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Watkins VJ, Shee AW, Field M, Alston L, Hills D, Albrecht SL, Ockerby C, Hutchinson AM. Rural healthcare workforce preparation, response, and work during the COVID-19 pandemic in Australia: Lessons learned from in-depth interviews with rural health service leaders. Health Policy 2024; 145:105085. [PMID: 38820760 DOI: 10.1016/j.healthpol.2024.105085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/10/2024] [Accepted: 05/19/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Low population density, geographic spread, limited infrastructure and higher costs are unique challenges in the delivery of healthcare in rural areas. During the COVID-19 pandemic, emergency powers adopted globally to slow the spread of transmission of the virus included population-wide lockdowns and restrictions upon movement, testing, contact tracing and vaccination programs. The aim of this research was to document the experiences of rural health service leaders as they prepared for the emergency pandemic response, and to derive from this the lessons learned for workforce preparedness to inform recommendations for future policy and emergency planning. METHODOLOGY AND METHODS Interviews were conducted with leaders from two rural public health services in Australia, one small (500 staff) and one large (3000 staff). Data were inductively coded and analysed thematically. PARTICIPANTS Thirty-three participants included health service leaders in executive, clinical, and administrative roles. FINDINGS Six major themes were identified: Working towards a common goal, Delivery of care, Education and training, Organizational governance and leadership, Personal and psychological impacts, and Working with the Local Community. Findings informed the development of a applied framework. CONCLUSION The study findings emphasise the critical importance of leadership, teamwork and community engagement in preparing the emergency pandemic response in rural areas. Informed by this research, recommendations were made to guide future rural pandemic emergency responses or health crises around the world.
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Affiliation(s)
- Vanessa J Watkins
- Deakin University, School of Nursing and Midwifery, Centre for Quality and Patient Safety in the Institute for Health Transformation, Geelong, Victoria Australia.
| | - Anna Wong Shee
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Michael Field
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia; Western Alliance Academic Health Science Centre, Geelong, Victoria, Australia
| | - Laura Alston
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Danny Hills
- Federation University Australia, Health Innovation and Transformation Centre, Ballarat, Victoria, Australia
| | - Simon L Albrecht
- Deakin University, School of Psychology, Burwood, Victoria, Australia
| | | | - Alison M Hutchinson
- Deakin University, School of Nursing and Midwifery, Centre for Quality and Patient Safety in the Institute for Health Transformation, Geelong, Victoria Australia; Barwon Health, Geelong, Victoria, Australia
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Ma Z, Rennert L. An epidemiological modeling framework to inform institutional-level response to infectious disease outbreaks: a Covid-19 case study. Sci Rep 2024; 14:7221. [PMID: 38538693 PMCID: PMC10973339 DOI: 10.1038/s41598-024-57488-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
Institutions have an enhanced ability to implement tailored mitigation measures during infectious disease outbreaks. However, macro-level predictive models are inefficient for guiding institutional decision-making due to uncertainty in local-level model input parameters. We present an institutional-level modeling toolkit used to inform prediction, resource procurement and allocation, and policy implementation at Clemson University throughout the Covid-19 pandemic. Through incorporating real-time estimation of disease surveillance and epidemiological measures based on institutional data, we argue this approach helps minimize uncertainties in input parameters presented in the broader literature and increases prediction accuracy. We demonstrate this through case studies at Clemson and other university settings during the Omicron BA.1 and BA.4/BA.5 variant surges. The input parameters of our toolkit are easily adaptable to other institutional settings during future health emergencies. This methodological approach has potential to improve public health response through increasing the capability of institutions to make data-informed decisions that better prioritize the health and safety of their communities while minimizing operational disruptions.
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Affiliation(s)
- Zichen Ma
- Department of Mathematics, Colgate University, Hamilton, NY, USA
- Center for Public Health Modeling and Response, Department of Public Health Sciences, Clemson University, 517 Edwards Hall, Clemson, SC, 29634, USA
| | - Lior Rennert
- Center for Public Health Modeling and Response, Department of Public Health Sciences, Clemson University, 517 Edwards Hall, Clemson, SC, 29634, USA.
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Rennert L, Ma Z. An epidemiological modeling framework to inform institutional-level response to infectious disease outbreaks: A Covid-19 case study. RESEARCH SQUARE 2023:rs.3.rs-3116880. [PMID: 37503237 PMCID: PMC10371141 DOI: 10.21203/rs.3.rs-3116880/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Institutions have an enhanced ability to implement tailored mitigation measures during infectious disease outbreaks. However, macro-level predictive models are inefficient for guiding institutional decision-making due to uncertainty in local-level model input parameters. We present an institutional-level modeling toolkit used to inform prediction, resource procurement and allocation, and policy implementation at Clemson University throughout the Covid-19 pandemic. Through incorporating real-time estimation of disease surveillance and epidemiological measures based on institutional data, we argue this approach helps minimize uncertainties in input parameters presented in the broader literature and increases prediction accuracy. We demonstrate this through case studies at Clemson and other university settings during the Omicron BA.1 and BA.4/BA.5 variant surges. The input parameters of our toolkit are easily adaptable to other institutional settings during future health emergencies. This methodological approach has potential to improve public health response through increasing the capability of institutions to make data-informed decisions that better prioritize the health and safety of their communities while minimizing operational disruptions.
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4
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Rinsky-Halivni L, Brammli-Greenberg S, Christiani DC. Ageing workers' mental health during COVID-19: a multilevel observational study on the association with the work environment, perceived workplace safety and individual factors. BMJ Open 2022; 12:e064590. [PMID: 36572502 PMCID: PMC9805828 DOI: 10.1136/bmjopen-2022-064590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES The stress and anxiety associated with the predisposition of ageing workers to severe COVID-19 illness, once occupationally infected, jeopardise their mental health. This study aimed to investigate the association between individual level, work environment exposure factors and perceived workplace safety with a decline in mental health of ageing workers from different industry sectors. DESIGN Observational study, prevalence assessment of survey added to longitudinal cohort data. SETTING The Survey of Health, Ageing and Retirement in Europe (SHARE) from 27 countries in Europe and Israel participating in the COVID-19 survey (summer 2020) and having prepandemic waves' SHARE data. PARTICIPANTS Workers aged 50-70 (n=6449) who attended their workplaces at least partially after the pandemic broke out. PRIMARY OUTCOME MEASURE Perceived decline in mental health compared with preoutbreak status. RESULTS Multilevel analyses demonstrated that 24.5% (95% CI 23.5% to 25.5%) of ageing workers in Europe experienced mental health decline associated with national-level self-reported COVID-19 burden. Workplace safety perception was the strongest predictor, as each one-point increase in unsafe perception was associated with 60% of mental health decline (OR=1.6, 95% CI 1.47 to 1.74), explaining 30% of increased reported mental health symptoms of ageing workers. Safety perception mediates the mental health outcomes of the work environment, such as workplace contagion risk and work location. Female gender (OR=1.77, 95% CI 1.55 to 2.02), financial difficulties (OR=1.19, 95% CI 1.1 to 1.28), higher vulnerability index (comorbidities, age >60) (OR=1.11, 95% CI 1.05 to 1.18), pre-existing mental problems (OR=1.78, 95% CI 1.55 to 2.04) and increased national burden of COVID-19 (OR=1.01, 95% CI 1.0 to 1.02) were associated with declines in mental health, whereas exclusively working on-site was protective. CONCLUSION Vulnerable subgroups for mental health declines among ageing workers were revealed, which warrant their screening and employers' evaluation of workplace conditions of ageing workers to prevent mental health-related implications. Workplace interventions should aim to reduce work environment influences on infection risk and mental distress.
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Affiliation(s)
- Lilah Rinsky-Halivni
- Takemi Program in International Health, Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Braun School of Public Health, Faculty of Medicine, The Hebrew University, Jerusalem, Israel
| | - Shuli Brammli-Greenberg
- Braun School of Public Health, Faculty of Medicine, The Hebrew University, Jerusalem, Israel
| | - David C Christiani
- Environmental Health, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
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Safranek CW, Scheinker D. A computer modeling method to analyze rideshare data for the surveillance of novel strains of SARS-CoV-2. Ann Epidemiol 2022; 76:136-142. [PMID: 36087658 PMCID: PMC9452418 DOI: 10.1016/j.annepidem.2022.08.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 07/15/2022] [Accepted: 08/29/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE No method is available to systematically study SARS-CoV-2 transmission dynamics using the data that rideshare companies share with government agencies. We developed a proof-of-concept method for the analysis of SARS-CoV-2 transmissions between rideshare passengers and drivers. METHOD To assess whether this method could enable hypothesis testing about SARS-CoV-2, we repeated ten 200-day agent-based simulations of SARS-CoV-2 propagation within the Los Angeles County rideshare network. Assuming data access for 25% of infections, we estimated an epidemiologist's ability to analyze the observable infection patterns to correctly identify a baseline viral variant A, as opposed to viral variant A with mask use (50% reduction in viral particle exchange), or a more infectious viral variant B (300% higher cumulative viral load). RESULTS Simulations had an average of 190,387 potentially infectious rideshare interactions, resulting in 409 average diagnosed infections. Comparison of the number of observed and expected passenger-to-driver infections under each hypothesis demonstrated our method's ability to consistently discern large infectivity differences (viral variant A vs. viral variant B) given partial data from one large city, and to discern smaller infectivity differences (viral variant A vs. viral variant A with masks) given partial data aggregated across multiple cities. CONCLUSIONS This novel statistical method suggests that, for the present and subsequent pandemics, government-facilitated analysis of rideshare data combined with diagnosis records may augment efforts to better understand viral transmission dynamics and to measure changes in infectivity associated with nonpharmaceutical interventions and emergent viral strains.
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Affiliation(s)
- Conrad W. Safranek
- Department of Biology, Computational Biology, Stanford University, CA,Department of Management Science and Engineering, Stanford University School of Engineering, CA
| | - David Scheinker
- Department of Management Science and Engineering, Stanford University School of Engineering, CA; Department of Pediatrics, Stanford University School of Medicine, CA; Clinical Excellence Research Center, Stanford University School of Medicine, CA.
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Whitley MD, Coulter ID, Khorsan R, Herman PM. Barriers to the Engagement of Complementary and Integrative Health Providers in Public Health Responses to COVID-19: Recommendations From a Multidisciplinary Expert Panel. J Manipulative Physiol Ther 2022; 45:566-574. [PMID: 37294218 PMCID: PMC10254438 DOI: 10.1016/j.jmpt.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 10/14/2022] [Accepted: 04/12/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The purpose of this project was to explore barriers to the involvement of complementary and integrative health (CIH) providers in the public health response to COVID-19 and potential solutions for future involvement in public health crises. METHODS An expert panel of 10 people, which included doctors of chiropractic, naturopathic doctors, public health practitioners, and researchers from the United States, was convened for a day-long online panel discussion. Facilitators asked panelists how CIH practitioners could contribute and be mobilized. We summarized themes and recommendations from the discussion. RESULTS Despite their skills and resources, few CIH providers participated in public health efforts like testing and contact tracing during the COVID-19 pandemic. Panelists described that CIH professionals may not have participated in those efforts due to the CIH providers possibly not having sufficient public health training and limited contact with public health professionals, as well as policy and financial challenges during the pandemic. Panelists proposed solutions to these barriers, including more public health training, stronger formal relationships between CIH and public health organizations, and improved financial support for both CIH care and public health efforts. CONCLUSION Through an expert panel discussion, we identified barriers that hindered the involvement of CIH providers in the public health response to the COVID-19 pandemic. During future pandemics in the United States, public health planners should recognize CIH providers as part of the existing labor resource, with clinical expertise and community-level connections that can be called upon in a crisis. During future events, CIH professional leaders should be more proactive in seeking out a supportive role and sharing their knowledge, skills, and expertise.
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Affiliation(s)
| | | | - Raheleh Khorsan
- Interprofessional Clinical Sciences, Southern California University of Health Sciences, Whittier, California
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Nagineni L, Kichena S, Bateman E, Takigawa K, Holland N, Perry C, Hogg T, Cervantes J, Delarosa JM, Longhurst M, Janssen H, Pfarr C, Manglik N, Ayoubieh H, Chacon J. Providing bilingual COVID-19 educational material for the border region during the pandemic. MEDEDPUBLISH 2022. [DOI: 10.12688/mep.19215.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Studies show that the introduction of early public health interventions correlates with decreased rates of transmission and reductions in mortality resulting from epidemic or pandemic events. Methods: Medical educators and students from Texas Tech University Health Sciences Center El Paso created the El Paso-Health Education and Awareness Team (EP-HEAT) to educate at-risk populations in the border region. The English and Spanish material created by EP-HEAT included information about disease symptoms, transmission, preventive measures and mental health resources. An online, anonymous survey was distributed to attendees to obtain feedback on the provided coronavirus disease (COVID-19) educational material. Results: The results showed that over 90% of participants agreed that the informational pamphlets increased their awareness and knowledge of COVID-19. Conclusions: In this study, educators and students created COVID-19-related material in virtual workshops and pamphlets, designed to increase knowledge about COVID-19, mitigate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and how to address mental health issues related to the pandemic. A majority of participants agreed or strongly agreed that the COVID-19 material developed by EP-HEAT helped raise awareness, understanding, and the importance of education about SARS-CoV-2/COVID-19.
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Biological, Psychological, and Physical Performance Variations in Football Players during the COVID-19 Lockdown: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052739. [PMID: 35270434 PMCID: PMC8910252 DOI: 10.3390/ijerph19052739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 12/31/2022]
Abstract
This prospective cohort study aimed to evaluate whether COVID-19 lockdown caused biological, psychological, and/or physical performance variations in footballers. We compared the 2018/2019 and 2019/2020 seasons evaluating the plasma volume, hematological parameters, iron/ferritin, creatine kinase, vitamin D, cortisol, testosterone, and physiological state of players of the Italian football major league (Serie A). Measurements were performed before the preparatory period (T0), at the beginning (T1) and in the middle (T2) of the championship, and in March (T3) and at the end of season (T4). The results showed that in the 2019/2020 season affected by the lockdown, the weight, BMI, and fat mass percentage were higher than in the previous season. Hematocrit, hemoglobin, red blood cells, and ferritin decreased during both seasons, more significantly than in the regular season. During both seasons, creatine kinase increased from T2 whilst iron concentrations decreased in T3. Testosterone increased in both seasons from T0 to T3 and returned to initial levels at T4; cortisol increased in T2 and T3 during the 2018/2019 season but not during the COVID-19 season. Physical performance tests revealed differences associated with lockdown. Thus, although from a medical point of view, none of the evaluated changes between the two seasons were clinically relevant, training at home during lockdown did not allow the players to maintain the jumping power levels typical of a competitive period.
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Guzman J, Recoco GA, Pandi AW, Padrones JM, Ignacio JJ. Evaluating workplace safety in the oil and gas industry during the COVID-19 pandemic using occupational health and safety Vulnerability Measure and partial least square Structural Equation Modelling. CLEANER ENGINEERING AND TECHNOLOGY 2022; 6:100378. [PMID: 35013732 PMCID: PMC8730645 DOI: 10.1016/j.clet.2021.100378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 12/05/2021] [Accepted: 12/25/2021] [Indexed: 06/14/2023]
Abstract
The study aims to apply the Partial Least Squares Structural Equation Modeling (PLS-SEM) to model workplace safety in the Oil and Gas Industry (OGI) during the COVID-19 pandemic. The five areas of the Occupational Health and Safety (OHS) Vulnerability Measure (e.g., Exposure to Workplace Hazards, Policies and Procedures in the Workplace, Perception on Health & Safety Culture in the Workplace, Self-Awareness in Health & Safety Procedures and Responsibilities, and Preventive Measure for Prevention of the Transmission of COVID-19 at Workplace) were considered as the constructs to be evaluated. Fifty workers from the oil and gas industry worldwide participated in the online survey, and the data were analyzed using the SmartPLS software. The results revealed that only Perception on Health & Safety Culture was a significant factor influencing the perceived workplace safety in the OGI during the COVID-19 pandemic (β = 0.603; t-value = 3.323; p-value = 0.001). The study suggested that the oil and gas companies should maintain a positive perception of health and safety culture to improve workplace safety even during the pandemic.
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Affiliation(s)
- Joshua Guzman
- Department of Petroleum Engineering, College of Engineering, Architecture and Technology, Palawan State University-Main Campus, Tiniguiban Heights, Tiniguiban, Puerto Princesa City, 5300, Palawan, Philippines
| | - Gwen Arianne Recoco
- Department of Petroleum Engineering, College of Engineering, Architecture and Technology, Palawan State University-Main Campus, Tiniguiban Heights, Tiniguiban, Puerto Princesa City, 5300, Palawan, Philippines
| | - Al Wahid Pandi
- Department of Petroleum Engineering, College of Engineering, Architecture and Technology, Palawan State University-Main Campus, Tiniguiban Heights, Tiniguiban, Puerto Princesa City, 5300, Palawan, Philippines
| | - Jerico M Padrones
- Department of Petroleum Engineering, College of Engineering, Architecture and Technology, Palawan State University-Main Campus, Tiniguiban Heights, Tiniguiban, Puerto Princesa City, 5300, Palawan, Philippines
- Department of Mathematics, College of Science, Palawan State University-Main Campus, Tiniguiban Heights, Tiniguiban, Puerto Princesa City, 5300 Palawan, Philippines, 5300, Palawan, Philippines
| | - Jonathan Jared Ignacio
- Department of Petroleum Engineering, College of Engineering, Architecture and Technology, Palawan State University-Main Campus, Tiniguiban Heights, Tiniguiban, Puerto Princesa City, 5300, Palawan, Philippines
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Wong NS, Lee SS, Mitchell KM, Yeoh EK, Wang C. Impact of pre-event testing and quarantine on reducing the risk of COVID-19 epidemic rebound: a modelling study. BMC Infect Dis 2022; 22:83. [PMID: 35073868 PMCID: PMC8785033 DOI: 10.1186/s12879-021-06963-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the evolving growth of the COVID-19 epidemic, travel restriction policies would need to be adjusted accordingly. Prohibition of mass event may be relaxed for social and economic benefits when virus transmission stops but could bear the risk of epidemic rebound. Against the background of the varied SARS-CoV-2 prevalence internationally, we modelled the potential impacts of pre-event interventions on epidemic risk of holding a mass event when COVID-19 is under control. METHODS We developed a mathematical model of SARS-CoV-2 transmission in Guangdong Province, China, where local virus transmission ceased to occur. A large-scale international trade fair was assumed to be held, with influx of people from overseas and rest of China over a short period of time, who participated for 2-week. Scenarios of pre-event intervention (none, quarantine arrangement and polymerase chain reaction (PCR) testing for participants) were compared. The influence of contact pattern, SARS-CoV-2 prevalence outside the province and China, and testing coverage were examined in sensitivity analyses. RESULTS In basecase scenario (no event), the epidemic has been under control since March 2020. The event would lead to the detection of 1% more confirmed cases by 31 July when community contact rate increases to pre-epidemic level. In event scenario without additional interventions, there would be 599 (93%) more new infections comparing with basecase scenario. To avert new infections, quarantining all participants before the event would be the most effective strategy, followed by quarantining all overseas participants and testing all other participants, and testing all participants before the event and on day 7. However, testing strategy is likely to be affected by the SARS-CoV-2 prevalence outside the event province. CONCLUSIONS Pre-event interventions are effective for reducing the risk of epidemic rebound caused by an international large-scale event. Universal testing for participants is likely to be an effective and feasible intervention.
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Affiliation(s)
- Ngai Sze Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Shui Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Kate M Mitchell
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Cheng Wang
- Dermatology Hospital of Southern Medical University, No. 2 Lujing Road, Guangzhou, 510095, Guangdong, China.
- Southern Medical University Institute for Global Health and Sexually Transmitted Diseases, Guangzhou, Guangdong, China.
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Industrial construction safety policies and practices with cost impacts in a COVID-19 pandemic environment: A Louisiana DOW case study. J Loss Prev Process Ind 2022; 76:104723. [PMID: 35002093 PMCID: PMC8719009 DOI: 10.1016/j.jlp.2021.104723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 10/21/2021] [Accepted: 12/24/2021] [Indexed: 12/21/2022]
Abstract
There are always significant challenges in improving the safety culture by changing and adding additional safety protocols. The unknown impacts of COVID-19 and how it quickly spreads led the industry to institute essential safety protocols. This paper addresses two problem statements. The first problem statement is: what are the additional safety protocols for process safety, construction & maintenance, and personal protective equipment requirements? The second problem statement is: what are the cost and schedule impacts of industrial construction projects resulting from implementing safety protocols and process safety during construction with the added PPE? While complying with added safety protocols, the industrial construction industry cannot forget that it has a distinct reputation for high incident rates and less than desirable safety performance. In 2017, the construction industry suffered 971 fatalities. This alarming number is compared to 1123 total fatalities in 2017 for the Gulf Coast States. The objective is to share the rationale and practices of social distancing, required additional PPE, and personal hygiene practices to reduce spreading and outbreaks during a pandemic within an industrial construction environment. Before any construction work, the process safety teams must clear, isolate, and tag out process lines, equipment, and instruments to be repaired or replaced. The information presented demonstrates the significant cost and schedule impacts that industrial construction companies will encounter during a pandemic like COVID-19. This paper aims to improve safety processes, cost & schedule impacts, and prescribe additional personal protective equipment in industrial construction during a pandemic such as COVID-19. The COVID-19 pandemic spread globally in a very short period. The reactions in mitigating the spread were suggestive, with little to no data on safety protective equipment and practices. The contribution this paper addresses are how to employ efficient safety practices and policies during a pandemic in an industrial construction environment.
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Trmčić A, Demmings E, Kniel K, Wiedmann M, Alcaine S. Food Safety and Employee Health Implications of COVID-19: A Review. J Food Prot 2021; 84:1973-1989. [PMID: 34265068 PMCID: PMC9906301 DOI: 10.4315/jfp-21-201] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/14/2021] [Indexed: 11/11/2022]
Abstract
The COVID-19 pandemic has greatly impacted the U.S. food supply and consumer behavior. Food production and processing are being disrupted as illnesses, proactive quarantines, and government-mandated movement restrictions cause labor shortages. In this environment, the food industry has been required to adopt new, additional practices to minimize the risk of COVID-19 cases and outbreaks among its workforce. Successfully overcoming these challenges requires a comprehensive approach that addresses COVID-19 transmission both within and outside the facility. Possible interventions include strategies (i) to vaccinate employees, (ii) to assure that employees practice social distancing, (iii) to assure that employees wear face coverings, (iv) to screen employees for COVID-19, (v) to assure that employees practice frequent hand washing and avoid touching their faces, (vi) to clean frequently touched surfaces, and (vii) to assure proper ventilation. Compliance with these control strategies must be verified, and an overall COVID-19 control culture must be established to implement an effective program. Despite some public misperceptions about the health risk of severe acute respiratory syndrome coronavirus 2 on foods or food packaging, both the virus biology and epidemiological data clearly support a negligible risk of COVID-19 transmission through food and food packing. However, COVID-19 pandemic-related supply chain and workforce disruptions and the shift in resources to protect food industry employees from COVID-19 may increase the actual food safety risks. The goal of this review was to describe the COVID-19 mitigation practices adopted by the food industry and the potential impact of these practices and COVID-19-related disruptions on the industry's food safety mission. A review of these impacts is necessary to ensure that the food industry is prepared to maintain a safe and nutritious food supply in the face of future global disruptions.
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Affiliation(s)
- Aljoša Trmčić
- Department of Food Science, Cornell University, Ithaca, New York 14850
| | | | - Kalmia Kniel
- Department of Animal and Food Sciences, University of Delaware, Newark, Delaware 19716, USA
| | - Martin Wiedmann
- Department of Food Science, Cornell University, Ithaca, New York 14850
| | - Sam Alcaine
- Department of Food Science, Cornell University, Ithaca, New York 14850,Author for correspondence. Tel: 607-255-9183; Fax: 607-254-4868
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Extent of compliance with COVID-19 prevention and control guidelines among supermarkets in Kampala Capital City and Mukono Municipality, Uganda. PLoS One 2021; 16:e0258840. [PMID: 34710126 PMCID: PMC8553093 DOI: 10.1371/journal.pone.0258840] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/07/2021] [Indexed: 12/03/2022] Open
Abstract
Background Despite the development and enforcement of preventive guidelines by governments, COVID-19 continues to spread across nations, causing unprecedented economic losses and mortality. Public places remain hotspots for COVID-19 transmission due to large numbers of people present; however preventive measures are poorly enforced. Supermarkets are among the high-risk establishments due to the high interactions involved, which makes compliance with the COVID-19 preventive guidelines of paramount importance. However, until now, there has been limited evidence on compliance with the set COVID-19 prevention guidelines. Therefore, this study aimed to measure compliance with the COVID-19 prevention guidelines among supermarkets in Kampala Capital City and Mukono Municipality Uganda. Methods A cross-sectional study was conducted among selected supermarkets in Kampala Capital City and Mukono Municipality in September 2020. A total of 229 supermarkets (195 in Kampala City and 34 in Mukono Municipality) were randomly selected for the study. Data were collected through structured observations on the status of compliance with COVID-19 prevention guidelines, and entered using the KoboCollect software, which was preinstalled on mobile devices (smart phones and tablets). Descriptive statistics were generated to measure compliance to the set COVID-19 Ministry of Health prevention guidelines using Stata 14 software. Results Only 16.6% (38/229) of the supermarkets complied with the COVID-19 prevention and control guidelines. In line with the specific measures, almost all supermarkets 95.2% (218/229) had hand washing facilities placed at strategic points such as the entrance, and 59.8% (137/229) of the supermarkets surveyed regularly disinfected commonly touched surfaces. Only 40.6% and 30.6% of the supermarkets enforced mandatory hand washing and use of face masks respectively for all customers accessing the premises. Slightly more than half, 52.4% (120/229) of the supermarkets had someone or a team in charge of enforcing compliance to COVID-19 measures and more than half, 55.5% (127/229) of the supermarkets had not provided their staff with job-specific training/mentorship on infection prevention and control for COVID-19. Less than a third, 26.2% (60/229) of the supermarkets had an infrared temperature gun for screening every customer, and only 5.7% (13/229) of the supermarkets captured details of clients accessing the supermarket as a measure to ease follow-up. Conclusion This study revealed low compliance with COVID-19 guidelines, which required mandatory preventive measures such as face masking, regular disinfection, social distancing, and hand hygiene. This study suggests the need for health authorities to strengthen enforcement of these guidelines, and to sensitise the supermarket managers on COVID-19 in order to increase the uptake of the different measures.
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14
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Chou TJ, Wu YR, Tsai JS, Cheng SY, Yao CA, Peng JK, Chiu TY, Huang HL. Telehealth-Based Family Conferences with Implementation of Shared Decision Making Concepts and Humanistic Communication Approach: A Mixed-Methods Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010801. [PMID: 34682545 PMCID: PMC8535301 DOI: 10.3390/ijerph182010801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 01/14/2023]
Abstract
Smartphone-enabled, telehealth-based family conferences represent an attractive and safe alternative to deliver communication during the COVID-19 pandemic. However, some may fear that the therapeutic relationship might be filtered due to a lack of direct human contact. The study aims to explore whether shared decision-making model combining VALUE (Value family statements, Acknowledge emotions, Listen, Understand the patient as a person, Elicit questions) and PLACE (Prepare with intention, Listen intently and completely, Agree on what matters most, Connect with the patient’s story, Explore emotional cues) framework can help physicians respond empathetically to emotional cues and foster human connectedness in a virtual context. Twenty-five virtual family conferences were conducted in a national medical center in Taiwan. The expression of verbal emotional distress was noted in 20% of patients and 20% of family members, while nonverbal distress was observed in 24% and 28%, respectively. On 10-point Likert scale, the satisfaction score was 8.7 ± 1.5 toward overall communication and 9.0 ± 1.1 on meeting the family’s needs. Adopting SDM concepts with VALUE and PLACE approaches helps physicians foster connectedness in telehealth family conferences. The model has high participant satisfaction scores and may improve healthcare quality among the pandemic.
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Affiliation(s)
- Tzu-Jung Chou
- Department of Family Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; (T.-J.C.); (J.-S.T.); (S.-Y.C.); (C.-A.Y.); (J.-K.P.); (T.-Y.C.)
| | - Yu-Rui Wu
- Department of Family Medicine, Taitung Christian Hospital, Taitung 950, Taiwan;
| | - Jaw-Shiun Tsai
- Department of Family Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; (T.-J.C.); (J.-S.T.); (S.-Y.C.); (C.-A.Y.); (J.-K.P.); (T.-Y.C.)
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan
- New Southbound Health Center, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Shao-Yi Cheng
- Department of Family Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; (T.-J.C.); (J.-S.T.); (S.-Y.C.); (C.-A.Y.); (J.-K.P.); (T.-Y.C.)
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan
- New Southbound Health Center, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Chien-An Yao
- Department of Family Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; (T.-J.C.); (J.-S.T.); (S.-Y.C.); (C.-A.Y.); (J.-K.P.); (T.-Y.C.)
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan
| | - Jen-Kuei Peng
- Department of Family Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; (T.-J.C.); (J.-S.T.); (S.-Y.C.); (C.-A.Y.); (J.-K.P.); (T.-Y.C.)
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan
- New Southbound Health Center, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Tai-Yuan Chiu
- Department of Family Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; (T.-J.C.); (J.-S.T.); (S.-Y.C.); (C.-A.Y.); (J.-K.P.); (T.-Y.C.)
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan
- New Southbound Health Center, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Hsien-Liang Huang
- Department of Family Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; (T.-J.C.); (J.-S.T.); (S.-Y.C.); (C.-A.Y.); (J.-K.P.); (T.-Y.C.)
- Department of Family Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan
- New Southbound Health Center, National Taiwan University Hospital, Taipei 100, Taiwan
- Correspondence: ; Tel.: +886-2-2312-3456 (ext. 66832)
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15
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Zafari Z, Goldman L, Kovrizhkin K, Muennig PA. The cost-effectiveness of common strategies for the prevention of transmission of SARS-CoV-2 in universities. PLoS One 2021; 16:e0257806. [PMID: 34591874 PMCID: PMC8483333 DOI: 10.1371/journal.pone.0257806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/10/2021] [Indexed: 12/21/2022] Open
Abstract
Background Most universities that re-open in the United States (US) for in-person instruction have implemented the Centers for Disease Prevention and Control (CDC) guidelines. The value of additional interventions to prevent the transmission of SARS-CoV-2 is unclear. We calculated the cost-effectiveness and cases averted of each intervention in combination with implementing the CDC guidelines. Methods We built a decision-analytic model to examine the cost-effectiveness of interventions to re-open universities. The interventions included implementing the CDC guidelines alone and in combination with 1) a symptom-checking mobile application, 2) university-provided standardized, high filtration masks, 3) thermal cameras for temperature screening, 4) one-time entry (‘gateway’) polymerase chain reaction (PCR) testing, and 5) weekly PCR testing. We also modeled a package of interventions (‘package intervention’) that combines the CDC guidelines with using the symptom-checking mobile application, standardized masks, gateway PCR testing, and weekly PCR testing. The direct and indirect costs were calculated in 2020 US dollars. We also provided an online interface that allows the user to change model parameters. Results All interventions averted cases of COVID-19. When the prevalence of actively infectious cases reached 0.1%, providing standardized, high filtration masks saved money and improved health relative to implementing the CDC guidelines alone and in combination with using the symptom-checking mobile application, thermal cameras, and gateway testing. Compared with standardized masks, weekly PCR testing cost $9.27 million (95% Credible Interval [CrI]: cost-saving-$77.36 million)/QALY gained. Compared with weekly PCR testing, the ‘package’ intervention cost $137,877 (95% CrI: $3,108-$19.11 million)/QALY gained. At both a prevalence of 1% and 2%, the ‘package’ intervention saved money and improved health compared to all the other interventions. Conclusions All interventions were effective at averting infection from COVID-19. However, when the prevalence of actively infectious cases in the community was low, only standardized, high filtration masks clearly provided value.
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Affiliation(s)
- Zafar Zafari
- University of Maryland School of Pharmacy, Baltimore, MD, United States of America
| | - Lee Goldman
- Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY, United States of America
| | - Katia Kovrizhkin
- Mailman School of Public Health, Columbia University New York City, NY, United States of America
| | - Peter Alexander Muennig
- Mailman School of Public Health, Columbia University New York City, NY, United States of America
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16
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Sledge D, Thomas HF. Public perceptions of the role of government and nonstate actors in responding to COVID-19. RISK, HAZARDS & CRISIS IN PUBLIC POLICY 2021; 12:266-282. [PMID: 34230842 PMCID: PMC8250604 DOI: 10.1002/rhc3.12216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 11/13/2022]
Abstract
In this article, we examine public perceptions of the importance of different levels of government and of nongovernmental entities in responding to the COVID‐19 pandemic. By analyzing the case of COVID‐19, we illuminate patterns that may be helpful for understanding public perceptions of the response to a broader range of crises, including the impacts of hurricanes, tornadoes, earthquakes, wildfires, and other hazards. We contribute to the public policy literature on public perceptions of government response to crises and expand it to include consideration of the role of nonstate actors. Drawing on a representative survey of 1200 registered voters in Texas, we find that individuals are more likely to view government as extremely important to respond to the pandemic than nonstate actors. We find that perceptions of the role of state and nonstate actors are shaped by risk perception, political ideology and religion, gender, and race/ethnicity. We do not find evidence that direct impacts from the COVID‐19 pandemic consistently shape perceptions of the role of state and nonstate actors.
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Affiliation(s)
- Daniel Sledge
- Department of Political ScienceUniversity of TexasArlingtonTexasUSA
| | - Herschel F. Thomas
- Department of Political ScienceWest Virginia UniversityMorgantownWest VirginiaUSA
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17
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Osorio-de-Castro CGS, O’Mathúna D, Fernandes Esher Moritz A, Silva Miranda E. Conflicts surrounding individual and collective aspects of ethics in health emergencies. ETHICS & BEHAVIOR 2021. [DOI: 10.1080/10508422.2021.1929233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Donal O’Mathúna
- College of Nursing and Center for Bioethics and Medical Humanities, Ohio State University College of Nursing
| | - Angela Fernandes Esher Moritz
- Department of Medicines Policy and Pharmaceutical Services, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation,
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18
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Lee DW, Lee J, Kim HR, Kang MY. Health-Related Productivity Loss According to Health Conditions among Workers in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7589. [PMID: 34300042 PMCID: PMC8307799 DOI: 10.3390/ijerph18147589] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/14/2021] [Accepted: 07/14/2021] [Indexed: 12/13/2022]
Abstract
This study aimed to investigate the degree of health-related productivity loss (HRPL) for common health conditions. A total of 4197 workers participated in a web-based questionnaire survey from January to February 2020. HRPL was measured using the Work Productivity and Activity Impairment questionnaire, and a difference in HRPL was calculated for each common health condition. The burden of productivity loss due to each health condition was calculated by the product of the difference in HRPL scores and the percentage of participants who complained. The health conditions most strongly associated with increased HRPL were infertility treatment (30.6%), osteoporosis (25.9%), cancer (25.3%), gastric ulcer or duodenal ulcer (25.0%) and anaemia (23.9%). The most important health conditions in order of their magnitude of induced burden of productivity loss were fatigue, neck or shoulder pain, insufficient sleep, back pain, headache, common cold and flu, insomnia, anxiety and diarrhoea or constipation. HRPL is more strongly and importantly associated with the aforementioned health conditions. Occupational health managers should prioritise addressing health conditions strongly and importantly associated with HRPL when implementing health promotion programmes.
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Affiliation(s)
- Dong-Wook Lee
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 08826, Korea;
| | - Jongin Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (J.L.); (H.-R.K.)
| | - Hyoung-Ryoul Kim
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (J.L.); (H.-R.K.)
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea; (J.L.); (H.-R.K.)
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19
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Iddins BO, Waugh MH, Buck B, Cato T, Graham DE, Attia K, Jones D, Partin A, Shourbaji R, Wesh C. Benchmarking SARS CoV-2 Infection in the Workplace to Support Continuity of Operations. J Occup Environ Med 2021; 63:548-556. [PMID: 33741830 PMCID: PMC8247538 DOI: 10.1097/jom.0000000000002188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The COVID-19 pandemic jeopardizes continuity of operations of workplaces and the health and safety of workers. Exemplar workplace-related SARS-CoV-2 benchmarks are described and illustrated with empirical data. METHODS Benchmarks were collected over a 9-month period on a large workplace (N = 5500+). These ranged from quantitative indices associated with RT-qPCR targeted testing and random surveillance screening, surveillance for new variants of SARS-CoV-2, intensive contact tracing, case management, return to work procedures, to monitoring of antibody seropositive status. RESULTS Data and analyses substantiated effectiveness of interventions. This was evidenced in suppressed infection rates, rapid case identification and isolation, acceptance of the program by employees, documentation of presumptive immunity, and working relationships with senior management. CONCLUSIONS These SARS-CoV-2 exemplar benchmarks provided an evidence-base for practice and contributed strategically to organizational decisions.
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Affiliation(s)
- Bart O Iddins
- Health Services Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee (Dr Iddins, Dr Waugh, Mr Buck, Ms Cato, Mr Attia, Mr Jones, Mr Partin, Ms Shourbaji, and Mr Wesh); University of Tennessee, Knoxville, Tennessee (Dr Waugh); Biosciences Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee (Dr Graham)
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20
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Mehrsafar AH, Moghadam Zadeh A, Jaenes Sánchez JC, Gazerani P. Competitive anxiety or Coronavirus anxiety? The psychophysiological responses of professional football players after returning to competition during the COVID-19 pandemic. Psychoneuroendocrinology 2021; 129:105269. [PMID: 34049198 PMCID: PMC8118697 DOI: 10.1016/j.psyneuen.2021.105269] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study aimed to examine the relationship between competitive anxiety, fear/anxiety of COVID-19, and autonomic and endocrine stress responses in professional football players after returning to competition during the COVID-19 pandemic. METHODS Ninety male professional football players (age: 26.33 ± 2.48 yr) volunteered to participate in this study, which included an official competition. Psychophysiological responses, including the Fear of COVID-19 Scale, the Coronavirus Anxiety Scale, and the Competitive State Anxiety Inventory-2 Revised, were collected 30 min before the competition. In addition, salivary alpha-amylase (sAA) and salivary cortisol (sCort) were collected at 8 a.m. and 15 min before the competition. RESULTS The main findings, based on the Pearson correlation, showed significant positive correlations between COVID-19 anxiety and somatic competitive anxiety (p = 0.01), cognitive competitive anxiety (p = 0.01), and competition response of sCort and sAA (p = 0.01). Moreover, fear of COVID-19 was positively correlated with COVID-19 anxiety (p = 0.01). On the contrary, the awakening response of sCort and sAA was not found to be correlated with psychological parameters (all p > 0.05). The analysis also indicated that there was no significant correlation between self-confidence with other psychological and physiological variables (all p > 0.05). The regression analysis showed that cognitive anxiety was a relevant predictor for the competition response of sCort and sAA (p < 0.05). Moreover, COVID-19 anxiety was the only predictor of somatic and cognitive anxiety (p < 0.05). CONCLUSIONS The present study provides the first preliminary evidence that COVID-19 anxiety and competitive anxiety might pose a negative impact on the athletic performance of professional football players during COVID-19 pandemic competitions. Thus, research is needed to build a strategy to reduce the psychophysiological stress related to COVID-19 and competition response.
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Affiliation(s)
- Amir Hossien Mehrsafar
- Department of Sport Psychology, Faculty of Sports Sciences, University of Tehran, Tehran, Iran; Center for International Scientific Studies and Collaboration (CISSC), Ministry of Science, Research and Technology, Tehran, Iran.
| | - Ali Moghadam Zadeh
- Center for International Scientific Studies and Collaboration (CISSC), Ministry of Science, Research and Technology, Tehran, Iran; Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.
| | - José Carlos Jaenes Sánchez
- Department of Social Anthropology, Basic Psychology & Health, Universidad Pablo de Olavide, Seville, Spain; Andalusian Center of Sport Medicine, Seville, Spain.
| | - Parisa Gazerani
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark; Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
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21
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Huang HL, Jan CFJ, Bih-Jeng Chang B, Chiu TY. Factors influencing the willingness of primary care physicians to provide care during the coronavirus disease pandemic: a nationwide survey in Taiwan. BMJ Open 2021; 11:e049148. [PMID: 34210735 PMCID: PMC8251678 DOI: 10.1136/bmjopen-2021-049148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic continues to advance worldwide with tremendous impact on public health, economy and society. Primary healthcare is crucial in every country during the pandemic for an integrated and coordinated healthcare delivery system; hence, it is of paramount importance to maintain a sufficient frontline workforce. This study aimed to identify factors influencing the willingness of primary care physicians to provide care during the COVID-19 pandemic. DESIGN Cross sectional study. SETTING Nationwide survey PARTICIPANTS: Primary care physicians working in the community in Taiwan were selected using a cluster sampling method based on practice region from May to June 2020. OUTCOME MEASURES The willingness of primary care physicians to provide care during the COVID-19 pandemic. RESULTS This study surveyed 1000 primary care physicians nationwide, and 625 valid questionnaires were received and included in the final analysis, with an effective response rate of 62.5%. Factors significantly associated with physicians willingness to provide care during COVID-19 were 'joining the Community Healthcare Group (CHCG)' (p<0.001), 'perceived more overall benefits for providing care' (p<0.001) 'perceived less overall barriers to providing care' (p<0.001), 'higher knowledge scores about COVID-19' (p=0.049) and 'physician's major specialties' (p=0.009) in the multivariate logistic regression model. CONCLUSIONS Building a comprehensive primary care system such as Taiwan's CHCG, training of more family physicians or general practitioners, and protecting and supporting primary care physicians were important in response to infectious disease pandemics. The findings of this study inform the development of guidelines to support and maintain the primary healthcare workforces during the COVID-19 pandemic and for future events.
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Affiliation(s)
- Hsien-Liang Huang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chyi-Feng Jeff Jan
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Brian Bih-Jeng Chang
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, Brian's Family Doctor clinic, New Taipei City, Taiwan
- Taiwan Medical Association, Taipei, Taiwan
| | - Tai-Yuan Chiu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Taiwan Medical Association, Taipei, Taiwan
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22
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing for essential food production workers: evolving thinking, pilot testing, and lessons learned. Public Health 2021; 197:56-62. [PMID: 34343819 PMCID: PMC8221033 DOI: 10.1016/j.puhe.2021.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022]
Abstract
An essential part of U.S. coronavirus disease 2019 (COVID-19) critical infrastructure is the country's food-production workforce. Keeping food-production workers safe during the COVID-19 pandemic has meant added workplace protections. Protection guidance came early from the Federal Government. Absent from such guidance were strategies to screen for the causative virus. Without viral screening, some food companies had outbreaks; some facilities had to close. Companies interested in viral screening had to devise their own strategies. One company devised a strategy having three main goals: (1) detecting asymptomatic infections, before opportunity for spread; (2) identifying workplace clusters, to indicate potential protection breakdowns; and (3) comparing company results to community infection rates. The company decided on pilot screenings at two U.S. production plants. Screenings involved mandatory viral testing (through reverse transcription polymerase chain reaction) and optional antibody testing (both immunoglobulins G and M). Pilot screenings showed benefits along with limitations: (1) detecting asymptomatic infections, but at questionably relevant time points; (2) identifying infection clusters, but with uncertain sites of transmission; (3) showing relatively low rates of infection, but absent details for meaningful community comparisons. Establishing a worker screening process was an enormous undertaking. Company employees had to stretch job roles and were distracted form usual responsibilities. Whether other companies would find sufficient benefits to justify similar screening is unclear. Moving forward, new Federal leadership could provide greater support for, and assistance with, worker screenings. In addition, new technologies could make future screenings more feasible and valuable. The worker screening experience from this pandemic offers learnings the next.
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23
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Burney IA, Abdwani R, Al-Hashmi K, Al-Wardy N, Al-Saadoon M. COVID-19 and the Clinical Phase of the Medical Doctorate Curriculum in Oman: Challenges and the way forward. Sultan Qaboos Univ Med J 2021; 21:e191-e194. [PMID: 34221465 PMCID: PMC8219317 DOI: 10.18295/squmj.2021.21.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/07/2020] [Accepted: 10/27/2020] [Indexed: 12/29/2022] Open
Abstract
COVID-19 has gripped the world with lightning speed. Since the onset of the pandemic, activity throughout the world came to a grinding halt. However, business had to continue and people have to learn to live with the virus while the pandemic continues to rage. Medical education is no exception and may even deserve special mention, as it prepares frontline workers against the endemics of tomorrow. We discuss here the journey of medical education at the College of Medicine and Health Sciences at Sultan Qaboos University, Muscat, Oman, as the pandemic struck the world and Oman. This work suggests a roadmap for changes, discusses challenges and proposes measures to mitigate the effects of COVID-19 on medical schools.
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Affiliation(s)
- Ikram A Burney
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Reem Abdwani
- Department of Child Health, Sultan Qaboos University, Muscat, Oman
| | - Khamis Al-Hashmi
- Department of Physiology, Sultan Qaboos University, Muscat, Oman
| | - Nadia Al-Wardy
- Department of Biochemistry, Sultan Qaboos University, Muscat, Oman
| | - Muna Al-Saadoon
- Department of Child Health, Sultan Qaboos University, Muscat, Oman
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24
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Wahezi DM, Lo MS, Rubinstein TB, Ringold S, Ardoin SP, Downes KJ, Jones KB, Laxer RM, Pellet Madan R, Mudano AS, Turner AS, Karp DR, Mehta JJ. American College of Rheumatology Guidance for the Management of Pediatric Rheumatic Disease During the COVID-19 Pandemic: Version 2. Arthritis Rheumatol 2021; 73:e46-e59. [PMID: 34114365 DOI: 10.1002/art.41772] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/08/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To provide clinical guidance to rheumatology providers who treat children with pediatric rheumatic disease (PRD) in the context of the coronavirus disease 2019 (COVID-19) pandemic. METHODS The task force, consisting of 7 pediatric rheumatologists, 2 pediatric infectious disease physicians, 1 adult rheumatologist, and 1 pediatric nurse practitioner, was convened on May 21, 2020. Clinical questions and subsequent guidance statements were drafted based on a review of the queries posed by the patients as well as the families and healthcare providers of children with PRD. An evidence report was generated and disseminated to task force members to assist with 3 rounds of asynchronous, anonymous voting by email using a modified Delphi approach. Voting was completed using a 9-point numeric scoring system with predefined levels of agreement (categorized as disagreement, uncertainty, or agreement, with median scores of 1-3, 4-6, and 7-9, respectively) and consensus (categorized as low, moderate, or high). To be approved as a guidance statement, median vote ratings were required to fall into the highest tertile for agreement, with either moderate or high levels of consensus. RESULTS To date, 39 guidance statements have been approved by the task force. Those with similar recommendations were combined to form a total of 33 final guidance statements, all of which received median vote ratings within the highest tertile of agreement and were associated with either moderate consensus (n = 5) or high consensus (n = 28). CONCLUSION These guidance statements have been generated based on review of the available literature, indicating that children with PRD do not appear to be at increased risk for susceptibility to SARS-CoV-2 infection. This guidance is presented as a "living document," recognizing that the literature on COVID-19 is rapidly evolving, with future updates anticipated.
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Affiliation(s)
- Dawn M Wahezi
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, New York, New York, United States
| | - Mindy S Lo
- Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Tamar B Rubinstein
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, New York, New York, United States
| | - Sarah Ringold
- Seattle Children's Hospital, Seattle, Washington, United States
| | - Stacy P Ardoin
- Nationwide Children's Hospital and Ohio State University, Columbus, Ohio, United States
| | - Kevin J Downes
- Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Karla B Jones
- Nationwide Children's Hospital and Ohio State University, Columbus, Ohio, United States
| | - Ronald M Laxer
- University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rebecca Pellet Madan
- New York University Grossman School of Medicine and Hassenfeld Children's Hospital, New York, New York, United States
| | | | - Amy S Turner
- American College of Rheumatology, Atlanta, Georgia, United States
| | - David R Karp
- University of Texas Southwestern Medical Center, Dallas
| | - Jay J Mehta
- Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
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Master SR, Neide B, Kollu S, Mulchandani S, Harris RM, Obstfeld AE. Facilitating Test Status Information Communication in the Time of COVID-19. Acad Pathol 2021; 8:23742895211006822. [PMID: 33884294 PMCID: PMC8040609 DOI: 10.1177/23742895211006822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/08/2021] [Accepted: 03/06/2021] [Indexed: 11/17/2022] Open
Abstract
The Coronavirus 2019 pandemic has strained nearly every aspect of pathology practice, including preanalytic, analytic, and postanalytic processes. Much of the challenges result from high demand for limited severe acute respiratory syndrome coronavirus 2 testing capacity, a resource required to facilitate patient flow throughout the hospital system and society at large. At our institution, this led to unprecedented increases in inquiries from providers to laboratory staff relating to the expected time to result for their patients. The demand was great enough to require redeployment of staff to handle the laboratory call volume. Although these data are available in our laboratory information system, the data do not interface to our electronic health record system. We developed systems using the R statistical programming language that abstract the necessary data regarding severe acute respiratory syndrome coronavirus 2 polymerase chain reaction testing from our lab system in real time, store it, and present it to clinicians for on demand querying. These data have been accessed over 2500 times by over 100 distinct users. Median length of each user session is approximately 4.9 minutes. Because our lab information system does not persistently store tracking information while our system does, we have been able to iteratively recalculate time to result values for each tracking stop as workflows have changed over time. Facility with informatics and programming concepts coupled with clinical understanding have allowed us to swiftly develop and iterate on applications which provide efficiency gains, allowing laboratory resources to focus on generating test results for our patients.
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Affiliation(s)
- Stephen R Master
- Department of Pathology, Children's Hospital of Philadelphia, PA, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Brandy Neide
- Department of Pathology, Children's Hospital of Philadelphia, PA, USA
| | - Sunaina Kollu
- Department of Pathology, Children's Hospital of Philadelphia, PA, USA
| | | | - Rebecca M Harris
- Department of Pathology, Children's Hospital of Philadelphia, PA, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Amrom E Obstfeld
- Department of Pathology, Children's Hospital of Philadelphia, PA, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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26
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Carlsten C, Gulati M, Hines S, Rose C, Scott K, Tarlo SM, Torén K, Sood A, de la Hoz RE. COVID-19 as an occupational disease. Am J Ind Med 2021; 64:227-237. [PMID: 33491195 PMCID: PMC8014565 DOI: 10.1002/ajim.23222] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/27/2020] [Accepted: 01/02/2021] [Indexed: 12/11/2022]
Abstract
The impact of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 permeates all aspects of society worldwide. Initial medical reports and media coverage have increased awareness of the risk imposed on healthcare workers in particular, during this pandemic. However, the health implications of COVID-19 for the global workforce are multifaceted and complex, warranting careful reflection and consideration to mitigate the adverse effects on workers worldwide. Accordingly, our review offers a framework for considering this topic, highlighting key issues, with the aim to prompt and inform action, including research, to minimize the occupational hazards imposed by this ongoing challenge. We address respiratory disease as a primary concern, while recognizing the multisystem spectrum of COVID-19-related disease and how clinical aspects are interwoven with broader socioeconomic forces.
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Affiliation(s)
- Christopher Carlsten
- Department of Medicine, Division of Respiratory MedicineThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Mridu Gulati
- Department of Pulmonary, Critical Care & Sleep MedicineYale UniversityNew HavenConnecticutUSA
| | - Stella Hines
- Department of MedicineUniversity of MarylandBaltimoreMarylandUSA
| | - Cecile Rose
- Department of Medicine, Division of Environmental & Occupational Health Sciences, National Jewish HealthUniversity of Colorado DenverDenverColoradoUSA
| | - Kenneth Scott
- Denver Health and Hospital AuthorityDenver Public HealthDenverColoradoUSA
| | - Susan M. Tarlo
- Occupational & Environmental Health Division, University Health NetworkUniversity of TorontoTorontoOntarioCanada
| | - Kjell Torén
- Occupational and Environmental Medicine Division, School of Public Health and Community Medicine, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Department of Occupational and Environmental MedicineSahlgrenska University HospitalGothenburgSweden
| | - Akshay Sood
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, School of MedicineUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | - Rafael E. de la Hoz
- Division of Occupational and Environmental MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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27
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Commentary on Special Report in The New England Journal of Medicine by Mark Barnes, JD, LLM, and Paul E Sax, MD, Challenges of "Return to Work" in an Ongoing Pandemic. J Occup Environ Med 2021; 62:e600. [PMID: 32826552 DOI: 10.1097/jom.0000000000002000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Fasola G, Pelizzari G, Zara D, Targato G, Petruzzellis G, Minisini AM, Bin A, Donato R, Mansutti M, Comuzzi C, Candoni A, Sperotto A, Fanin R. Feasibility and Predictive Performance of a Triage System for Patients with Cancer During the COVID-19 Pandemic. Oncologist 2021; 26:e694-e703. [PMID: 33539583 PMCID: PMC8014855 DOI: 10.1002/onco.13706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/22/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Triage procedures have been implemented to limit hospital access and minimize infection risk among patients with cancer during the coronavirus disease (COVID-19) outbreak. In the absence of prospective evidence, we aimed to evaluate the predictive performance of a triage system in the oncological setting. MATERIALS AND METHODS This retrospective cohort study analyzes hospital admissions to the oncology and hematology department of Udine, Italy, during the COVID-19 pandemic (March 30 to April 30, 2020). A total of 3,923 triage procedures were performed, and data of 1,363 individual patients were reviewed. RESULTS A self-report triage questionnaire identified 6% of triage-positive procedures, with a sensitivity of 66.7% (95% confidence interval [CI], 43.0%-85.4%), a specificity of 94.3% (95% CI, 93.5%-95.0%), and a positive predictive value of 5.9% (95% CI, 4.3%-8.0%) for the identification of patients who were not admitted to the hospital after medical review. Patients with thoracic cancer (odds ratio [OR], 1.69; 95% CI, 1.13-2.53, p = .01), younger age (OR, 1.52; 95% CI, 1.15-2.01, p < .01), and body temperature at admission ≥37°C (OR, 9.52; 95% CI, 5.44-16.6, p < .0001) had increased risk of positive triage. Direct hospital access was warranted to 93.5% of cases, a further 6% was accepted after medical evaluation, whereas 0.5% was refused at admission. CONCLUSION A self-report questionnaire has a low positive predictive value to triage patients with cancer and suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) symptoms. Differential diagnosis with tumor- or treatment-related symptoms is always required to avoid unnecessary treatment delays. Body temperature measurement improves the triage process's overall sensitivity, and widespread SARS-CoV-2 testing should be implemented to identify asymptomatic carriers. IMPLICATIONS FOR PRACTICE This is the first study to provide data on the predictive performance of a triage system in the oncological setting during the coronavirus disease outbreak. A questionnaire-based triage has a low positive predictive value to triage patients with cancer and suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) symptoms, and a differential diagnosis with tumor- or treatment-related symptoms is mandatory to avoid unnecessary treatment delays. Consequently, adequate recourses should be reallocated for a triage implementation in the oncological setting. Of note, body temperature measurement improves the overall sensitivity of the triage process, and widespread testing for SARS-CoV-2 infection should be implemented to identify asymptomatic carriers.
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Affiliation(s)
- Gianpiero Fasola
- Department of Oncology, Santa Maria della Misericordia HospitalUdineItaly
| | - Giacomo Pelizzari
- Department of Oncology, Santa Maria della Misericordia HospitalUdineItaly
| | - Diego Zara
- Department of Oncology, Santa Maria della Misericordia HospitalUdineItaly
| | - Giada Targato
- Department of Oncology, Santa Maria della Misericordia HospitalUdineItaly
| | | | | | - Alessandra Bin
- Department of Oncology, Santa Maria della Misericordia HospitalUdineItaly
| | - Raffaela Donato
- Department of Oncology, Santa Maria della Misericordia HospitalUdineItaly
| | - Mauro Mansutti
- Department of Oncology, Santa Maria della Misericordia HospitalUdineItaly
| | - Chiara Comuzzi
- Department of Hematology, Santa Maria della Misericordia HospitalUdineItaly
| | - Anna Candoni
- Department of Hematology, Santa Maria della Misericordia HospitalUdineItaly
| | | | - Renato Fanin
- Department of Hematology, Santa Maria della Misericordia HospitalUdineItaly,Department of Medicine, University of UdineUdineItaly
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29
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Ibáñez MJ, Guerrero M, Yáñez-Valdés C, Barros-Celume S. Digital social entrepreneurship: the N-Helix response to stakeholders' COVID-19 needs. JOURNAL OF TECHNOLOGY TRANSFER 2021; 47:556-579. [PMID: 33814697 PMCID: PMC8007451 DOI: 10.1007/s10961-021-09855-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2021] [Indexed: 01/23/2023]
Abstract
This study explores the emergence of a new entrepreneurship phenomenon (digital social entrepreneurship) as a result of the collaboration among many agents (N-Helix), given the government’s limited capacity to respond to the stakeholders’ needs satisfaction related to an exogenous event (e.g., the COVID-19 pandemic). Our theory development is based on three ongoing academic debates related to (a) the unrepresentativeness of the stakeholder theory in entrepreneurship research; (b) the emergence of digital social entrepreneurship (DSE) as a bridge between stakeholders’ needs, socio-economic actors, and digital-social initiatives; and (c) the role of N-Helix collaborations to facilitate the emergence of global knowledge-intensive initiatives and the rapid adoptions of open innovations. Our results support our assumptions about the positive mediation effect of DSE in the relationship between N-Helix collaborations and stakeholders’ satisfaction. Notably, results show how pandemic has intensified these relationships and how DSE in N-Helix collaborations can generate social impacts globally. Some implications for policy-makers have emerged from our results that should be considered during/post-COVID-19 pandemic.
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Affiliation(s)
- María J Ibáñez
- School of Business and Economics, Universidad del Desarrollo, Av. Plaza 680, Las Condes, Santiago Chile
| | - Maribel Guerrero
- School of Business and Economics, Universidad del Desarrollo, Av. Plaza 680, Las Condes, Santiago Chile.,Northumbria Centre for Innovation, Regional Transformation, and Entrepreneurship (iNCITE). Business and Law Faculty, Newcastle Business School, Sutherland Building, 2 Ellison Pl, Newcastle upon Tyne, UK.,Centre for Innovation Research (CIRCLE), Lund University, Sölvegatan 16, Lund, Sweden
| | - Claudia Yáñez-Valdés
- School of Business and Economics, Universidad del Desarrollo, Av. Plaza 680, Las Condes, Santiago Chile
| | - Sebastián Barros-Celume
- School of Business and Economics, Universidad del Desarrollo, Av. Plaza 680, Las Condes, Santiago Chile
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30
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Escorpizo R, Kroll T. Specialty Grand Challenge: Disability, Rehabilitation, and Inclusion. FRONTIERS IN REHABILITATION SCIENCES 2021; 1:622575. [PMID: 36570607 PMCID: PMC9782682 DOI: 10.3389/fresc.2020.622575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/14/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Reuben Escorpizo
- Department of Rehabilitation and Movement Science, The University of Vermont, Burlington, VT, United States,*Correspondence: Reuben Escorpizo
| | - Thilo Kroll
- UCD Centre for Education, Research and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin (UCD), Dublin, Ireland
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31
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How did Occupational and Employee Health Services Provide Strategic Input to Organizational Emergency Contingency Planning During the COVID-19 Pandemic? A Case Study. J Occup Environ Med 2021; 63:e153-e155. [PMID: 33652449 PMCID: PMC7934327 DOI: 10.1097/jom.0000000000002146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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32
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Plantes PJ, Fragala MS, Clarke C, Goldberg ZN, Radcliff J, Goldberg SE. Model for Mitigation of Workplace Transmission of COVID-19 Through Population-Based Testing and Surveillance. Popul Health Manag 2021; 24:S16-S25. [PMID: 33493409 PMCID: PMC7875134 DOI: 10.1089/pop.2020.0322] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The coronavirus disease-2019 (COVID-19) pandemic is having a widespread impact on societies across the globe. As part of the effort to control transmission in the United States, many businesses either closed or instituted nonpharmaceutical control measures and allowed only essential workers on-site. During summer and fall of 2020, employers began formulating "return to work" strategies designed to mitigate the risk of transmission among employees. On a population level, several countries implemented national testing and surveillance strategies that proved effective in mitigating citizen-to-citizen transmission and contributed to suppressing COVID-19. A crucial component of many such strategies is population-based testing to identify and engage individuals with asymptomatic or presymptomatic infection, which also is relevant to return-to-work strategies. The authors describe an approach that multisite employers might use to help mitigate transmission of COVID-19 in the workplace. This approach leverages a bioinformatics platform informed by real-time PCR test data at the county and subcounty (eg, Public Use Microdata Area) level, allowing for population-based testing to be selectively targeted for employees in geographies with elevated SARS-CoV-2 positivity. A "Command Center" application integrates data from multiple sources (eg, local infection trends, employee symptom diaries, Bluetooth thermometers) in real time, which can be used to inform decisions regarding surveillance and employee self-isolation or quarantine; a mobile phone-based application provides for rapid, secure communication with employees. This overview is based on peer-reviewed literature and the early experience of a large employer with implementing bioinformatics tools to mitigate the impact of the pandemic on the workplace.
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Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused widespread disruptions in various sectors of medicine, including medical education. Although the necessary focus has been on patient care and public safety and the long-lasting impact of COVID-19 remains to be determined, the impact on medical education warrants further attention and action. While it seems minuscule compared with the toll the global pandemic has caused worldwide, the impact on medical education, including graduate medical education, carries the potential to alter career progression and outcomes. We have assessed the effects of COVID-19 on dermatology clinics, residency education, and medical education, exploring recommendations and actions taken by governing bodies and offering additional suggestions of our own.
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Affiliation(s)
- Virginia A Jones
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Kayla A Clark
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Carolina Puyana
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Maria M Tsoukas
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA.
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34
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Almeharish A, Assiri AM, Alfattani A, De Vol E. Coping with the COVID-19 Pandemic's Unique Challenges Associated with Medical Research: A Saudi Institution Approach. Risk Manag Healthc Policy 2020; 13:3173-3178. [PMID: 33408539 PMCID: PMC7779308 DOI: 10.2147/rmhp.s283582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/10/2020] [Indexed: 11/23/2022] Open
Abstract
The spread of COVID-19 has become a significant threat to economic activity throughout the world, and it has made life particularly difficult for research institutions. According to a report published by Spain's largest public research body, Cybermetrics Labs, King Faisal Specialist Hospital and Research Centre (KFSH&RC) is ranked first among the leading hospitals in the Arab world, and it has instituted a wide range of policy changes to accommodate researchers by providing them with additional flexibility. The aim of this project was to highlight the most prevalent COVID-related global challenges facing research institutions and describe how research protocol at KFSH&RC has been adjusted to minimize the disruption experienced by its researchers.
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Affiliation(s)
- Amani Almeharish
- Department of Biostatics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdullah M Assiri
- Department of Comparative Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Areej Alfattani
- Department of Biostatics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Edward De Vol
- Department of Biostatics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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35
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Sato APS. Pandemic and vaccine coverage: challenges of returning to schools. Rev Saude Publica 2020; 54:115. [PMID: 33175029 PMCID: PMC7647469 DOI: 10.11606/s1518-8787.2020054003142] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/16/2020] [Indexed: 12/16/2022] Open
Abstract
Since March 2020, Brazil has faced the pandemic of the coronavirus disease 2019 (Covid-19), which has severely modified the way in which the population lives and uses health services. As such, face-to-face attendance has dropped dramatically, even for child vaccination, due to measures of social distancing to mitigate the transmission of the virus. Several countries have recorded a substantial drop in vaccination coverage in children, especially of those under two years of age. In Brazil, administrative data indicate the impact of the covid-19 pandemic on this downward trend, which was already an important challenge of the National Immunization Program in recent years. Many children will be susceptible to immunopreventable diseases, which reinforces the need to assess the vaccine status of schoolchildren before returning to face-to-face classes.
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Affiliation(s)
- Ana Paula Sayuri Sato
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
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36
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Zuber S, Brüssow H. COVID 19: challenges for virologists in the food industry. Microb Biotechnol 2020; 13:1689-1701. [PMID: 32700430 PMCID: PMC7404336 DOI: 10.1111/1751-7915.13638] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/08/2020] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic is not only a challenge for public health and hospitals, but affects many aspects of our societies. This Lilliput minireview deals with problems that the pandemic causes for the food industry, addressing the presence and persistence of SARS-CoV-2 in the food environment, methods of virus inactivation and the protection of the food worker and the consumer. So far food has not been implicated in the transmission of the infection, but social disruptions caused by the pandemic could cause problems with food security.
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Affiliation(s)
- Sophie Zuber
- Institute of Food Safety and Analytical ScienceNestlé ResearchLausanne 261000Switzerland
| | - Harald Brüssow
- Department of BiosystemsLaboratory of Gene TechnologyKU LeuvenLeuvenBelgium
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37
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Zhao J, Jia J, Qian Y, Zhong L, Wang J, Cai Y. COVID-19 in Shanghai: IPC Policy Exploration in Support of Work Resumption Through System Dynamics Modeling. Risk Manag Healthc Policy 2020; 13:1951-1963. [PMID: 33116976 PMCID: PMC7550726 DOI: 10.2147/rmhp.s265992] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/04/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose It is unclear how and to what extent various infection prevention and control (IPC) policies affect the spread of an epidemic during work resumption. In order to assess the impact of IPC policies, this research addresses the results of a policy simulation in Shanghai, China, which estimates the transmission dynamics of COVID-19 under various IPC policies and offers evidence-based outcomes of work resumption policies for the world. Materials and Methods This simulation research is based on a system dynamics (SD) model that integrates IPC work resumption policies implemented in Shanghai into the classical susceptible-exposed-infected-removed (SEIR) epidemiological model. Input data were obtained from official websites, the Baidu migration index and published literature. The SD model was validated by comparing results with real-world data. Results The simulations show that a non-quarantined and non-staged approach to work resumption (Policy 1) would bring a small secondary outbreak of COVID-19. The quarantined but non-staged approach (Policy 2) and the non-quarantined but staged approach (Policy 3) would not bring a secondary outbreak of COVID-19. However, they both would generate more newly confirmed cases than the staged and quarantined approach (Policy 4). Moreover, the 14-day quarantine policy alone appears to be more effective in reducing transmission risk than the staged work resumption policy alone. The combined staged and quarantined IPC policy led to the fewest confirmed cases caused by work resumption in Shanghai, and the spread of COVID-19 stopped (ie, the number of newly confirmed cases reduced to zero) at the earliest date. Conclusion Conservative IPC policies can prevent a second outbreak of COVID-19 during work resumption. The dynamic systems model designed in this study can serve as a tool to test various IPC work resumption policies, facilitating decision-making in responses to combating the COVID-19 pandemic.
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Affiliation(s)
- Jidi Zhao
- Faculty of Economics and Management, East China Normal University, Shanghai, People's Republic of China
| | - Jianguo Jia
- System Dynamics Chapter, Systems Engineering Society of China, Beijing, People's Republic of China
| | - Ying Qian
- School of Management, Shanghai University, Shanghai, People's Republic of China
| | - Lumin Zhong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jiancong Wang
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Yuyang Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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38
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Wahezi DM, Lo MS, Rubinstein TB, Ringold S, Ardoin SP, Downes KJ, Jones KB, Laxer RM, Pellet Madan R, Mudano AS, Turner AS, Karp DR, Mehta JJ. American College of Rheumatology Guidance for the Management of Pediatric Rheumatic Disease During the COVID-19 Pandemic: Version 1. Arthritis Rheumatol 2020; 72:1809-1819. [PMID: 32705780 PMCID: PMC7404941 DOI: 10.1002/art.41455] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/21/2020] [Indexed: 12/16/2022]
Abstract
Objective To provide clinical guidance to rheumatology providers who treat children with pediatric rheumatic disease (PRD) in the context of the coronavirus disease 2019 (COVID‐19) pandemic. Methods The task force, consisting of 7 pediatric rheumatologists, 2 pediatric infectious disease physicians, 1 adult rheumatologist, and 1 pediatric nurse practitioner, was convened on May 21, 2020. Clinical questions and subsequent guidance statements were drafted based on a review of the queries posed by the patients as well as the families and healthcare providers of children with PRD. An evidence report was generated and disseminated to task force members to assist with 3 rounds of asynchronous, anonymous voting by email using a modified Delphi approach. Voting was completed using a 9‐point numeric scoring system with predefined levels of agreement (categorized as disagreement, uncertainty, or agreement, with median scores of 1–3, 4–6, and 7–9, respectively) and consensus (categorized as low, moderate, or high). To be approved as a guidance statement, median vote ratings were required to fall into the highest tertile for agreement, with either moderate or high levels of consensus. Results The task force drafted 33 guidance statements, which were voted upon during the second and third rounds of voting. Of these 33 statements, all received median vote ratings within the highest tertile of agreement and were associated with either moderate consensus (n = 6) or high consensus (n = 27). Statements with similar recommendations were combined, resulting in 27 final guidance statements. Conclusion These guidance statements have been generated based on review of the available literature, indicating that children with PRD do not appear to be at increased risk for susceptibility to SARS–CoV‐2 infection. This guidance is presented as a “living document,” recognizing that the literature on COVID‐19 is rapidly evolving, with future updates anticipated.
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Affiliation(s)
- Dawn M Wahezi
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, New York, New York
| | - Mindy S Lo
- Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Tamar B Rubinstein
- Children's Hospital at Montefiore and Albert Einstein College of Medicine, New York, New York
| | | | - Stacy P Ardoin
- Nationwide Children's Hospital and Ohio State University, Columbus, Ohio
| | - Kevin J Downes
- Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Karla B Jones
- Nationwide Children's Hospital and Ohio State University, Columbus, Ohio
| | - Ronald M Laxer
- University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rebecca Pellet Madan
- New York University Grossman School of Medicine and Hassenfeld Children's Hospital, New York, New York
| | | | - Amy S Turner
- American College of Rheumatology, Atlanta, Georgia
| | - David R Karp
- University of Texas Southwestern Medical Center, Dallas
| | - Jay J Mehta
- Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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39
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Return to work during coronavirus disease 2019 (COVID-19): Temperature screening is no panacea. Infect Control Hosp Epidemiol 2020; 42:1166-1167. [PMID: 32962769 PMCID: PMC7542314 DOI: 10.1017/ice.2020.1225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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40
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Affiliation(s)
- Ewan Macdonald
- Institute of Health and Wellbeing University of Glasgow, Glasgow, UK
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Acharya D, Lee K, Lee DS, Lee YS, Moon SS. Mortality Rate and Predictors of Mortality in Hospitalized COVID-19 Patients with Diabetes. Healthcare (Basel) 2020; 8:healthcare8030338. [PMID: 32933191 PMCID: PMC7551813 DOI: 10.3390/healthcare8030338] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 01/08/2023] Open
Abstract
Studies have confirmed COVID-19 patients with diabetes are at higher risk of mortality than their non-diabetic counterparts. However, data-driven evidence of factors associated with increased mortality risk among hospitalized COVID-19 patients with diabetes is scarce in South Korea. This study was conducted to determine the mortality rate and identify risk factors of mortality among hospitalized COVID-19 patients with type 2 diabetes in Gyeongsangbuk-do province, South Korea. In this hospital-based, cross-sectional study, we enrolled a total of 324 patients with confirmed COVID-19, hospitalized at two of the tertiary level healthcare facilitates of Gyeongsangbuk-do, South Korea from 18 February to 30 June 2020. Demographic and clinical data and laboratory profiles were analyzed and multivariate logistic regression analysis was used to identify risk factors of mortality among diabetic patients with COVID-19. Of the 324 patients, 55 (16.97%) had diabetes mellitus. The mean age of all study subjects was 55 years, and the mean age of those with diabetes was greater than that of those without (69.8 years vs. 51.9 years). Remarkably, the mortality rate was much higher among those with diabetes (20.0% vs. 4.8%). Multivariate logistic regression analysis revealed that an older age (≥70 years) and a high serum lactate dehydrogenase (LDH) levels significantly predicted mortality among hospitalized COVID-19 patients with diabetes. Our study cautions more attention to be paid to patients with diabetes mellitus hospitalized for COVID-19, especially those aged ≥ 70 years and those with a high serum LDH level, to reduce the risk of mortality.
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Affiliation(s)
- Dilaram Acharya
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Korea; (D.A.); (K.L.)
- Department of Community Medicine, Kathmandu University, Devdaha Medical College and Research Institute, Rupandehi 32900, Nepal
| | - Kwan Lee
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Korea; (D.A.); (K.L.)
| | - Dong Seok Lee
- Department of Pediatrics, Dongguk University College of Medicine, Gyeongju 38067, Korea;
| | - Yun Sik Lee
- Department of General Surgery, Andong Medical Center, Andong 36694, Korea;
| | - Seong-Su Moon
- Department of Internal Medicine, Dongguk University College of Medicine, Dongguk University Gyeongju hospital, Dongdae-ro 87, Gyeongju 38067, Korea
- Correspondence:
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Kassaye SG, Spence AB, Lau E, Bridgeland DM, Cederholm J, Dimolitsas S, Smart JC. Rapid Deployment of a Free, Privacy-Assured COVID-19 Symptom Tracker for Public Safety During Reopening: System Development and Feasibility Study. JMIR Public Health Surveill 2020; 6:e19399. [PMID: 32788148 PMCID: PMC7431234 DOI: 10.2196/19399] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/30/2020] [Accepted: 07/28/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the number of cases of coronavirus disease (COVID-19) in the United States has exponentially increased. Identifying and monitoring individuals with COVID-19 and individuals who have been exposed to the disease is critical to prevent transmission. Traditional contact tracing mechanisms are not structured on the scale needed to address this pandemic. As businesses reopen, institutions and agencies not traditionally engaged in disease prevention are being tasked with ensuring public safety. Systems to support organizations facing these new challenges are critically needed. Most currently available symptom trackers use a direct-to-consumer approach and use personal identifiers, which raises privacy concerns. OBJECTIVE Our aim was to develop a monitoring and reporting system for COVID-19 to support institutions conducting monitoring activities without compromising privacy. METHODS Our multidisciplinary team designed a symptom tracking system after consultation with experts. The system was designed in the Georgetown University AvesTerra knowledge management environment, which supports data integration and synthesis to identify actionable events and maintain privacy. We conducted a beta test for functionality among consenting Georgetown University medical students. RESULTS The symptom tracker system was designed based on guiding principles developed during peer consultations. Institutions are provided access to the system through an efficient onboarding process that uses clickwrap technology to document agreement to limited terms of use to rapidly enable free access. Institutions provide their constituents with a unique identifier to enter data through a web-based user interface to collect vetted symptoms as well as clinical and epidemiologic data. The website also provides individuals with educational information through links to the COVID-19 prevention recommendations from the US Centers for Disease Control and Prevention. Safety features include instructions for people with new or worsening symptoms to seek care. No personal identifiers are collected in the system. The reporter mechanism safeguards data access so that institutions can only access their own data, and it provides institutions with on-demand access to the data entered by their constituents, organized in summary reports that highlight actionable data. Development of the system began on March 15, 2020, and it was launched on March 20, 2020. In the beta test, 48 Georgetown University School of Medicine students or their social contacts entered data into the system from March 31 to April 5, 2020. One of the 48 users (2%) reported active COVID-19 infection and had no symptoms by the end of the monitoring period. No other participants reported symptoms. Only data with the unique entity identifier for our beta test were generated in our summary reports. CONCLUSIONS This system harnesses insights into privacy and data sharing to avoid regulatory and legal hurdles to rapid adaption by entities tasked with maintaining public safety. Our pilot study demonstrated feasibility and ease of use. Refinements based on feedback from early adapters included release of a Spanish language version. These systems provide technological advances to complement the traditional contact tracing and digital tracing applications being implemented to limit SARS-CoV-2 transmission during reopening.
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Affiliation(s)
- Seble G Kassaye
- Department of Medicine, Georgetown University, Washington, DC, United States
| | - Amanda Blair Spence
- Department of Medicine, Georgetown University, Washington, DC, United States
| | - Edwin Lau
- LEDR Technologies Inc, Seattle, WA, United States
| | | | | | - Spiros Dimolitsas
- Office of the Senior Vice President for Research, Georgetown University, Washington, DC, United States
| | - J C Smart
- Office of the Senior Vice President for Research, Georgetown University, Washington, DC, United States
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Foster S. The return-to-work conundrum. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:839. [PMID: 32697645 DOI: 10.12968/bjon.2020.29.14.839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sam Foster, Chief Nurse, Oxford University Hospitals, describes the problems faced by trusts as they attempt to limit the risks faced by employees returning to the workplace as the coronavirus lockdown eases.
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Affiliation(s)
- Sam Foster
- Chief Nurse, Oxford University Hospitals
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Habibzadeh F. Word War III. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2020; 11:117-118. [PMID: 32683423 PMCID: PMC7426734 DOI: 10.34172/ijoem.2020.2139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/10/2020] [Indexed: 11/26/2022]
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Jackson Filho JM, Algranti E. Desafios e paradoxos do retorno ao trabalho no contexto da pandemia de COVID-19. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2020. [DOI: 10.1590/2317-6369ed0000220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Eduardo Algranti
- Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho (Fundacentro), Brasil
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Chawla N, Ray S, Gupta A, Maramaraj K, Kumar S, Anand K. Return to work strategy with antibody-based tests in COVID19: An observational study from a metropolitan area, India. JOURNAL OF MARINE MEDICAL SOCIETY 2020. [DOI: 10.4103/jmms.jmms_90_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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