Asunto(s)
COVID-19 , Defensa Civil , Control de Enfermedades Transmisibles , Investigación Biomédica Traslacional , COVID-19/epidemiología , COVID-19/prevención & control , Defensa Civil/organización & administración , Defensa Civil/tendencias , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/tendencias , Barreras de Comunicación , Desarrollo de Medicamentos , Predicción , Salud Global/normas , Salud Global/tendencias , Humanos , Cooperación Internacional , Salud Pública , SARS-CoV-2 , Investigación Biomédica Traslacional/métodos , Investigación Biomédica Traslacional/normas , Investigación Biomédica Traslacional/tendenciasAsunto(s)
COVID-19/epidemiología , Defensa Civil , Personal de Salud , Necesidades y Demandas de Servicios de Salud , Hospitales , Incidentes con Víctimas en Masa , Defensa Civil/métodos , Defensa Civil/organización & administración , Personal de Salud/ética , Personal de Salud/psicología , Humanos , Líbano , Resiliencia Psicológica , SARS-CoV-2 , Responsabilidad SocialAsunto(s)
Instituciones de Atención Ambulatoria , COVID-19 , Defensa Civil , Control de Enfermedades Transmisibles , Complicaciones de la Diabetes , Diabetes Mellitus Tipo 2 , Pacientes no Presentados , Telemedicina , Factores de Edad , Instituciones de Atención Ambulatoria/organización & administración , Instituciones de Atención Ambulatoria/estadística & datos numéricos , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/psicología , Cardiotónicos/uso terapéutico , Defensa Civil/organización & administración , Defensa Civil/normas , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/etiología , Complicaciones de la Diabetes/terapia , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/terapia , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Uso de Internet/estadística & datos numéricos , Italia/epidemiología , Pacientes no Presentados/psicología , Pacientes no Presentados/estadística & datos numéricos , Innovación Organizacional , Distanciamiento Físico , SARS-CoV-2 , Telemedicina/métodos , Telemedicina/normasRESUMEN
Failures in preparation and response led to a worsened crisis.
Asunto(s)
COVID-19/prevención & control , Medicina Preventiva/normas , Defensa Civil/organización & administración , Defensa Civil/normas , Humanos , Medicina Preventiva/tendencias , Organización Mundial de la Salud/organización & administraciónRESUMEN
Racially and ethnically diverse and socioeconomically disadvantaged communities have historically been disproportionately affected by disasters and public health emergencies in the United States. The U.S. Department of Health and Human Services' Office of Minority Health established the National Consensus Panel on Emergency Preparedness and Cultural Diversity to provide guidance to agencies and organizations on developing effective strategies to advance emergency preparedness and eliminate disparities among racially and ethnically diverse communities during these crises. Adopting the National Consensus Panel recommendations, the Johns Hopkins Medicine Office of Diversity, Inclusion, and Health Equity; Language Services; and academic-community partnerships used existing health equity resources and expertise to develop an operational framework to support the organization's COVID-19 response and to provide a framework of health equity initiatives for other academic medical centers. This operational framework addressed policies to support health equity patient care and clinical operations, accessible COVID-19 communication, and staff and community support and engagement, which also supported the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care. Johns Hopkins Medicine identified expanded recommendations for addressing institutional policy making and capacity building, including unconscious bias training for resource allocation teams and staff training in accurate race, ethnicity, and language data collection, that should be considered in future updates to the National Consensus Panel's recommendations.
Asunto(s)
Centros Médicos Académicos/organización & administración , COVID-19/etnología , Desastres/prevención & control , Equidad en Salud/normas , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/virología , Defensa Civil/organización & administración , Consenso , Diversidad Cultural , Etnicidad/estadística & datos numéricos , Programas de Gobierno/organización & administración , Programas de Gobierno/normas , Disparidades en Atención de Salud/etnología , Humanos , Grupos Minoritarios/estadística & datos numéricos , Formulación de Políticas , Salud Pública/normas , SARS-CoV-2/genética , Participación Social , Factores Socioeconómicos , Estados Unidos/epidemiologíaAsunto(s)
Brotes de Enfermedades , Administración Hospitalaria , COVID-19/epidemiología , COVID-19/terapia , Defensa Civil/métodos , Defensa Civil/organización & administración , Toma de Decisiones , Cuidados Paliativos al Final de la Vida/organización & administración , Administración Hospitalaria/métodos , Planificación Hospitalaria , Humanos , PandemiasAsunto(s)
COVID-19 , Defensa Civil , Control de Enfermedades Transmisibles , Agencias Gubernamentales , Regulación Gubernamental , COVID-19/epidemiología , COVID-19/prevención & control , Defensa Civil/legislación & jurisprudencia , Defensa Civil/organización & administración , Defensa Civil/normas , Control de Enfermedades Transmisibles/legislación & jurisprudencia , Control de Enfermedades Transmisibles/organización & administración , Control de Enfermedades Transmisibles/normas , Agencias Gubernamentales/legislación & jurisprudencia , Agencias Gubernamentales/organización & administración , Agencias Gubernamentales/normas , Humanos , Evaluación de Necesidades , Práctica de Salud Pública/legislación & jurisprudencia , Práctica de Salud Pública/normas , SARS-CoV-2 , Reino Unido/epidemiologíaAsunto(s)
Defensa Civil/organización & administración , Intervención en la Crisis (Psiquiatría)/organización & administración , Planificación en Desastres/organización & administración , National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division/organización & administración , Sistema de Vigilancia de Factor de Riesgo Conductual , Urgencias Médicas , Humanos , Técnicas de Planificación , Salud Pública/normas , Estados UnidosRESUMEN
BACKGROUND/OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has taken a disproportionate toll on long-term care facility residents and staff. Our objective was to review the empirical evidence on facility characteristics associated with COVID-19 cases and deaths. DESIGN: Systematic review. SETTING: Long-term care facilities (nursing homes and assisted living communities). PARTICIPANTS: Thirty-six empirical studies of factors associated with COVID-19 cases and deaths in long-term care facilities published between January 1, 2020 and June 15, 2021. MEASUREMENTS: Outcomes included the probability of at least one case or death (or other defined threshold); numbers of cases and deaths, measured variably. RESULTS: Larger, more rigorous studies were fairly consistent in their assessment of risk factors for COVID-19 outcomes in long-term care facilities. Larger bed size and location in an area with high COVID-19 prevalence were the strongest and most consistent predictors of facilities having more COVID-19 cases and deaths. Outcomes varied by facility racial composition, differences that were partially explained by facility size and community COVID-19 prevalence. More staff members were associated with a higher probability of any outbreak; however, in facilities with known cases, higher staffing was associated with fewer deaths. Other characteristics, such as Nursing Home Compare 5-star ratings, ownership, and prior infection control citations, did not have consistent associations with COVID-19 outcomes. CONCLUSION: Given the importance of community COVID-19 prevalence and facility size, studies that failed to control for these factors were likely confounded. Better control of community COVID-19 spread would have been critical for mitigating much of the morbidity and mortality long-term care residents and staff experienced during the pandemic. Traditional quality measures such as Nursing Home Compare 5-Star ratings and past deficiencies were not consistent indicators of pandemic preparedness, likely because COVID-19 presented a novel problem requiring extensive adaptation by both long-term care providers and policymakers.
Asunto(s)
COVID-19 , Hogares para Ancianos/organización & administración , Cuidados a Largo Plazo , Casas de Salud/organización & administración , Ajuste de Riesgo , Instituciones de Cuidados Especializados de Enfermería/organización & administración , Anciano , COVID-19/mortalidad , COVID-19/prevención & control , Defensa Civil/organización & administración , Humanos , Control de Infecciones/métodos , Control de Infecciones/normas , Cuidados a Largo Plazo/métodos , Cuidados a Largo Plazo/tendencias , Evaluación de Resultado en la Atención de Salud , SARS-CoV-2Asunto(s)
Envejecimiento , COVID-19 , Defensa Civil , Redes Comunitarias , Anciano Frágil , Investigación sobre Servicios de Salud , Servicios Preventivos de Salud/normas , Investigación en Rehabilitación/normas , Anciano , Envejecimiento/ética , Envejecimiento/fisiología , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/terapia , Defensa Civil/organización & administración , Defensa Civil/normas , Redes Comunitarias/organización & administración , Redes Comunitarias/normas , Investigación sobre Servicios de Salud/ética , Investigación sobre Servicios de Salud/organización & administración , Investigación sobre Servicios de Salud/normas , Humanos , Evaluación de Necesidades , Selección de Paciente , Medición de Riesgo , SARS-CoV-2RESUMEN
The built environment has been integral to response to the global pandemic of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In particular, engineering controls to mitigate risk of exposure to SARS-CoV-2 and other newly emergent respiratory pathogens in the future will be important. Anticipating emergence from this pandemic, or at least adaptation given increasing administration of effective vaccines, and the safety of patients, personnel, and others in health care facilities remain the core goals. This article summarizes known risks and highlights prevention strategies for daily care as well as response to emergent infectious diseases and this parapandemic phase.
Asunto(s)
COVID-19 , Defensa Civil , Instituciones de Salud/tendencias , Control de Infecciones , Administración de la Seguridad/organización & administración , COVID-19/epidemiología , COVID-19/prevención & control , Defensa Civil/métodos , Defensa Civil/organización & administración , Ambiente Controlado , Arquitectura y Construcción de Hospitales/métodos , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , SARS-CoV-2RESUMEN
COVID-19 has infected hundreds of millions of people across the globe. The pandemic has also inflicted serious damages on global and regional governing political structures to a degree meriting a revisit of their own raison d'etre. The global economic fallout is also unprecedented as the flows of goods and people got severely disrupted while lockdowns hit the transport, services and retail industries, among others. We argue that three realities need to be genuinely addressed for building a post COVID-19 order that has to be amply equipped to deal with the next global crisis, as well as the ones on-going for decades. First, there is need to shelf-away the hitherto practiced doctrine that global crises and problems are confronted through local responses. Second, the COVID-19 pandemic has cautioned us on the need to (re)invest in basic, many may consider naïve and simple, public health functions such as sanitation as well as transparent national and global health monitoring. Third, the pandemic is a clear reprimand to discard the mantra that privatization of healthcare delivery system is the solution in favor of viewing health as a public good that needs to be managed and executed by the state and its public sector, be it national, sub-regional or local. It is critical that we learn from such pandemic and advance our societies to become stronger.
Asunto(s)
COVID-19 , Defensa Civil/organización & administración , Control de Enfermedades Transmisibles , Atención a la Salud , Salud Global , Salud Pública , COVID-19/economía , COVID-19/epidemiología , COVID-19/prevención & control , Atención a la Salud/economía , Atención a la Salud/normas , Atención a la Salud/tendencias , Predicción , Salud Global/normas , Salud Global/tendencias , Humanos , SARS-CoV-2 , Medicina Social/tendenciasRESUMEN
Coronavirus disease 2019(COVID-19) has brought great disasters to humanity, and its influence continues to intensify. In response to the public health emergencies, prompt relief supplies are key to reduce the damage. This paper presents a method of emergency medical logistics to quick response to emergency epidemics. The methodology includes two recursive mechanisms: (1) the time-varying forecasting of medical relief demand according to a modified susceptible-exposed-infected- Asymptomatic- recovered (SEIAR) epidemic diffusion model, (2) the relief supplies distribution based on a multi-objective dynamic stochastic programming model. Specially, the distribution model addresses a hypothetical network of emergency medical logistics with considering emergency medical reserve centers (EMRCs), epidemic areas and e-commerce warehousing centers as the rescue points. Numerical studies are conducted. The results show that with the cooperation of different epidemic areas and e-commerce warehousing centers, the total cost is 6% lower than without considering cooperation of different epidemic areas, and 9.7% lower than without considering cooperation of e-commerce warehousing centers. Particularly, the total cost is 20% lower than without considering any cooperation. This study demonstrates the importance of cooperation in epidemic prevention, and provides the government with a new idea of emergency relief supplies dispatching, that the rescue efficiency can be improved by mutual rescue between epidemic areas in public health emergency.
Asunto(s)
COVID-19/epidemiología , COVID-19/prevención & control , Defensa Civil/organización & administración , Servicios Médicos de Urgencia/organización & administración , Pandemias , Salud Pública/métodos , COVID-19/transmisión , COVID-19/virología , China/epidemiología , Defensa Civil/economía , Urgencias Médicas/epidemiología , Servicios Médicos de Urgencia/economía , Humanos , Colaboración Intersectorial , Modelos Estadísticos , SARS-CoV-2/patogenicidad , SARS-CoV-2/fisiologíaAsunto(s)
COVID-19 , Defensa Civil , Necesidades y Demandas de Servicios de Salud , Liderazgo , Ageísmo/prevención & control , COVID-19/epidemiología , COVID-19/prevención & control , Defensa Civil/organización & administración , Defensa Civil/normas , Gestión de Recursos de Personal en Salud/organización & administración , Gestión de Recursos de Personal en Salud/normas , Atención a la Salud/organización & administración , Necesidades y Demandas de Servicios de Salud/organización & administración , Necesidades y Demandas de Servicios de Salud/tendencias , Humanos , SARS-CoV-2 , Determinantes Sociales de la Salud , Estados Unidos/epidemiologíaRESUMEN
Emergency preparedness is a continuous quality improvement process through which roles and responsibilities are defined to effectively anticipate, respond to, and recover from the impact of emergencies. This process results in documented plans that provide a backbone structure for developing the core capacities to address health threats. Nevertheless, several barriers can impair an effective preparedness planning, as it needs a 360° perspective to address each component according to the best evidence and practice. Preparedness planning shares common principles with health technology assessment (HTA) as both encompass a multidisciplinary and multistakeholder approach, follow an iterative cycle, adopt a 360° perspective on the impact of intervention measures, and conclude with decision-making support. Our "Perspective" illustrates how each HTA domain can address different component(s) of a preparedness plan that can indeed be seen as a container of multiple HTAs, which can then be used to populate the entire plan itself. This approach can allow one to overcome preparedness barriers, providing an independent, systematic, and robust tool to address the components and ensuring a comprehensive evaluation of their value in the mitigation of the impact of emergencies.
Asunto(s)
Defensa Civil/organización & administración , Planificación en Desastres/organización & administración , Evaluación de la Tecnología Biomédica/organización & administración , Defensa Civil/economía , Defensa Civil/normas , Planificación en Desastres/economía , Planificación en Desastres/normas , Práctica Clínica Basada en la Evidencia/normas , HumanosRESUMEN
COVID-19 has exacted a disproportionate toll on the health of persons living in nursing homes. Healthcare providers and other decision-makers in those settings must refer to multiple evolving sources of guidance to coordinate care delivery in such a way as to minimize the introduction and spread of the causal virus, SARS-CoV-2. It is essential that guidance be presented in an accessible and usable format to facilitate its translation into evidence-based best practice. In this article, we propose the Haddon matrix as a tool well-suited to this task. The Haddon matrix is a conceptual model that organizes influencing factors into pre-event, event, and post-event phases, and into host, agent, and environment domains akin to the components of the epidemiologic triad. The Haddon matrix has previously been applied to topics relevant to the care of older persons, such as fall prevention, as well as to pandemic planning and response. Presented here is a novel application of the Haddon matrix to pandemic response in nursing homes, with practical applications for nursing home decision-makers in their efforts to prevent and contain COVID-19.
Asunto(s)
COVID-19 , Defensa Civil/organización & administración , Práctica Clínica Basada en la Evidencia , Hogares para Ancianos/organización & administración , Control de Infecciones , Modelos Organizacionales , Casas de Salud/organización & administración , Anciano , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/transmisión , Transmisión de Enfermedad Infecciosa/prevención & control , Práctica Clínica Basada en la Evidencia/métodos , Práctica Clínica Basada en la Evidencia/tendencias , Servicios de Salud para Ancianos/organización & administración , Servicios de Salud para Ancianos/normas , Servicios de Salud para Ancianos/tendencias , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Control de Infecciones/normas , Innovación Organizacional , SARS-CoV-2 , Estados UnidosAsunto(s)
Defensa Civil , Industria Farmacéutica , Medicamentos Esenciales , Planificación en Salud/organización & administración , Reserva Estratégica , Capacidad de Reacción , COVID-19/epidemiología , Defensa Civil/métodos , Defensa Civil/organización & administración , Planificación en Desastres/organización & administración , Industria Farmacéutica/organización & administración , Industria Farmacéutica/normas , Industria Farmacéutica/estadística & datos numéricos , Medicamentos Esenciales/clasificación , Medicamentos Esenciales/economía , Medicamentos Esenciales/provisión & distribución , Humanos , Legislación de Medicamentos , Evaluación de Necesidades , SARS-CoV-2 , Reserva Estratégica/legislación & jurisprudencia , Reserva Estratégica/organización & administración , Capacidad de Reacción/legislación & jurisprudencia , Capacidad de Reacción/organización & administración , Capacidad de Reacción/normas , Estados UnidosRESUMEN
PROBLEM: In accordance with guidelines from the Association of American Medical Colleges, medical schools across the United States suspended clerkships and transitioned preclinical courses online in March 2020 because of the COVID-19 pandemic. Hospitals and health systems faced significant burdens during this time, particularly in New York City. APPROACH: Third- and fourth-year medical students at the Icahn School of Medicine at Mount Sinai formed the COVID-19 Student WorkForce to connect students to essential roles in the Mount Sinai Hospital System and support physicians, staff members, researchers, and hospital operations. With the administration's support, the WorkForce grew to include over 530 medical and graduate students. A methodology was developed for clinical students to receive elective credit for these volunteer activities. OUTCOMES: From March 15, 2020, to June 14, 2020, student volunteers recorded 29,602 hours (2,277 hours per week) in 7 different task forces, which operated at 7 different hospitals throughout the health system. Volunteers included students from all years of medical school as well as PhD, master's, and nursing students. The autonomous structure of the COVID-19 Student WorkForce was unique and contributed to its ability to quickly mobilize students to necessary tasks. The group leaders collaborated with other medical schools in the New York City area, sharing best practices and resources and consulting on a variety of topics. NEXT STEPS: Going forward, the COVID-19 Student WorkForce will continue to collaborate with student leaders of other institutions and prevent volunteer burnout; transition select initiatives into structured, precepted student roles for clinical education; and maintain a state of readiness in the event of a second surge of COVID-19 infections in the New York City area.
Asunto(s)
Agotamiento Profesional/prevención & control , COVID-19/prevención & control , Defensa Civil/organización & administración , Estudiantes de Medicina/estadística & datos numéricos , Recursos Humanos/organización & administración , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/virología , Prácticas Clínicas/legislación & jurisprudencia , Prácticas Clínicas/métodos , Educación a Distancia/legislación & jurisprudencia , Educación a Distancia/métodos , Guías como Asunto , Recursos en Salud , Hospitales , Humanos , Cuerpo Médico de Hospitales/organización & administración , Cuerpo Médico de Hospitales/estadística & datos numéricos , Ciudad de Nueva York/epidemiología , Guías de Práctica Clínica como Asunto , SARS-CoV-2/aislamiento & purificación , Facultades de Medicina/organización & administración , Estudiantes de Medicina/psicología , VoluntariosRESUMEN
BACKGROUND: Convalescent plasma (CP) has been used in the past in various pandemics, in particular in H1N1, SARS and MERS infections. In Spring 2020, when ongoing the SARS-CoV-2 pandemics, the Veneto Region (V-R) has proposed setting-up an anti-SARS-CoV-2 CP (CCP) Bank, with the aim of preparing a supply of CCP immediately available in case of subsequest epidemic waves. MATERIALS AND METHODS: Key-points to be developed for a quick set-up of the V-R CCP Bank have been recruitment of donors recovered from COVID-19 infection, laboratory analysis for the biological qualification of the CCP units, including titre of neutralizing antibodies and reduction of pathogens, according to National Blood Centre (CNS) Directives, adaptation of the V-R Information Technology systems and cost analysis. Some activities, including diagnostic and viral inactivation processes, have been centralized in 2 or 3 sites. Laboratory analysis upon preliminary admission of the donor included all tests required by the Italian laws and the CNS directives. RESULTS: From April to August 2020, 3,298 people have contacted the V-R Blood Transfusion Services: of these, 1,632 have been evaluated and examined as first time donors and those found to be suitable have carried out 955 donations, from which 2,626 therapeutic fractions have been obtained, at a cost around 215,00 Euro. Since October 2020, the number of COVID-19 inpatients has had a surge with a heavy hospital overload. Moreover, the high request of CCP therapy by clinicians has been just as unexpected, showing a wide therapeutic use. CONCLUSIONS: The organizational model here presented, which has allowed the rapid collection of a large amount of CCP, could be useful when facing new pandemic outbreaks, especially in low and middle income countries, with generally acceptable costs.