What's Important: Facing Fear in the Time of COVID-19

Comparison of Fear of COVID-19 in Medical and Nonmedical Personnel in a Public Hospital in Mexico: a Brief Report

The world is social distancing, and compulsory confinement has caused stress, psychological instability, stigmatization, fear, and discrimination in the general population. In this cross-sectional survey study, we administered the Fear of COVID-19 Scale (FCV-19S) to hospital medical and nonmedical personnel. A total of 1216 participants were surveyed from May 25 to May 29 of 2020. We asked all the staff for their participation in the study, and physical copies of the survey were distributed to the staff willing to participate. All surveys were answered anonymously. We found that the global FCV-19S mean score was 16.4 ± 6.1, with a significant difference between women and men's scores. Medical students presented higher scores than experienced medical personnel. Additionally, the medical and nursing personnel presented a higher level of fear than hospital staff who did not work directly with COVID-19 patients. Our findings suggest that greater knowledge of medicine or infectious diseases could decrease the overall psychological impact of the pandemic disease.

Orthopaedic, trauma surgery, and Covid-2019 pandemic: clinical panorama and future prospective in Europe

Purpose

This study investigated the impact of the Covid-19 pandemic in Europe on consultations, surgeries, and traumas in the field of orthopaedic and trauma surgery. Strategies to resume the clinical activities were also discussed.

Methods

This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. All the comparative studies reporting data on the impact of Covid-19 in the field of orthopaedic and trauma surgery in Europe were accessed. Only comparative clinical studies which investigated the year 2020 versus 2019 were eligible.

Results

57 clinical investigations were included in the present study. Eight studies reported a reduction of the orthopaedic consultations, which decreased between 20.9 and 90.1%. Seven studies reported the number of emergency and trauma consultations, which were decreased between 37.7 and 74.2%. Fifteen studies reported information with regard to the reasons for orthopaedic and trauma admissions. The number of polytraumas decreased between 5.6 and 77.1%, fractures between 3.9 and 63.1%. Traffic accidents admissions dropped by up to 88.9%, and sports-related injuries dropped in a range of 59.3% to 100%. The overall reduction of the surgical interventions ranged from 5.4 to 88.8%.

Conclusion

The overall trend of consultations, surgeries, and rate of traumas and fragility fractures appear to decrease during the 2020 European COVID pandemic compared to the pre-pandemic era. Given the heterogeneities in the clinical evidence, results from the present study should be considered carefully.

Level of evidence

Level IV, systematic review.

The Impact of COVID-19 on the Orthopaedic Surgery Residency Experience

INTRODUCTION

The rapid spread of the COVID-19 virus led to dramatic changes in graduate medical education and surgical practice. The purpose of this study was to evaluate the effects of the COVID-19 pandemic on Orthopaedic Surgery residency education in the United States.

METHODS

A survey sent to all residents of the 201 ACGME-accredited Orthopaedic Surgery programs in the United States.

RESULTS

A total of 309 Orthopaedic surgery residents responded to our survey. A subset of 283 (91.6%) residents surveyed reported decreased Orthopaedic-related clinical duty hours due to the COVID-19 pandemic, and 300/309 (97.1%) reported a decrease in surgical case volume. 298 (96.4%) residents reported that their program had scheduled activities or made changes to supplement their education, most common being virtual and video conferences 296/309 (95.5%), required practice questions 132/309 (42.7%), required reading or pre-recorded lectures 122/309 (39.5%), in-person small group meetings or lectures 24/309 (7.77%), and surgical simulation activities 17/309 (5.50%). Almost half (152/309 (48.9%)) of respondents reported their overall resident education was somewhat or much worse due to the impact of COVID-19. Over a quarter (81 (26.2%)) of residents reported their well-being was negatively impacted by residency-related changes due to COVID-19.

CONCLUSIONS

Based on these results, the COVID-19 pandemic has brought about significant changes to the training experience of Orthopaedic surgery residents in the United States. Although the majority of residents in this sample had favorable opinions of the educational changes their programs have instituted in light of the pandemic, clinical duty hours and case volume were reported to have substantially decreased, with a large portion of residents viewing their overall resident education as worsened and reporting negative impacts on their overall well-being.

The fear of COVID-19 outbreak among health care professionals in Gaza Strip, Palestine

INTRODUCTION

The emergence of the COVID-19 and its consequences has led to fears, worries, and anxiety among individuals, particularly among healthcare professionals. The present study aimed to assess the fear of COVID-19 among different healthcare professionals in the Gaza Strip, Palestine.

METHODS

A cross-sectional, snowball sampling technique and an online questionnaire were employed among healthcare professionals. A total of 300 participants completed the questionnaire. The validated fear of COVID-19 Scale Arabic version was used. Statistical analysis was performed using SPSS version 22.

RESULTS

The sample fear mean score was 17.53 ± 5.78; more than half of the study participants (54.3%) consider it as low levels of fear and 45.7% of the participants consider it as high levels of fear. Statistically significant differences were found between males and females, and different healthcare professional's disciplines. Females have a higher mean score compared to males. The highest fear mean scores were found among Lab-Technicians (20.19 ± 7.42), followed by X-ray-Technicians (17.95 ± 3.96), Nurses (17.1 ± 5.55), and Physicians (16.25 ± 4.66).

CONCLUSION

The fear of COVID-19 was high among female healthcare professionals compared to males, as well as, among Lab-Technicians compared to Physicians and Nurses. There is a need to establish a strategy to continues measuring the psychological effect of COVID-19 among healthcare professionals especially females.

The hidden impact of rapid spread of the COVID-19 pandemic in professional, financial, and psychosocial health of Latin American orthopedic trauma surgeons

OBJECTIVE

To assess the quality of life of Latin American orthopedic trauma surgeons during the beginning of COVID-19 pandemic in Latin America.

METHODS

A total of 400 orthopedic trauma surgeons from 14 Latin American countries were invited to complete an electronic survey aiming to understand the general situation of COVID-19 in each country and how COVID-19 had impacted life's participant financially and psychosocially. The relationship between the occurrence of the disease and the existence of legal regulations on the medical activity in the respondent's country, protocols for tracking the disease among patients hospitalized in an emergency basis due to skeletal trauma, and personal protective equipment to deal with patients diagnosed with COVID-19 who need orthopedic trauma surgery was investigated, as well as the financial and psychosocial impact caused by the disease. Data was statistically analyzed with significance p < 0.05.

RESULTS

220 respondents completed the survey. 21 respondents were diagnosed with COVID-19. Local regulation was decisive in terms of increasing the risk for COVID-19 disease (p = 0.001). 91.8% of the respondents reported being concerned about their financial health and 57.7% described a state of feeling emotionally overextended. 75.0% believe that pandemic can change their professional activity.

CONCLUSION

The rapid spread of the COVID-19 pandemic in Latin America has negatively impacted the professional, financial, and psychosocial health of orthopedic trauma surgeons. It seems reasonable to state that the combination of psychosocial distress and deprivation together with financial uncertainty and decreased revenue can be straightly related to development of burnout symptoms among doctors.

Orthopaedic surgery after COVID-19 - A blueprint for resuming elective surgery after a pandemic

Background

The COVID-19 outbreak was fraught with danger and despair as many medically necessary surgeries were cancelled to preserve precious healthcare resources and mitigate disease transmission. As the rate of infection starts to slow, healthcare facilities and economies attempt to return to normalcy in a graduated manner and the massive pent-up demand for surgeries needs to eventually be addressed in a systematic and equitable manner.

Materials and methods

Guidelines from the Alliance of International Organizations of Orthopaedics and Traumatology, Orthopaedic Trauma Association, American College of Surgeons, American Society of Anaesthesiologists, Association of perioperative Registered Nurses, American Hospital Association, Centers for Medicare and Medicaid Services, World Health Organization and Centers for Disease Control and Prevention were evaluated and summarized into a working framework, relevant to orthopaedic surgeons.

Results

The guiding principles for restarting elective surgeries in a safe and acceptable manner include up-to-date disease awareness, projection and judicious management of equipment and facilities, effective human resource management, a fair and transparent system to prioritize cases, optimization of peri-operative workflows and continuous data gathering and clinical governance.

Conclusion

The world was ill prepared for the initial COVID-19 outbreak. However, with effective forward planning, institutions can ramp-up elective surgical caseload in a safe and equitable manner.

•

As COVID-19 resolves, the pent-up demand for surgeries needs to be addressed in a systematic and equitable manner.

•

Up-to-date disease awareness is necessary for projection and judicious management of equipment and facilities.

•

Effective human resource management and optimization of peri-operative workflows will improve clearance of elective caseload.

•

A fair and transparent system to prioritize cases is required to reduce patient confusion and vexation.

•

Continuous data gathering and clinical governance ensures continuity of operative services in the event of a second wave.

The role of the orthopaedic surgeon in the COVID-19 era: cautions and perspectives

The current coronavirus disease 2019 (COVID-19) pandemic has revolutionized global healthcare in an unprecedented way and with unimaginable repercussions. Resource reallocation, socioeconomic confinement and reorganization of production activities are current challenges being faced both at the national and international levels, in a frame of uncertainty and fear. Hospitals have been restructured to provide the best care to COVID-19 patients while adopting preventive strategies not to spread the infection among healthcare providers and patients affected by other diseases. As a consequence, the concept of urgency and indications for elective treatments have been profoundly reshaped. In addition, several providers have been recruited in COVID-19 departments despite their original occupation, resulting in a profound rearrangement of both inpatient and outpatient care. Orthopaedic daily practice has been significantly affected by the pandemic. Surgical indications have been reformulated, with elective cases being promptly postponed and urgent interventions requiring exceptional attention, especially in suspected or COVID-19⁺ patients. This has made a strong impact on inpatient management, with the need of a dedicated staff, patient isolation and restrictive visiting hour policies. On the other hand, outpatient visits have been limited to reduce contacts between patients and the hospital personnel, with considerable consequences on post-operative quality of care and the human side of medical practice.

In this review, we aim to analyze the effect of the COVID-19 pandemic on the orthopaedic practice. Particular attention will be dedicated to opportune surgical indication, perioperative care and safe management of both inpatients and outpatients, also considering repercussions of the pandemic on resident education and ethical implications.

Impact of COVID 19 lockdown on orthopaedic surgeons in India: A survey

BACKGROUND

In the fight against COVID 19, the government of India announced a 3 weeks lockdown of the entire country of 1.3 billion people on 24th March 2020.

METHODS

One week after the lockdown was announced, we conducted an anonymous online survey of the orthopaedic surgeons in India through social media platforms to assess the impact of the lockdown during COVID 19. The survey had a total of 13 questions with (3-5) options and was designed with an aim to understand the perception and the state of mind of the Orthopaedic surgeons in the lockdown situation.

RESULTS

The survey was completed by 611 orthopaedic surgeons from 140 cities in India. There were 22.5% orthopaedic surgeons who said that they were definitely stressed out, and 40.5% who said they were mildly stressed out. As the age decreased, the percentage of orthopaedic surgeons feeling "definitely stressed out" increased. Disruption of life-work balance and uncertainties regarding return to work were other strongly associated factors with the "definitely stressed out" group.

CONCLUSION

The psychological impact of the lockdown during COVID 19 on orthopaedic surgeons may become a potential concern that will require addressal through open discussion.

LEVEL OF EVIDENCE

diagnostic level 4.