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Hider S, Muller S, Gray L, Manning F, Brooks M, Heining D, Menon A, Packham J, Roddy E, Ryan S, Scott IC, Paskins Z. Exploring the longer-term impact of the COVID-19 pandemic on physical and mental health of people with inflammatory rheumatic diseases: a cross-sectional survey. Clin Rheumatol 2023:10.1007/s10067-023-06565-0. [PMID: 36882533 PMCID: PMC9990972 DOI: 10.1007/s10067-023-06565-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE To assess the longer term impact of the COVID-19 pandemic on the self-reported physical and mental health of people with inflammatory rheumatic diseases (IRDs). METHODS Two thousand twenty-four patients with IRDs were randomly selected from electronic health records. Survey invitations were sent (August 2021 coinciding with relaxation of UK COVID-19 restrictions) using SMS and postal approaches. Self-reported data included demographics, shielding status and physical (MSK-HQ) and mental health (PHQ8 and GAD7). RESULTS Six hundred thirty-nine people completed the survey (mean (SD) age 64.5 (13.1) years, 384 (60%) female). Moderate/severe impact of the pandemic on physical and mental health was reported by 250 (41%) and 241 (39%) respectively. One hundred seventy-two (29%) reported moderate/severe depression (PHQ8 ≥ 10) and 135 (22%) moderate/severe anxiety (GAD7 ≥ 10). Females reported greater impacts of the pandemic on physical health (44% vs 34%), mental health (44% vs 34%), arthritis symptoms (49% vs 36%) and lifestyle factors (weight gain and reduced exercise and physical activity) than males. The physical and mental impacts were less in people with RA compared with other IRDs. Physical health impacts did not differ between age groups, but younger patients reported greater impacts on mental health. CONCLUSION The COVID-19 pandemic has had a significant impact on the physical and mental health of people with IRDs. These effects were greatest in females. Recovery needs to address the negative impact of the pandemic on lifestyle factors to minimise the long-term impacts for people with IRDs. Key Points • The pandemic had a significant impact on long term physical and mental health in almost 40% of people with IRDs. • The impact of the pandemic was greater in women for physical health, mental health and arthritis symptoms. • Many people reported negative pandemic impacts on lifestyle factors including weight and physical activity.
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Affiliation(s)
- Samantha Hider
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-On-Trent, UK. .,School of Medicine, Keele University, Keele, UK.
| | - Sara Muller
- School of Medicine, Keele University, Keele, UK
| | - Lauren Gray
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-On-Trent, UK
| | - Fay Manning
- School of Medicine, Keele University, Keele, UK.,School of Medicine, University of Exeter, Exeter, UK
| | - Mike Brooks
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-On-Trent, UK
| | - Dominic Heining
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-On-Trent, UK
| | - Ajit Menon
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-On-Trent, UK
| | - Jonathan Packham
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-On-Trent, UK.,Academic Unit of Population and Lifespan Sciences, University of Nottingham, Nottingham, UK
| | - Edward Roddy
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-On-Trent, UK.,School of Medicine, Keele University, Keele, UK
| | - Sarah Ryan
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-On-Trent, UK
| | - Ian C Scott
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-On-Trent, UK.,School of Medicine, Keele University, Keele, UK
| | - Zoe Paskins
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-On-Trent, UK.,School of Medicine, Keele University, Keele, UK
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Abstract
The standard methodology for the assessment of cultural heritage significance relies on hindsight, with a passage of time elapsed between the creation of the site or object and its assessment. There are, however, cases where heritage significance is instant (e.g., sites associated with the first Moon landing). This paper argues that hindsight will not be required to determine that the COVID-19 pandemic will come to be considered as a significant historic event, as COVID-19 has already manifested itself as a social, cultural and economic disruptor on a global scale with a mortality in the millions. Heritage professionals have the unique opportunity to assess and document places and structures associated with the pandemic, that are poised to be worthy of a heritage listing in the near future, while they are still in use and function as intended. This paper discusses the nature of the sites and structures and explores possible management approaches to safeguard evidence of the pandemic for future generations.
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Chung SC, Marlow S, Tobias N, Alogna A, Alogna I, You SL, Khunti K, McKee M, Michie S, Pillay D. Lessons from countries implementing find, test, trace, isolation and support policies in the rapid response of the COVID-19 pandemic: a systematic review. BMJ Open 2021; 11:e047832. [PMID: 34187854 PMCID: PMC8251680 DOI: 10.1136/bmjopen-2020-047832] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To systematically learn lessons from the experiences of countries implementing find, test, trace, isolate, support (FTTIS) in the first wave of the COVID-19 pandemic. DESIGN, DATA SOURCES AND ELIGIBILITY CRITERIA We searched MEDLINE (PubMed), Cochrane Library, SCOPUS and JSTOR, initially between 31 May 2019 and 21 January 2021. Research articles and reviews on the use of contact tracing, testing, self-isolation and quarantine for COVID-19 management were included in the review. DATA EXTRACTION AND SYNTHESIS We extracted information including study objective, design, methods, main findings and implications. These were tabulated and a narrative synthesis was undertaken given the diverse research designs, methods and implications. RESULTS We identified and included 118 eligible studies. We identified the core elements of an effective find, test, trace, isolate, support (FTTIS) system needed to interrupt the spread of a novel infectious disease, where treatment or vaccination was not yet available, as pertained in the initial stages of the COVID-19 pandemic. We report methods used to shorten case finding time, improve accuracy and efficiency of tests, coordinate stakeholders and actors involved in an FTTIS system, support individuals isolating and make appropriate use of digital tools. CONCLUSIONS We identified in our systematic review the key components of an FTTIS system. These include border controls, restricted entry, inbound traveller quarantine and comprehensive case finding; repeated testing to minimise false diagnoses and pooled testing in resource-limited circumstances; extended quarantine period and the use of digital tools for contact tracing and self-isolation. Support for mental or physical health and livelihoods is needed for individuals undergoing self-isolation/quarantine. An integrated system with rolling-wave planning can best use effective FTTIS tools to respond to the fast-changing COVID-19 pandemic. Results of the review may inform countries considering implementing these measures.
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Affiliation(s)
- Sheng-Chia Chung
- Institute of Health Informatics, University College London, London, UK
| | - Sushila Marlow
- Department of Chemical Engineering, University College London, London, UK
| | - Nicholas Tobias
- Bartlett School of Planning, University College London, London, UK
| | | | - Ivano Alogna
- British Institute of International and Comparative Law, London, UK
| | - San-Lin You
- Department of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Martin McKee
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK
| | - Susan Michie
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Deenan Pillay
- Division of Infection and Immunity, University College London, London, UK
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4
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A scoping review of the experience of implementing population testing for SARS-CoV-2. Public Health 2021; 198:22-29. [PMID: 34352612 PMCID: PMC8233909 DOI: 10.1016/j.puhe.2021.06.012] [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: 12/16/2020] [Revised: 05/30/2021] [Accepted: 06/15/2021] [Indexed: 11/22/2022]
Abstract
Objectives The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – also known as the coronavirus disease (COVID-19) – pandemic has led to the swift introduction of population testing programmes in many countries across the world, using testing modalities such as drive-through, walk-through, mobile and home visiting programmes. Here, we provide an overview of the literature describing the experience of implementing population testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Study design Scoping review. Methods We conducted a scoping review using Embase, Medline and the Cochrane library in addition to a grey literature search. We identified indicators relevant to process, quality and resource outcomes related to each testing modality. Results In total, 2999 titles were identified from the academic literature and the grey literature search, of which 22 were relevant. Most studies were from the USA and the Republic of Korea. Drive-through testing centres were the most common testing modality evaluated and these provided a rapid method of testing whilst minimising resource use. Conclusions The evidence base for population testing lacks high quality studies, however, the literature provides evaluations of the advantages and limitations of different testing modalities. There is a need for robust evidence in this area to ensure that testing is deployed in a safe and effective manner in response to the COVID-19 pandemic.
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Nasonov EL. 2019 Coronavirus disease (COVID-19): contribution of rheumatology. TERAPEVT ARKH 2021; 93:71504. [DOI: 10.26442/00403660.2021.05.200799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 06/11/2021] [Indexed: 12/15/2022]
Abstract
The 2019 coronavirus disease (COVID-19) pandemic become a major challenge for humanity and a unique opportunity to get an idea of the real achievements of modern biology and medicine. In the course of the pandemic, a large number of new fundamental and medical issues have been revealed regarding the relationship between viral infection and many common chronic non-infectious diseases, among which immune-mediated rheumatic diseases (IMRD) occupy an important position. It is now well known that SARS-CoV-2 infection is accompanied by a wide range of extrapulmonary clinical and laboratory disorders, some of which are characteristic of IMRD and other autoimmune and autoinflammatory diseases in humans. The most severe consequence of alterations in regulation of the immunity in COVID-19 and IMRD is the so-called cytokine storm syndrome, which is defined as COVID-19-associated hyperinflammatory syndrome in COVID-19, and as macrophage activation syndrome in IMRD. The COVID-19-associated hyperinflammatory syndrome was used as a reason for drug repurposing and off-label use of a wide range of anti-inflammatory drugs, which have been specially developed for the treatment of IMRD over the past 20 years. Common immunopathological mechanisms and approaches to pharmacotherapy in COVID-19 and IMRD determined the unique place of rheumatology among medical specialties contributing to combat the COVID-19 pandemic. The article provides the basic provisions of the International and National Association of Rheumatologists and the Association of Rheumatologists of Russia (ARR) recommendations for management of patients with IMRD during the COVID-19 pandemic.
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Lessons Learned From an Analysis of the Emergency Medical Services' COVID-19 Drive-Through Testing Facilities in Israel. Disaster Med Public Health Prep 2021; 16:2091-2096. [PMID: 33588964 PMCID: PMC8129685 DOI: 10.1017/dmp.2021.50] [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] [Indexed: 01/15/2023]
Abstract
One strategy for the containment of a pandemic is mass testing. Magen David Adom (MDA), the Israeli National Emergency Medical Services (EMS) Organization undertook this mission by operating a nationwide series of drive-through testing complexes. The objective of this study is to learn lessons from an analysis of these centers. Data from 198 stationary and mobile drive-through complexes from March 20, 2020, through October 17, 2020, were analyzed for temporal and geographic factors, and cost. Also, an operational improvement program was implemented and analyzed. A total of 931,074 patients were sampled in the MDA drive-through system: 46.9% in stationary complexes, and 53.1% in mobile complexes. The optimized cost per patient of home testing was estimated at 74.5 USD compared with 6.55 USD in the drive-through centers. An operational improvement program lowered the total sampling time from 128 s/patient to 98 s and decreased the total cost per patient from 6.55 USD to 6.27 USD. The EMS led drive-through complexes were cost-effective and efficient in performing large numbers of viral tests, especially when compared with home testing. Established concepts in clinical operations should be implemented to increase the number of persons that can be tested and decrease cost.
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Cleaton N, Raizada S, Barkham N, Venkatachalam S, Sheeran TP, Adizie T, Sapkota H, Singh BM, Bateman J. The impact of COVID-19 on rheumatology patients in a large UK centre using an innovative data collection technique: prevalence and effect of social shielding. Rheumatol Int 2021; 41:707-714. [PMID: 33559727 PMCID: PMC7871319 DOI: 10.1007/s00296-021-04797-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/05/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES We sought to gain insight into the prevalence of COVID-19 and the impact stringent social distancing (shielding) has had on a large cohort of rheumatology (RD) follow-up patients from a single large UK centre. METHODS We linked COVID-19-related deaths, screening and infection rates to our RD population (1.2.20-1.5.20) and audited active rheumatology follow-up patients through survey data communicated via a linked mobile phone SMS message. We assessed epidemiology, effect of stringent social distancing (shielding) and quality of life (HRQoL) by Short Form 12 (SF12). RESULTS There were 10,387 active follow-up patients, 7911 had linked mobile numbers. 12/10,387 RD patients died from COVID-19 (0.12%); local population 4131/7,415,149 (0.12%). For patients with mobile phones, 1693/7911 (21%) responded and of these, 1605 completed the SF12. Inflammatory arthritis predominated 1174/1693 (69%); 792/1693 (47%) were shielding. Advice on shielding/distancing was followed by 1372/1693(81%). 61/1693 (4%) reported COVID-19 (24/61 shielding); medication distribution was similar in COVID and non-COVID patients. Mental SF12 (MCS) but not physical (PCS) component scores were lower in COVID (60) vs. non-COVID (1545), mean differences: MCS, - 3.3; 95% CI - 5.2 to - 1.4, P < 0.001; PCS, - 0.4; 95% CI, - 2.1 to 1.3). In 1545 COVID-negative patients, those shielding had lower MCS (- 2.1; 95% CI - 2.8 to - 1.4) and PCS (- 3.1, 95% CI - 3.7 to - 2.5), both P < 0.001. CONCLUSIONS Our full RD cohort had no excess of COVID deaths compared to the general local population. Our survey data suggest that shielding adversely affects both mental and physical health in RD. These data broaden our understanding of shielding, indicating need for further study.
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Affiliation(s)
- N. Cleaton
- Departments of Rheumatology, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - S. Raizada
- Departments of Rheumatology, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - N. Barkham
- Departments of Rheumatology, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - S. Venkatachalam
- Departments of Rheumatology, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - T. P. Sheeran
- Departments of Rheumatology, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - T. Adizie
- Departments of Rheumatology, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - H. Sapkota
- Departments of Rheumatology, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - B. M. Singh
- Diabetes and Endocrinology, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - J. Bateman
- Departments of Rheumatology, Royal Wolverhampton NHS Trust, Wolverhampton, UK
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DE POLO ANNA, SCHIAVON CHIARA, BRANCHER MARIKA, CIAN SERENA, ZALLOT CHIARA, PUPO ANITA, RIZZATO DONATELLA, CINQUETTI SANDRO. Drive-through vaccinations prove successful in immunizing mountain communities against tick-borne encephalitis during the COVID-19 pandemic. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 61:E497-E500. [PMID: 33628952 PMCID: PMC7888386 DOI: 10.15167/2421-4248/jpmh2020.61.4.1814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/04/2020] [Indexed: 11/16/2022]
Abstract
In March 2020, the COVID-19 pandemic disrupted most of the routine outpatient activities in Italian hospitals and Prevention Departments, including those vaccinations which were not urgent and/or scheduled for children aged 0-6 years. Since June 2020, when the pandemic entered a milder phase, in the alpine Province of Belluno (Veneto, North-Eastern Italy), 12,152 doses of vaccine against tick-borne encephalitis have been administered by means of the innovative “drive-through” modality. No significant adverse events have occurred and popular demand has steadily grown, proving the “drive-through” approach to be safe, efficient and successful.
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Affiliation(s)
- ANNA DE POLO
- University of Padova, School of Specialization in Hygiene and Public Health, Padova, Italy
- Prevention Department, A.U.L.S.S. 1 Dolomiti, Veneto Region, Italy
- Correspondence: Anna De Polo, University of Padova, School of Specialization in Hygiene and Public Health, via L. Loredan 18, 35131 Padova, Italy - Tel. +39 043 7516917 - E-mail: ;
| | - CHIARA SCHIAVON
- Prevention Department, A.U.L.S.S. 1 Dolomiti, Veneto Region, Italy
| | - MARIKA BRANCHER
- Prevention Department, A.U.L.S.S. 1 Dolomiti, Veneto Region, Italy
| | - SERENA CIAN
- Prevention Department, A.U.L.S.S. 1 Dolomiti, Veneto Region, Italy
| | - CHIARA ZALLOT
- Prevention Department, A.U.L.S.S. 1 Dolomiti, Veneto Region, Italy
| | - ANITA PUPO
- Prevention Department, A.U.L.S.S. 1 Dolomiti, Veneto Region, Italy
| | | | - SANDRO CINQUETTI
- Prevention Department, A.U.L.S.S. 1 Dolomiti, Veneto Region, Italy
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9
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Murtas R, Andreano A, Gervasi F, Guido D, Consolazio D, Tunesi S, Andreoni L, Greco MT, Gattoni ME, Sandrini M, Riussi A, Russo AG. Association between autoimmune diseases and COVID-19 as assessed in both a test-negative case-control and population case-control design. AUTOIMMUNITY HIGHLIGHTS 2020; 11:15. [PMID: 33023649 PMCID: PMC7537783 DOI: 10.1186/s13317-020-00141-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/17/2020] [Indexed: 01/15/2023]
Abstract
Background COVID-19 epidemic has paralleled with the so called infodemic, where countless pieces of information have been disseminated on putative risk factors for COVID-19. Among those, emerged the notion that people suffering from autoimmune diseases (AIDs) have a higher risk of SARS-CoV-2 infection. Methods The cohort included all COVID-19 cases residents in the Agency for Health Protection (AHP) of Milan that, from the beginning of the outbreak, developed a web-based platform that traced positive and negative cases as well as related contacts. AIDs subjects were defined ad having one the following autoimmune disease: rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjogren disease, ankylosing spondylitis, myasthenia gravis, Hashimoto’s disease, acquired autoimmune hemolytic anemia, and psoriatic arthritis. To investigate whether AID subjects are at increased risk of SARS-CoV-2 infection, and whether they have worse prognosis than AIDs-free subjects once infected, we performed a combined analysis of a test-negative design case–control study, a case–control with test-positive as cases, and one with test-negative as cases (CC-NEG). Results During the outbreak, the Milan AHP endured, up to April 27th 2020, 20,364 test-positive and 34,697 test-negative subjects. We found no association between AIDs and being positive to COVID-19, but a statistically significant association between AIDs and being negative to COVID-19 in the CC-NEG. If, as likely, test-negative subjects underwent testing because of respiratory infection symptoms, these results imply that autoimmune diseases may be a risk factor for respiratory infections in general (including COVID-19), but they are not a specific risk factor for COVID-19. Furthermore, when infected by SARS-CoV-2, AIDs subjects did not have a worse prognosis compared to non-AIDs subjects. Results highlighted a potential unbalance in the testing campaign, which may be correlated to the characteristics of the tested person, leading specific frail population to be particularly tested. Conclusions Lack of availability of sound scientific knowledge inevitably lead unreliable news to spread over the population, preventing people to disentangle them form reliable information. Even if additional studies are needed to replicate and strengthen our results, these findings represent initial evidence to derive recommendations based on actual data for subjects with autoimmune diseases.
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Affiliation(s)
- Rossella Murtas
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy
| | - Anita Andreano
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy
| | - Federico Gervasi
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy
| | - Davide Guido
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy
| | - David Consolazio
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy
| | - Sara Tunesi
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy
| | - Laura Andreoni
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy
| | - Maria Teresa Greco
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy
| | - Maria Elena Gattoni
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy
| | - Monica Sandrini
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy
| | - Antonio Riussi
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy
| | - Antonio Giampiero Russo
- Epidemiology Unit, Agency for Health Protection of Milan, Corso Italia 19, 20122, Milan, Italy.
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10
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Challenges in delivering rheumatology care during COVID-19 pandemic. Clin Rheumatol 2020; 39:2817-2821. [PMID: 32712743 PMCID: PMC7382561 DOI: 10.1007/s10067-020-05312-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 12/20/2022]
Abstract
COVID-19 has significantly affected healthcare systems around the world. To prepare for this unprecedented emergency, elective patient care was put on hold across the National Health Service (NHS). Rheumatology service had to be reorganised with a cancellation of elective clinics and clinical reconfiguration to continue to deliver care to patients, support frontline, and prevent viral transmission. The rheumatology community’s responsibility of providing a continuity of care for patients had to be balanced with measures to reduce the risk of viral transmission and also protection of both the patients and staff. We describe our experience of delivering rheumatology service as recommended by the National Institute for Health and Care Excellence (NICE NG167) guidelines at a district general hospital during the current pandemic.Key Points • Prepare to deliver a rapid mass communication; ensure email and mobile phones registered in patients’ records; enable access to text and video messaging. • To ensure wider access to innovative digital technology in clinical practice; implement telephone and video consultations where appropriate. • To consider setting up community OP clinics, for example, mobile and satellite clinics. |
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11
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Wallis G, Siracusa F, Blank M, Painter H, Sanchez J, Salinas K, Mamuyac C, Marudamuthu C, Wrigley F, Corrah T, Rampling T, Logan S, Goodman A, Miller D, Williams B, McGregor A, Parris V, Sandhu G, John L, Papineni P, Whittington A. Experience of a novel community testing programme for COVID-19 in London: Lessons learnt. Clin Med (Lond) 2020; 20:e165-e169. [PMID: 32680837 DOI: 10.7861/clinmed.2020-0436] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We describe the London community testing programme developed for COVID-19, audit its effectiveness and report patient acceptability and patient adherence to isolation guidance, based upon a survey conducted with participants.Any patients meeting the Public Health England (PHE) case definition for COVID-19 who did not require hospital admission were eligible for community testing. 2,053 patients with suspected COVID-19 were tested in the community between January and March 2020. Of those tested, 75 (3.6%) were positive. 88% of patients that completed a patient survey felt safe and 82% agreed that community testing was preferable to hospital admission. 97% were able to remain within their own home during the isolation period but just 41% were able to reliably isolate from other members of their household.The London community testing programme allowed widespread testing for COVID-19 while minimising patient transport, hospital admissions and staff exposures. Community testing was acceptable to patients and preferable to admission to hospital. Patients were able to reliably isolate in their home but not from household contacts. The authors believe in the importance, feasibility and acceptability of community testing for COVID-19 as a part of a package of interventions to mitigate a second wave of infection.
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Affiliation(s)
- Gabriel Wallis
- London North West University Healthcare NHS Trust, Harrow, UK
| | | | - Michael Blank
- London North West University Healthcare NHS Trust, Harrow, UK
| | - Helena Painter
- London North West University Healthcare NHS Trust, Harrow, UK
| | - Javier Sanchez
- London North West University Healthcare NHS Trust, Harrow, UK
| | - Kelcy Salinas
- London North West University Healthcare NHS Trust, Harrow, UK
| | | | | | | | - Tumena Corrah
- London North West University Healthcare NHS Trust, Harrow, UK
| | - Tommy Rampling
- The Hospital for Tropical Diseases, London, UK; and University College London Hospitals NHS Foundation Trust, London, UK
| | - Sarah Logan
- The Hospital for Tropical Diseases, London, UK; and University College London Hospitals NHS Foundation Trust, London, UK
| | - Anna Goodman
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Bhanu Williams
- London North West University Healthcare NHS Trust, Harrow, UK
| | | | - Victoria Parris
- London North West University Healthcare NHS Trust, Harrow, UK
| | | | - Laurence John
- London North West University Healthcare NHS Trust, Harrow, UK
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12
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Lindholm DA, Kiley JL, Jansen NK, Hoard RT, Bondaryk MR, Stanley EM, Alvarado GR, Markelz AE, Cybulski RJ, Okulicz JF. Outcomes of Coronavirus Disease 2019 Drive-Through Screening at an Academic Military Medical Center. Open Forum Infect Dis 2020; 7:ofaa306. [PMID: 32782913 PMCID: PMC7408221 DOI: 10.1093/ofid/ofaa306] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/13/2020] [Indexed: 11/13/2022] Open
Abstract
Drive-through coronavirus disease 2019 screening can evaluate large numbers of patients while reducing healthcare exposures and personal protective equipment use. We describe the characteristics of screened individuals as well as drive-through process and outcome measures. Optimal drive-through screening involves rapid turnaround of test results and linkage to follow-up care.
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Affiliation(s)
- David A Lindholm
- Infectious Disease Service, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA.,Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
| | - John L Kiley
- Infectious Disease Service, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA.,Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
| | - Nathan K Jansen
- Infectious Disease Service, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA.,Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
| | - Robert T Hoard
- Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
| | - Matthew R Bondaryk
- Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
| | - Elizabeth M Stanley
- Department of Medical Management, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
| | - Gadiel R Alvarado
- Infectious Disease Service, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA.,Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
| | - Ana E Markelz
- Infectious Disease Service, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA.,Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
| | - Robert J Cybulski
- Department of Pathology and Laboratory Services, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
| | - Jason F Okulicz
- Infectious Disease Service, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA.,Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Department of Medicine, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, Texas, USA
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