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COVID-19: Ventilation of African VIPs despite ressource deprivation in Malawi?
Anasthesiologie und Intensivmedizin ; 62(SUPPL 12):S246-S247, 2021.
Article in English | EMBASE | ID: covidwho-1553154
ABSTRACT
Introduction Our Critical Care Unit is a precious ressource in Malawi. Covid (C) could have lead to even more challenges on the withholding of ventilation. Often our non-physicians are involved in this decision. Not much is known about their opinions. Object To assess in a pilot study which hierarchical and social realities might influence the allocation of our ICU beds for our clinical officers (COs) and medical assistants (MAs). Methods Six patients in need of artificial respiration had to be evaluated in a questionnaire (Q).4 suffered from Covid (2 high ranking Ministry of Health [MoH] officials responsible for the countrywide response either against malaria or against Covid, the son of a business woman offering 100000 $ for ventilators to hospital and a tribal leader. 1 lady suffering from hemorrhagic shock after cesarean section and 1 from rabies. Non-physicians were asked to decide on the order of admission. The first patient to be admitted scores 1 point, the last 6 points. Lowest scoring is admitted first. The answers were compared with a Q our collaborators filled out previously (17 septic/nonseptic reasons for ICU). Moreover we tried in a series of confidental informal interviews to learn about life's reality on Covid ventilation. Results 19 Q were filled out correctly, so representing 90.5 % of our colleagues. 1st to admit was the mother after CS (1.1 points);2 nd Patient with rabies (3 p.);All four dignitaries suffering from Covid scored worse 3 rd The donating business-woman (3.63 p.);4th MOH collaborator for Covid (3.95 p.);5th MoH collaborator for malaria (4.37 p.);6th Traditional leader (4.95 p.). The same participants rated in the previous survey again CS 1 st, for admission, but rabies 2 nd last. Covid was then admitted as last and 3rd last. CS, but even rabies scored in comparison to 4 Covid cases even higher than in the first survey against 2 covid cases and several other non-covid related reasons for ICU admission. The patients with non-covid disease scored 2.05 points vs. the four dignitaries with a mean of 4.22 p. The business woman scored higher (3.63 p.) than the three potentially important members of government and civil society (mean 4.42 p.). We found in the previous survey that the dignitaries there (policeman, priest and businesswoman) scored uimpressively. The confidental background check discovered that at least four real life VIPs were admitted to hospital, and died there through Covid-without being ventilated. Conclusion Non-dignitaries with non-covid diseases scored higher than all dignitaries with Covid. MoH personal and traditional leaders are not seen as important in the fight against epidemics. An impressive implementation of a tough health policy was found.
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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Anasthesiologie und Intensivmedizin Year: 2021 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Anasthesiologie und Intensivmedizin Year: 2021 Document Type: Article