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1.
Indian J Palliat Care ; 26(Suppl 1): S45-S47, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1792228

ABSTRACT

BACKGROUND: The ongoing coronavirus disease 2019 (COVID-19) pandemic has affected all the aspects of life of mankind, posing unique challenges for health-care services. In order to contain the spread of the virus, a countrywide mass lockdown has been imposed in India. Although the lockdown has modified the epidemic trajectory, it has affected the lives of many non-COVID patients. Patients in need of care could not approach hospitals. METHODS: This retrospective observational study was conducted in the Department of Onco-Anaesthesia and Palliative Medicine at a tertiary care center in India. The yearly data of patient flow for the year 2019 was compared with that during the lockdown. RESULTS: The single-day average of out-patients, in-patients, and other department consultation requests requiring palliative care decreased drastically during the lockdown in comparison to the previous year. The single-day average of teleconsultations increased more than double during the lockdown. CONCLUSION: Although lockdown decreases the spread of the epidemic, it increases the suffering of other patients who require medical care. Various steps have to be adopted in the regular working pattern of hospitals to cater to the needs of the patients requiring care, without increasing the risk of contracting COVID-19.

2.
MMWR Morb Mortal Wkly Rep ; 69(14): 411-415, 2020 Apr 10.
Article in English | MEDLINE | ID: covidwho-1389840

ABSTRACT

Presymptomatic transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), might pose challenges for disease control. The first case of COVID-19 in Singapore was detected on January 23, 2020, and by March 16, a total of 243 cases had been confirmed, including 157 locally acquired cases. Clinical and epidemiologic findings of all COVID-19 cases in Singapore through March 16 were reviewed to determine whether presymptomatic transmission might have occurred. Presymptomatic transmission was defined as the transmission of SARS-CoV-2 from an infected person (source patient) to a secondary patient before the source patient developed symptoms, as ascertained by exposure and symptom onset dates, with no evidence that the secondary patient had been exposed to anyone else with COVID-19. Seven COVID-19 epidemiologic clusters in which presymptomatic transmission likely occurred were identified, and 10 such cases within these clusters accounted for 6.4% of the 157 locally acquired cases. In the four clusters for which the date of exposure could be determined, presymptomatic transmission occurred 1-3 days before symptom onset in the presymptomatic source patient. To account for the possibility of presymptomatic transmission, officials developing contact tracing protocols should strongly consider including a period before symptom onset. Evidence of presymptomatic transmission of SARS-CoV-2 underscores the critical role social distancing, including avoidance of congregate settings, plays in controlling the COVID-19 pandemic.


Subject(s)
Asymptomatic Diseases , Betacoronavirus , Coronavirus Infections/transmission , Adult , Cluster Analysis , Contact Tracing , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Female , Humans , Male , Middle Aged , SARS-CoV-2 , Singapore/epidemiology
3.
Int J Environ Res Public Health ; 18(7)2021 04 01.
Article in English | MEDLINE | ID: covidwho-1378284

ABSTRACT

To reduce the spread of the virus, authorities have imposed restrictive measures, such as limiting movement of individuals, shutting down non-essential stores, imposing a general or local quarantine, along with physical distancing and isolation of vulnerable people. Remote working has become the 'new normal' for many organizations, engendering further challenges for employees, who have started experiencing anxiety, technostress caused by digitalization and lack of social interaction, frustration, occupational burden, counterproductive work behavior, exhaustion, burnout, depersonalization, and increased turnover intention. All these factors, corroborated by prolonged restrictions, have contributed to a decrease in employee satisfaction, diminishing performance and generating a counterproductive behavior. Based on Social Exchange Theory, this research plans to investigate the influence of internal marketing on job satisfaction, task performance, and counterproductive work behavior in the context of the COVID-19 pandemic in an emerging market, namely Romania. Based on a quantitative research study among 850 employees, we show that internal marketing strongly and significantly impacts job satisfaction, while insignificantly impacting task performance and counterproductive work behavior. Job satisfaction actuates task performance in a significant and positive manner, contributing to a reduction in counterproductive work behaviors. This paper highlights the effects of internal marketing orientation on job satisfaction, and the effects of job satisfaction on job performance and counterproductive work behaviors.


Subject(s)
Burnout, Professional , COVID-19 , Burnout, Professional/epidemiology , Humans , Job Satisfaction , Marketing , Pandemics , Romania , SARS-CoV-2 , Task Performance and Analysis
4.
Palliat Med ; 35(7): 1225-1237, 2021 07.
Article in English | MEDLINE | ID: covidwho-1243765

ABSTRACT

BACKGROUND: Specialist palliative care services play an important role in conducting advance care planning during COVID-19. Little is known about the challenges to advance care planning in this context, or the changes services made to adapt. AIM: Describe the challenges that UK specialist palliative care services experienced regarding advance care planning during COVID-19 and changes made to support timely conversations. DESIGN: Online survey of UK palliative/hospice services' response to COVID-19. Closed-ended responses are reported descriptively. Open-ended responses were analysed using a thematic Framework approach using the Social Ecological Model to understand challenges. RESPONDENTS: Two hundred and seventy-seven services. RESULTS: More direct advance care planning was provided by 38% of services, and 59% provided more support to others. Some challenges to advance care planning pre-dated the pandemic, whilst others were specific to/exacerbated by COVID-19. Challenges are demonstrated through six themes: complex decision making in the face of a new infectious disease; maintaining a personalised approach; COVID-19-specific communication difficulties; workload and pressure; sharing information; and national context of fear and uncertainty. Two themes demonstrate changes made to support: adapting local processes and adapting local structures. CONCLUSIONS: Professionals and healthcare providers need to ensure advance care planning is individualised by tailoring it to the values, priorities, and ethnic/cultural/religious context of each person. Policymakers need to consider how high-quality advance care planning can be resourced as a part of standard healthcare ahead of future pandemic waves. In facilitating this, we provide questions to consider at each level of the Social Ecological Model.


Subject(s)
Advance Care Planning , COVID-19 , Humans , Palliative Care , Pandemics , SARS-CoV-2 , United Kingdom
5.
PLoS One ; 16(5): e0251368, 2021.
Article in English | MEDLINE | ID: covidwho-1242246

ABSTRACT

COVID-19 is challenging healthcare preparedness, world economies, and livelihoods. The infection and death rates associated with this pandemic are strikingly variable in different countries. To elucidate this discrepancy, we analyzed 2431 early spread SARS-CoV-2 sequences from GISAID. We estimated continental-wise admixture proportions, assessed haplotype block estimation, and tested for the presence or absence of strains' recombination. Herein, we identified 1010 unique missense mutations and seven different SARS-CoV-2 clusters. In samples from Asia, a small haplotype block was identified, whereas samples from Europe and North America harbored large and different haplotype blocks with nonsynonymous variants. Variant frequency and linkage disequilibrium varied among continents, especially in North America. Recombination between different strains was only observed in North American and European sequences. In addition, we structurally modelled the two most common mutations, Spike_D614G and Nsp12_P314L, which suggested that these linked mutations may enhance viral entry and replication, respectively. Overall, we propose that genomic recombination between different strains may contribute to SARS-CoV-2 virulence and COVID-19 severity and may present additional challenges for current treatment regimens and countermeasures. Furthermore, our study provides a possible explanation for the substantial second wave of COVID-19 presented with higher infection and death rates in many countries.


Subject(s)
Recombination, Genetic , SARS-CoV-2/pathogenicity , Spike Glycoprotein, Coronavirus/genetics , Virulence/physiology , COVID-19/pathology , COVID-19/virology , Databases, Genetic , Genetic Variation , Haplotypes , Humans , Linkage Disequilibrium , Molecular Dynamics Simulation , Mutation, Missense , Principal Component Analysis , Protein Structure, Tertiary , RNA-Dependent RNA Polymerase/chemistry , RNA-Dependent RNA Polymerase/genetics , RNA-Dependent RNA Polymerase/metabolism , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , SARS-CoV-2/metabolism , Severity of Illness Index , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/metabolism
6.
Acta Neurol Scand ; 144(3): 229-235, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1240997

ABSTRACT

The COVID-19 pandemic has brought challenges for healthcare management of patients with multiple sclerosis (MS). Concerns regarding vulnerability to infections and disease-modifying therapies (DMTs) and their complications have been raised. Recent published guidelines on the use of DMTs in relation to COVID-19 in MS patients have been diverse between countries with lack of evidence-based facts. In Sweden, there exists a particular interest in anti-CD20 therapy as a possible risk factor for severe COVID-19 due to the large number of rituximab-treated patients off-label in the country. Rapid responses from the Swedish MS Association (SMSS) and the Swedish MS registry (SMSreg) have resulted in national guidelines on DMT use for MS patients and implementation of a COVID-19 module in the SMSreg. Recently updated guidelines also included recommendations on COVID-19 vaccination with regard to the different DMTs. Social distancing policies forced implementation of telemedicine consultation to replace in-person consultations as part of regular MS health care. Patient-reported outcome measures (PROMs) in SMSreg have been useful in this respect. This paper reports our experiences on the progress of national MS health care during the COVID-19 pandemic, in addition to offering an overview of the present scientific context.


Subject(s)
COVID-19/epidemiology , Multiple Sclerosis/epidemiology , Multiple Sclerosis/therapy , COVID-19/drug therapy , COVID-19 Vaccines , Humans , Pandemics , Physical Distancing , Rituximab/therapeutic use , Sweden/epidemiology , Telemedicine
7.
J Pediatr Nurs ; 61: 140-143, 2021.
Article in English | MEDLINE | ID: covidwho-1240545

ABSTRACT

It is the position of the International Network for Child and Family Centered Care (INCFCC) that COVID19 restrictions pose tremendous challenges for the health care team in their efforts to provide child and family centered care (CFCC). COVID-19 restrictions impact on the family's right to be presernt with their ill child and to contribute to the caring process. A limited number of articles have discussed challenges about the successful delivery of CFCC during the COVID-19 pandemic. Based on current literature, the INCFCC stresses the need for continuous facilitation implementation of child and family centred care as, it is essential for children's physical and psychological wellbeing. Furthermore we believe that the families' presence and participation holds more benefits than risks to the health of children, their families, and the health care team.


Subject(s)
COVID-19 , Child , Family , Humans , Pandemics , Patient-Centered Care , SARS-CoV-2
8.
Front Pharmacol ; 12: 647652, 2021.
Article in English | MEDLINE | ID: covidwho-1238879

ABSTRACT

Recent advances in cell based therapies for lung diseases and critical illnesses offer significant promise. Despite encouraging preclinical results, the translation of efficacy to the clinical settings have not been successful. One of the possible reasons for this is the lack of understanding of the complex interaction between mesenchymal stromal cells (MSCs) and the host environment. Other challenges for MSC cell therapies include cell sources, dosing, disease target, donor variability, and cell product manufacturing. Here we provide an overview on advances and current issues with a focus on MSC-based cell therapies for inflammatory acute respiratory distress syndrome varieties and other inflammatory lung diseases.

9.
Transl Neurodegener ; 10(1): 15, 2021 04 30.
Article in English | MEDLINE | ID: covidwho-1215126

ABSTRACT

Alzheimer's disease (AD) has emerged as a key comorbidity of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The morbidity and mortality of COVID-19 are elevated in AD due to multiple pathological changes in AD patients such as the excessive expression of viral receptor angiotensin converting enzyme 2 and pro-inflammatory molecules, various AD complications including diabetes, lifestyle alterations in AD, and drug-drug interactions. Meanwhile, COVID-19 has also been reported to cause various neurologic symptoms including cognitive impairment that may ultimately result in AD, probably through the invasion of SARS-CoV-2 into the central nervous system, COVID-19-induced inflammation, long-term hospitalization and delirium, and post-COVID-19 syndrome. In addition, the COVID-19 crisis also worsens behavioral symptoms in uninfected AD patients and poses new challenges for AD prevention. In this review, we first introduce the symptoms and pathogenesis of COVID-19 and AD. Next, we provide a comprehensive discussion on the aggravating effects of AD on COVID-19 and the underlying mechanisms from molecular to social levels. We also highlight the influence of COVID-19 on cognitive function, and propose possible routes of viral invasion into the brain and potential mechanisms underlying the COVID-19-induced cognitive impairment. Last, we summarize the negative impacts of COVID-19 pandemic on uninfected AD patients and dementia prevention.


Subject(s)
Alzheimer Disease/complications , COVID-19/complications , Pandemics , Aged , Aged, 80 and over , Alzheimer Disease/epidemiology , COVID-19/epidemiology , Comorbidity , Humans
10.
Vaccine ; 39(22): 3018-3024, 2021 05 21.
Article in English | MEDLINE | ID: covidwho-1208593

ABSTRACT

The Japanese immunization program has made considerable progress since 2009: several new vaccines have been introduced and most are included in the National Immunization Program (NIP). In October 2020, the Japanese law on immunization was revised, which resulted in a few laudable achievements. First, rotavirus vaccines were added to the NIP, 10 years after their introduction, and noteworthy studies of vaccine effectiveness and the incidence of intussusception in Japanese children were published. Second, rules on vaccine intervals-which had been a longstanding concern-were withdrawn. In addition to this revision of the law, the Japanese version of the Vaccine Information Statement (VIS) was released by the Japan Pediatric Society in 2018. The VIS provides useful caregiver information on general immunization concepts and individual vaccines. Further challenges for the Japanese immunization program include (1) administering a booster dose of pertussis-containing vaccine to preschool children or teenagers, (2) reestablishing the active recommendation for human papilloma virus vaccines, (3) adding the mumps and influenza vaccines to the NIP, and (4) ensuring optimal dosing of seasonal influenza vaccines. During the current coronavirus disease 2019 (COVID-19) pandemic, vaccination rates among children have been decreasing in many countries. In Japan, vaccination rates have been stable in infants, but declining among toddlers and school-aged children, despite public awareness of the need for timely administration of vaccines during the pandemic. Clearly, further action is needed if we are to adequately protect children living in Japan from vaccine-preventable diseases.


Subject(s)
COVID-19 , Adolescent , Child , Child, Preschool , Humans , Immunization Programs , Infant , Japan , SARS-CoV-2 , Vaccination
11.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 64(4): 426-434, 2021 Apr.
Article in German | MEDLINE | ID: covidwho-1196562

ABSTRACT

The COVID-19 pandemic poses major challenges for the German notification system in public infection control. For the federal state of Schleswig-Holstein evaluations, the state reporting office supports the public health departments by providing daily and weekly evaluations and supports the transmission of notification data to the Robert Koch Institute according to the Infection Protection Act.In the present report of the state notification office of Schleswig-Holstein, the SARS-CoV­2 reporting data for the period from March to September 2020 are evaluated. Based on the development of the infection numbers, this period was divided into two phases of similar size: March to May and June to September. A total of 4898 infection cases were reported. Upon comparison of the phases, there were particularly marked differences in hospitalization and mortality, age, and countries of infection site. In the first phase, elderly persons were particularly affected by high rates of hospitalization and mortality. In the second phase, the average age and hospitalization and mortality rates were significantly lower, and a particularly large proportion were associated with international travel activity. The evaluation of the outbreak documentation revealed a particular focus in private household settings. This article describes the epidemic situation in a low-incidence state within the Federal Republic of Germany.


Subject(s)
COVID-19 , Pandemics , Aged , Germany/epidemiology , Humans , Incidence , SARS-CoV-2
12.
J Med Virol ; 93(3): 1320-1342, 2021 03.
Article in English | MEDLINE | ID: covidwho-1196505

ABSTRACT

The 2019 novel coronavirus disease (COVID-19) now is considered a global public health emergency. One of the unprecedented challenges is defining the optimal therapy for those patients with severe pneumonia and systemic manifestations of COVID-19. The optimal therapy should be largely based on the pathogenesis of infections caused by this novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the onset of COVID-19, there have been many prepublications and publications reviewing the therapy of COVID-19 as well as many prepublications and publications reviewing the pathogenesis of SARS-CoV-2. However, there have been no comprehensive reviews that link COVID-19 therapies to the pathogenic mechanisms of SARS-CoV-2. To link COVID-19 therapies to pathogenic mechanisms of SARS-CoV-2, we performed a comprehensive search through MEDLINE, PubMed, medRxiv, EMBASE, Scopus, Google Scholar, and Web of Science using the following keywords: COVID-19, SARS-CoV-2, novel 2019 coronavirus, pathology, pathologic, pathogenesis, pathophysiology, coronavirus pneumonia, coronavirus infection, coronavirus pulmonary infection, coronavirus cardiovascular infection, coronavirus gastroenteritis, coronavirus autopsy findings, viral sepsis, endotheliitis, thrombosis, coagulation abnormalities, immunology, humeral immunity, cellular immunity, inflammation, cytokine storm, superantigen, therapy, treatment, therapeutics, immune-based therapeutics, antiviral agents, respiratory therapy, oxygen therapy, anticoagulation therapy, adjuvant therapy, and preventative therapy. Opinions expressed in this review also are based on personal experience as clinicians, authors, peer reviewers, and editors. This narrative review linking COVID-19 therapies with pathogenic mechanisms of SARS-CoV-2 has resulted in six major therapeutic goals for COVID-19 therapy based on the pathogenic mechanisms of SARS-CoV-2. These goals are listed below: 1. The first goal is identifying COVID-19 patients that require both testing and therapy. This is best accomplished with a COVID-19 molecular test from symptomatic patients as well as determining the oxygen saturation in such patients with a pulse oximeter. Whether a symptomatic respiratory illness is COVID-19, influenza, or another respiratory pathogen, an oxygen saturation less than 90% means that the patient requires medical assistance. 2. The second goal is to correct the hypoxia. This goal generally requires hospitalization for oxygen therapy; other respiratory-directed therapies such as prone positioning or mechanical ventilation are often used in the attempt to correct hypoxemia due to COVID-19. 3. The third goal is to reduce the viral load of SARS-CoV-2. Ideally, there would be an oral antiviral agent available such as seen with the use of oseltamivir phosphate for influenza. This oral antiviral agent should be taken early in the course of SARS-CoV-2 infection. Such an oral agent is not available yet. Currently, two options are available for reducing the viral load of SARS-CoV-2. These are post-Covid-19 plasma with a high neutralizing antibody titer against SARS-CoV-2 or intravenous remdesivir; both options require hospitalization. 4. The fourth goal is to identify and address the hyperinflammation phase often seen in hospitalized COVID-19 patients. Currently, fever with an elevated C-reactive protein is useful for diagnosing this hyperinflammation syndrome. Low-dose dexamethasone therapy currently is the best therapeutic approach. 5. The fifth goal is to identify and address the hypercoagulability phase seen in many hospitalized COVID-19 patients. Patients who would benefit from anticoagulation therapy can be identified by a marked increase in d-dimer and prothrombin time with a decrease in fibrinogen. To correct this disseminated intravascular coagulation-like phase, anticoagulation therapy with low molecular weight heparin is preferred. Anticoagulation therapy with unfractionated heparin is preferred in COVID-19 patients with acute kidney injuries. 6. The last goal is prophylaxis for persons who are not yet infected. Potential supplements include vitamin D and zinc. Although the data for such supplements is not extremely strong, it can be argued that almost 50% of the population worldwide has a vitamin D deficiency. Correcting this deficiency would be beneficial regardless of any impact of COVID-19. Similarly, zinc is an important supplement that is important in one's diet regardless of any effect on SARS-CoV-2. As emerging therapies are found to be more effective against the SARS-CoV-2 pathogenic mechanisms identified, they can be substituted for those therapies presented in this review.


Subject(s)
COVID-19/physiopathology , COVID-19/therapy , Lung/pathology , SARS-CoV-2/pathogenicity , Antiviral Agents/therapeutic use , COVID-19/complications , Humans , Hypoxia/prevention & control , Inflammation/drug therapy , Viral Load/drug effects
13.
Clin Endosc ; 54(5): 688-693, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1168043

ABSTRACT

BACKGROUND/AIMS: The coronavirus disease (COVID)-19 pandemic presents challenges for gastrointestinal endoscopy. Although the virus is transmitted through contact and droplets, aerosol-generating procedures produce aerosols that can spread through airborne routes. Several gastrointestinal societies have released statements to protect patients and health care providers (HCPs). This study describes a barrier box that may be used as an adjunctive device in addition to personal protective equipment during endoscopies. METHODS: A transparent acrylic box called "Endoshield" was created to place over patient's head and shoulders and was tested for its ease of use for the endoscopist and suitability for patient size and position. RESULTS: Twelve children (66.67%, male) with a median age of 9 years (range, 2-11 years) underwent emergency or urgent endoscopy between April and June 2020 during the COVID-19 outbreak. The most common presenting symptom was life-threatening gastrointestinal bleeding (8/12, 66.67%), while the rest had urgent symptoms (4/12, 33.33%). The "Endoshield" was suitable for all patient positions (left lateral position: 9/12, 75% and supine position: 3/12, 25%). The patients and HCPs were followed up for their symptoms on day 14, and none of them had any symptoms of concern. CONCLUSION: The "Endoshield" is affordable, reusable, and suitable for both positions.

14.
Acta Med Port ; 34(5): 355-361, 2021 May 02.
Article in English | MEDLINE | ID: covidwho-1156228

ABSTRACT

INTRODUCTION: The COVID-19 pandemic poses unprecedented challenges for healthcare services and has led to changes in the usage pattern of the pediatric population. We aimed to describe the impact of COVID-19 on children's health, wellbeing, and access to medical care in Portugal. MATERIAL AND METHODS: We conducted a cross-sectional study through an anonymous online survey via social media. The collected data refers to a period between the 16th of March and the 17th of May 2020. RESULTS: We obtained responses to the survey on 19 745 children. Of the previously scheduled outpatient consultations, 54.2% were postponed by healthcare institutions and 21.6% of planned vaccinations were missed. Parents expressed concerns regarding psychological, social, and physical consequences for their children due to the pandemic. DISCUSSION: The observed reduction of pediatric emergency department visits and the postponement of outpatient consultations and vaccine administrations are potentially harmful for non-COVID patients. The current pandemic and the imposed social distance might have an important negative impact on the mental health of children. CONCLUSION: Further studies are necessary to fully comprehend the outcomes of the decreased access to medical care, as well as the collateral damage for children beyond the clinical aspects of the pandemic. Defining strategies regarding the urge to vaccinate children and not postpone urgent evaluations should be a public health priority.


Introdução: A pandemia COVID-19 constitui um desafio sem precedentes para os serviços de saúde e conduziu a alterações no padrão de utilização dos recursos pela população pediátrica. Procurámos descrever o impacto da pandemia COVID-19 na saúde infantil e no acesso à saúde em Portugal. Material e Métodos: Realizámos um estudo retrospetivo, recolhendo dados através da aplicação de um inquérito anónimo online nas redes sociais. Os dados referem-se ao período entre 16 de março e 17 de maio de 2020. Resultados: Obtivemos respostas ao inquérito relativas a 19 745 crianças. Da análise às respostas, concluímos que 54,2% das consultas previamente agendadas foram adiadas pelas instituições de saúde e 21,6% das vacinações previstas não se realizaram. Os pais expressaram preocupação quanto às consequências psicológicas, sociais e físicas da pandemia nos seus filhos. Discussão: A reduzida utilização dos serviços de urgência pediátricos, bem como a não realização de consultas e vacinações previamente agendadas é potencialmente lesiva para os doentes não-COVID. A pandemia e o isolamento social imposto poderão causar um impacto negativo na saúde mental das crianças. Conclusão: Estudos adicionais são necessários para melhor compreender as consequências da diminuição do acesso à saúde, bem como os efeitos psicológicos, sociais e físicos nas crianças. A definição de estratégias para incentivar a vacinação e o não adiamento de avaliações médicas urgentes deveriam ser prioridades de Saúde Pública.


Subject(s)
COVID-19 , Child Health , Health Impact Assessment/methods , Pandemics , Pediatrics , COVID-19/epidemiology , COVID-19/psychology , Child , Cross-Sectional Studies , Health Services Accessibility , Humans , Parents , Portugal , Quality of Health Care , SARS-CoV-2
15.
Int J Soc Psychiatry ; 68(4): 738-744, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1146853

ABSTRACT

BACKGROUND: This study reviewed the psychological consequences of the novel coronavirus disease COVID-19 and the challenges that face post-traumatic interventions. COVID-19 pandemic has multifaceted psychological effects extending social stigmatization to COVID-19 patients, resulted in delaying in medical care and hiding important medical history, particularly of travel, this in turn will increase the risk of transmission. OBJECTIVES OF THE STUDY: To explore if there is significant impacts of public health emergency COVID-19 on mental health among clients attending Al/Karkh Care centers. METHODS: Cross-sectional study describes the mental health status among clients attending Al-Karkh Health Centers during the COVID-19 pandemic, using mental health reports from Mental Health Unit/Al-Karkh Health Directorate, which were collected from January to August. Using (SPSS25) for statistical analysis. Statistical test Chi-square used and p value of ⩽.05 was considered significant. RESULTS: The percentages of psychological disturbances among clients is higher throughout the first 7 months of 2019 than 2020, till August the percentage of psychological disturbances started to hike up in 2020 than in 2019 (6%), (5.4%) respectively. Throughout the months of 2020 up to August there was significant difference between male and female clients in mental disturbances p value <.0001. CONCLUSION: The current study found that COVID-19 pandemic is expected to raise great challenges for mental health services in health care centers and constitute a mental health risk especially to women and girls compared to men.


Subject(s)
COVID-19 , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Mental Health , Pandemics , SARS-CoV-2
16.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 64(4): 426-434, 2021 Apr.
Article in German | MEDLINE | ID: covidwho-1144316

ABSTRACT

The COVID-19 pandemic poses major challenges for the German notification system in public infection control. For the federal state of Schleswig-Holstein evaluations, the state reporting office supports the public health departments by providing daily and weekly evaluations and supports the transmission of notification data to the Robert Koch Institute according to the Infection Protection Act.In the present report of the state notification office of Schleswig-Holstein, the SARS-CoV­2 reporting data for the period from March to September 2020 are evaluated. Based on the development of the infection numbers, this period was divided into two phases of similar size: March to May and June to September. A total of 4898 infection cases were reported. Upon comparison of the phases, there were particularly marked differences in hospitalization and mortality, age, and countries of infection site. In the first phase, elderly persons were particularly affected by high rates of hospitalization and mortality. In the second phase, the average age and hospitalization and mortality rates were significantly lower, and a particularly large proportion were associated with international travel activity. The evaluation of the outbreak documentation revealed a particular focus in private household settings. This article describes the epidemic situation in a low-incidence state within the Federal Republic of Germany.


Subject(s)
COVID-19 , Pandemics , Aged , Germany/epidemiology , Humans , Incidence , SARS-CoV-2
17.
Cureus ; 13(2): e13354, 2021 Feb 15.
Article in English | MEDLINE | ID: covidwho-1145697

ABSTRACT

Background The COVID-19 pandemic challenges our ability to safely treat breast cancer patients and requires revisiting current techniques to evaluate optimal strategies. Potential long-term sequelae of breast radiation have been addressed by deep inspiration breath-hold (DIBH), prone positioning, and four-dimensional computed tomography (4DCT) average intensity projection (AveIP)-based planning techniques. Dosimetric comparisons to determine the optimal technique to minimize the normal tissue dose for left-sided breast cancers have not been performed. Methods Ten patients with left-sided, early-stage breast cancer undergoing whole breast radiation were simulated in the prone position, supine with DIBH, and with a free-breathing 4DCT scan. The target and organs at risk (OAR) contours were delineated in all scans. Target volume coverage and OAR doses were assessed. One-way analysis of variance (ANOVA) and Kruskal-Wallis one-way ANOVA were used to detect differences in dosimetric parameters among the different treatment plans. Significance was set as p < 0.05. Results We demonstrate differences in heart and lung dose by the simulation technique. The mean heart doses in the prone, DIBH, and AveIP plans were 129 cGy, 154 cGy, and 262 cGy, respectively (p=0.02). The lung V20 in the prone, DIBH, and AveIP groups was 0.5%, 10.3% and 9.5%, respectively (p <0.001). Regardless of technique, lumpectomy planning target volume (PTV) coverage did not differ between the three plans with 95% of the lumpectomy PTV volume covered by 100.4% in prone plans, 98.5% in AveIP plans, and 99.3% in DIBH plans (p=0.7). Conclusions Prone positioning provides dosimetric advantages as compared to DIBH. When infection risks are considered as in the current coronavirus disease 2019 (COVID-19) pandemic, prone plans have advantages in reducing the risk of disease transmission. In instances where prone positioning is not feasible, obtaining an AveIP simulation may be useful in more accurately assessing heart and lung toxicity and informing a risk/benefit discussion of DIBH vs free breath-hold techniques.

18.
World Neurosurg ; 148: 256-262, 2021 04.
Article in English | MEDLINE | ID: covidwho-1144984

ABSTRACT

Coronavirus disease 2019 (COVID-19) has disrupted lives and indelibly impacted the practice of medicine since emerging as a pandemic in March 2020. For neurosurgery departments throughout the United States, the pandemic has created unique challenges across subspecialties in devising methods of triage, workflow, and operating room safety. Located in New York City, at the early epicenter of the COVID-19 crisis, the Weill Cornell Medicine Department of Neurological Surgery was disrupted and challenged in many ways, requiring adaptations in clinical operations, workforce management, research, and education. Through our department's collective experience, we offer a glimpse at how our faculty and administrators overcame obstacles, and transformed in the process, at the height of the COVID-19 pandemic.


Subject(s)
COVID-19 , Delivery of Health Care , Education, Distance , Neurosurgery/organization & administration , Neurosurgical Procedures , Teleworking , Academic Medical Centers , Biomedical Research , Faculty, Medical , Health Personnel , Hospital Departments , Humans , Neurosurgery/education , Neurosurgery/methods , New York City , Operating Rooms , Personnel Management , SARS-CoV-2 , Triage , Webcasts as Topic , Workflow
19.
Vaccines (Basel) ; 9(3)2021 Mar 12.
Article in English | MEDLINE | ID: covidwho-1143623

ABSTRACT

Background-misinformation and mistrust often undermines community vaccine uptake, yet information in rural communities, especially of developing countries, is scarce. This study aimed to identify major challenges associated with coronavirus disease 2019 (COVID-19) vaccine clinical trials among healthcare workers and staff in Uganda. Methods-a rapid exploratory survey was conducted over 5 weeks among 260 respondents (66% male) from healthcare centers across the country using an online questionnaire. Twenty-seven questions assessed knowledge, confidence, and trust scores on COVID-19 vaccine clinical trials from participants in 46 districts in Uganda. Results-we found low levels of knowledge (i.e., confusing COVID-19 with Ebola) with males being more informed than females (OR = 1.5, 95% CI: 0.7-3.0), and mistrust associated with policy decisions to promote herbal treatments in Uganda and the rushed international clinical trials, highlighting challenges for the upcoming Oxford-AstraZeneca vaccinations. Knowledge, confidence and trust scores were higher among the least educated (certificate vs. bachelor degree holders). We also found a high level of skepticism and possible community resistance to DNA recombinant vaccines, such as the Oxford-AstraZeneca vaccine. Preference for herbal treatments (38/260; 14.6%, 95% CI: 10.7-19.3) currently being promoted by the Ugandan government raises major policy concerns. High fear and mistrust for COVID-19 vaccine clinical trials was more common among wealthier participants and more affluent regions of the country. Conclusion-our study found that knowledge, confidence, and trust in COVID-19 vaccines was low among healthcare workers in Uganda, especially those with higher wealth and educational status. There is a need to increase transparency and inclusive participation to address these issues before new trials of COVID-19 vaccines are initiated.

20.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 64(4): 454-462, 2021 Apr.
Article in German | MEDLINE | ID: covidwho-1137111

ABSTRACT

COVID-19 has been challenging our society since January 2020. Due to global travel, the new coronavirus has rapidly spread worldwide. This article aims to provide an overview of the challenges in implementing measures in the air and maritime transport sector from the perspective of the German Public Health Service (Öffentlicher Gesundheitsdienst, ÖGD). Significant events and measures for air and maritime transport between January and August 2020 were selected. Lessons learned are discussed.During the COVID-19 pandemic, the ÖGD has been operating in a field of tension between the dynamics of scientific knowledge, political decision-making, social acceptance and consent.There are specific challenges at points of entry such as airports and seaports. These include staff shortages and the need to implement measures with a high organisational effort at very short notice such as health authority passenger checks carried out on aircraft, the establishment of test centres at points of entry and control of compliance with quarantine measures. Aggravating the situation, passenger lists, which are necessary for effective contact tracing, are often not available or incomplete. There is also a lack of digital tools for contact tracing but also, for example, the exchange of personal data within the ÖGD. Further difficulties in outbreak management arise from the cramped conditions on board ships and from the potential psychological stress on crew members and passengers, which have not yet been sufficiently considered.In view of all these challenges, it is paramount to strengthen the German Public Health Service in general and at points of entry and to intensify the exchange between the national, federal state and local levels.


Subject(s)
COVID-19 , Pandemics , Germany/epidemiology , Health Services , Humans , Pandemics/prevention & control , Public Health , Quarantine , SARS-CoV-2
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