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1.
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
3.
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
4.
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
5.
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
7.
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
9.
Am J Trop Med Hyg ; 102(6): 1181-1183, 2020 06.
Artículo en Inglés | MEDLINE | ID: covidwho-596857

RESUMEN

Novel coronavirus disease (COVID-19), named a pandemic by the WHO, is the current global health crisis. National and international collaboration are indispensable for combating COVID-19 and other similar potential outbreaks. International efforts to tackle this complex problem have led to remarkable scientific advances. Yet, as a global society, we can and must take additional measures to fight this pandemic. Undoubtedly, our approach toward COVID-19 was not perfect, and testing has not been deployed fast enough to arrest the epidemic early on. It is critical that we revise our approaches to be more prepared for pandemics as a united body by promoting global cooperation and commitment.


Asunto(s)
Betacoronavirus/patogenicidad , Defensa Civil/organización & administración , Infecciones por Coronavirus/epidemiología , Cooperación Internacional/legislación & jurisprudencia , Pandemias , Neumonía Viral/epidemiología , Antivirales/síntesis química , Antivirales/uso terapéutico , Asia/epidemiología , Betacoronavirus/efectos de los fármacos , Técnicas de Laboratorio Clínico/normas , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/prevención & control , Europa (Continente)/epidemiología , Humanos , Medio Oriente/epidemiología , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/prevención & control , Vacunas Virales/biosíntesis , Vacunas Virales/uso terapéutico
10.
Nat Med ; 26(7): 1005-1008, 2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-595980
12.
Inflamm Bowel Dis ; 26(8): 1149-1154, 2020 07 17.
Artículo en Inglés | MEDLINE | ID: covidwho-526670

RESUMEN

BACKGROUND: The outbreak of COVID-19 has rapidly evolved into a pandemic that has represented a challenge to health systems worldwide. Inflammatory bowel disease (IBD) units have been forced to change their practices to address the disease and to ensure the quality of care. METHODS: We conducted a national survey among IBD gastroenterologist members of the Spanish Working Group on Crohn's Disease and Colitis regarding changes of practice, IBD treatments, and diagnosis and treatment of COVID-19. RESULTS: We received 54 answers from Spanish hospitals. One hundred percent of the IBD units rescheduled onsite visits to telematic consultation, and elective endoscopic and surgical procedures were delayed. Protective measures were also taken in the infusion units (100% of health centers) and hospital pharmacies, with 40.7% sending subcutaneous medications to patients. No switching between intravenous and subcutaneous anti-tumor necrosis factor drugs were made. We also found that 96.1% of IBD units advised their patients to maintain treatment if they were asymptomatic for COVID-19. For patients with COVID-19 symptoms, 92.6% of IBD units referred them to primary care or the emergency department. In addition, 7.5% of IBD units made a COVID-19 diagnosis through polymerase chain reaction and/or chest x-ray.Modifications in IBD treatment and treatment recommended for COVID-19 are also discussed. CONCLUSIONS: We report a representative national survey of changes made in the structure, diagnosis of COVID-19, and modifications in IBD treatments within IBD units.


Asunto(s)
Defensa Civil/organización & administración , Infecciones por Coronavirus/epidemiología , Prestación de Atención de Salud/organización & administración , Innovación Organizacional , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Manejo de la Enfermedad , Brotes de Enfermedades/prevención & control , Femenino , Unidades Hospitalarias/organización & administración , Humanos , Enfermedades Inflamatorias del Intestino/epidemiología , Enfermedades Inflamatorias del Intestino/terapia , Relaciones Interprofesionales , Masculino , Evaluación de Resultado en la Atención de Salud , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , España/epidemiología , Encuestas y Cuestionarios
14.
Ann Glob Health ; 86(1): 51, 2020 05 18.
Artículo en Inglés | MEDLINE | ID: covidwho-460242

RESUMEN

The developed countries of the world were ill-prepared for the pandemic that they have suffered. When we compare developed to developing countries, the sophisticated parameters we use do not necessarily address the weaknesses in the healthcare systems of developed countries that make them susceptible to crises like the present pandemic. We strongly suggest that better preparation for such events is necessary for a country to be considered developed.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Prestación de Atención de Salud , Países Desarrollados/clasificación , Reglamento Sanitario Internacional , Pandemias , Neumonía Viral/epidemiología , Salud Pública , Betacoronavirus/aislamiento & purificación , Defensa Civil/organización & administración , Defensa Civil/normas , Prestación de Atención de Salud/organización & administración , Prestación de Atención de Salud/normas , Humanos , Reglamento Sanitario Internacional/organización & administración , Reglamento Sanitario Internacional/normas , Salud Pública/normas
16.
Euro Surveill ; 25(21)2020 05.
Artículo en Inglés | MEDLINE | ID: covidwho-437617

RESUMEN

The coronavirus disease (COVID-19) pandemic has caused tremendous pressure on hospital infrastructures such as emergency rooms (ER) and outpatient departments. To avoid malfunctioning of critical services because of large numbers of potentially infected patients seeking consultation, we established a COVID-19 rapid response infrastructure (CRRI), which instantly restored ER functionality. The CRRI was also used for testing of hospital personnel, provided epidemiological data and was a highly effective response to increasing numbers of suspected COVID-19 cases.


Asunto(s)
Defensa Civil/organización & administración , Infecciones por Coronavirus/epidemiología , Coronavirus , Brotes de Enfermedades , Manejo de Atención al Paciente , Neumonía Viral/epidemiología , Adulto , Betacoronavirus , Alemania/epidemiología , Humanos , Persona de Mediana Edad , Pandemias , Medición de Riesgo , Centros de Atención Terciaria , Triaje
17.
AAPS PharmSciTech ; 21(5): 153, 2020 May 24.
Artículo en Inglés | MEDLINE | ID: covidwho-343702

RESUMEN

The supply of affordable, high-quality pharmaceuticals to US patients has been on a critical path for decades. In and beyond the COVID-19 pandemic, this critical path has become tortuous. To regain reliability, reshoring of the pharmaceutical supply chain to the USA is now a vital national security need. Reshoring the pharmaceutical supply with old know-how and outdated technologies that cause inherent unpredictability and adverse environmental impact will neither provide the security we seek nor will it be competitive and affordable. The challenge at hand is complex akin to redesigning systems, including corporate and public research and development, manufacturing, regulatory, and education ones. The US academic community must be engaged in progressing solutions needed to counter emergencies in the COVID-19 pandemic and in building new methods to reshore the pharmaceutical supply chain beyond the pandemic.


Asunto(s)
Antivirales/provisión & distribución , Betacoronavirus/efectos de los fármacos , Defensa Civil/organización & administración , Infecciones por Coronavirus/terapia , Necesidades y Demandas de Servicios de Salud/organización & administración , Evaluación de Necesidades/organización & administración , Pandemias , Neumonía Viral/terapia , Vacunas Virales/provisión & distribución , Antivirales/economía , Betacoronavirus/patogenicidad , Defensa Civil/economía , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Costos de los Medicamentos , Necesidades y Demandas de Servicios de Salud/economía , Humanos , Evaluación de Necesidades/economía , Pandemias/economía , Neumonía Viral/economía , Neumonía Viral/epidemiología , Neumonía Viral/virología , Estados Unidos , Vacunas Virales/economía
18.
Am J Gastroenterol ; 115(6): 801-804, 2020 06.
Artículo en Inglés | MEDLINE | ID: covidwho-330592
19.
Head Neck ; 42(7): 1477-1481, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: covidwho-265904

RESUMEN

The COVID-19 pandemic has had a dramatic impact on care delivery among health care institutions and providers in the United States. As a categorical cancer center, MD Anderson has prioritized care for our patients based on acuity of their disease. We continue to implement measures to protect patients and employees from acquiring the infection within our facilities, and to provide acute management of cancer patients with concomitant COVID-19 infections who are considered at high risk of death. The Division of Patient Experience, formerly established in October 2016, has played an integral role in the institution's pandemic response from its inception. The team actively supported programs and processes in anticipation of the pandemic's effect on our patients and employees. We will describe how the team continues to serve in the ever-dynamic environment as we approach the expected surge in COVID-19 cases among our patient population, our employees, and in our community.


Asunto(s)
Instituciones Oncológicas/organización & administración , Defensa Civil/organización & administración , Infecciones por Coronavirus/epidemiología , Neoplasias/epidemiología , Organización y Administración , Neumonía Viral/epidemiología , Oncología Quirúrgica/organización & administración , Infecciones por Coronavirus/prevención & control , Prestación de Atención de Salud/organización & administración , Humanos , Control de Infecciones/métodos , Comunicación Interdisciplinaria , Neoplasias/cirugía , Innovación Organizacional , Evaluación de Resultado en la Atención de Salud , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Grupo de Atención al Paciente/organización & administración , Neumonía Viral/prevención & control , Estados Unidos
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