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1.
BMJ Glob Health ; 5(6)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32546589

RESUMO

Since the COVID-19 outbreak, Wuhan has adopted three methods of admitting patients for treatment: designated hospitals, newly built temporary hospitals and Fangcang shelter hospitals. It has been proven that converting large-scale public venues such as stadiums and exhibition centres into Fangcang shelter hospitals, which serve as hospitals for isolation, treatment and disease monitoring of patients with mild symptoms, is the most effective way to control virus transmission and reduce mortality. This paper presents some experiences learnt from treating COVID-19 in Wuhan, the first city to report the outbreak and which suffered from a shortage of emergency supplies, heavy workload among staff and a shortage of hospital beds during the early stages of the pandemic. The experiences include location, accessibility, spacious outdoor area, spacious indoor space, power supply, architectural layout design and partition isolation, ventilation, sewage, and problems in the construction and management of Fangcang shelter hospitals. During the COVID-19 pandemic, traditional approaches to disaster preparedness have demonstrated intrinsic problems, such as poor economic performance, inefficiency and lack of flexibility. Converting large-scale public venues into Fangcang shelter hospitals is an important means to rapidly improve the function of the city's healthcare system during a pandemic. This valuable experience in Wuhan will help other countries in their battle against the current COVID-19 pandemic and will also contribute to disaster preparedness and mitigation in the future.


Assuntos
Infecções por Coronavirus , Planejamento em Desastres , Hospitais de Isolamento , Pandemias , Pneumonia Viral , Logradouros Públicos , Betacoronavirus , China , Surtos de Doenças , Abrigo de Emergência , Humanos
3.
J Microbiol Immunol Infect ; 53(3): 377-380, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32205090

RESUMO

We argue that enhanced Traffic Control Bundling (eTCB) can interrupt the community-hospital-community transmission cycle, thereby limiting COVID-19's impact. Enhanced TCB is an expansion of the traditional TCB that proved highly effective during Taiwan's 2003 SARS outbreak. TCB's success derived from ensuring that Health Care Workers (HCWs) and patients were protected from fomite, contact and droplet transmission within hospitals. Although TCB proved successful during SARS, achieving a similar level of success with the COVID-19 outbreak requires adapting TCB to the unique manifestations of this new disease. These manifestations include asymptomatic infection, a hyper-affinity to ACE2 receptors resulting in high transmissibility, false negatives, and an incubation period of up to 22 days. Enhanced TCB incorporates the necessary adaptations. In particular, eTCB includes expanding the TCB transition zone to incorporate a new sector - the quarantine ward. This ward houses patients exhibiting atypical manifestations or awaiting definitive diagnosis. A second adaptation involves enhancing the checkpoint hand disinfection and gowning up with Personal Protective Equipment deployed in traditional TCB. Under eTCB, checkpoint hand disinfection and donning of face masks are now required of all visitors who seek to enter hospitals. These enhancements ensure that transmissions by droplets, fomites and contact are disrupted both within hospitals and between hospitals and the broader community. Evidencing eTCB effectiveness is Taiwan's success to date in containing and controlling the community-hospital-community transmission cycle.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Quarentena/métodos , Betacoronavirus , Surtos de Doenças/prevenção & controle , Desinfecção das Mãos/métodos , Hospitais de Isolamento/métodos , Humanos , Máscaras , Equipamento de Proteção Individual , Taiwan
4.
Medwave ; 20(2): e7841, 2020 03 18.
Artigo em Espanhol | MEDLINE | ID: mdl-32191681

RESUMO

This article investigates the emergence of two institutions for the control of public hygiene in Chile between 1879 and 1920: colleges of royal physicians and isolation hospitals using the case of smallpox in La Araucanía, a region located in the South of Chile. We cover the characteristics and context of these institutions that allowed the State of Chile to address the problems of public hygiene and to prompt health professionals to professionalize the practice of medicine. The liberal positivist state of the late nineteenth century understood that the issue of hygiene was not only a matter of individual responsibility but had a social, public, and environmental dimension. People practiced hygiene alongside the existence of hygienic and anti-hygienic environments. Therefore, hygiene, the royal colleges of physicians, health records, isolation hospitals, doctors, and vaccinators are studied. All of these components of the health care system of the time were in permanent tension with the central government authorities due to the insufficient resources provided by the state for the care of infected patients with smallpox. The study follows a qualitative methodology with a descriptive historiographic design. We used archival primary and secondary sources available in Chile and Germany. The results show that the presence of smallpox appeared ferociously in South-Central Chile in the second half of the 19th century and remained in La Araucanía until the first half of the 20th century. The extent to which smallpox spread, spawning fear and insecurity in people of different social classes, had as one of its leading causes the precarious conditions of health and hygiene of the population.


Assuntos
Higiene/história , Varíola , Chile/epidemiologia , Assistência à Saúde , História do Século XIX , História do Século XX , Hospitais de Isolamento/história , Humanos , Varíola/epidemiologia , Varíola/prevenção & controle , Varíola/transmissão
5.
Nephrol Dial Transplant ; 35(5): 737-741, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32196116

RESUMO

COVID-19, a disease caused by a novel coronavirus, is a major global human threat that has turned into a pandemic. This novel coronavirus has specifically high morbidity in the elderly and in comorbid populations. Uraemic patients on dialysis combine an intrinsic fragility and a very frequent burden of comorbidities with a specific setting in which many patients are repeatedly treated in the same area (haemodialysis centres). Moreover, if infected, the intensity of dialysis requiring specialized resources and staff is further complicated by requirements for isolation, control and prevention, putting healthcare systems under exceptional additional strain. Therefore, all measures to slow if not to eradicate the pandemic and to control unmanageably high incidence rates must be taken very seriously. The aim of the present review of the European Dialysis (EUDIAL) Working Group of ERA-EDTA is to provide recommendations for the prevention, mitigation and containment in haemodialysis centres of the emerging COVID-19 pandemic. The management of patients on dialysis affected by COVID-19 must be carried out according to strict protocols to minimize the risk for other patients and personnel taking care of these patients. Measures of prevention, protection, screening, isolation and distribution have been shown to be efficient in similar settings. They are essential in the management of the pandemic and should be taken in the early stages of the disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Diálise Renal , Cuidadores , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Contaminação de Equipamentos , Hospitais de Isolamento , Humanos , Equipe de Assistência ao Paciente , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão
6.
Med Hist ; 64(1): 1-31, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31933500

RESUMO

At the end of the nineteenth century, the northern port of Liverpool had become the second largest in the United Kingdom. Fast transatlantic steamers to Boston and other American ports exploited this route, increasing the risk of maritime disease epidemics. The 1901-3 epidemic in Liverpool was the last serious smallpox outbreak in Liverpool and was probably seeded from these maritime contacts, which introduced a milder form of the disease that was more difficult to trace because of its long incubation period and occurrence of undiagnosed cases. The characteristics of these epidemics in Boston and Liverpool are described and compared with outbreaks in New York, Glasgow and London between 1900 and 1903. Public health control strategies, notably medical inspection, quarantine and vaccination, differed between the two countries and in both settings were inconsistently applied, often for commercial reasons or due to public unpopularity. As a result, smaller smallpox epidemics spread out from Liverpool until 1905. This paper analyses factors that contributed to this last serious epidemic using the historical epidemiological data available at that time. Though imperfect, these early public health strategies paved the way for better prevention of imported maritime diseases.


Assuntos
Controle de Doenças Transmissíveis/métodos , Epidemias/história , Hospitais de Isolamento/história , Quarentena/história , Varíola/história , Comércio/história , Controle de Doenças Transmissíveis/legislação & jurisprudência , História do Século XIX , História do Século XX , Humanos , Programas de Rastreamento/história , Prática de Saúde Pública/história , Navios/história , Varíola/epidemiologia , Vacina Antivariólica/história , Viagem/história , Reino Unido , Estados Unidos , Vacinação/história
7.
Int J Health Care Qual Assur ; 32(6): 991-1003, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31282260

RESUMO

PURPOSE: The purpose of this paper, a point prevalence study, is to quantify the incidence of isolation and identify the type of communicable diseases in isolation. The paper evaluates isolation precaution communication, availability of personal protective equipment (PPE) as well as other equipment necessary for maintaining isolation precautions. DESIGN/METHODOLOGY/APPROACH: A standardised audit tool was developed in accordance with the National Standards for the Prevention and Control of Healthcare Associated Infections (May 2009). Data were collected from 14 March 2017 to 16 March 2017, through observation of occupied isolation rooms in an academic hospital in Dublin, Ireland. The data were subsequently used for additional analysis and discussion. FINDINGS: In total, 14 per cent (125/869) of the total inpatient population was isolated at the time of the study. The most common isolation precaution was contact precautions (96.0 per cent). In all, 88 per cent of known contact precautions were due to multi-drug resistant organisms. Furthermore, 96 per cent of patients requiring isolation were isolated, 92.0 per cent of rooms had signage, 90.8 per cent had appropriate signs and 93.0 per cent of rooms had PPE available. Finally, 31 per cent of rooms had patient-dedicated and single-use equipment and 2.4 per cent had alcohol wipes available. PRACTICAL IMPLICATIONS: The audit tool can be used to identify key areas of noncompliance associated with isolation and inform continuous improvement and education. ORIGINALITY/VALUE: Currently, the rate of isolation is unknown in Ireland and standard guidelines are not established for the evaluation of isolation rooms. This audit tool can be used as an assessment for isolation room compliance.


Assuntos
Infecção Hospitalar/prevenção & controle , Guias como Assunto , Hospitais de Isolamento/organização & administração , Controle de Infecções/normas , Auditoria Médica , Centros Médicos Acadêmicos , Bases de Dados Factuais , Feminino , Fidelidade a Diretrizes/estatística & dados numéricos , Recursos em Saúde , Humanos , Irlanda , Masculino
8.
Public Health Rep ; 134(2): 150-154, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30657730

RESUMO

OBJECTIVES: Social distancing is the practice of restricting contact among persons to prevent the spread of infection. This study sought to (1) identify key features of preparedness and the primary concerns of local public health officials in deciding to implement social distancing measures and (2) determine whether any particular factor could explain the widespread variation among health departments in responses to past outbreaks. METHODS: We conducted an online survey of health departments in the United States in 2015 to understand factors influencing health departments' decision making when choosing whether to implement social distancing measures. We paired survey results with data on area population demographic characteristics and analyzed them with a focus on broad trends. RESULTS: Of 600 health departments contacted, 150 (25%) responded. Of these 150 health departments, 63 (42%) indicated that they had implemented social distancing in the past 10 years. Only 10 (7%) health departments had a line-item budget for isolation or quarantine. The most common concern about social distancing was public health impact (n = 62, 41%). Concerns about law, politics, finances, vulnerable populations, and sociocultural issues were each identified by 7% to 10% of health departments. We were unable to clearly predict which factors would influence these decisions. CONCLUSIONS: Variations in the decision to implement social distancing are likely the result of differences in organizational authority and resources and in the primary concerns about implementing social distancing. Research and current social distancing guidelines for health departments should address these factors.


Assuntos
Tomada de Decisões , Surtos de Doenças/prevenção & controle , Isolamento de Pacientes/organização & administração , Administração em Saúde Pública/métodos , Hospitais de Isolamento/provisão & distribução , Humanos , Política , Administração em Saúde Pública/economia , Administração em Saúde Pública/legislação & jurisprudência , Quarentena/organização & administração , Fatores Socioeconômicos , Estados Unidos
9.
Clin Microbiol Infect ; 21S: e1-e5, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24750421

RESUMO

Highly infectious diseases (HIDs) are defined as being transmissible from person to person, causing life-threatening illnesses and presenting a serious public health hazard. In most European Union member states specialized isolation facilities are responsible for the management of such cases. Ground ambulances are often affiliated with those facilities because rapid relocation of patients is most desirable. To date, no pooled data on the accessibility, technical specifications and operational procedures for such transport capacities are available. During 2009, the 'European Network for HIDs' conducted a cross-sectional analysis of hospitals responsible for HID patients in Europe including an assessment of (a) legal aspects; (b) technical and infrastructure aspects; and (c) operational procedures for ground ambulances used for HID transport. Overall, 48 isolation facilities in 16 European countries were evaluated and feedback rates ranged from 78% to 100% (n = 37 to n = 48 centres). Only 46.8% (22/47) of all centres have both national and local guidelines regulating HID patient transport. If recommended, specific equipment is found in 90% of centres (9/10), but standard ambulances in only 6/13 centres (46%). Exclusive entrances (32/45; 71%) and pathways (30/44; 68.2%) for patient admission, as well as protocols for disinfection of ambulances (34/47; 72.3%) and equipment (30/43; 69.8%) exist in most centres. In conclusion, the availability and technical specifications of ambulances broadly differ, reflecting different preparedness levels within the European Union. Hence, regulations for technical specifications and operational procedures should be harmonized to promote patient and healthcare worker safety.


Assuntos
Doenças Transmissíveis/terapia , Hospitais de Isolamento/estatística & dados numéricos , Controle de Infecções/normas , Isolamento de Pacientes/normas , Transporte de Pacientes/estatística & dados numéricos , Ambulâncias/normas , Ambulâncias/provisão & distribução , Estudos Transversais , Desinfecção , Europa (Continente) , Pesquisas sobre Serviços de Saúde , Hospitais de Isolamento/legislação & jurisprudência , Hospitais de Isolamento/normas , Humanos , Controle de Infecções/legislação & jurisprudência , Controle de Infecções/organização & administração , Isolamento de Pacientes/instrumentação , Isolamento de Pacientes/legislação & jurisprudência , Transporte de Pacientes/legislação & jurisprudência , Transporte de Pacientes/normas
10.
Acta Med Hist Adriat ; 17(2): 233-250, 2019 12.
Artigo em Servo-Croata (Latino) | MEDLINE | ID: mdl-32390443

RESUMO

In the late 19th and early 20th centuries, a hospital for infectious diseases in the Zenikovic area was operating in Rijeka as a hospital - subsidiary of the City Hospital of St. Spirit. After purchasing the property of the naval captain Dionysius Jakovcic, the existing buildings were adapted, and several other buildings, necessary for the organization of an infectious hospital, were constructed in the early eighties of the 19th century. The terrain and buildings were divided into clean and unclean areas. The main building was adapted to the main facilities for treatment and accommodation, while the smaller building was used for economic pur-poses. Due to the increase of the capacity at the turn of the century, further adaptations were made, larger wooden barracks and other temporary facilities were also constructed. The terrain of the hospital was linked to two ambitious projects of the hospitals in Rijeka, which were created at the beginning of the 20th century but were not realized.The hospital operated until the twenties of the 20th century when this department together with the City Hospital was moved to the former Naval Academy complex, while the hospital area was given a new purpose in the interwar and postwar periods.


Assuntos
Arquitetura Hospitalar/história , Hospitais de Isolamento/história , Croácia , História do Século XIX , História do Século XX , Humanos
11.
Rev Chilena Infectol ; 35(3): 314-316, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-30534912

RESUMO

The author presents a historical review about the creation of Doctor Lucio Cordova Infectious Diseases Hospital. Lucio Cordova MD, Counselor of the Charity Board in 1938, promoted a model pavilion for the hospitalization of patients with communicable diseases. An outbreak of meningococcal meningitis, between 1941 and 1942, hurried the construction of the Infectious Disease Pavilion, which was finished in 1949. The important work of the first chief of the new unit, Roque Kraljevic MD, is highlighted. In 1963, the Infectious Disease Pavilion was transformed into Dr. Lucio Cordova Infectious Diseases Hospital.


Assuntos
Doenças Transmissíveis/história , Hospitais de Isolamento/história , Chile , História do Século XX , Humanos
13.
Emerg Infect Dis ; 23(6): 965-967, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28518036

RESUMO

To identify barriers to maintaining and applying capabilities of US high-level isolation units (HLIUs) used during the Ebola virus disease outbreak, during 2016 we surveyed HLIUs. HLIUs identified sustainability challenges and reported the highly infectious diseases they would treat. HLIUs expended substantial resources in development but must strategize models of sustainability to maintain readiness.


Assuntos
Defesa Civil/organização & administração , Doença pelo Vírus Ebola/prevenção & controle , Hospitais de Isolamento/provisão & distribução , Ebolavirus/patogenicidade , Doença pelo Vírus Ebola/economia , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/transmissão , Hospitais de Isolamento/economia , Humanos , Saúde Pública/métodos , Estados Unidos/epidemiologia
15.
Infect Control Hosp Epidemiol ; 37(3): 313-8, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26641267

RESUMO

OBJECTIVE: To describe current Ebola treatment center (ETC) locations, their capacity to care for Ebola virus disease patients, and infection control infrastructure features. DESIGN: A 19-question survey was distributed electronically in April 2015. Responses were collected via email by June 2015 and analyzed in an electronic spreadsheet. SETTING: The survey was sent to and completed by site representatives of each ETC. PARTICIPANTS: The survey was sent to all 55 ETCs; 47 (85%) responded. RESULTS: Of the 47 responding ETCs, there are 84 isolation beds available for adults and 91 for children; of these pediatric beds, 35 (38%) are in children's hospitals. In total, the simultaneous capacity of the 47 reporting ETCs is 121 beds. On the basis of the current US census, there are 0.38 beds per million population. Most ETCs have negative pressure isolation rooms, anterooms, and a process for category A waste sterilization, although only 11 facilities (23%) have the capability to sterilize infectious waste on site. CONCLUSIONS: Facilities developed ETCs on the basis of Centers for Disease Control and Prevention guidance, but specific capabilities are not mandated at this present time. Owing to the complex and costly nature of Ebola virus disease treatment and variability in capabilities from facility to facility, in conjunction with the lack of regulations, nationwide capacity in specialized facilities is limited. Further assessments should determine whether ETCs can adapt to safely manage other highly infectious disease threats.


Assuntos
Doença pelo Vírus Ebola/terapia , Número de Leitos em Hospital/estatística & dados numéricos , Hospitais de Isolamento/estatística & dados numéricos , Hospitais Pediátricos/estatística & dados numéricos , Controle de Infecções/normas , Centers for Disease Control and Prevention, U.S. , Humanos , Inquéritos e Questionários , Estados Unidos
17.
Infect Control Hosp Epidemiol ; 36(12): 1472-5, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26311001

RESUMO

Environmental samples were collected from 100 hospital rooms, 32 noncontact rooms, and 68 contact isolation rooms. We isolated 202 and 1,830 MRSA colonies in noncontact and contact isolation rooms, respectively. The study identified MRSA isolates in hospital rooms of patients without colonization or infection with MRSA. Infect. Control Hosp. Epidemiol. 2015;36(12):1472-1475.


Assuntos
Exposição Ambiental/análise , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Bases de Dados Factuais , Contaminação de Equipamentos , Hospitais de Isolamento , Humanos , Infecções Estafilocócicas , Texas , Estados Unidos , United States Department of Veterans Affairs
18.
Rev Chilena Infectol ; 32(2): 227-9, 2015 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-26065457

RESUMO

Due to the smallpox epidemic in Santiago in 1872, a Commission or Central Board of isolation hospitals was created. These institutions were endowed with the necessary personnel to receive and assist the sick, highlighting the work of medical students, interns at these hospitals. The total number of patients treated in the infirmaries of Santiago reached 6,782, with a fatality rate of 3,073 (45.3%).


Assuntos
Hospitais de Isolamento/história , Varíola/história , Chile/epidemiologia , Epidemias/história , História do Século XIX , Humanos , Varíola/mortalidade
19.
Rev Soc Bras Med Trop ; 48 Suppl 1: 55-62, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26061371

RESUMO

Leprosy is an ancient infectious disease caused by Mycobacterium leprae. According to comparative genomics studies, this disease originated in Eastern Africa or the Near East and spread with successive human migrations. The Europeans and North Africans introduced leprosy into West Africa and the Americas within the past 500 years. In Brazil, this disease arrived with the colonizers who disembarked at the first colonies, Rio de Janeiro, Salvador and Recife, at the end of the sixteenth century, after which it was spread to the other states. In 1854, the first leprosy cases were identified in State of Amazonas in the north of Brazil. The increasing number of leprosy cases and the need for treatment and disease control led to the creation of places to isolate patients, known as leprosaria. One of them, Colonia Antônio Aleixo was built in Amazonas in 1956 according to the most advanced recommendations for isolation at that time and was deactivated in 1979. The history of the Alfredo da Matta Center (AMC), which was the first leprosy dispensary created in 1955, parallels the history of leprosy in the state. Over the years, the AMC has become one of the best training centers for leprosy, general dermatology and sexually transmitted diseases in Brazil. In addition to being responsible for leprosy control programs in the state, the AMC has carried out training programs on leprosy diagnosis and treatment for health professionals in Manaus and other municipalities of the state, aiming to increase the coverage of leprosy control activities. This paper provides a historical overview of leprosy in State of Amazonas, which is an endemic state in Brazil.


Assuntos
Hanseníase/epidemiologia , Hanseníase/prevenção & controle , Brasil/epidemiologia , História do Século XIX , História do Século XX , História do Século XXI , Hospitais de Isolamento/história , Humanos , Hanseníase/história , Mycobacterium leprae , Prevalência
20.
Artigo em Alemão | MEDLINE | ID: mdl-26104541

RESUMO

BACKGROUND: Patients suffering from highly contagious, life-threatening infections should be treated in specialized clinical facilities that follow the highest infection control standards. Consensus statements defining technical equipment and operational procedures have been published in recent years, but the level of adherence to these has not been evaluated. METHODS: Data summarized here comparing German and European isolation facilities are the partial results of a cross-sectional analysis conducted by the "European Network for Highly Infectious Diseases" that included 48 clinical care facilities in 16 European nations. Data collection was conducted using questionnaires and on-site visits, focussing on aspects of infrastructure, technical equipment, and the availability of trained personnel. RESULTS: Although all centres enrolled were listed as "isolation units", all aspects evaluated differed broadly. Eighteen facilities fulfilled the definition of a 'High Level Isolation Unit', as 6/8 enrolled German facilities did. In contrast, 24 facilities could not operate independently from their co-located hospital. DISCUSSION: Within and between nations contributing data disparities regarding the fulfilment of guidelines published were seen. German isolation facilities mostly fulfilled all criteria evaluated and performed on a high technical level. However, data presented do not reflect the current situation in Germany due to the time that has elapsed since the study was conducted. Hence, longitudinal data collection and harmonisation of terminology at least on national level needs to be implemented.


Assuntos
Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Arquitetura Hospitalar/métodos , Hospitais de Isolamento/organização & administração , Pandemias/prevenção & controle , Isolamento de Pacientes/organização & administração , Europa (Continente) , Alemanha , Humanos , Doenças Raras , Índice de Gravidade de Doença
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