic anxiety and workplace avoidance behavior. CONCLUSIONS: Fear of COVID-19 was significantly associated with workplace phobia which may negatively affect doctors' performance. Therefore, important steps are needed to protect doctors' health by providing sufficient resources to allay their fears and anxieties which consequently help them in carrying out their frontline duties in response to the COVID-19 pandemic.


Subject(s)
COVID-19 , Phobic Disorders , Adult , Fear , Female , Humans , Male , Pakistan/epidemiology , Pandemics , SARS-CoV-2 , Workplace
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