COVID-19 response measures - a Singapore Neurosurgical Academic Medical Centre experience segregated team model to maintain tertiary level neurosurgical care during the COVID-19 outbreak

Covid-19 and organisational development: important signs of a new pillar for sustainability

Purpose

The global pandemic has had a considerable effect on organisations’ performance and development and on the daily lives of the general population. This study aims to analyse the recent literature on the topics of Covid-19 and sustainability and proposes to rethink and redefine sustainability with the intersection of human health as a fourth sustainable pillar.

Design/methodology/approach

Using the Scopus and ISI Web of Science databases, 119 articles were analysed in detail and classified according to concepts and principles for achieving sustainable development, based on the Brundtland Report, 1987.

Findings

The results indicate a high number of publications in the social dimension, with a relevant proportion of studies in the health sector. This study allows us to conclude that all sectors of society are being affected by the pandemic. However, the enormous tension and the immediate impact felt by the health sector during the pandemic reflect directly on the population, and there are clear signs that in the medium and long term, instability and uncertainty in the environmental, economic and social dimensions will remain. In national health systems, monitoring, innovating in human resource management and investing in information technology can ensure organizations’ reliability and sustainability. The conclusion involves the suggestion of introducing health as a new pillar for sustainability to consolidate the basis and structure of the United Nations’ Sustainable Development Objectives. The use of fundamental concepts is necessary and must be aligned to reassess the results obtained in studies, in comparison with observational data.

Practical implications

The implications arising from the inclusion of health as a fourth pillar of sustainability are diverse. The need to build a new theoretical and conceptual framework for sustainability derives from the fact that health reflects the concern of many postulants in this field of practices. The determining or conditioning conditions of the observed effects of the pandemic by COVID-19, whether situated simply as factors and/or economic, environmental or social reflexes that precede them, requires a conceptual development that allows its approach, as a complex object, whose determinations are subject to variable degrees of uncertainty and diversity.

Originality/value

This study aims to redefine the concept of sustainability, considering that health has become a public health emergency of international interest. Health affects the supply chain, cash flow, interferes with the educational format and interrupts the workforce’s routine, among other aspects, showing the true nature of its importance and its impact in all spheres (economic, environmental and social).

One Year on: An Overview of Singapore's Response to COVID-19-What We Did, How We Fared, How We Can Move Forward

Background—One year has passed since the first COVID-19 case in Singapore. This scoping review commemorates Singaporean researchers that have expanded the knowledge on this novel virus. We aim to provide an overview of healthcare-related articles published in peer-reviewed journals, authored by the Singapore research community about COVID-19 during the first year of the pandemic. Methods—This was reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. It included healthcare-related articles about COVID-19 published between 23 January 2020 and 22 January 2021 with a Singapore-affiliated author. MEDLINE, Embase, Scopus, Web of Science, CINAHL, PsycINFO, Google Scholar, and local journals were searched. The articles were screened independently by two reviewers. Results—The review included 504 articles. Most of the articles narrated the changes to hospital practice (210), while articles on COVID-19 pathology (94) formed most of the non-narrative papers. Publications on public health (61) and the indirect impacts to clinical outcomes (45) were other major themes explored by the research community. The remaining articles detailed the psychological impact of the pandemic (35), adaptations of medical education (30), and narratives of events (14). Conclusion—Amidst a resurgence of community cases involving variant COVID-19 strains, the resources from the research community will provide valuable guidance to navigate these uncertain times.

A simple mathematical tool to forecast COVID-19 cumulative case numbers

Objective

Mathematical models are known to help determine potential intervention strategies by providing an approximate idea of the transmission dynamics of infectious diseases. To develop proper responses, not only are more accurate disease spread models needed, but also those that are easy to use.

Materials and methods

As of July 1, 2020, we selected the 20 countries with the highest numbers of COVID-19 cases in the world. Using the Verhulst–Pearl logistic function formula, we calculated estimates for the total number of cases for each country. We compared these estimates to the actual figures given by the WHO on the same dates. Finally, the formula was tested for longer-term reliability at t = 18 and t = 40 weeks.

Results

The Verhulst–Pearl logistic function formula estimated the actual numbers precisely, with only a 0.5% discrepancy on average for the first month. For all countries in the study and the world at large, the estimates for the 40th week were usually overestimated, although the estimates for some countries were still relatively close to the actual numbers in the forecasting long term. The estimated number for the world in general was about 8 times that actually observed for the long term.

Conclusions

The Verhulst–Pearl equation has the advantage of being very straightforward and applicable in clinical use for predicting the demand on hospitals in the short term of 4–6 weeks, which is usually enough time to reschedule elective procedures and free beds for new waves of the pandemic patients.

Impact of COVID-19 on Neurosurgical Training in Southeast Asia

OBJECTIVE

Neurosurgery departments worldwide have been forced to restructure their training programs because of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we describe the impact of COVID-19 on neurosurgical training in Southeast Asia.

METHODS

We conducted an online survey among neurosurgery residents in Indonesia, Malaysia, Philippines, Singapore, and Thailand from May 22 to 31, 2020 using Google Forms. The 33-item questionnaire collected data on elective and emergency neurosurgical operations, ongoing learning activities, and health worker safety.

RESULTS

A total of 298 of 470 neurosurgery residents completed the survey, equivalent to a 63% response rate. The decrease in elective neurosurgical operations in Indonesia and in the Philippines (median, 100% for both) was significantly greater compared with other countries (P < 0.001). For emergency operations, trainees in Indonesia and Malaysia had a significantly greater reduction in their caseload (median, 80% and 70%, respectively) compared with trainees in Singapore and Thailand (median, 20% and 50%, respectively; P < 0.001). Neurosurgery residents were most concerned about the decrease in their hands-on surgical experience, uncertainty in their career advancement, and occupational safety in the workplace. Most of the residents (n = 221, 74%) believed that the COVID-19 crisis will have a negative impact on their neurosurgical training overall.

CONCLUSIONS

An effective national strategy to control COVID-19 is crucial to sustain neurosurgical training and to provide essential neurosurgical services. Training programs in Southeast Asia should consider developing online learning modules and setting up simulation laboratories to allow trainees to systematically acquire knowledge and develop practical skills during these challenging times.

The impact of a segregated team roster on obstetric and gynecology services in response to the COVID-19 pandemic in a tertiary care center in India

Objective

To determine the impact of roster reorganization on ensuring uninterrupted services while providing necessary relief to healthcare workers (HCW) in the obstetrics department of a tertiary care center amid the COVID‐19 outbreak.

Methods

The COVID‐19 rostering response began in April 2020 and evolved in two phases: (1) development of new areas for screening and managing suspected/positive cases of COVID‐19; and (2) team segregation according to area of work. The impact of these changes on HCWs and patients was assessed 3 months later.

Results

Developing separate areas helped to minimize the risk of exposure of patients and HCWs to those with COVID‐19. Residents and consultants worked intensively in clinical areas for 1 week followed by 1–2 weeks of non‐clinical or standby assignments, providing adequate opportunity for isolation. Frequent re‐evaluation of the roster was nevertheless required as the pandemic progressed. Segregating teams vertically significantly reduced the number of contacts identified on contact tracing and quarantine leaves, while maintaining patient satisfaction with no increase in adverse events. Residents found the roster to be “smart” and “pandemic‐appropriate.”

Conclusion

The “COVID emergency roster” helped ensure quality care with minimum risk of exposure and sufficient breaks for physical and psychological recovery of HCWs.

Risk Reduction of COVID-19 Pandemic in Pakistan

This study attempt to examine the risk reduction mechanism of the COVID-19 outbreak in Pakistan. World Health Organization (WHO) declared the emergency and provided guidelines to reduce the risk of a pandemic. Thus, people tried to adopt multiple health safety measures to reduce the risk of a pandemic outbreak. Therefore, this study was designed to conduct an online survey technique to collect information from 1264 individuals in Pakistan. The rationale to select the technique was based on the pandemic situations in the country i.e. COVID-19. Moreover, it was used to main social distancing and following the health safety measures. Thus, a well-structured questionnaire was administered based on an attitudinal scale and google form was used. The inclusion criteria were defined on the questionnaire such as an independent age bracket (18-60), resident of Pakistan, using social media, and literate. The response was stopped after reaching the sample at 1264 participants. The study findings reveal that social isolation, social distancing, and the use of personal protective equipment (PPE) had a significant positive impact on risk reduction of COVID-19 among individuals. Moreover, hand and respiratory hygienic along with the risk of infection also significantly contributing to minimizing the pandemic outbreak.