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1.
Curr Psychol ; 41(2): 1057-1064, 2022.
Article in English | MEDLINE | ID: covidwho-1748411

ABSTRACT

As in the whole world, the Novel Coronavirus (COVID-19) pandemic poses many threats to healthcare workers in our country too, which leads to anxiety in healthcare workers. This study was conducted to explore the anxiety levels of healthcare workers during the COVID-19 pandemic. The study is a cross-sectional study. The population consisted of health care workers employed in hospitals in seven regions in Turkey. All volunteer healthcare workers were included in the study, and 356 healthcare workers responded to the questionnaire. The data were collected using the State Anxiety Inventory and a questionnaire created by the researchers using an online questionnaire between 10 May 2020 and 15 May 2020. In the evaluation of the data, mean, standard deviation, percentages, t-test, one-way ANOVA, Pearson correlation, and multiple regression analysis were used. 33% of healthcare workers did not have anxiety, 50% had mild, and 17% had severe anxiety. The anxiety scores of those who were nurses (p < 0.001), who were working in the emergency room (p < 0.001), who were involved in treatment for COVID-19 patients (p = 0.040), who left their homes to prevent transmission to their families and relatives during the pandemic (p = 0.038), and whose working hours had changed (p = 0.036) were found to be significantly higher. It was observed that there was a positive and significant relationship between the fear of death and disease transmission, uncertainty, loneliness, anger, and hopelessness, and anxiety levels in healthcare workers. The main factors that significantly affected the anxiety levels of healthcare workers were male gender, weekly working hours, the presence of chronic diseases, and feelings of anger and uncertainty. In conclusion, during the COVID-19 pandemic, healthcare workers experienced some negative emotions, their anxiety levels increased, and they were psychologically affected. Planning psychosocial interventions for healthcare workers in the high-risk group will make significant contributions to the health system.

2.
BMJ ; 369: m2195, 2020 06 10.
Article in English | MEDLINE | ID: covidwho-1430181

ABSTRACT

OBJECTIVE: To examine the protective effects of appropriate personal protective equipment for frontline healthcare professionals who provided care for patients with coronavirus disease 2019 (covid-19). DESIGN: Cross sectional study. SETTING: Four hospitals in Wuhan, China. PARTICIPANTS: 420 healthcare professionals (116 doctors and 304 nurses) who were deployed to Wuhan by two affiliated hospitals of Sun Yat-sen University and Nanfang Hospital of Southern Medical University for 6-8 weeks from 24 January to 7 April 2020. These study participants were provided with appropriate personal protective equipment to deliver healthcare to patients admitted to hospital with covid-19 and were involved in aerosol generating procedures. 77 healthcare professionals with no exposure history to covid-19 and 80 patients who had recovered from covid-19 were recruited to verify the accuracy of antibody testing. MAIN OUTCOME MEASURES: Covid-19 related symptoms (fever, cough, and dyspnoea) and evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, defined as a positive test for virus specific nucleic acids in nasopharyngeal swabs, or a positive test for IgM or IgG antibodies in the serum samples. RESULTS: The average age of study participants was 35.8 years and 68.1% (286/420) were women. These study participants worked 4-6 hour shifts for an average of 5.4 days a week; they worked an average of 16.2 hours each week in intensive care units. All 420 study participants had direct contact with patients with covid-19 and performed at least one aerosol generating procedure. During the deployment period in Wuhan, none of the study participants reported covid-19 related symptoms. When the participants returned home, they all tested negative for SARS-CoV-2 specific nucleic acids and IgM or IgG antibodies (95% confidence interval 0.0 to 0.7%). CONCLUSION: Before a safe and effective vaccine becomes available, healthcare professionals remain susceptible to covid-19. Despite being at high risk of exposure, study participants were appropriately protected and did not contract infection or develop protective immunity against SARS-CoV-2. Healthcare systems must give priority to the procurement and distribution of personal protective equipment, and provide adequate training to healthcare professionals in its use.


Subject(s)
Coronavirus Infections/prevention & control , Health Personnel , Infection Control/instrumentation , Pandemics/prevention & control , Personal Protective Equipment/supply & distribution , Pneumonia, Viral/prevention & control , Adult , Betacoronavirus , COVID-19 , China , Coronavirus Infections/diagnosis , Cross-Sectional Studies , Female , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Intensive Care Units , Male , Middle Aged , Occupational Exposure/prevention & control , Pneumonia, Viral/diagnosis , SARS-CoV-2
3.
Int J Health Plann Manage ; 36(S1): 20-25, 2021 May.
Article in English | MEDLINE | ID: covidwho-1318707

ABSTRACT

During the COVID-19 pandemic, health care workers (HCWs) have been lauded as heroes, yet both before and during the pandemic, they lacked the protections needed to keep them safe. We summarize data on HCW infections and deaths during previous epidemics, the costs of the failure to protect them, and provide recommendations for strengthening HCW protections by investments in and implementation of infection prevention and control and water, sanitation, and hygiene programs, training and career development, and national and global monitoring of HCW infections. We must move from placing individuals at undue risk to accepting collective responsibility and accountability for the well-being of our HCWs and take concrete actions to protect HCWs who risk their lives to protect patients and populations.


Subject(s)
COVID-19/transmission , Health Personnel , Infectious Disease Transmission, Patient-to-Professional/economics , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Communicable Disease Control/methods , Humans , Pandemics , SARS-CoV-2
4.
Sci Immunol ; 6(59)2021 05 25.
Article in English | MEDLINE | ID: covidwho-1243688

ABSTRACT

The emergence of SARS-CoV-2 variants harboring mutations in the spike (S) protein has raised concern about potential immune escape. Here, we studied humoral and cellular immune responses to wild type SARS-CoV-2 and the B.1.1.7 and B.1.351 variants of concern in a cohort of 121 BNT162b2 mRNA-vaccinated health care workers (HCW). Twenty-three HCW recovered from mild COVID-19 disease and exhibited a recall response with high levels of SARS-CoV-2-specific functional antibodies and virus-specific T cells after a single vaccination. Specific immune responses were also detected in seronegative HCW after one vaccination, but a second dose was required to reach high levels of functional antibodies and cellular immune responses in all individuals. Vaccination-induced antibodies cross-neutralized the variants B.1.1.7 and B.1.351, but the neutralizing capacity and Fc-mediated functionality against B.1.351 was consistently 2- to 4-fold lower than to the homologous virus. In addition, peripheral blood mononuclear cells were stimulated with peptide pools spanning the mutated S regions of B.1.1.7 and B.1.351 to detect cross-reactivity of SARS-CoV-2-specific T cells with variants. Importantly, we observed no differences in CD4+ T-cell activation in response to variant antigens, indicating that the B.1.1.7 and B.1.351 S proteins do not escape T-cell-mediated immunity elicited by the wild type S protein. In conclusion, this study shows that some variants can partially escape humoral immunity induced by SARS-CoV-2 infection or BNT162b2 vaccination, but S-specific CD4+ T-cell activation is not affected by the mutations in the B.1.1.7 and B.1.351 variants.


Subject(s)
Antibodies, Viral/immunology , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , COVID-19/immunology , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , COVID-19 Vaccines/immunology , Cell Line , Cross Reactions/immunology , Humans , Immunologic Memory/immunology , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics , Vaccination
5.
BMJ Open ; 11(5): e044065, 2021 05 19.
Article in English | MEDLINE | ID: covidwho-1236458

ABSTRACT

INTRODUCTION: Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient-provider relationships, is difficult to build in such communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now COVID-19, is widespread. CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. OBJECTIVES: In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system. DESIGN, PARTICIPANTS, SETTING: Within the observation phase of a 3-year intervention study, we conducted interviews, focus groups and observations with patients, CHWs, their supervisors and, facility managers in Sedibeng. RESULTS: CHWs had low levels of workplace trust. They had recently been on strike demanding better pay, employment conditions and recognition of their work. They did not have the equipment to perform their work safely, and some colleagues did not trust, or value, their contribution. There was considerable interpersonal trust between CHWs and patients, however, CHWs' efforts were hampered by structural poverty, alcohol abuse and no identification documents among long-term migrants. Those supervisors who understood the extent of the poverty supported CHW efforts to help the community. When patients had withdrawn from care, often due to nurses' insensitive behaviour, the CHWs' attempts to repair patients' institutional trust often failed due to the vulnerabilities of the community, and lack of support from the health system. CONCLUSION: Strategies are needed to build workplace trust including supportive supervision for CHWs and better working conditions, and to build interpersonal and institutional trust by ensuring sensitivity to social inequalities and the effects of structural poverty among healthcare providers. Societies need to care for everyone.


Subject(s)
COVID-19 , Community Health Workers , Humans , Qualitative Research , SARS-CoV-2 , South Africa , Trust
6.
Int J Environ Res Public Health ; 18(10)2021 May 14.
Article in English | MEDLINE | ID: covidwho-1234709

ABSTRACT

The experience of working on the frontlines of the COVID-19 healthcare crisis has presented a cumulative traumatic experience that affects healthcare professionals' well-being. Psychological resources such as resilience and adaptive defense mechanisms are essential in protecting individuals from severe stress and burnout. During September 2020, 233 healthcare workers responded to an online survey to test the impact of demographic variables, COVID-19 exposure, and psychological resources in determining stress and burnout during the COVID-19 emergency. Frontline workers reported higher scores for stress, emotional exhaustion, and depersonalization (p < 0.001) as compared to colleagues working in units not directly serving patients with COVID-19. Mature defensive functioning was associated with resilience and personal accomplishment (r = 0.320; p < 0.001), while neurotic and immature defenses were related to perceived stress and burnout. Stress and burnout were predicted by lower age, female gender, greater exposure to COVID-19, lower resilience, and immature defensive functioning among healthcare professionals (R2 = 463; p < 0.001). Working on the frontlines of the COVID-19 pandemic appears to provoke greater stress and burnout. On the other hand, resilience and adaptive defense mechanisms predicted better adjustment. Future reaction plans should promote effective programs offering support for healthcare workers who provide direct care to patients with COVID-19.


Subject(s)
Burnout, Professional , COVID-19 , Burnout, Professional/epidemiology , Burnout, Psychological , Defense Mechanisms , Female , Health Personnel , Humans , Pandemics , SARS-CoV-2
7.
J Med Internet Res ; 23(5): e27331, 2021 05 19.
Article in English | MEDLINE | ID: covidwho-1234629

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, health care workers are sharing their challenges, including sleep disturbances, on social media; however, no study has evaluated sleep in predominantly US frontline health care workers during the COVID-19 pandemic. OBJECTIVE: The aim of this study was to assess sleep among a sample of predominantly US frontline health care workers during the COVID-19 pandemic using validated measures through a survey distributed on social media. METHODS: A self-selection survey was distributed on Facebook, Twitter, and Instagram for 16 days (August 31 to September 15, 2020), targeting health care workers who were clinically active during the COVID-19 pandemic. Study participants completed the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI), and they reported their demographic and career information. Poor sleep quality was defined as a PSQI score ≥5. Moderate-to-severe insomnia was defined as an ISI score >14. The Mini-Z Burnout Survey was used to measure burnout. Multivariate logistic regression tested associations between demographics, career characteristics, and sleep outcomes. RESULTS: A total of 963 surveys were completed. Participants were predominantly White (894/963, 92.8%), female (707/963, 73.4%), aged 30-49 years (692/963, 71.9%), and physicians (620/963, 64.4%). Mean sleep duration was 6.1 hours (SD 1.2). Nearly 96% (920/963, 95.5%) of participants reported poor sleep (PSQI). One-third (288/963, 30%) reported moderate or severe insomnia. Many participants (554/910, 60.9%) experienced sleep disruptions due to device use or had nightmares at least once per week (420/929, 45.2%). Over 50% (525/932, 56.3%) reported burnout. In multivariable logistic regressions, nonphysician (odds ratio [OR] 2.4, 95% CI 1.7-3.4), caring for patients with COVID-19 (OR 1.8, 95% CI 1.2-2.8), Hispanic ethnicity (OR 2.2, 95% CI 1.4-3.5), female sex (OR 1.6, 95% CI 1.1-2.4), and having a sleep disorder (OR 4.3, 95% CI 2.7-6.9) were associated with increased odds of insomnia. In open-ended comments (n=310), poor sleep was mapped to four categories: children and family, work demands, personal health, and pandemic-related sleep disturbances. CONCLUSIONS: During the COVID-19 pandemic, nearly all the frontline health care workers surveyed on social media reported poor sleep, over one-third reported insomnia, and over half reported burnout. Many also reported sleep disruptions due to device use and nightmares. Sleep interventions for frontline health care workers are urgently needed.


Subject(s)
COVID-19/epidemiology , Health Personnel , Sleep Wake Disorders/epidemiology , Social Media , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2/isolation & purification , Surveys and Questionnaires
8.
Health Policy ; 125(7): 833-840, 2021 07.
Article in English | MEDLINE | ID: covidwho-1213246

ABSTRACT

Hungary, like many countries, features a complex mix of the public and private sector in the financing and provision of health care services. At the same time, the health system also faces challenges related to shortages of health professionals, low public financing, and informal payments. With the added pressure from the COVID-19 pandemic, Hungarian policymakers acted rapidly to pass a sweeping regulation aimed at these issues. Over two days, the Hungarian parliament introduced and unanimously approved a new regulation, Act C of 2020 on the Employment Status of Health Workers, that replaces the existing public employment relationship between health professionals, public providers and their controlling authorities. The Act, passed on 6 October 2020, brings the employment of health workers under strict central control by introducing a new employment status similar to that of the armed forces. The Act also provides doctors with an unprecedented 120% salary increase and criminalizes informal payments. The reception has been overwhelmingly negative, with thousands of health professionals indicating that they would not sign the new contracts, and the policy also contains serious technical and feasibility concerns. Although the first statistics show that only about 3-5% of the active workforce did not sign the contract by 1 March 2021, the implementation of the reform still faces serious challenges.


Subject(s)
COVID-19 , Employment , Health Personnel/psychology , Health Workforce , Private Sector , Humans , Hungary , Pandemics , SARS-CoV-2
9.
J Neurol ; 268(12): 4422-4428, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1209610

ABSTRACT

Central and peripheral nervous system involvement during acute COVID-19 is well known. Although many patients report some subjective symptoms months after the infection, the exact incidence of neurological and cognitive sequelae of COVID-19 remains to be determined. The aim of this study is to investigate if objective neurological or cognitive impairment is detectable four months after SARS-CoV-2 infection, in a group of patients who had mild-moderate COVID-19. A cohort of 120 health care workers previously affected by COVID-19 was examined 4 months after the diagnosis by means of neurological and extensive cognitive evaluation and compared to a group of 30 health care workers who did not have COVID-19 and were similar for age and co morbidities. At 4 month follow-up, 118/120 COVID-19 cases had normal neurological examination, two patients had neurological deficits. COVID-19 patients did not show general cognitive impairment at MMSE. In COVID-19 cases the number of impaired neuropsychological tests was not significantly different from non COVID-19 cases (mean 1.69 and 1 respectively, Mann-Whitney p = n.s.), as well as all the mean tests' scores. Anxiety, stress and depression scores resulted to be significantly higher in COVID-19 than in non COVID-19 cases. The results do not support the presence of neurological deficits or cognitive impairment in this selected population of mild-moderate COVID-19 patients four months after the diagnosis. Severe emotional disorders in patients who had COVID-19 in the past are confirmed.


Subject(s)
COVID-19 , Cognition , Follow-Up Studies , Humans , Neuropsychological Tests , SARS-CoV-2
10.
Ann Surg Oncol ; 28(9): 4816-4826, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1190139

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has resulted in unparalleled changes to patient care, including the suspension of cancer surgery. Concerns regarding COVID-19-related risks to patients and healthcare workers with the re-introduction of major complex minimally invasive and open surgery have been raised. This study examines the COVID-19 related risks to patients and healthcare workers following the re-introduction of major oesophago-gastric (EG) surgery. PATIENTS AND METHODS: This was an international, multi-centre, observational study of consecutive patients treated by open and minimally invasive oesophagectomy and gastrectomy for malignant or benign disease. Patients were recruited from nine European centres serving regions with a high population incidence of COVID-19 between 1 May and 1 July 2020. The primary endpoint was 30-day COVID-19-related mortality. All staff involved in the operative care of patients were invited to complete a health-related survey to assess the incidence of COVID-19 in this group. RESULTS: In total, 158 patients were included in the study (71 oesophagectomy, 82 gastrectomy). Overall, 87 patients (57%) underwent MIS (59 oesophagectomy, 28 gastrectomy). A total of 403 staff were eligible for inclusion, of whom 313 (78%) completed the health survey. Approaches to mitigate against the risks of COVID-19 for patients and staff varied amongst centres. No patients developed COVID-19 in the post-operative period. Two healthcare workers developed self-limiting COVID-19. CONCLUSIONS: Precautions to minimise the risk of COVID-19 infection have enabled the safe re-introduction of minimally invasive and open EG surgery for both patients and staff. Further studies are necessary to determine the minimum requirements for mitigations against COVID-19.


Subject(s)
COVID-19 , Pandemics , Health Personnel , Humans , Minimally Invasive Surgical Procedures , SARS-CoV-2
11.
Sex Transm Dis ; 48(8): 606-613, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1189533

ABSTRACT

BACKGROUND: As public health personnel and resources are redirected to COVID-19, sexually transmitted diseases (STD) programs have been unable to sustain pre-COVID-19 activities. METHODS: We used California (CA) surveillance data to describe trends in case reporting for gonorrhea, chlamydia, and syphilis of any stage in the pre- versus post-COVID-19 eras (January-June 2019 and January-June 2020). We also analyzed data from an electronic survey administered by the CA STD Control Branch to local health jurisdictions in April, June, and September of 2020, assessing the impact of COVID-19 on STD programs. RESULTS: There were sharp declines in cases of all reportable bacterial STDs occurring in conjunction with the March 19, 2020 CA stay-at-home order, most of which did not return to baseline by July. Comparing January-June 2020 to January-June of 2019, there were decreases in reported cases of chlamydia (31%), late syphilis (19%), primary/secondary syphilis (15%), early nonprimary nonsecondary syphilis (14%), and gonorrhea (13%). The largest percentage declines in STD case reporting were among Hispanic, Asian/Pacific Islander, and Black persons. Seventy-eight percent of local health jurisdiction respondents indicated that half or more of their workforce had been redeployed to COVID-19 by September 2020. CONCLUSIONS: During the COVID-19 era, STD case reporting and programmatic functions have diminished throughout CA. Because this may contribute to decreases or delays in STD diagnosis and treatment-with resultant increases in STD transmission-providers and public health officials should prepare for potential increases in STD-related morbidity in the months and years to come.


Subject(s)
COVID-19 , Gonorrhea , Sexually Transmitted Diseases , California/epidemiology , Gonorrhea/epidemiology , Gonorrhea/prevention & control , Humans , Pandemics , Public Health Surveillance , SARS-CoV-2 , Sexually Transmitted Diseases/epidemiology , Sexually Transmitted Diseases/prevention & control
12.
Infect Control Hosp Epidemiol ; 43(3): 334-343, 2022 03.
Article in English | MEDLINE | ID: covidwho-1189150

ABSTRACT

BACKGROUND: Nosocomial outbreaks leading to healthcare worker (HCW) infection and death have been increasingly reported during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: We implemented a strategy to reduce nosocomial acquisition. METHODS: We summarized our experience in implementing a multipronged infection control strategy in the first 300 days (December 31, 2019, to October 25, 2020) of the COVID-19 pandemic under the governance of Hospital Authority in Hong Kong. RESULTS: Of 5,296 COVID-19 patients, 4,808 (90.8%) were diagnosed in the first pandemic wave (142 cases), second wave (896 cases), and third wave (3,770 cases) in Hong Kong. With the exception of 1 patient who died before admission, all COVID-19 patients were admitted to the public healthcare system for a total of 78,834 COVID-19 patient days. The median length of stay was 13 days (range, 1-128). Of 81,955 HCWs, 38 HCWs (0.05%; 2 doctors and 11 nurses and 25 nonprofessional staff) acquired COVID-19. With the exception of 5 of 38 HCWs (13.2%) infected by HCW-to-HCW transmission in the nonclinical settings, no HCW had documented transmission from COVID-19 patients in the hospitals. The incidence of COVID-19 among HCWs was significantly lower than that of our general population (0.46 per 1,000 HCWs vs 0.71 per 1,000 population; P = .008). The incidence of COVID-19 among professional staff was significantly lower than that of nonprofessional staff (0.30 vs 0.66 per 1,000 full-time equivalent; P = .022). CONCLUSIONS: A hospital-based approach spared our healthcare service from being overloaded. With our multipronged infection control strategy, no nosocomial COVID-19 in was identified among HCWs in the first 300 days of the COVID-19 pandemic in Hong Kong.


Subject(s)
COVID-19 , Cross Infection , COVID-19/epidemiology , COVID-19/prevention & control , Cross Infection/epidemiology , Cross Infection/prevention & control , Health Personnel , Hong Kong/epidemiology , Hospitals , Humans , Infection Control , Pandemics/prevention & control
13.
World J Clin Cases ; 9(10): 2170-2180, 2021 Apr 06.
Article in English | MEDLINE | ID: covidwho-1178581

ABSTRACT

The exact risk association of coronavirus disease 2019 (COVID-19) for surgeons is not quantified which may be affected by their risk of exposure and individual factors. The objective of this review is to quantify the risk of COVID-19 among surgeons, and explore whether facemask can minimise the risk of COVID-19 among surgeons. A systematised review was carried out by searching MEDLINE to locate items on severe acute respiratory syndrome coronavirus 2 or COVID-19 in relation to health care workers (HCWs) especially those work in surgical specialities including surgical nurses and intensivists. Additionally, systematic reviews that assessed the effectiveness of facemask against viral respiratory infections, including COVID-19, among HCWs were identified. Data from identified articles were abstracted, synthesised and summarised. Fourteen primary studies that provided data on severe acute respiratory syndrome coronavirus 2 infection or experience among surgeons and 11 systematic reviews that provided evidence of the effectiveness of facemask (and other personal protective equipment) were summarised. Although the risk of COVID-19 could not be quantified precisely among surgeons, about 14% of HCWs including surgeons had COVID-19, there could be variations depending on settings. Facemask was found to be somewhat protective against COVID-19, but the HCWs' compliance was highly variable ranging from zero to 100%. Echoing surgical societies' guidelines we continue to recommend facemask use among surgeons to prevent COVID-19.

14.
Rom J Intern Med ; 59(2): 166-173, 2021 Jun 01.
Article in English | MEDLINE | ID: covidwho-1171557

ABSTRACT

Introduction. An on-going coronavirus disease 2019 (COVID-19) has become a challenge all over the world. Since an endoscopy unit and its staff are at potentially high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we conducted a survey for the management of the gastrointestinal endoscopic practice, personal protective equipment (PPE), and risk assessment for COVID-19 during the pandemic at multiple facilities.Methods. The 11-item survey questionnaire was sent to representative respondent of Department of Gastroenterology, Osaka City University Hospital, and its 19 related facilities.Results. A total of 18 facilities submitted valid responses and a total of 373 health care professionals (HCPs) participated. All facilities (18/18: 100%) were screening patients at risk for SARS-CoV-2 infection before endoscopy. During the pandemic, we found that the total volume of endoscopic procedures decreased by 44%. Eleven facilities (11/18: 61%) followed recommendations of the Japan Gastroenterological Endoscopy Society (JGES); consequently, about 35%-50% of esophagogastroduodenoscopy and colonoscopy were canceled. Mask (surgical mask or N95 mask), face shield/goggle, gloves (one or two sets), and gown (with long or short sleeves) were being used by endoscopists, nurses, endoscopy technicians, and endoscope cleaning staff in all the facilities (18/18: 100%). SARS-CoV-2 infection risk assessment of HCPs was conducted daily in all the facilities (18/18: 100%), resulting in no subsequent SARS-CoV-2 infection in HCPs.Conclusion. COVID-19 has had a dramatic impact on the gastrointestinal endoscopic practice. The recommendations of the JGES were appropriate as preventive measures for the SARSCoV-2 infection in the endoscopy unit and its staff.


Subject(s)
COVID-19 , Endoscopy, Gastrointestinal , Infection Control , Occupational Exposure/prevention & control , Risk Assessment , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Endoscopy, Gastrointestinal/methods , Endoscopy, Gastrointestinal/standards , Health Care Surveys , Humans , Infection Control/instrumentation , Infection Control/methods , Infection Control/organization & administration , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Japan/epidemiology , Personal Protective Equipment/classification , Personal Protective Equipment/standards , Personal Protective Equipment/supply & distribution , SARS-CoV-2 , Safety Management/trends
15.
Front Pediatr ; 9: 630365, 2021.
Article in English | MEDLINE | ID: covidwho-1170107

ABSTRACT

Background: COVID-19 has brought to the fore an urgent need for secure information and communication technology (ICT) supported healthcare delivery, as the pertinence of infection control and social distancing continues. Telemedicine for paediatric care warrants special consideration around logistics, consent and assent, child welfare and communication that may differ to adult services. There is no systematic evidence synthesis available that outlines the implementation issues for incorporating telemedicine to paediatric services generally, or how users perceive these issues. Methods: We conducted a rapid mixed-methods evidence synthesis to identify barriers, facilitators, and documented stakeholder experiences of implementing paediatric telemedicine, to inform the pandemic response. A systematic search was undertaken by a research librarian in MEDLINE for relevant studies. All identified records were blind double-screened by two reviewers. Implementation-related data were extracted, and studies quality appraised using the Mixed-Methods Appraisal Tool. Qualitative findings were analysed thematically and then mapped to the Consolidated Framework for Implementation Research. Quantitative findings about barriers and facilitators for implementation were narratively synthesised. Results: We identified 27 eligible studies (19 quantitative; 5 mixed-methods, 3 qualitative). Important challenges highlighted from the perspective of the healthcare providers included issues with ICT proficiency, lack of confidence in the quality/reliability of the technology, connectivity issues, concerns around legal issues, increased administrative burden and/or fear of inability to conduct thorough examinations with reliance on subjective descriptions. Facilitators included clear dissemination of the aims of ICT services, involvement of staff throughout planning and implementation, sufficient training, and cultivation of telemedicine champions. Families often expressed preference for in-person visits but those who had tried tele-consultations, lived far from clinics, or perceived increased convenience with technology considered telemedicine more favourably. Concerns from parents included the responsibility of describing their child's condition in the absence of an in-person examination. Discussion: Healthcare providers and families who have experienced tele-consultations generally report high satisfaction and usability for such services. The use of ICT to facilitate paediatric healthcare consultations is feasible for certain clinical encounters and can work well with appropriate planning and quality facilities in place.

16.
Pol Arch Intern Med ; 131(3): 226-232, 2021 03 30.
Article in English | MEDLINE | ID: covidwho-1158486

ABSTRACT

INTRODUCTION: According to the current data, there has been no increase in the incidence of COVID­19 in patients with inflammatory bowel disease (IBD). OBJECTIVES: The available data are based on symptomatic cases and do not include the asymptomatic ones. To measure the exact infection rate, we initiated a study that aimed to assess the seroprevalence of anti-SARS­CoV­2 antibodies in IBD. PATIENTS AND METHODS: A total of 864 individuals were enrolled in the study, including 432 patients with IBD (290 with Crohn disease and 142 with ulcerative colitis) and 432 controls without IBD (healthcare professionals) matched for age and sex. Serum samples were prospectively collected, and the presence of anti-SARS­CoV­2 immunoglobulin (Ig) G and IgM + IgA antibodies were measured using the enzyme­linked immunoassay method (Vircell Microbiologists). RESULTS: A significantly higher percentage of positive results for anti-SARS­CoV­2 antibodies, both in the IgG and IgM + IgA class, was found in patients with IBD (4.6% and 6%, respectively, compared with 1.6% and 1.1%, respectively, in controls; both P values <0.05). No patient had symptomatic COVID­19. There was no association among patients' age, sex, drugs used for IBD, or disease activity and the occurrence of IgG antibodies. CONCLUSION: Patients with IBD may be at higher risk of developing SARS­CoV­2 infection, defined as the presence of elevated levels of anti-SARS­CoV­2 IgG antibodies, but not of having a symptomatic and / or severe course of COVID­19 compared with healthcare professionals without IBD.


Subject(s)
COVID-19/epidemiology , Inflammatory Bowel Diseases/epidemiology , Colitis, Ulcerative , Humans , SARS-CoV-2 , Seroepidemiologic Studies
17.
Global Health ; 17(1): 34, 2021 03 29.
Article in English | MEDLINE | ID: covidwho-1158211

ABSTRACT

BACKGROUND: Mental burden due to the SARS-CoV-2 pandemic has been widely reported for the general public and specific risk groups like healthcare workers and different patient populations. We aimed to assess its impact on mental health during the early phase by comparing pandemic with prepandemic data and to identify potential risk and protective factors. METHODS: For this systematic review and meta-analyses, we systematically searched PubMed, PsycINFO, and Web of Science from January 1, 2019 to May 29, 2020, and screened reference lists of included studies. In addition, we searched PubMed and PsycINFO for prepandemic comparative data. Survey studies assessing mental burden by the SARS-CoV-2 pandemic in the general population, healthcare workers, or any patients (eg, COVID-19 patients), with a broad range of eligible mental health outcomes, and matching studies evaluating prepandemic comparative data in the same population (if available) were included. We used multilevel meta-analyses for main, subgroup, and sensitivity analyses, focusing on (perceived) stress, symptoms of anxiety and depression, and sleep-related symptoms as primary outcomes. RESULTS: Of 2429 records retrieved, 104 were included in the review (n = 208,261 participants), 43 in the meta-analysis (n = 71,613 participants). While symptoms of anxiety (standardized mean difference [SMD] 0.40; 95% CI 0.15-0.65) and depression (SMD 0.67; 95% CI 0.07-1.27) were increased in the general population during the early phase of the pandemic compared with prepandemic conditions, mental burden was not increased in patients as well as healthcare workers, irrespective of COVID-19 patient contact. Specific outcome measures (eg, Patient Health Questionnaire) and older comparative data (published ≥5 years ago) were associated with increased mental burden. Across the three population groups, existing mental disorders, female sex, and concerns about getting infected were repeatedly reported as risk factors, while older age, a good economic situation, and education were protective. CONCLUSIONS: This meta-analysis paints a more differentiated picture of the mental health consequences in pandemic situations than previous reviews. High-quality, representative surveys, high granular longitudinal studies, and more research on protective factors are required to better understand the psychological impacts of the SARS-CoV-2 pandemic and to help design effective preventive measures and interventions that are tailored to the needs of specific population groups.


Subject(s)
COVID-19/psychology , Mental Disorders/etiology , Mental Health , Pandemics , Adolescent , Adult , Aged , Anxiety/epidemiology , Anxiety/etiology , Depression/epidemiology , Depression/etiology , Female , Humans , Male , Mental Disorders/epidemiology , Middle Aged , Protective Factors , SARS-CoV-2 , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , Stress, Psychological/epidemiology , Stress, Psychological/etiology
18.
Front Public Health ; 9: 638975, 2021.
Article in English | MEDLINE | ID: covidwho-1156166

ABSTRACT

Objective: Understanding gender differences in responses of health-care workers (HCWs) to COVID-19 outbreak is an effective way to promote customized supports. Methods: During February 2020, 103 HCWs infected with COVID-19 (64 females and 39 males) and 535 uninfected HCWs (383 females and 152 males) were recruited in a cross-sectional study. Level of attention, six emotional status, and self-evaluation of eight protective measures were recorded. Multivariable Firth's logistic regressions were applied to explored independent effect of gender. Results: During early outbreak, female HCWs were more likely to give greater attention, adjusted OR:1.92 (95%CI 1.14-3.23) in total HCWs. Higher proportion of anxiety was observed in female HCWs, adjusted OR:3.14 (95%CI 1.98-4.99) for total HCWs, 4.32(95%CI 1.32-14.15) for infected HCWs and 2.97 (1.78, 4.95) for uninfected HCWs. Proportion of pessimism, fear, full of fighting spirit, and optimism were low, and no gender differences were observed. During a later outbreak, a majority of HCWs reported being very familiar with eight protective measures. After training, a proportion of high self-evaluation in hand hygiene, wearing gloves, and surgical masks increased independently in female HCWs, and adjusted ORs were 3.07 (95% CI 1.57-5.99), 2.37 (95% CI 1.26-4.49), and 1.92 (95% CI 1.02-3.62), respectively. Infection status amplified gender difference in anxiety, hand hygiene, and glove wearing. Conclusion: Female HCWs perceived the outbreak seriously, effective emotional and psychological well-ness should be targeted at female HCWs preferentially, and male HCWs should be encouraged to express their feelings and be further trained.


Subject(s)
Adaptation, Psychological , COVID-19/psychology , Disease Outbreaks/statistics & numerical data , Health Personnel/psychology , Health Risk Behaviors , Infections/psychology , Stress, Psychological , Adult , COVID-19/epidemiology , China/epidemiology , Cross-Sectional Studies , Female , Health Personnel/statistics & numerical data , Humans , Male , Middle Aged , SARS-CoV-2 , Sex Factors , Surveys and Questionnaires
19.
Soc Work Health Care ; 60(2): 177-186, 2021.
Article in English | MEDLINE | ID: covidwho-1149805

ABSTRACT

Purpose: While global pandemics such as the COVID-19 public health crisis are known to increase the likelihood of frontline health care workers experiencing the negative effects of stress and trauma, many health care workers on the frontlines of the COVID-19 pandemic lack adequate support. This paper presents the findings of a social work led peer support model, COVID-19 Am I Resilient (cAIR), developed and deployed during the first wave of the COVID-19 pandemic.Methods: This quality improvement initiative was developed and piloted within the Clinical Education and Practice department at a large urban health care system. The pilot included provision of peer support through synchronous video presentations, one-on-one peer support, and resourcing and referral. Pilot outcomes of feasibility and staff engagement were evaluated using participant responses to an online survey as well as attendance records at project activities.Implications: Developed to help frontline health care workers thrive in the midst, and wake, of the COVID-19 pandemic, the pilot study of the cAIR peer support model has implications for further development and implementation of peer support for typically underrepresented health care disciplines working during the COVID-19 pandemic as well as future public health emergencies.


Subject(s)
COVID-19/epidemiology , Health Personnel/psychology , Mental Health Services/organization & administration , Peer Group , Social Work/organization & administration , Burnout, Professional/prevention & control , Burnout, Professional/psychology , Humans , Pandemics , Pilot Projects , Quality Improvement/organization & administration , Resilience, Psychological , SARS-CoV-2
20.
BMJ Open Gastroenterol ; 8(1)2021 02.
Article in English | MEDLINE | ID: covidwho-1088232

ABSTRACT

OBJECTIVE: To evaluate the risk of common infections in individuals with inflammatory bowel disease (IBD) [ulcerative colitis and Crohn's disease] compared with matched controls in a contemporary UK primary care population. DESIGN: Matched cohort analysis (2014-2019) using the Royal College of General Practitioners Research and Surveillance Centre primary care database. Risk of common infections, viral infections and gastrointestinal infections (including a subset of culture-confirmed infections), and predictors of common infections, were evaluated using multivariable Cox proportional hazards models. RESULTS: 18 829 people with IBD were matched to 73 316 controls. People with IBD were more likely to present to primary care with a common infection over the study period (46% vs 37% of controls). Risks of common infections, viral infections and gastrointestinal infections (including stool culture-confirmed infections) were increased for people with ulcerative colitis and Crohn's disease compared with matched controls (HR range 1.12-1.83, all p<0.001). Treatment with oral glucocorticoid therapy, immunotherapies and biologic therapy, but not with aminosalicylates, was associated with increased infection risk in people with IBD. Despite mild lymphopenia and neutropenia being more common in people with IBD (18.4% and 1.9%, respectively) than in controls (6.5% and 1.5%, respectively), these factors were not associated with significantly increased infection risk in people with IBD. CONCLUSION: People with IBD are more likely to present with a wide range of common infections. Health professionals and people with IBD should remain vigilant for infections, particularly when using systemic corticosteroids, immunotherapies or biologic agents. TRIAL REGISTRATION NUMBER: Clinicaltrials.gov (NCT03835780).


Subject(s)
Colitis, Ulcerative , Colitis , Inflammatory Bowel Diseases , Cohort Studies , Colitis, Ulcerative/complications , Humans , Inflammatory Bowel Diseases/complications , Primary Health Care
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