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2.
Front Health Serv Manage ; 37(1): 39-44, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-730519

RESUMEN

Catastrophic weather, like a pandemic, can wreak havoc on hospital operations. NYU Langone Health in New York City has experienced the extremes of both phenomena. In 2012, Superstorm Sandy severely damaged the system's core facilities, disabled operations, and forced the evacuation of more than 220 patients to other health systems. In 2020, the arrival of the novel coronavirus severely disrupted operations again-but this time, we were better prepared. Our experience in dealing with Superstorm Sandy taught us critical lessons that supported our readiness for COVID-19. Those lessons can be summed up as preparation, organization, and innovation.


Asunto(s)
Defensa Civil/organización & administración , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Tormentas Ciclónicas , Planificación en Desastres/organización & administración , Servicios Médicos de Urgencia/organización & administración , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Betacoronavirus , Humanos , Ciudad de Nueva York
4.
Vaccine ; 38(39): 6184-6189, 2020 09 03.
Artículo en Inglés | MEDLINE | ID: covidwho-701883

RESUMEN

Inactivated viral vaccines have long been used in humans for diseases of global health threat and are now among the vaccines for COVID-19 under development. The Brighton Collaboration Viral Vector Vaccines Safety Working Group (V3SWG) has prepared a standardized template to describe the key considerations for the benefit-risk assessment of inactivated viral vaccines. This will help key stakeholders to assess potential safety issues and understand the benefit-risk of the vaccine platform. The standardized and structured assessment provided by the template would also help to contribute to improved communication and support public acceptance of licensed inactivated viral vaccines.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Aprobación de Drogas/legislación & jurisprudencia , Pandemias/prevención & control , Neumonía Viral/prevención & control , Medición de Riesgo , Vacunas Virales/normas , Betacoronavirus/efectos de los fármacos , Betacoronavirus/inmunología , Betacoronavirus/patogenicidad , Defensa Civil , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/virología , Regulación Gubernamental , Humanos , Inmunogenicidad Vacunal , Cooperación Internacional , Seguridad del Paciente , Neumonía Viral/epidemiología , Neumonía Viral/inmunología , Neumonía Viral/virología , Vacunas de Productos Inactivados , Vacunas Virales/administración & dosificación , Vacunas Virales/biosíntesis
5.
JNMA J Nepal Med Assoc ; 58(225): 355-359, 2020 May 30.
Artículo en Inglés | MEDLINE | ID: covidwho-699160

RESUMEN

The COVID-19 pandemic is unfolding at an unprecedented pace. The unprecedented threat provides an opportunity to emerge with robust health systems. Nepal has implemented several containment measures such as Rapid Response Team formulation; testing; isolation; quarantine; contact tracing;surveillance, establishment of COVID-19 Crisis Management Centre and designation of dedicated hospitals to gear up for the pandemic. The national public health emergency management mechanisms need further strengthening with the proactive engagement of relevant ministries; we need a strong, real-time national surveillance system and capacity building of a critical mass of health care workers; there is a need to further assess infection prevention and control capacity; expand the network of virus diagnostic laboratories in the private sector with adequate surge capacity;implement participatory community engagement interventions and plan for a phased lockdown exit strategy enabling sustainable suppression of transmission at low-level and enabling in resuming some parts of economic and social life.


Asunto(s)
Defensa Civil , Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Servicios Médicos de Urgencia/organización & administración , Pandemias/prevención & control , Neumonía Viral , Betacoronavirus/aislamiento & purificación , Defensa Civil/legislación & jurisprudencia , Defensa Civil/métodos , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Regulación Gubernamental , Humanos , Nepal/epidemiología , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Salud Pública/métodos
6.
Curr Opin Ophthalmol ; 31(5): 416-422, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-691736

RESUMEN

PURPOSE OF REVIEW: To highlight the lessons learned from the Ebola outbreak that may inform our approach to the COVID-19 pandemic, particularly related to the widespread disruption of healthcare, ophthalmic disease manifestations, and vision health systems strengthening for future outbreaks. RECENT FINDINGS: Coronavirus disease 2019 (COVID-19), first detected in China in December 2019, has become a worldwide health emergency, with significant disruption of all aspects of society, including travel, business, and medical care. Although this pandemic has had unprecedented effects on healthcare delivery in the United States, experiences from recent Ebola virus disease (EVD) outbreaks in Africa provide insight and inform our approach to COVID-19 and outbreak preparedness. Like COVID-19, the rapid emergence of Ebola required new clinical and surgical approaches to understand its associated spectrum of ophthalmic complications and the potential for Ebola viral persistence within the eye and in tear film. Recent reports of ophthalmic findings associated with COVID-19 include conjunctivitis, retinopathy, and molecular evidence of virus within the tear film in a minority of cases. Yet, more rigorous approaches to understand ophthalmic disease and transmission risk associated with COVID-19 are needed. Gaps also remain in our understanding of eye disease associated with other high priority emerging infectious diseases including Nipah, Lassa fever, Marburg virus, and others. SUMMARY: Thoroughly understanding the ophthalmic findings and transmission risk associated with COVID-19 is paramount during this pandemic, providing additional measures of safety while resuming ophthalmic care for all patients. Vision health systems preparedness measures developed during recent EVD outbreaks and the current pandemic provide models for ophthalmic clinical practice, research, and education, as we continue to address COVID-19 and future emerging infectious disease threats.


Asunto(s)
Betacoronavirus , Defensa Civil/organización & administración , Enfermedades Transmisibles Emergentes/epidemiología , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades , Transmisión de Enfermedad Infecciosa/prevención & control , Fiebre Hemorrágica Ebola/epidemiología , Neumonía Viral/epidemiología , Infecciones por Coronavirus/transmisión , Prestación de Atención de Salud , Salud Global , Humanos , Pandemias , Neumonía Viral/transmisión
11.
J Am Med Dir Assoc ; 21(7): 924-927, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: covidwho-651432

RESUMEN

OBJECTIVES: In the United States, home health agencies (HHAs) provide essential services for patients recovering from post-acute care and older adults who are aging in place. During the COVID-19 pandemic, HHAs may face additional challenges caring for these vulnerable patients. Our objective was to explore COVID-19 preparedness of US HHAs and compare results by urban/rural location. DESIGN: Cross-sectional study. SETTING/PARTICIPANTS: Using a stratified random sample of 978 HHAs, we conducted a 22-item online survey from April 10 to 17, 2020. METHODS: Summary statistics were computed; open-ended narrative responses were synthesized using qualitative methods. RESULTS: Similar to national data, most responding HHAs (n = 121, 12% response rate) were for-profit and located in the South. Most HHAs had infectious disease outbreaks included in their emergency preparedness plan (76%), a staff member in charge of outbreak/disaster preparedness (84%), and had provided their staff with COVID-19 education and training (97%). More urban HHAs had cared for confirmed and recovered COVID-19 patients than rural HHAs, but urban HHAs had less capacity to test for COVID-19 than rural HHAs (9% vs 21%). Most (69%) experienced patient census declines and had a current and/or anticipated supply shortage. Rural agencies were affected less than urban agencies. HHAs have already rationed (69%) or implemented extended use (55%) or limited reuse (61%) of personal protective equipment (PPE). Many HHAs reported accessing supplemental PPE from state/local resources, donations, and do-it-yourself efforts; more rural HHAs had accessed these additional resources compared with urban HHAs. CONCLUSIONS/IMPLICATIONS: This survey reveals challenges that HHAs are having in responding to the COVID-19 pandemic, particularly among urban agencies. Of greatest concern are the declines in patient census, which drastically affect agency revenue, and the shortages of PPE and disinfectants. Without proper protection, HHA clinicians are at risk of self-exposure and viral transmission to patients and vulnerable family members.


Asunto(s)
Defensa Civil/organización & administración , Infecciones por Coronavirus/prevención & control , Brotes de Enfermedades/prevención & control , Agencias de Atención a Domicilio/organización & administración , Evaluación de Resultado en la Atención de Salud , Pandemias/prevención & control , Neumonía Viral/prevención & control , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Femenino , Humanos , Control de Infecciones , Masculino , Pandemias/estadística & datos numéricos , Equipo de Protección Personal/estadística & datos numéricos , Neumonía Viral/epidemiología , Medición de Riesgo , Población Rural , Estados Unidos , Población Urbana , Poblaciones Vulnerables/estadística & datos numéricos
12.
Emerg Med J ; 37(9): 567-570, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: covidwho-647095

RESUMEN

For many of us in emergency medicine, rising to the challenge of the COVID-19 crisis will be the single most exciting and challenging episode of our careers. Lessons have been learnt on how to make quick and effective changes without being hindered by the normal restraints of bureaucracy. Changes that would normally have taken months to years to implement have been successfully introduced over a period of several weeks. Although we have managed these changes largely by command and control, compassionate leadership has identified leaders within our team and paved the way for the future. This article covers the preparation and changes made in response to COVID-19 in a London teaching hospital.


Asunto(s)
Defensa Civil , Infecciones por Coronavirus , Servicio de Urgencia en Hospital , Innovación Organizacional , Pandemias , Neumonía Viral , Planificación Estratégica , Capacidad de Reacción , Betacoronavirus , Gestión del Cambio , Defensa Civil/métodos , Defensa Civil/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Eficiencia Organizacional , Servicio de Urgencia en Hospital/organización & administración , Servicio de Urgencia en Hospital/tendencias , Humanos , Liderazgo , Londres , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control
14.
Pediatr Infect Dis J ; 39(9): e221-e225, 2020 09.
Artículo en Inglés | MEDLINE | ID: covidwho-636869

RESUMEN

BACKGROUND: In Italy, the response to coronavirus disease 2019 (COVID-19) pandemic upgraded from social distancing on February 23, 2020, to national lockdown on March 11, 2020. We described how the pandemic affected a tertiary care children hospital with a dedicated COVID-19 regional center. METHODS: We analyzed the characteristics of emergency department (ED) visits, urgent hospitalizations and severe acute respiratory syndrome (SARS)-COV-2 reverse transcription-polymerase chain reaction testing, and COVID-19 patients across 3 response phases: before the first Italian case, before national lockdown and during lockdown. RESULTS: ED visits decreased from a daily mean of 239.1 before the first COVID-19 Italian case, to 79.6 during lockdown; urgent hospitalizations decreased from 30.6 to 21.2. As of April 20, 2020, 1970 persons were tested for SARS-CoV-2 reverse transcription-polymerase chain reaction and 2.6% were positive. Positive rates were 1.2% in the ED, 21.1% in the COVID center and 0.5% in other wards. The median age of COVID-19 patients (N = 33) was 6.7 years, 27% had coexisting conditions and 79% were related to family clusters. CONCLUSIONS: The pandemic strongly impacted on the use of hospital services, with a 67% reduction in ED visits and a 31% reduction in urgent hospitalizations. Separating the flows of suspected patients from all other patients, and centralization of suspected and confirmed cases in the COVID center enabled to control the risk of nosocomial SARS-CoV-2 transmission. Delay in hospital use for urgent care must be avoided, and clear communication on infection prevention and control must be provided to families. Further studies are needed to assess how the reduction in hospital use affected children healthcare needs during the pandemic.


Asunto(s)
Defensa Civil , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Adolescente , Atención Ambulatoria , Betacoronavirus/aislamiento & purificación , Niño , Preescolar , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/virología , Servicio de Urgencia en Hospital/organización & administración , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Hospitalización/estadística & datos numéricos , Hospitales Pediátricos/organización & administración , Hospitales Pediátricos/estadística & datos numéricos , Humanos , Lactante , Italia/epidemiología , Masculino , Pandemias , Neumonía Viral/terapia , Neumonía Viral/virología , Centros de Atención Terciaria/organización & administración , Centros de Atención Terciaria/estadística & datos numéricos
15.
J Perioper Pract ; 30(7-8): 210-220, 2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-636523

RESUMEN

This article aims to describe the early experience of a large major trauma operating theatres department in the East of England during the outbreak of the coronavirus disease 2019 (COVID-19) pandemic. To date and to our knowledge, a small amount of reports describing a surgical department's response to this unprecedented pandemic have been published, but a well-documented account from within the United Kingdom (UK) has not yet been reported in the literature. We describe our preparation and response, including: operating theatres management during the COVID-19 pandemic, operational aspects and communication, leadership and support. The process review of measures presented covers approximately the two-month period between March and May 2020 and emphasises the fluidity of procedures needed. We discuss how significant challenges were overcome to secure implementation and reliable oversight. The visible presence of clinical leads well sighted on every aspect of the response guaranteed standardisation of procedures, while sustaining a vital feedback loop. Finally, we conclude that an effective response requires rapid analysis of the complex problem that is of providing care for patients intraoperatively during the COVID-19 pandemic, and that retrospective sense-making is essential to maintain adaptability.


Asunto(s)
Defensa Civil/organización & administración , Infecciones por Coronavirus/epidemiología , Control de Infecciones/organización & administración , Quirófanos/organización & administración , Neumonía Viral/epidemiología , Centros Traumatológicos/organización & administración , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/prevención & control , Brotes de Enfermedades/prevención & control , Femenino , Humanos , Masculino , Pandemias/prevención & control , Grupo de Atención al Paciente/organización & administración , Neumonía Viral/prevención & control , Administración de la Seguridad , Reino Unido/epidemiología
16.
Wien Klin Wochenschr ; 132(13-14): 400-402, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: covidwho-635183

RESUMEN

Mankind has to prepare for a pandemic with respect to medical and practical aspects, but also with respect to ethical issues. There are various ethical guidelines for managing infectious disease outbreaks, but they do not apply to the specific aspects of the COVID-19 pandemic, since they were formulated after the different kinds of outbreaks of avian influenza and Ebola. Today we are confronted with completely new issues endangering our fundamental human rights. As COVID-19 is spreading all over the world, we are in a desperate situation to find treatment solutions; however, despite the urgency, scientific rules have to be applied as bad science is unethical since it might be harmful for patients. Fake news and alternative facts might not be easily recognized and are also threatening scientific values. Pandemics might be leading to a meltdown of the health system if no measures are being taken constraining fundamental human rights. Tracking of persons is violating human rights as well if not accepted on a voluntary basis. A failure to have safeguards for times of crisis leads to a scarcity of medicinal products and goods resulting in a nationalistic approach and ignorance of international solidarity. And last but not least selective measures and triage in intensive care have to be taught to young physicians and nursing staff in medical schools in order to be prepared in times of an infectious disease outbreak and scarcity of resources.


Asunto(s)
Defensa Civil , Infecciones por Coronavirus , Derechos Humanos , Pandemias/ética , Neumonía Viral , Betacoronavirus , Defensa Civil/ética , Infecciones por Coronavirus/epidemiología , Humanos , Medios de Comunicación de Masas , Neumonía Viral/epidemiología , Asignación de Recursos/ética , Revelación de la Verdad
19.
Eur J Orthop Surg Traumatol ; 30(6): 951-954, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: covidwho-615373
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